Aust Fam Physician
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Australia continues to explore methods to restructure primary health care services to meet stressors within the health system. The primary health care strategy and its support for larger general practices and multidisciplinary team contributions, raise opportunities for re-engineering general practice services.
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To ascertain whether children with asthma in the Australian Capital Territory were taking preventer medications in accordance with National Asthma Council Australia guidelines. ⋯ This study suggests that home medical management of asthma with preventers for children may not be optimal.
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Increasing numbers of young adults with cerebral palsy (CP) are transitioning to adult services from coordinated multidisciplinary paediatric hospital services. Limitations on provision of adult services include inadequate funding, lack of trained staff, and fragmented medical, surgical and allied health teams. ⋯ Over the past 2 decades, interventions such as botulinum toxin-A, intrathecal baclofen infusion, gastrostomy feeding and single event multilevel orthopaedic surgery have improved the lives of children with CP. These interventions are generally delivered within multidisciplinary rehabilitation programs in paediatric hospitals. As the most recent cohorts of children move into adulthood, they, and their carers, have expectations of similarly structured services in the adult health care sector. The Children's Hospital at Westmead and Westmead Hospital, together with The Spastic Centre of New South Wales, recognised this need and developed a multidisciplinary consultative clinic for adults with CP.
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The antenatal shared care model has become increasingly popular among Australian women as the preferred mode of pregnancy care. General practitioners are often asked by their pregnant women patients about the nutrients needed during pregnancy. ⋯ Much attention has been given to micronutrients such as folate and iron, but less regard to other trace elements that are also important in pregnancy. Encouraging a balanced diet and ensuring the adequacy of these micronutrients is essential for minimising pregnancy complications. However, GPs should also be aware of the maximum level of recommended intakes and any possible adverse effects.
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Since the mid 1990s, there has been a global resurgence of bed bugs (Cimex spp.), which are blood feeding insects that readily bite humans. Patients suffering with bite reactions are increasingly presenting to medical practitioners. ⋯ Common dermatological responses include the early development of small macular spots that may later progress into prominent wheals accompanied by intense itching. Patients exposed to numerous bed bugs can present with a widespread erythematous rash or urticaria. Bullous eruptions are not uncommon and anaphylaxis has been reported, albeit rarely. There is no evidence that bed bugs transmit human pathogens, but they are responsible for significant psychological distress, can produce anaemia when abundant, and have been implicated in the triggering of asthmatic reactions. Symptomatic control involves treatment of the patient with antihistamines and corticosteroids, and ensuring that the infestation responsible for the problem is effectively eliminated.