Aust Fam Physician
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Urinary incontinence is common in the community and may impact significantly on quality of life; yet only one-third of sufferers seek medical attention. There are many treatment options for patients suffering with urinary incontinence. ⋯ Most urinary incontinence can be evaluated and treated in the primary care setting after careful history and simple clinical assessment. Initial treatment, for both urge urinary incontinence and stress urinary incontinence, is lifestyle modification and pelvic floor muscle treatment. Urinary urgency responds to bladder training and pharmacotherapy with anticholinergic medication. Pharmacotherapy has a limited place in stress incontinence. If there is complex symptomatology or primary management fails, then referral to a specialist is suggested.
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Evidence and quality standards support the use of professional interpreters and discourage the use of family interpreters in medical consultations. The Northern Division of General Practice documented the use of professional and family interpreters in local general practices, together with barriers and possible facilitators in the use of professional interpreters. ⋯ Surveys of practices and GPs found the use of professional interpreters is uncommon. Over two-thirds of practices reported never using the free Doctors Priority Line phone interpreting service. Family members were frequently used as interpreters, with most GPs preferring to use family rather than professional interpreters. Over a third of practices were unaware of the Doctors Priority Line. Findings suggested that relevant standards are commonly not understood or implemented.
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Each year bushfire threatens Australia's rural, forest, and urban-rural areas. Australia's rural fire fighters work to curtail this threat in hot, smoky conditions, often at risk to their physical health. General practitioners, especially in rural areas, can help preserve the health of fire fighters during the fire season by understanding the stressors they face on the fireground. ⋯ General practitioners can help preserve fire fighters' health during bushfire suppression in a number of ways, including: identifying fire fighters at risk of cardiac distress during physical labour and educating them about the early warning signs; advocating regular exercise; discouraging smoking; and promoting the benefits of maintaining fluid, carbohydrate, and electrolyte levels during a shift.
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Comparative Study
Management of skin cancer in Australia--a comparison of general practice and skin cancer clinics.
Skin cancer is common in Australia and its increasing incidence has been matched by an increase in specifically focused skin cancer clinics staffed by general practitioners. This study compares the management of skin cancer in general practice with that of skin cancer clinic networks. ⋯ The benign to malignant excision rate was similar in general practice and the skin cancer clinic networks, but one network reported very different rates of biopsy and complex wound closure. This raises questions as to whether outcomes are improved by these measures. These results demonstrate the usefulness of three billing data outcome measures in comparing activity in different clinical settings. However, the billing based NNT may not be a useful measure.
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Narrative, metaphor and image are habitual forms of making sense of the world and can be powerfully harnessed for professional development. Writing is a particular form of expression and communication that allows practitioners to speedily identify and engage with their most sensitively critical aspects of practice, and forms the basis for critical, confidential, trusted discussion. This article gives underlying theories and dominant practices of reflective writing as a professional development activity.