Aust Fam Physician
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Case histories are based on actual medical negligence claims or medicolegal referrals, however, certain facts have been omitted or changed by the author to ensure the anonymity of the parties involved. The aim of this article is to outline the legislative framework in relation to advance health directives and enduring powers of attorney or guardianship, with a particular focus on the medical and legal issues of relevance with respect to an assessment of mental capacity.
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Symptoms other than pain are a heavy burden for patients with either malignant or progressive nonmalignant disease and significantly reduce quality of life. ⋯ The approach to management of the symptoms of malignant or progressive nonmalignant disease is the same, regardless of the diagnosis. Management includes evaluation, treatment--depending on the underlying pathological mechanism, explanation for both the patient and their family, and ongoing review of goals of care.
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Depression and anxiety often begin in pregnancy, particularly third trimester, therefore 'perinatal' rather than postnatal depression might be a better term to describe this disorder. ⋯ Psychological difficulties are common after childbirth and have potentially serious consequences. Treatment needs to consider the complex interplay of biology and psychology, and both mother and infant need consideration. Early, assertive identification and sensitive management, mindful of risks and benefits to both mother and infant, is the best current approach to improving outcomes.
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For some women, pregnancy can bring a myriad of distressing symptoms. Nausea affects up to 85% of women during early pregnancy and about half of these women also experience vomiting. ⋯ Conventional anti-emetics bring with them a risk of potential teratogenic effects during the critical stage of early pregnancy. Women tend to feel more comfortable taking a natural or herbal substance to help manage these issues.