Aust Fam Physician
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Exposure to air pollution (both indoor and outdoor) has many potential adverse effects on human health. ⋯ Motor vehicle and industrial emissions are the primary contributors to outdoor air pollution in Australia. High levels of ozone and other pollutants can cause respiratory symptoms in susceptible individuals. Air quality advisory systems exist in most states. Clinicians can incorporate the health effects of air pollution, and awareness of advisory systems in the education of their susceptible patients and their carers. Asthma and chronic airways disease management plans should include provision for possible exposure to high pollution events and steps that can be taken to reduce exposure.
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Febrile convulsions, or febrile seizures, are frequently encountered in paediatrics, and despite often being self limiting, these seizures strike fear in the hearts of patients' carers. ⋯ The initial assessment of a child who convulses with fever should be directed at finding a cause for the fever, rather than the seizure itself, once the seizure has abated. A lumbar puncture should be performed if there is clinical suspicion of meningitis. Electroencephalograms and neuroimaging studies are not routinely indicated. Overall, febrile seizures carry a good prognosis, although one-third of children have recurrent attacks. Febrile seizures are genetic in origin. The risk of later epilepsy is small but increased if the child has a complex febrile seizure, neurological deficit, or a family history of epilepsy. Carers should be counselled in the management of seizures. The effectiveness of prophylactic treatment with medication remains controversial.
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Providing high quality pre- and peri-operative care to patients with diabetes, renal disease and hypertension requires forethought and planning. General practitioners can play a vital role in this process. A preoperative assessment provides an opportunity to support the patient, communicate accurate and relevant clinical information to the procedural team, and make therapeutic adjustments that aid a successful recovery.
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Australian general practice training was regionalised in 2002 to better meet the specific health care needs of local communities. As a result, 22 unique regions were established, each containing a variety of training practices and learning contexts. The core learning opportunities in distinct learning contexts have not been well explored. ⋯ Benefits in defining the learning contexts and opportunities within a general practice training region apply to registrars, trainers, providers, policy makers and standard setters. Context definition provides a valuable tool for more targeted and effective training, contributes to curriculum development and facilitates a more responsive and appropriate education program. We encourage adaptation of this model to other regions.
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The General Practice Education and Training (GPET) board endorsed a framework for general practice training in Aboriginal and Torres Strait Islander health in September 2003. Training that conforms with the framework is required for accreditation of regional training providers. ⋯ The KRAs concerning delivery of Aboriginal and Torres Strait Islander training and recruitment and support of training posts were well achieved, while those concerning organisational and systems issues required further action. Good progress has been made towards implementation of the framework. Adequate funding and ongoing commitment to respectful and practical partnerships with the Aboriginal and Torres Strait Islander community controlled sector are required to further this.