Aust Fam Physician
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Dizziness and loss of consciousness are common clinical problems presenting in general practice. ⋯ A range of disorders with varying pathology cause a transient loss of consciousness associated with postural collapse (syncope) by interruption of blood flow to the brain. Syncope and seizures are the only common causes of recurrent episodes of loss of consciousness. The vasovagal reaction or 'common faint' and postural hypotension are both common and benign causes of syncope. Syncope can also result from cardiac causes that include disorders of cardiac rhythm and mechanical obstruction to cardiac output. Cardiac causes of syncope are associated with much higher morbidity and mortality than postural hypotension or fainting. Specific treatment is available for the various cardiac causes of syncope and thus accurate diagnosis is imperative.
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An increase in perinatal mortality prompted a review of services to pregnant women in remote northern and western Queensland, Australia. In order to address the needs of the indigenous population in particular, a range of service changes was implemented to improve outcomes. ⋯ Mt Isa Hospital is the supplier of obstetric services for the north and west of Queensland. Poor antenatal access rates and other service issues for Indigenous patients were identified as contributing to these poor outcomes. Consultation with Indigenous patients and health service providers prompted changes in modes of delivery of services that in the short term seem to have improved results. The models for delivery of services include primary health care clinics in remote communities. Aboriginal community controlled health services, and flying obstetrician clinics.
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In preparation for investigating burnout among general practitioners internationally, we examined the validity and reliability of an instrument called the Maslach Burnout Inventory (MBI). ⋯ This pilot study suggests the MBI scale is reliable and valid. We believe it of use in identifying GPs at risk of, or already experiencing, burnout.
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The role of divisions of general practice has changed significantly since its inception. Divisions have evolved from simply assisting general practitioners in their practices and providing complementary support to existing health services through project work, to becoming major instruments of organisational change. ⋯ In the process of the change in the role of divisions we have experienced a paradigm clash between the essential work of GPs as effective medical practitioners, and their role in divisions as managers and leaders of the wider health care system change.