The Medical journal of Australia
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Comparative Study
Metformin and lactic acidosis in an Australian community setting: the Fremantle Diabetes Study.
To determine the incidence of lactic acidosis in community-based patients with type 2 diabetes, with special reference to metformin therapy. ⋯ The incidence of lactic acidosis in patients with type 2 diabetes is low but increases with age and duration of diabetes, as cardiovascular and renal causes become more prevalent. Metformin does not increase the risk of lactic acidosis, even when other recognised precipitants are present.
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Review Meta Analysis
Models of chronic disease management in primary care for patients with mild-to-moderate asthma or COPD: a narrative review.
To review the literature for any promising strategies for the primary care management of mild-to-moderate asthma and chronic obstructive pulmonary disease (COPD) in adults. ⋯ The role of primary health care in management of mild-to-moderate asthma and COPD requires further investigation using randomised controlled trials.
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To identify the types of strategy used to coordinate care within primary health care (PHC) and between PHC, health services and health-related services in Australia and other countries that have comparable health systems, and to describe what is known about their effectiveness; to review the implications for health policy and practice in Australia. ⋯ The largely incremental approach to improving coordination of care in Australia has involved a broad range of strategy types but has also perpetuated existing structural problems. Reforms in governance, funding and patient registration in primary health care would provide a stronger base for effective care coordination.
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Comparative Study
Impact of specialty on attitudes of Australian medical practitioners to end-of-life decisions.
To compare attitudes and practices of Australian medical practitioners, by specialty, to a range of medical decisions at the end of life. ⋯ Perceptions about the causation of death and aspects of medical culture appear to influence physicians' attitudes towards medical decisions at the end of life. Our findings have implications for medical education, interprofessional communication and discussion between the medical profession and the community.