Internal medicine journal
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Internal medicine journal · Jul 2021
Adherence to Guidelines Regarding Anticoagulation and Risk Factors for Progression of Atrial Fibrillation in a Nurse-Led Clinic.
Atrial fibrillation (AF) is the commonest cardiac arrhythmia associated with an increased risk of stroke. Evidence suggests that management in a specialty clinic improves clinical outcomes of patients. ⋯ Management of AF in a nurse-led clinic was associated with high level of adherence to anticoagulation guidelines. Age, obesity and excessive alcohol intake were significant predictors for progression of AF.
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Indigenous Australians are at increased risk of developing dementia - Alzheimer disease and mixed dementia diagnoses are the most common. While prion diseases have been reported in Indigenous peoples of Papua New Guinea and the United States, the occurrence and phenotype of prion disease in Indigenous Australians is hitherto unreported. ⋯ CJD occurs in Indigenous Australians with clinical phenotype and occurrence rates similar to non-Indigenous Australians. These findings contrast with a previous report where the incidence rate of CJD in a non-Australian indigenous population was reported to be decreased.
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Internal medicine journal · Jul 2021
Workplace stress, common mental disorder and suicidal ideation in junior doctors.
Doctors-in-training report elevated rates of mental disorders and high levels of stress. Whilst a number of work-related sources of stress have been identified in the medical profession, it remains unclear as to the relative importance of workplace stressors for mental ill-health in junior doctors. ⋯ This study identifies modifiable workplace variables that are influential in junior doctors' mental health, and in doing so, provides meaningful evidence-informed targets for future interventions to prevent suicide and mental disorder in this population.
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Internal medicine journal · Jul 2021
Management of diabetes-related foot disease in the outpatient setting during the COVID-19 pandemic.
The use of telephone and/or video consultation in routine management of acute diabetes-related foot disease (DFD) before the coronavirus disease 2019 (COVID-19) pandemic at a tertiary hospital is unprecedented. In March 2020, the Diabetes Feet Australia (DFA) released a national guideline to inform DFD management during the COVID-19 pandemic. The present study aimed to describe the adherence to the DFA guideline of managing acute DFD using telephone and/or video consultation at a Western Australian tertiary hospital during this period. We found >80% adherence rate to the DFA guideline and the management of active DFD using telephone and/or video consultations was feasible and acceptable in carefully selected patients.
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Internal medicine journal · Jul 2021
Patient satisfaction and acceptability with telehealth at specialist medical outpatient clinics during the COVID-19 pandemic in Australia.
Outpatient clinics were shifted rapidly to telehealth in Australia during the Coronavirus disease 19 (COVID-19) pandemic, drastically altering patient care and experience. ⋯ This study offers unique insights into patients' experiences with telehealth, which until the current global pandemic, has been an uncommon mode of consultation delivery in urban areas. This study suggests when defining the place of telehealth in future healthcare delivery, patient perspective and careful patient selection will be key. Disease progression, language and cognitive ability, health literacy, technology access and patient and clinician preference are important considerations when deciding how effectively to embed and integrate telehealth into consultations.