Australian Family Physician December 2007 - GPs and the environment
Vol 36, (12) 977–1088
The theme for the December issue of AFP
is GPs and the environment. This month's articles include climate change
and
primary health care, environmental toxins, drought and its effect on
mental health, recycled water, recurring melanoma, primary
hyperparathyroidism, cardiac rehabilitation and healthy patients,
healthy planet. Also included is the 2007 AFP index.
GPs and the environment
Grant Blashki
'Whoever would study medicine aright must learn
of the following subjects. First he must consider the
effect of the seasons of the year and the differences
between them. Secondly he must study the warm
and the cold winds, both those which are in common
to every country and those peculiar to a particular
locality. Lastly, the effect of water on the health must
not be forgotten'.
Letters To The Editor
The opinions expressed by correspondents in this column are in no way endorsed by either the Editors or The Royal Australian College of General Practitioners
List of reviewers 2007
All articles submitted to Australian Family Physician are sent for blind peer review. Reviewers provide a critical commentary on the scientific quality of the material and its interest and relevance to general practice.
AFP Index 2007
Index to volume 36, 2007
Skin malignancies in general practice
Salma Fahridin, Christopher
Harrison, Helena Britt,
Janice Charles
Skin malignancies are associated with environmental
factors and were therefore considered an appropriate
selection for this issue of Australian Family Physician.
Climate change and primary health care
Grant Blashki, Tony McMichael, David J Karoly
Climate change is a global public health problem,
with serious health impacts predicted to manifest
in varying ways in different parts the world.
Drought and its effect on mental health - How GPs can help
Gina-Maree Sartore, Brian Kelly, Helen J Stain
Drought has been a recurring natural disaster in
Australia for much of our recorded history. Unlike other
natural disasters, it is a long term event and the effects
can be chronic.
Fighting with fire - How bushfire suppression can impact on fire fighters health
Brad Aisbett, Matthew Phillips, Michael Sargeant, Barry Gilbert, David Nichols
Australia is one of the most bushfire prone countries
in the world. Fire fighters from Australia's regional
fire brigades and land management agencies protect
people and property from the annual bushfire threat.
Recycled water and human health effects
Joanne O'Toole, Karin Leder, Martha Sinclair
Water recycling is a critical component of our efforts
as a community toward a sustainable future.
Environmental toxins and health - The health impact of pesticides
Marc Cohen
Pesticides, including insecticides, herbicides and
fungicides, are widely used in Australian agriculture.
Many pesticides are known endocrine disruptors, which
confuse the body by their uptake at oestrogen receptor
sites.
Healthy patients, healthy planet - Green recommendations for GP health promotion
Graeme Horton, Parker Magin
Our planet is struggling to cope with the burden of
human activity. Our ecosystems are being altered and
degraded to an extent greater than any other period of
human history because of increasing demands for food,
fresh water, fuel and timber.
'Detox': science or sales pitch?
Marc Cohen
There is no question that the world is becoming
increasingly toxic, with worldwide dissemination of
industrial chemicals, pesticides, heavy metals and
radioactive elements.
Lead - Toxicology and assessment in general practice
Greg Cunningham
Fortunately there has been a steady fall in the
incidence of lead toxicity in recent decades. Lead
toxicity is a notifiable condition, with laboratories
undertaking the notification process.
Recurring melanoma - A case study
Steven Tomas
Melanoma occurs more frequently in Australia then anywhere else in the world, and has a notoriously
unpredictable prognosis and the potential for very late recurrence.
Exercise based cardiac rehabilitation in chronic heart failure
Frances M Wise
Chronic heart failure (CHF) is a leading cause
of morbidity in the industrialised world.
Age related macular degeneration - Should your patients be taking additional supplements?
Amanda A Jones
The use of over-the-counter complementary medicines and supplements is growing. Patients with age related macular
degeneration (AMD) are likely to have heard of, or are possibly already taking, additional supplements that may increase
their chances of retaining useful eyesight.
Primary hyperparathyroidism and familial hyperparathyroid syndromes
Miriam Blackburn
Serum parathyroid hormone (PTH) estimations are
now frequently requested in the work up of patients
with osteoporosis, renal and metabolic disorders. It
is therefore important to differentiate between the
various hyperparathyroid disorders, which can simply
be classified into primary, secondary and tertiary
hyperparathyroidism.
Clinical use of anti-TNF-α biological agents - A guide for GPs
John Chang, Laila Girgis
Tumour necrosis factor-α (TNF-α) is a pro-inflammatory
cytokine known to have a critical role in the
pathogenesis of various inflammatory or immune
mediated diseases such as rheumatoid arthritis (RA)
and ankylosing spondylitis.
Fitting disability into practice - Focus on spinal cord injury
Linda Mann, James W Middleton, Grace Leong
Health surveillance and promotion activities are
cornerstones of general practice. Fulfilling these roles
adequately within the context of a busy practice may
prove challenging. This is compounded in the care of
persons with unfamiliar specialised needs.
Clinical teacher training - Maximising the 'ad hoc' teaching encounter
Eugen Molodysky
Classically, the patient is absent when the learner makes an 'ad hoc' corridor enquiry of their supervisor. This teaching
encounter challenges the supervisor to ensure that the educational benefit is not limited by the brevity of the encounter.
Clinical challenge
Questions for this month's clinical challenge are based on articles in this issue. The style and scope of questions is in keeping with the MCQ of the College Fellowship exam. The quiz is endorsed by the RACGP Quality Assurance and Continuing Professional Development Program and has been allocated 4 CPD points per issue.
AFP in Practice
AFP in Practice questions are designed to get you started in a small group learning (SGL) activity in your practice or with colleagues. Requirements to earn 30 Category 1 CPD points for a SGL activity are: minimum of four and a maximum of 10 people, minimum of 8 hours of discussion in a year, and at least two GPs.
Unsafe sharps management
Sara Bird
The general practitioner saw a mother and her young child at the practice. While the GP was
talking to the mother, the 3 year old child climbed onto a stool in the consulting room and
managed to put his hand into the sharps container.
Living with toxic poisioning
Jude Nechwatal
In 1991 I was working as an administration officer at a
school in North Queensland. I worked with two other
women in a very small office and there were three
other offices nearby, each with one person in them.
Weapons of war - Humanitarian and medical impact
Hadia Haikal-Mukhtar, Sue Wareham
Most of us have patients who have loved ones living
far away, sometimes in conflict zones or in other
dangerous locations, and we share in the anxiety and
distress that such situations bring to relatives.
Narrative and poetry writing for professional development
Gillie Bolton
Significant personal professional narratives, stories,
and vital metaphors of practice can be explored
through expressive writing and discussion. These
enable critical, positive reflection, understanding of the
perspective nature of experience, and deep questioning
of values, ethics, professional identity, and personal
responsibilities.
Inadequate chemoprophylaxis and the risk of malaria
Peter Massey, David N Durrheim, Rick Speare
Malaria is the most important parasitic disease affecting
people living in and travelling to malaria endemic areas.
Due to large scale global travel some people infected
with malaria may develop symptoms in countries where
malaria is not endemic.
Physical activity promotion in general practice - Patient attitudes
Carolyn Raina Elley, Sarah Dean, Ngaire Kerse
Substantial evidence exists for the health benefit of
physical activity. Interventions delivered in primary
health care have been assessed by randomised
controlled trials (RCTs) and have found short term or
small average increases in physical activity or fitness
levels.
GPs want tailored, user friendly evidence summaries - A cross sectional study in New South Wales
Lyndal J Trevena, Les Irwig, Anna Isaacs, Alexandra Barratt
General practitioners are the first point of contact
with the health care system in many countries. It
has been estimated that 80-85% of the population in
countries such as Australia, the United Kingdom and
Canada have a regular GP to whom they would turn for
health care at least once per year.
Registrar clinical teaching visits - Evaluation of an assessment tool
John Fraser
Formative assessment assists in guiding learning.
Australian general practice training has used
external clinical teaching (ECT) visits as a form of
formative assessment during training for many years.
During these visits, a senior general practitioner
observes the consultations of registrars, provides
structured feedback and makes recommendations
to improve performance.
Management of skin cancer in Australia - A comparison of general practice and skin cancer clinics
Patrick Byrnes, Evan Ackermann, Ian Douglas Williams, Geoffrey K Mitchell, Deborah Askew
Australia has the highest incidence of melanoma in
the world, and skin cancer is the most common cancer
treated in Australia, accounting for more than 800 000
patient encounters each year. Moreover, the incidence
of both melanocytic (MSC) and nonmelanocytic skin
cancers (NMSC) is increasing.
Share this on Facebook