Australian Family Physician December 2003 - Summer Hazards
Vol 32 (12):961-1056
Our December 2003 issue includes articles on marine
envenomations,
sexual health for travellers, bushfires and drowning management and
prevention. Research includes capacity building in primary health care,
immunisation coverage in inner suburban areas of Australia and
increasing preventive activities in general practice.
Editorial: What stories should GPs be telling?
Richard Flanagan
The following is an excerpt of the keynote address by Richard Flanagan to the 46th National Convention of The Royal Australian College of General Practitioners, Hobart, Tasmania, October, 2003.
Marine envenomations Part 1 - Jellyfish
B Nimorakiotakis, K D Winkel
Many venomous marine creatures inhabit Australian waters, causing significant morbidity and occasional fatalities. Part 1 of this article looks at jellyfish envenomations, an important overall cause of marine injuries.
Marine envenomations Part 2 - Other marine envenomations
B Nimorakiotakis, K D Winkel
Australian waters contain a variety of venomous creatures, including jellyfish, stinging fish, blue-ringed octopus, sea snakes, cone snails and stingrays.
Sexual health for travellers
Elizabeth Hamlyn, Linda Dayan
Sexually transmitted infections (STIs) are prevalent worldwide, yet a high proportion of international travellers engage in unprotected sex while overseas and may be at risk.
Bushfires, 2003 - A rural GP's perspective
Mark Robinson
Extensive bushfires in January and February of 2003 had a major impact on many communities in northeast Victoria, East Gippsland, southern New South Wales and Canberra. These fires eventually engulfed an area roughly equivalent to the entire area of Germany.
Drowning management and prevention
Robert Grenfell
Accidental drowning causes over 300 deaths annually in Australia, and many more instances of 'near drowning'.
Monitoring: To infinity and beyond!
Sepehr Shakib, Alison George
For many patients, the initial prescription is only the beginning of the prescribing process, with the prescription needing to be repeated, sometimes for the life of the patient.
Referral of patients with depression to specialist psychological care from general practice
Grant Blashki, Ian B Hickie, Lyn Littlefield, Elizabeth M Scott, Jane E Pirkis, Grace Groom, Jeffrey C Richards, Tracey A Davenport
This fifth and final article in the 'Psychological treatments in general practice' series provides a practical four step approach to assist general practitioners to refer patients with depression from general practice to specialist psychological care.
Medication errors - warfarin
Sara Bird
This article examines some of the medicolegal issues surrounding the initiation and monitoring of warfarin in general practice.
Burning feet syndrome - A clinical review
Ravinder P S Makkar, Anju Arora, Amitabh Monga, Ajay Kr Gupta, Surabhi Mukhopadhyay
Burning pain in the feet has been known to occur as a distinct clinical symptom for almost two centuries. Despite being a common and fascinating clinical entity, this syndrome has received scant attention in the medical literature and has been described only in anecdotal reports.
Predictive value: Will I need insulin?
Patrick Phillips
Jenny presented with a three week history of polyuria, polydipsia, weight loss and thrush. Her urine test showed 4+ glycosuria. You tell Jenny you think she has diabetes; she is now worried that she will need insulin.
The decision to enter general practice
Chris Pearce, Kelsey Hegarty
The numbers applying to enter the Australian General Practice Training Program have been declining over the past few years, leading to unfilled places in some of the new general practice training consortia.
Eye series: Sudden onset double vision
Chris Hodge, Frank Martin
A 50 year old woman presents complaining of double vision. She had become aware of double images while watching television the previous night. There was no associated pain or headache. Apart from being overweight the patient is relatively healthy.
Clinical challenge
Earn 4 Points in Clinical Challenge
Questions for this month's clinical challenge are based on articles in this issue.
Brain teaser: Rash and scratching
Mike Starr
Sam's mother brings him in to see you because he has developed a rash and is scratching and irritable. He has dry skin, with eczematous and erythematous papules. He has a rash on his feet as shown.
Systemic or topical treatment for impetigo?
Hannah Gunn, Chris Del Mar
C K, a four year old boy, presented with several variously sized, irregular but well circumscribed lesions, with golden crusting developing over two weeks - classic presentation of impetigo.
Intellect: If we don't use it do we lose it?
Craig Hassed
Medicine it would seem, despite being a science, is no less subject to myths as any other walk in life. One myth we were taught was that the central nervous system (CNS) after initial development, changed very little.
Postcards: Life on Nguiu
Jill Sass
This is my story of my time in an indigenous community; preparing emergency services for cyclone Craig, a Tiwi footy grand final, 'bush holiday', bush camping with Tiwi friends, participating in health promotional activities, witnessing and being involved in ceremony, and enduring the heat and change of seasons.
Rethinking general practice for the 21st century - The patient counts!
Joachim P Sturmberg, Carmel Martin, Leon Piterman
Increasingly, reforms to health care systems appear to interfere with the traditional (healer) role of the general practitioner, and are perceived to disrupt patient care and the therapeutic relationship.
Expanding medical education in general practice
Richard Hays, Tarun Sen Gupta, Craig Veitch, Alice Chang, Ben Chapman, Alison Discher, Kate Heazlewood, Benedict Ponti, Nathan Walmsley
General practitioners are major providers of medical education, with recent expansion at both undergraduate and postgraduate levels, particularly in rural areas.
Closing the gap and widening the scope - New directions for research capacity building in primary health care
Edi Albert, Sharon Mickan
Research capacity building initiatives abound within primary health care to increase the research base of the many component health professionals and organisations.
Is low immunisation coverage in inner urban areas of Australia due to low uptake or poor notification?
Brynley P Hull, Glenda L Lawrence, C Raina MacIntyre, Peter B McIntyre
The Australian Childhood Immunisation Register (ACIR) consistently reveals pockets of lower immunisation coverage in inner urban areas. We investigated whether low uptake or poor notification of immunisation is the main reason for this difference.
Does external support from divisions increase preventive activities in rural Australian general practice?
Erica L James, Lynette Talbot, Chris Fishley
General practitioners can play an important role in disease prevention and health promotion. However, there are a number of barriers including structural disincentives.