Australian Family Physician May - Sleep
Vol 38, (5) 273 - 368
The theme for the May issue of AFP is Sleep. This
month's articles include Insomnia, Sleep apnoea – a general
practice approach, Kids that go bump in the night, Restless legs
syndrome, Sleep and depression – theory and practice and
The patient centred medical home – a new
model of practice in the USA.
Small ‘l’ leadership
Jenni Parsons
Recently I attended the RACGP Leadership Masterclass in
Sydney. When I enrolled, I thought, ‘Yes... sounds interesting...
good speakers... I need to learn something about leadership...’
As the time drew closer I started to get a bit anxious about the
whole thing.
The patient centred medical home - A new model of practice in the USA
Rick Kellerman
A new model of medical practice, the patient centred medical home (PCMH), has gained traction in the United States as an advancement in primary care delivery that will bring better value to patients and to those who pay for health care.
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.
Insomnia
Janice Charles, Christopher Harrison, Helena Britt
Management of insomnia rose significantly by age, from
0.2% of encounters with patients aged <25 years to 2.7% with
patients aged 75 years and over.
Sleep apnoea - A general practice approach
Kirk Kee, Matthew T Naughton
Snoring and sleepiness are common presentations in general
practice.
Kids that go bump in the night
Margot Davey
Incomplete arousal from deep sleep in children causes night time disruption and can present as confusional arousals, sleep walking or night terrors. These nocturnal events are common in childhood but can be extremely concerning to parents and disruptive to families.
Restless legs syndrome
Brendon Yee, Roo Killick, Keith Wong
Restless legs syndrome (RLS) is a common, but frequently
undiagnosed, chronic, sensorimotor disorder. In western
countries, it is seen in approximately 10% of the general
population, with a higher prevalence in women and the elderly
(10–20%).
Sleep and depression - Theory and practice
Michael Berk
Sleep disorders are particularly common in the primary care setting, and are intimately interlinked with depression.
Persistent hyperkalaemia
Bo Xu, Michael Murray
Persistent hyperkalaemia in elderly patients caused by
hyporeninaemic hypoaldosteronism is relatively common and often
under recognised in the general practice setting.
Management of chalazia in general practice
Hannah Gilchrist, Graham Lee
Chalazia, or meibomian cysts, are often seen in general practice.
While most can be resolved with a minor operation in a designated
procedure room, there is a lack of published literature on the details
of the incision and curettage used to treat this condition.
Live kidney donors - Assessment and follow up
Vicki Levidiotis
Live kidney donation has increased steadily over the past decade,
both in Australia and internationally.
Could it be Henoch-Schönlein purpura?
Danforn C E Lim, Lisa N C Cheng, Felix W S Wong
Henoch-Schönlein purpura is the most common form of systemic
vasculitis in the paediatric setting with 90% of cases occuring in
childhood.
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 40 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.
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.
A patient's duty to follow up
Sara Bird
This article discusses a recent Supreme Court of the Northern
Territory judgment, which examined the responsibility of patients for
their own medical care and follow up.
GPs with special interests - Benefits to patients, GPs and the community
Geoffrey Spurling, Claire Jackson
Some general practitioners are naturally drawn to particular
patients and skill sets, and it is from this intellectual curiosity that
they develop special interests.
Choosing general practice as a career - The influences of education and training
Jeremy Bunker, Narelle Shadbolt
In Australia, most medical students graduate without a firm career
choice, with this decision being made during their early postgraduate
years.
Book reviews
Books reviewed this month are Pocket notes on neonatology 2nd edition by Davies, Cartwright, Inglis, The essence of health – The Seven Pillars of Wellbeing by Craig Hassed, The Anatomist: A True Story of Gray's Anatomy by Bill Hayes and Practical Cardiology by Tracey Baker, George Nikoli and Simon O'Connor.
Rural smokers - A prevention opportunity
Anna Chapman, Stephen Bunker, James Dunbar, Benjamin Philpot, Kevin McNamara, Andrew Baird, Erkki Vartiainen, Tiina Laatikainen, Edward Janus
Smoking is the largest single cause of preventable death and disease in Australia. This study describes smoking prevalence and the characteristics of rural smokers to guide general practitioners in targeting particular groups.
The 45 year old health check - Feasibility and impact on practices and patient behaviour
Cheryl Amoroso, Mark F Harris, Amando Ampt, Rachel A Laws, Suzanne McKenzie, Anna M Williams, Upali W Jayasinghe, Nicholas A Zwar, Gawaine Powell Davies
The 45 year old health check (MBS item 717) for patients aged 45–49 years was introduced in 2006. This study evaluated its impact on preventive care and patient reported risk factors.
Cardiovascular risk assessment in Australian general practice
Ruchi Gupta, Nigel P Stocks, Jessica Broadbent
Australian general practitioners are encouraged to assess absolute
cardiovascular risk (CVR) using a CVR calculator such as the New
Zealand Cardiovascular Risk Calculator.
