Australian Family Physician November - Violence
Vol 40, (11) 841–936
The theme for the November issue of AFP is violence. This
month's articles include intimate partner violence, aggressive behaviour
in general practice, benzodiazepine prescribing and aggression,
nonaccidental injury in childhood, chronic fatigue syndrome, steroid
associated infective keratitis and obstructive sleep apnoea.
Intimate partner violence - identification and response in general practice
Kelsey Hegarty, Lorna O'Doherty
Intimate partner violence is a common problem among
women attending general practice, with around one in
10 women currently experiencing physical, sexual or
emotional abuse by a partner.
Nonaccidental injury in childhood
Anne Smith
Nonaccidental injury is a significant cause of mortality and
morbidity, especially in infants and young children.
Benzodiazepines - Their role in aggression and why GPs should prescribe with caution
Katy A Jones, Suzanne Nielsen, Raimondo Bruno, Matthew Frei, Dan I Lubman
Benzodiazepines are widely prescribed in Australia, despite
concerns about their potential for abuse and dependence.
Aggressive behaviour - Prevention and management in the general practice environment
Moira G Sim, Toni Wain, Eric Khong
Aggressive behaviour is commonly encountered in the
general practice setting and can often be de-escalated
using good communication skills.
Asking the important questions
Rachel Lee
It is nearly a decade since the World
Health Organization declared violence
to be a major public health problem, yet
for many of us violence remains someone
else’s territory – an issue for lawyers,
police and government – not something
for general practices or primary care
providers to grapple with.
Unintended pregnancies - Reducing rates by improving access to contraception
Jayne Lucke, Danielle Herbert, Deborah Loxton, Edith Weisberg
Unintended pregnancies have significant
social, health and financial costs.
Importantly, there is surprisingly little
information available about the prevalence
of unintended pregnancy in Australia.
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
The prepubertal hymen
Anne Smith
This article sets out
to describe some of the common variations in hymenal anatomy in order to dispel myths
and misperceptions surrounding genital examination findings in young girls.
Ambulatory blood pressure monitoring
National Heart Foundation and High Blood Pressure Research Council of Australia Ambulatory Blood Pressure Monitoring Consensus Committee
This article forms part of our ‘Tests and results’ series for 2011 which aims to provide
information about common tests that general practitioners order regularly. It considers areas
such as indications, what to tell the patient, what the test can and cannot tell you, and
interpretation of results.
Primary hyperparathyroidism - Is vitamin D supplementation safe?
Wayne Rankin
Vitamin D deficiency is commonly seen in patients with primary hyperparathyroidism.
However, there is a widespread reluctance to provide vitamin D supplementation to this
group of patients.
Obstructive sleep apnoea and snoring - Is examination necessary?
Omar Mulla, Frank Agada, David Dawson, Sanjai Sood
This article outlines two cases of snoring and obstructive sleep apnoea (OSA)
secondary to parapharyngeal space tumours.
Steroid associated infective keratitis - Case studies for caution
Neil Sharma, Ethan Nguyen, Ju-Lee Ooi, John Males
These two cases demonstrate the importance
of caution regarding the use of corticosteroid
eye drops in the primary care setting.
Occupational violence
Parker Magin, Jon Adams
The problem of violence directed toward
general practitioners and their practice staff is acknowledged worldwide. In Australia, the tragic 2006 murder of a Melbourne GP
while practising in her surgery highlighted the seriousness of the issue.
Patient centred care – are international medical graduates 'expert novices'?
Maria R Dahm
The Australian Medical Council (AMC) asserts that ‘good medical practice is
patient centred’. Qualitative studies
conducted in Canada, the United States
of America and Australia, where
international medical graduates (IMGs)
represent a crucial part of the healthcare workforce, have shown that some IMGs are unfamiliar with the patient centred model of care. Unfortunately, little is
known about how IMGs develop the
communication skills required for patient centred care (PCC), a medical model that is new to many of them.
Lifestyle intervention – a study on maintenance in general practice
Roshan Dhanapalaratnam, Mahnaz Fanaian, Mark F Harris
Chronic diseases such as cardiovascular
disease and diabetes are a major
contributor to the burden of disease in
Australia. Primary prevention of these
conditions requires management of a
number of physiological and behavioural
risk factors which are common in patients
presenting to general practice. Although
factors such as smoking, nutrition, alcohol
and physical activity (SNAP) need be
addressed by policies and programs
outside the health system, there are a
number of effective interventions that
health providers can offer.
Treating chronic fatigue syndrome – a study into the scientific evidence for pharmacological treatments
Sanne Kreijkamp-Kaspers, Ekua Weba Brenu, Sonya Marshall, Don Staines, Mieke L Van Driel
Chronic fatigue syndrome (CFS), also
referred to as myalgic encephalomyelitis, is a disabling condition. In addition to fatigue for more than 6 months that is not relieved by sleep and interferes with activities of daily life, patients suffer other symptoms such as cognitive impairment, muscle and joint pains and sore throat.
Web based diabetes care planning – sociotechnical barriers to implementation in general practice
Akuh Adaji, Peter Schattner, Leon Piterman
The use of care plans in the management of
patients with chronic disease is a common practice within primary care. A care plan is ‘a written, comprehensive, and longitudinal plan of action that sets out the healthcare needs of a patient and the types of services and supports needed to meet those needs’.
Child abuse – mandatory reporting requirements
Sara Bird
All Australian states and territories have legislation that requires
medical practitioners to report cases of child abuse to the appropriate
child protection service. This article outlines the obligations of medical
practitioners to report child abuse and highlights the differences that exist
in the legislative requirements in each state and territory.
Advanced rural skills training – the value of an addiction medicine rotation
Julaine Allan
Alcohol and drug use is widespread in the Australian community. Alcohol
in particular is a key factor affecting
the health of Australians and a major
contributor to preventable disease, illness, death and social harms which cost in excess of $15 billion per year. Alcohol is associated with serious long term health effects, disease, hospitalisations, accidents, violence, homicides and suicides. Importantly, the co-occurrence of drug and alcohol and mental health problems, particularly depression and anxiety, is under-recognised and undertreated in Australia.
Fitness to drive forms – a guide for GPs
Fiona Landgren
This article forms part of our 'Paperwork' series for 2011, providing information about a range of paperwork that general practitioners complete regularly. The aim of the series is to provide information on the purpose of the paperwork, and hints on how to complete it accurately. This will allow the GP to be more efficient and the patient to have an accurately completed piece of paperwork for the purpose required.
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 multiple choice questions of the RACGP Fellowship exam. The quiz is endorsed by the RACGP Quality Improvement and Continuing Professional Development Program and has been allocated 4 Category 2 points per issue. Answers to this clinical challenge are available immediately following successful completion online. Clinical challenge quizzes may be completed at any time throughout the 2011–2013 triennium, therefore the previous months answers are not published.