Australian Family Physician

BACKGROUND: The recent death of a Victorian surgeon who was assaulted by a member of the public when leaving work has re-highlighted the risk and potential cost of violence experienced by healthcare workers. OBJECTIVE: The aim of this article is to outline the risk of occupational violence experienced by doctors, and general practitioners in particular, and to discuss practical measures that can be taken to manage this risk. DISCUSSION: The majority of doctors have experienced aggression or violence in their workplaces in the past 12 months...

BACKGROUND: Legal and ethical obligations do not always align when doctors become aware of a clinical situation involving a person with whom they have no pre existing therapeutic relationship. Noting a potentially malignant skin lesion, such as a melanoma on a person outside the clinical setting, provides a pertinent example. OBJECTIVE: The aim of this article is to describe the legal, ethical and professional considerations surrounding proffering a dermatological opinion in the case of suspected melanoma outside the clinical setting...

BACKGROUND: The use of dose administration aids (DAAs), such as compartmentalised boxes (eg dosette) or medicine packs (eg Webster-pak), is common, particularly among patients with chronic disease. The aim of this study was to investigate factors influencing patients' decisions to commence using a DAA with a view to summarising implications for practice for general practitioners (GPs). METHODS: Semi-structured interviews were undertaken with participants living in a regional town in South Australia...

BACKGROUND: Identifying factors related to risky sexual behaviour may contribute to preventive and interventional approaches to reduce negative mental health outcomes among young women. The aim of this study was to investigate the association between psychological distress and risky sexual behaviours in females aged 16-25 years in Victoria, Australia. METHODS: Data were extracted from the Young Female Health Initiative (YFHI), a study in which participants were recruited via advertisements on Facebook...

BACKGROUND: The optimal role of general practice in population weight management remains unclear. The aim of this mixed-methods study was to test the feasibility of routinely weighing all adult patients attending their general practice as an intervention to aid weight management in clinical practice. METHODS: Consenting patients in six general practices were weighed at each presentation over a 12-month period. Data were analysed using linear mixed growth models...

BACKGROUND: Marine organism wound infections are common in coastal regions of Western Australia. Local treatment guidelines are based on studies from elsewhere. The objective of this article was to identify the causative organisms in marine wounds sustained in the subtropical and tropical coastal waters of the Indian Ocean, Gascoyne region (north-west), Western Australia. METHODS: This was a prospective study. A single wound swab was taken from 28 consenting patients who presented with a suppurating marine wound to the emergency departments of Carnarvon and Exmouth hospitals...

BACKGROUND: Obesity management in general practice sometimes involves referral of patients for bariatric surgery. Integral to the success of long-term weight loss maintenance is supporting the patient's psychological, nutritional and exercise needs. OBJECTIVE: This article is written to equip general practitioners (GPs) to manage the comprehensive needs, before and after bariatric surgery, of patients who are obese. DISCUSSION: The number of patients undergoing bariatric surgery in Australia has increased significantly in the past few years...

BACKGROUND: Growth is one of the fundamental processes of adolescent development. Careful history and examination, and relevant tar-geted investigations, can streamline the referral process, highlighting the important role of primary healthcare clinicians. OBJECTIVE: This article will provide a guide for clinicians to categorise growth patterns in adolescents, and recognise patients who may have a growth disorder. It will assist clinicians in considering appropriate investigations, and provide guidance for when to refer the adolescent to appropriate paediatric specialists...

BACKGROUND: Constipation is best defined as difficulty passing stools that may be infrequent (≤2 per week), painful and associated with stool retention. Childhood constipation is common, with a prevalence of 3-30% worldwide. Most constipation in children is functional and related to behavioural withholding after an unpleasant stool event. Successful diagnosis and management can occur in primary care, and specialist referral is only needed for refractory cases or concerns regarding organic pathology...

BACKGROUND: Major depressive disorder (MDD) in children (5-12 years of age) is a confronting and serious psychiatric illness. MDD has significant ramifications for the psychosocial development of the child, yet it remains under-recognised and undertreated. General practice is where these children and their parents will first present. OBJECTIVE: The aim of this article is to provide general practitioners (GPs) with a framework for considering MDD in a child and recommendations for treatment...

BACKGROUND: Atopic eczema is a relapsing inflammatory skin condition that can be lifelong. Management of eczema is often focused on infants, with many school-aged children undertreated. Uncontrolled eczema has a significant impact on the quality of life of the child and their family. OBJECTIVE: The objective of this article is to discuss the practical management of eczema in school-aged children. DISCUSSION: This article will describe how eczema manifests in school-aged children, focusing on when to suspect triggers and how to manage these from a general practice perspective, and when to refer the child on to specialist services...

BACKGROUND: Acne vulgaris affects more than 90% of Australian adolescents aged 16-18 years. It may have a significantly deleterious effect on their self-esteem and emotional state. Moderate-to-severe acne can lead to scarring. There are many treatment options available. Most teenagers obtain information from their peers or from the internet. OBJECTIVE: The aim of this article is to inform general practitioners (GPs) of the pathogenesis, physiology and description of acne, as well as therapeutic options, including topical and systemic therapies...

BACKGROUND: The objective of this article is to investigate patients' attitudes to the use of chaperones for intimate physical examinations (IPEs) in a sample of Australian general practices. METHODS: A cross-sectional survey of adult patients from 13 randomly selected general practices in regional New South Wales was conducted between September and November 2012. Generalised linear mixed models were used for analysis. RESULTS: Of 780 surveys distributed, 687 (88%) were returned; the age range was 18-91 years and 356 (52%) were from female patients...

BACKGROUND: Hepatocellular carcinoma (HCC) surveillance reduces mortality in at-risk people living with chronic hepatitis B (CHB), but is difficult to achieve in practice. The objective of this study was to measure participation and adherence to liver cancer HCC surveillance in eligible patients in a community health centre, following support from the Integrated Hepatitis B Service (IHBS). METHODS: A retrospective analysis of the medical records of patients with CHB who met the indications for HCC surveillance over a 4...

No abstract text is available yet for this article.

BACKGROUND: Longevity, the increase in the ageing population and a lifestyle of minimal physical activity come with a hefty price. Consequently, two diseases are increasingly becoming a concern for the welfare of patients and the health industry: osteoporosis and sarcopenia. These conditions are usually interrelated through several mechanisms and metabolic pathways, and comprise a syndrome called osteosarcopenia. OBJECTIVE: As patients with osteosarcopenia represent an important subset of frail individuals at higher risk of institutionalisation, falls and fractures, the aim of this review is to further familiarise general practitioners with osteosarcopenia as a new geriatric syndrome that requires early diagnosis and effective therapeutic interventions...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: General practitioners (GPs) are often the first health professional consulted in regard to eating disorders and their varied presentations. Given the prognostic significance of early detection of, and intervention for, such conditions, it is important that GPs feel confident to do so. OBJECTIVE: The aim of this article was to heighten awareness of the role of early identification and diagnosis of eating disorders, especially anorexia nervosa and bulimia nervosa, in the primary care setting...

BACKGROUND: Diverticular disease and its spectrum of complications are increasingly encountered in the Australian population. Accurate management of patients before and after an acute episode entails extension beyond the acute event to include dietary advice and colonoscopy. OBJECTIVE: The objectives of this article are to evaluate the literature regarding dietary factors and diverticular disease, routine colonoscopy and antibiotic treatment in acute diverticulitis, to enable primary care physicians to manage patients and provide sound advice after hospital admission...