Aust Fam Physician
-
General practitioners (GPs) tend to focus most of their energies on providing primary healthcare to individuals, with less attention to the overall population health issues in their community. In contrast, public health practitioners tend to focus on the health needs of entire populations, by addressing the social determinants of health, with less attention to individual patient care. ⋯ GPs have an important role in public health both through individual patient care and by engaging with public health issues at local, community and global levels. Adopting a population perspective to healthcare is an important part of modern general practice.
-
Fostering generalism is particularly important in rural and regional medical practice in order to maximise the effectiveness of the medical workforce in meeting the needs of an ageing population. There are many areas in which support for generalist practitioners could be increased. ⋯ Six areas of particular relevance to rural and regional practice are: workforce support; rural and regional training pipelines; access to continuing professional development; flexibility in practice ownership; family support; and recognition and remuneration.
-
Adolescents at risk of suicide present a particularly difficult management challenge for all clinicians involved in their care. Adolescents have more suicidal thoughts and behaviours than adults. Management of adolescents at risk of suicide has specific challenges, which are different from those for suicidal adults. ⋯ This article summarises the demographic, clinical, family and environmental and psychological factors associated with adolescent suicide risk. Steps towards the management of suicidal adolescents are presented and include risk assessment and safety planning.
-
Concussion is common in many sports and recreational activities. It is thought to reflect a functional rather than structural injury to the brain. The clinical features are typically short-lived and usually resolve spontaneously. Complications, however, can occur and may include prolonged symptoms and/or cognitive deficits in the short term, as well as depression and cumulative deterioration in brain function in the longer term. ⋯ The critical issues in the clinical management of concussion in sport include making a diagnosis, differentiating between concussion and other pathologies (particularly structural head injury), recognising the presence of any modifying factors (which may increase the risk of complications) and determining when the patient can safely return to competition. The key components of safe return-to-play decisions include rest, neuropsychological testing and a graded program of exertion before return to sport.
-
Headache remains the most common cause of neurological consultation in clinical practice for which correct diagnosis and treatment are essential. ⋯ By far the most important diagnostic tool for proper headache diagnosis is the taking of a concise and representative history of the headaches. Migraine and TTH exist along a continuum and identification of the patient's position on this continuum has important implications for management.