Aust Fam Physician
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Public health is the organised efforts of society to prevent disease, promote health and prolong life in the population. While the focus of general practice is on the care of individuals and families, general practitioners (GPs) have an essential role in promoting the health of the population. ⋯ Clinical general practice contributes to promoting population health. In addition, many GPs undertake work that extends beyond clinical care. The Royal Australian College of General Practitioners' (RACGP's) curriculum includes population health and the context of practice as one of its five domains. Core skills include the incorporation of a population health perspective into clinical practice, and leadership and advocacy in addressing the health needs of the community effectively and equitably.
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Shoulder injury related to vaccine administration (SIRVA) is a previously described phenomenon that is the result of improper vaccine delivery. Appropriate injection technique for administration of intramuscular vaccinations can reduce the risk of shoulder injury. ⋯ SIRVA has previously been described in the world literature. Seventeen cases in women and five cases in men were found. Pain and reduction in the range of movement within a few hours of vaccination were cardinal signs of a shoulder injury. This included injuries to the soft tissues of the shoulder as well as injuries to bone and joint. SIRVA can be avoided with correct vaccination technique as described.
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A polymorphism is a variant within a gene that does not necessarily affect its function, unlike a pathogenic mutation. Genetic testing for two common polymorphisms in the methylenetetrahydrofolate reductase gene (MTHFR), 677C>T and 1298A>C, is being accessed by general practitioners (GPs) and alternative medicine practitioners (based on in-house records from referrals), and promoted through some pharmacies in Western Australia (based on the authors' personal communication). Due to the large, varied and often conflicting data reported on MTHFR, these polymorphisms have been weakly associated with multiple conditions, including autism, schizophrenia, cardiac disease, fetal neural tube defects, poor pregnancy outcomes and colorectal cancer. ⋯ On the basis of the available scientific evidence, we propose that there are very limited clinical indications for testing for the 677C>T and the 1298A>C polymorphisms in the MTHFR gene, and that testing is not indicated as a non-specific screening test in the asymptomatic general population.
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Many general practitioners (GPs) struggle to meet the demand for their services at residential aged care facilities (RACFs). The aim of this study was to describe and examine the effect on service provision and GPs of a new model of RACF care in a rural general practice. ⋯ This service model has much to offer GPs who are willing to engage in team care. It is an efficient model of high-quality care that overcomes key barriers associated with providing sustainable general practice services to RACF residents.