Aust Fam Physician
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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.
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Aboriginal and Torres Strait Islander health is generally the worst of any population group in Australia. Inaccessibility to health services is one possible cause of this. Shared medical appointments (SMAs) appear to be a culturally competent and appropriate way of improving access to, and the quality of, primary healthcare services for Aboriginal and Torres Strait Islander peoples. ⋯ The results, though not generalisable, suggest that SMAs may offer a culturally safe and appropriate tool to enhance Aboriginal and Torres Strait Islander peoples' access to primary care.
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Clostridium difficile infection (CDI) has emerged as a serious worldwide public health threat. Although C. difficile has always been a cause of diarrhoeal disease in patients presenting to general practice, the rates of community-associated CDI (CA CDI) have increased. ⋯ Changes in the colonic flora (most often because of antibiotic use) and exposure to C. difficile are both required for the disease to develop. Potential sources of C. difficile in the community include the home environment, food and water, workplace and environment. Identification of risk factors for CDI may help in the early diagnosis and subsequent management of infection, and these are being explored further. GPs have a role in understanding and managing CA CDI through prudent prescribing, patient education and adequate testing.
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Randomized Controlled Trial Clinical Trial
Communication across the divide. A trial of structured communication between general practice and emergency departments.
To evaluate the impact of structured form letters for general practitioner to emergency department (ED) communication. ⋯ This study demonstrates that improvements to communication between GPs and EDs are difficult and may require a systemic change within general practice and the hospital. Electronic systems may allow the sort of reciprocal communication required to establish and sustain improvement.