Aust Fam Physician
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Out of hospital cardiac arrest victims contribute significantly to adult mortality figures but are encountered infrequently by most general practitioners and their staff. A number of scientific organisations produce guidelines for the basic and advanced management of cardiac arrest. ⋯ General practitioners are required to manage cardiac arrest victims infrequently. The initiation of bystander cardiopulmonary resuscitation and the rapid defibrillation of suitable cardiac rhythms determine a favourable outcome. All staff working at a surgery must be skilled in basic life support. The GP needs an understanding of advanced life support principles.
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Children in Australia are infrequent recipients of general practitioner (GP) home visits. ⋯ There is infrequent use of home-visiting GP services by children who present to EDs with lower urgency conditions. These services refer some children with low-urgency conditions to the ED.
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Erectile dysfunction is a common but often neglected condition. Prevalence increases with age, but is not insignificant in younger men. ⋯ Erectile dysfunction may be classified as vasculogenic, neurogenic, endocrinological, drug-related, psychogenic or mixed. Commonly, erectile dysfunction is a cause of anxiety and even depression. Risk factors, such as smoking and hypertension, and reversible causes, such as hypogonadism or offending medications, should be addressed. At present, oral pharmacotherapy represents the first-line option for most patients with erectile dysfunction. It is of utmost importance to evaluate and treat comorbidities, such as depression, metabolic syndrome and cardiovascular disease, that often accompany erectile dysfunction. Patients will undoubtedly benefit from comprehensive management by a dedicated GP. Occasionally, referral to a urologist, psychologist or sexual health physician may be required.
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Dementia is a national health priority in Australia. Most people with dementia are over the age of 65 years, have a number of comorbidities and experience a trajectory of functional decline. General practitioners (GPs) have an important role in the diagnosis and management of people with dementia. The Cognitive Decline Partnership Centre's Clinical practice guidelines and principles of care for people with dementia (Guidelines) was recently approved by the National Health and Medical Research Council (NHMRC). ⋯ The Guidelines synthesise current evidence in dementia care and emphasise: timely diagnosis; encouraging the person with dementia to exercise, eat well and keep doing as much for themselves as possible; supporting and training carers to provide care; and reducing prescription of potentially harmful medications where possible.
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The Aboriginal and Torres Strait Islander life expectancy gap is associated with lower primary care usage by Indigenous Australians. Many Indigenous Australians regard private general practitioners as their usual source of healthcare. However, a range of barriers results in relatively low access to primary care, with subsequent inadequate prevention and management of chronic disease. Indigenous primary care requires development of a set of attributes by the GP. Clinician autonomy may need to be tempered to be responsive to the needs of local indigenous communities. ⋯ Over a period of 1 year, registered indigenous patients at the private general practice clinic increased from 10 to 147; monthly attendance increased from five to 40 (p<0.001). Local engagement between private practices and indigenous communities may be implemented widely to reduce the primary care gap.