The Medical journal of Australia
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To identify factors that influence the extent to which general practitioners use absolute risk (AR) assessment in cardiovascular disease (CVD) risk assessment. ⋯ This study provides an in-depth insight into the factors that influence GPs' use of AR in CVD risk assessment. The results suggest that GPs use a range of strategies in different situations, so different approaches may be required to improve the use of AR guidelines in practice.
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The gold standard for treatment of atopic dermatitis is topical corticosteroids. Parental alternative health beliefs and fear of topical corticosteroids may lead to non-adherence and treatment failure. At the extreme end, such beliefs may result in neglect constituting reportable child maltreatment. We examine the legal repercussions of such abuse in the criminal case resulting from the death of Gloria Sam.
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To examine patterns of the sickness certification of workers compensation claimants by general practitioners in Victoria, Australia, by nature of injury or illness. ⋯ The high proportion of medical certificates recommending complete absence from work presents major challenges in terms of return to work, labour force productivity, the viability of the compensation system, and long-term social and economic development. There is substantial variation in the type and duration of medical certificates issued by GPs. People with mental health conditions are unlikely to receive a certificate recommending alternative duties. Further research is required to understand GP certification behaviour.
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Surgery rarely cures OSA, but the lack of cure should not be judged as failure. New higher-level evidence shows excellent clinical outcomes with surgery, in long-term health, short-term symptoms and quality of life, even when complete cure is not achieved. ⋯ Evaluating surgical treatments is complicated because placebo control is usually not feasible with invasive therapies, randomisation to or away from invasive therapy may limit patient enrolment and generalisability, and surgery is a heterogeneous array of procedures and combinations of procedures. Despite these testing challenges, well controlled studies are showing important benefits of surgery and, moreover, of combinations of surgical procedures.