Canadian family physician Médecin de famille canadien
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Question I have several patients, mostly girls, who are living with Raynaud phenomenon. Does this condition appear in children, and what should be the course of action?Answer Raynaud phenomenon, described in the 1860s, can present in children and even in the first decade of life. While most children will have primary Raynaud phenomenon, with no serious adverse consequences, in others it might be a sign of a pending systemic disease. Those children with a positive reaction to antinuclear antibody, specific autoantibodies associated with connective tissue disease, or nail fold capillary changes require referral to a pediatric rheumatologist and close follow-up.
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To determine whether including Indigenous Elders as part of routine primary care improves depressive symptoms and suicidal ideation in Indigenous patients. ⋯ Encounters with Indigenous Elders, as part of routine primary care, were associated with a clinically and statistically significant reduction in depressive symptoms and suicide risk among Indigenous patients. Emergency department use decreased, which might reduce crisis-oriented mental health care costs. Further expansion and evaluation of the role of Indigenous Elders as part of routine primary care is warranted.
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To determine if there has been an increase in preventive care among adults with intellectual and developmental disabilities (IDD) as a result of the publication of the Canadian consensus guidelines on the care of adults with IDD in 2006 and 2011. ⋯ Despite the publication of the guidelines there has not been a corresponding increase in the uptake of the annual health examination or in the quality of preventive care among adults with IDD. More is required to reduce this documented inequity in care.
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To implement a Health Check protocol for patients with intellectual and developmental disabilities (IDD) and assess outcomes. ⋯ Performing the Health Check was associated with improved preventive care and staff experience. Wider implementation and evaluation is needed, along with protocol adjustments to provide more support to staff for this work.