Canadian family physician Médecin de famille canadien
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Review
Approach to providing care for aging adults with intellectual and developmental disabilities.
To provide an approach to caring for aging adults with intellectual and developmental disabilities (IDD) in the context of the onset of new or worsening chronic illnesses and the need for planning for the end of life. ⋯ Primary care physicians can provide and coordinate appropriate care for patients with IDD as they face the health challenges associated with aging and dying. Being aware of patients' baseline cognitive abilities and decision-making skills, as well as changes in cognitive abilities associated with aging and complexity of illness, will help determine patients' capacity to consent, identify appropriate treatment choices, and guide coordination of care. Further research and consensus statements are needed to guide best practices based on the Canadian experience and to allow continuing development of caring, professional, and competent providers to support aging adults with all levels of IDD.
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To summarize high-quality studies for 10 topics from 2018 that have strong relevance to primary care practice. ⋯ Research from 2018 produced several high-quality studies in CVD but also spanned the breadth of primary care including pediatrics, women's health, and pain management, among other areas.
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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 help increase the confidence of both caregivers and clinicians in providing palliative care to adults with intellectual and developmental disabilities (IDD) using an easy-to-follow framework to improve and overcome barriers to effective palliative care in this population. ⋯ The validated tools and recommendations provided will assist with communication, symptom interpretation, treatment decisions, advanced care planning, addressing grief, and important considerations in end-of-life care.