Internal medicine journal
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Internal medicine journal · Oct 2021
How do hospitals help patients prepare for and participate in outpatient clinics?
Patients attending general medicine outpatient clinics (GM OPC) at hospital face multiple healthcare demands in an environment that has evolved with the clinician at its centre. The ideas, knowledge and understanding that patients bring to their clinic appointments are not well studied in the New Zealand setting. ⋯ Limited information and support is provided to patients attending follow-up GM OPC and is not tailored to individuals' health literacy. This practice assumes patients have comparable health literacy to clinicians, which may have downstream impacts on the usefulness of the clinic experience. The information that health users bring to clinic may be improved by increasing pre-clinic user engagement and deploying patient-centred tools within the healthcare environment.
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Internal medicine journal · Oct 2021
Clinical Characteristics and Outcomes of COVID-19 in a low-prevalence, well-resourced setting, Sydney, Australia.
The Northern Sydney Local Health District was one of the first health regions to be affected by COVID-19 in Australia. ⋯ In this low prevalence, well resourced Australian setting, we report an overall low mortality. Factors associated with adverse patient outcomes on multivariate analysis were age greater than 80 and the presence of two or more comorbidities. These data can assist in early risk stratification of COVID-19 patients, and in surge capacity planning for hospitals.
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Internal medicine journal · Oct 2021
Case ReportsCan depressed patients make a decision to request voluntary assisted dying?
Depressive symptoms, including those as part of a major depressive disorder, are common at the end of life. A number of psychiatrists consider that a diagnosis of major depression precludes the capacity to make a decision to request voluntary assisted dying (VAD), although this is not a unanimous view. ⋯ The difference of view can be related to whether major depression was diagnosed and the association made between depression and the capacity to request VAD. The view that an absence of major depression is required in order to establish the capacity to request VAD is potentially at odds with the legal definition and not necessarily in keeping with the patient's experience at the end of life.
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Internal medicine journal · Oct 2021
A Content Analysis of Euthanasia Polls in Australia and New Zealand - Words Do Matter.
There has been widespread public and political interest in Euthanasia and Physician-Assisted Suicide (EPAS) in recent years. Polling in Australia and New Zealand has generally shown a majority of people support some form of legal EPAS; however, the level of support varies between polls. ⋯ Use of emotive phrases and language is associated with influencing attitudes to EPAS in Australia and New Zealand. Therefore, caution should be exercised when interpreting public support for EPAS based on individual polls.
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Internal medicine journal · Oct 2021
Prediction of cardiovascular events in patients with chronic myeloid leukaemia using baseline risk factors and coronary artery calcium scoring.
A standardised method for cardiovascular risk stratification in chronic myeloid leukaemia patients treated with tyrosine kinase inhibitors is lacking. We report an algorithm for risk stratification applicable to all patients commencing tyrosine kinase inhibitor therapy based on age, prior cardiovascular disease and Framingham Risk Score, incorporating coronary artery calcium scoring in patients at intermediate Framingham Risk Score risk. Of 88 patients retrospectively studied, major adverse cardiovascular event rates in our study-defined low-, intermediate- and high-risk categories were 0%, 10% and 19% respectively. Of nine patients down-classified from intermediate to low risk on the basis of coronary artery calcium scoring, none went on to experience a major adverse cardiovascular event.