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https://www.readbyqxmd.com/read/29769039/expert-clinician-s-perspectives-on-environmental-medicine-and-toxicant-assessment-in-clinical-practice
#1
Nicole Bijlsma, Marc Maurice Cohen
BACKGROUND: Most clinicians feel ill-equipped to assess or educate patients about toxicant exposures, and it is unclear how expert environmental medicine clinicians assess these exposures or treat exposure-related conditions. We aimed to explore expert clinicians' perspectives on their practice of environmental medicine to determine the populations and toxicants that receive the most attention, identify how they deal with toxicant exposures and identify the challenges they face and where they obtain their knowledge...
May 16, 2018: Environmental Health and Preventive Medicine
https://www.readbyqxmd.com/read/29754592/general-practitioners-views-on-the-influence-of-cost-on-the-prescribing-of-asthma-preventer-medicines-a-qualitative-study
#2
Jacqueline Tudball, Helen K Reddel, Tracey-Lea Laba, Stephen Jan, Anthony Flynn, Michele Goldman, Kirsty Lembke, Elizabeth Roughead, Guy B Marks, Nick Zwar
Objective Out-of-pocket costs strongly affect patient adherence with medicines. For asthma, guidelines recommend that most patients should be prescribed regular low-dose inhaled corticosteroids (ICS) alone, but in Australia most are prescribed combination ICS-long-acting β2-agonists (LABA), which cost more to patients and government. The present qualitative study among general practitioners (GPs) explored the acceptability, and likely effect on prescribing, of lower patient copayments for ICS alone. Methods Semistructured telephone interviews were conducted with 15 GPs from the greater Sydney area; the interviews were transcribed and thematically analysed...
May 14, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29751123/high-altitude-species-high-profits-can-the-trade-in-wild-harvested-fritillaria-cirrhosa-liliaceae-be-sustained
#3
REVIEW
A B Cunningham, J A Brinckmann, S-J Pei, P Luo, U Schippmann, X Long, Y-F Bi
ETHNOPHARMACOLOGICAL RELEVANCE: Fritillaria cirrhosa D. Don bulbs contain alkaloids and are one of the most intensively exploited alpine Himalayan medicinal species. In terms of proprietary medicines, our study shows that 210 F. cirrhosa products are offered by 46 suppliers, most of which (44) are situated in China and two in Nepal. A widepread commercial use is as one of the main ingredients in cough syrups. A well known example is "Nin Jiom Pei Pa Koa Herbal Cough & Throat Syrup", which typically contains more F...
May 8, 2018: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/29736897/the-normalization-of-intersex-bodies-and-othering-of-intersex-identities-in-australia
#4
EDITORIAL
Morgan Carpenter
Once described as hermaphrodites and later as intersex people, individuals born with intersex variations are routinely subject to so-called "normalizing" medical interventions, often in childhood. Opposition to such practices has been met by attempts to discredit critics and reasserted clinical authority over the bodies of women and men with "disorders of sex development." However, claims of clinical consensus have been selectively constructed and applied and lack evidence. Limited transparency and lack of access to justice have helped to perpetuate forced interventions...
May 7, 2018: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29674362/implementation-of-an-evidence-based-model-of-care-for-low-back-pain-in-emergency-departments-protocol-for-the-sydney-health-partners-emergency-department-shaped-trial
#5
Gustavo C Machado, Bethan Richards, Chris Needs, Rachelle Buchbinder, Ian A Harris, Kirsten Howard, Kirsten McCaffery, Laurent Billot, James Edwards, Eileen Rogan, Rochelle Facer, David Lord Cowell, Chris G Maher
INTRODUCTION: Patients with low back pain often seek care in emergency departments, but the problem is that many patients receive unnecessary or ineffective interventions and at the same time miss out on the basics of care, such as advice on self-management. This pattern of care has important consequences for the healthcare system (expensive and inefficient) and for patients (poor health outcomes). We hypothesised that the implementation of an evidence-based model of care for low back pain will improve emergency care by reducing inappropriate overuse of tests and treatments and improving patient outcomes...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29666309/hospital-admissions-associated-with-medication-non-adherence-a-systematic-review-of-prospective-observational-studies
#6
Pajaree Mongkhon, Darren M Ashcroft, C Norman Scholfield, Chuenjid Kongkaew
BACKGROUND: Medication non-adherence in ambulatory care has received substantial attention in the literature, but less so as it affects acute care. Accordingly, we aimed to estimate the frequency with which non-adherence to medication contributes to hospital admissions. METHODS: We searched the Cochrane Library, EMBASE, Cumulative Index to Nursing and Allied Health Literature, International Pharmaceutical Abstracts and PubMed (until December 2017) to identify prospective observational studies that examined prevalence rates of hospital admissions associated with medication non-adherence...
April 17, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29566039/effect-of-environmental-factors-on-the-germination-and-emergence-of-salvia-verbenaca-l-cultivars-verbenaca-and-vernalis-an-invasive-species-in-semi-arid-and-arid-rangeland-regions
#7
Muhammad Mansoor Javaid, Singarayer Florentine, Hafiz Haider Ali, Sandra Weller
Salvia verbenaca (wild sage) is a commonly cultivated herbal medicine plant, which is native to the Mediterranean climate regions of Europe, Africa, Asia and the Middle East. However, it has become an invasive species in semi-arid and arid regions of southern Australia. Two varieties are present in this region, var. verbenaca and var. vernalis, each of which can be distinguished by differences in morphology and flowering period. Following trials to determine the optimum temperate regime for germination and response to light and dark, seeds of both varieties were tested for their response to variations in pH, moisture stress, salinity, and burial depth...
2018: PloS One
https://www.readbyqxmd.com/read/29527576/multidisciplinary-analysis-of-invasive-meningococcal-disease-as-a-framework-for-continuous-quality-and-safety-improvement-in-regional-australia
#8
Kathryn A Taylor, David N Durrheim, Tony Merritt, Peter Massey, John Ferguson, Nick Ryan, Carolyn Hullick
Background: System factors in a regional Australian health district contributed to avoidable care deviations from invasive meningococcal disease (IMD) management guidelines. Traditional root cause analysis (RCA) is not well-suited to IMD, focusing on individual cases rather than system improvements. As IMD requires complex care across healthcare silos, it presents an opportunity to explore and address system-based patient safety issues. Context: Baseline assessment of IMD cases (2005-2006) identified inadequate triage, lack of senior clinician review, inconsistent vital sign recording and laboratory delays as common issues, resulting in antibiotic administration delays and inappropriate or premature discharge...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29519859/treating-people-with-arthritis-with-traditional-chinese-medicine-tcm-an-examination-of-the-perception-of-tcm-practitioners
#9
Lu Yang, Wenbo Peng, Jon Adams, David William Sibbritt
INTRODUCTION: Emerging evidence has shown that traditional Chinese medicine (TCM) has a positive effect on arthritis. This research provides the first critical, systematic examination of TCM practitioners' perceptions of TCM use for people with arthritis. METHODS: An online survey was distributed to all TCM professionals including acupuncturists and Chinese herbal medicine practitioners registered with the Practitioner Research and Collaborate Initiative (PRACI) practitioner database...
March 8, 2018: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/29473300/review-article-managing-medical-emergencies-in-rural-australia-a-systematic-review-of-the-training-needs
#10
REVIEW
Tarsh Pandit, Robin Ray, Sabe Sabesan
The aim of the study was to determine the training needs of doctors managing emergencies in rural and remote Australia. A systematic review of Australian articles was performed using MEDLINE (OVID) and INFORMIT online databases from 1990 to 2016. The search terms included 'Rural Health', 'Emergency Medicine', 'Emergency Medical Services', 'Education, Medical, Continuing' and 'Family Practice'. Only peer-reviewed articles, available in full-text that focussed on the training needs of rural doctors were reviewed...
February 22, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29417914/primary-care-practitioner-perceptions-and-attitudes-of-complementary-medicine-a-content-analysis-of-free-text-responses-from-a-survey-of-non-metropolitan-australian-general-practitioners
#11
Jon L Wardle, David W Sibbritt, Jon Adams
AimThis study examines GP perceptions, attitudes and knowledge of complementary medicine (CM), and to understand contextual factors that influence these perceptions, attitudes and knowledge. BACKGROUND: CM use is increasing, and its influence on primary care becoming increasingly significant. Although general practitioners (GPs) often have central primary care gate-keeper roles within health systems, few studies have looked specifically at GPs' perceptions, attitudes and knowledge of CM...
May 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29381876/recent-and-emerging-reproductive-biology-research-in-australia-and-new-zealand-highlights-from-the-society-for-reproductive-biology-annual-meeting-2017
#12
M J Bertoldo, P H Andraweera, E G Bromfield, F L Cousins, L A Lindsay, P Paiva, S L Regan, R D Rose, L K Akison
Research in reproductive science is essential to promote new developments in reproductive health and medicine, agriculture and conservation. The Society for Reproductive Biology (SRB) 2017 conference held in Perth (WA, Australia) provided a valuable update on current research programs in Australia and New Zealand. This conference review delivers a dedicated summary of significant questions, emerging concepts and innovative technologies presented in the symposia. This research demonstrates significant advances in the identification of precursors for a healthy pregnancy, birth and child, and discusses how these factors can influence disease risk...
January 31, 2018: Reproduction, Fertility, and Development
https://www.readbyqxmd.com/read/29334809/accidental-pharmacological-poisonings-in-young-children-population-based-study-in-three-settings
#13
Jane C Bell, Jason P Bentley, Catriona Downie, Rose Cairns, Nicholas A Buckley, Annette Katelaris, Sallie-Anne Pearson, Natasha Nassar
INTRODUCTION: Pharmacological poisonings in young children are avoidable. Previous studies report calls to poisons centres, presentations to emergency departments (ED) or hospital admissions. There are limited data assessing concurrent management of poisonings across all three settings. We aimed to describe accidental pharmacological poisonings in young children across our Poisons Information Centre (PIC), EDs and hospitals. METHODS: A population-based study in New South Wales, Australia, of PIC calls, ED presentations and hospital admissions for accidental pharmacological poisoning in children aged <5 years, 2007-2013...
January 15, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29201367/services-aimed-at-achieving-desirable-clinical-outcomes-in-patients-with-chronic-kidney-disease-and-diabetes-mellitus-a-narrative-review
#14
REVIEW
Fergus William Gardiner, Ezekiel Uba Nwose, Phillip Taderera Bwititi, Judith Crockett, Lexin Wang
There is a large number of patients with chronic kidney disease (CKD), diabetes mellitus (DM), and hypertension (HT) but whether the targets on blood pressure (BP) control in patients with DM and/or CKD are met is not clear. This narrative review therefore investigated evidence on services aimed at achieving desirable clinical results in patients with CKD and DM, and HT in Australia. Literature pertaining to pathology diagnosis and management of these patients as well as the complexities in management were considered...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/29179708/comparing-doctors-legal-compliance-across-three-australian-states-for-decisions-whether-to-withhold-or-withdraw-life-sustaining-medical-treatment-does-different-law-lead-to-different-decisions
#15
Ben P White, Lindy Willmott, Colleen Cartwright, Malcolm Parker, Gail Williams, Juliet Davis
BACKGROUND: Law purports to regulate end-of-life care but its role in decision-making by doctors is not clear. This paper, which is part of a three-year study into the role of law in medical practice at the end of life, investigates whether law affects doctors' decision-making. In particular, it considers whether the fact that the law differs across Australia's three largest states - New South Wales (NSW), Victoria and Queensland - leads to doctors making different decisions about withholding and withdrawing life-sustaining treatment from adults who lack capacity...
November 28, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29175699/-do-it-yourself-vaccine-rejection-and-complementary-and-alternative-medicine-cam
#16
Katie Attwell, Paul R Ward, Samantha B Meyer, Philippa J Rokkas, Julie Leask
In this article, we elucidate a symbiotic relationship between complementary and alternative medicine (CAM) and rejection of, or hesitancy towards, vaccination. In Fremantle, Western Australia, and Adelaide, South Australia, we conducted in-depth interviews from September 2013-December 2015 with 29 parents who had refused or delayed some or all of their children's vaccines. Our qualitative analysis found that for many, their do-it-yourself ethic and personal agency was enhanced by self-directed CAM use, alongside (sometimes informal) CAM practitioner instruction...
January 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29076236/choosing-public-or-private-emergency-departments-in-australia
#17
COMMENT
Katherine Walker, Michael Ben-Meir
Emergency medicine was once exclusively provided in public hospitals in Australia, but now over half a million consultations per annum are in private (7% total emergency consultations). Private EDs have excess capacity and are staffed by senior doctors (majority FACEM) with open access to investigations and broad specialist inpatient services. Public EDs struggle with rising attendances and overcapacity. Private hospitals have high levels of patient satisfaction and aim to optimise service provision. A major barrier to private ED attendances is out-of-pocket costs...
February 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29072509/matthew-flinders-senior-1751-1802-surgeon-and-man-midwife
#18
Linda Shields, Julie Jomeen, Wendy Smyth, David Stanley
Until the eighteenth century, midwifery was the sole domain of women, but changes in medical science saw it appropriated by medical men and the 'man-midwife' emerged. This paper demonstrates the work of a man-midwife in a small English village in one year, 1775, using his accounts and correspondence. The man was Matthew Flinders Senior, 'surgeon and man-midwife' at Donington, Lincolnshire. He was the father of Captain Matthew Flinders, the famous navigator who mapped the coast line of Australia and who coined that name...
January 1, 2017: Journal of Medical Biography
https://www.readbyqxmd.com/read/29068247/australian-elapid-snake-envenomation-in-cats-clinical-priorities-and-approach
#19
REVIEW
Trudi J Mcalees, Linda A Abraham
Practical relevance: No fewer than 140 species of terrestrial snakes reside in Australia, 92 of which possess venom glands. With the exception of the brown tree snake, the venom-producing snakes belong to the family Elapidae. The venom of a number of elapid species is more toxic than that of the Indian cobra and eastern diamondback rattle snake, which has earned Australia its reputation for being home to the world's most venomous snakes. Clinical challenges: The diagnosis of elapid snake envenomation is not always easy...
November 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29054933/social-media-enabled-learning-in-emergency-medicine-a-case-study-of-the-growth-engagement-and-impact-of-a-free-open-access-medical-education-blog
#20
Simon Carley, Iain Beardsell, Natalie May, Liz Crowe, Janos Baombe, Alan Grayson, Richard Carden, Ashley Liebig, Chris Gray, Ross Fisher, Daniel Horner, Laura Howard, Richard Body
BACKGROUND: Clinicians are increasingly using social media for professional development and education. In 2012, we developed the St.Emlyn's blog, an open access resource dedicated to providing free education in the field of emergency medicine. OBJECTIVE: To describe the development and growth of this international emergency medicine blog. METHOD: We present a narrative description of the development of St.Emlyn's blog. Data on scope, impact and engagement were extracted from WordPress, Twitter and Google Analytics...
February 2018: Postgraduate Medical Journal
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