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Using electronic medical record data to assess chronic kidney disease,type 2 diabetes and cardiovascular disease testing,recognition and management as documented in Australian general practice:a cross-sectional analysis

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Family Medicine and Community Health 2022年第1期10卷 25-35页

作者： Julia L Jones Natalie G Lumsden Koen Simons Anis Ta'eed Maximilian P de Courten Tissa Wijeratne Nicholas Cox Christopher J A Neil Jo-Anne Manski-Nankervis Peter Shane Hamblin Edward D Janus Craig L Nelson Nephrology Western HealthMelbourneVictoriaAustralia Medicine University of MelbourneMelbourneVictoriaAustralia Western Health Chronic Disease Alliance MelbourneVictoriaAustralia general practice University of MelbourneMelbourneVictoriaAustralia Epidemiology and Biostatistics University of MelbourneMelbourneVictoriaAustralia Mitchell Institute for Education and Health Policy MelbourneVictoriaAustralia Chronic Disease Prevention and Management Victoria UniversityMelbourneVictoria3011 La Trobe University MelbourneVictoriaAustralia Neurology Western HealthMelbourneVictoriaAustralia Cardiology Western HealthMelbourneVictoriaAustralia Endocrinology and Diabetes Western HealthMelbourneVictoriaAustralia Medicine Western HealthMelbourneVictoriaAustralia

Objectives To evaluate the capacity of general practice(GP)electronic medical record(EMR)data to assess risk factor detection,disease diagnostic testing,diagnosis,monitoring and pharmacotherapy for the interrelated chronic vascular diseases-chronic kidney disease(CKD),type 2 diabetes(T2D)and cardiovascular *** Cross-sectional analysis of data extracted on a single date for each practice between 12 April 2017 and 18 April 2017 incorporating data from any time on or before data extraction,using baseline data from the Chronic Disease early detection and Improved Management in PrimAry Care *** data were extracted from GP EMRs using the Pen Computer Systems Clinical Audit Tool and descriptive statistics used to describe the study *** Eight GPs in victoria,*** Patients were≥18 years and attended GP≥3 times within 24 months.37946 patients were *** Risk factor and disease testing/monitoring/treatment were assessed as per Australian guidelines(or US guidelines if none available),with guidelines simplified due to limitations in data availability where *** factor assessment in those requiring it:30%of patients had body mass index and 46%blood pressure within guideline recommended *** testing in at-risk population:17%had diagnostic testing as per recommendations for CKD and 37%for *** undiagnosed disease:Pathology tests indicating possible disease with no diagnosis already coded were present in 6.7%for CKD,1.6%for T2D and 0.33%familial *** prevalence:Coded diagnoses were recorded in 3.8%for CKD,6.6%for T2D,4.2%for ischaemic heart disease,1%for heart failure,1.7%for ischaemic stroke,0.46%for peripheral vascular disease,0.06%for familial hypercholesterolaemia and 2%for atrial *** prescriptions:the proportion of patients prescribed guideline-recommended medications ranged from 44%(beta blockers for patients for some condi

关键词： diagnosis testing record

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general practice training in China:A multimodal experiential program provided by Australian educators

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Family Medicine and Community Health 2018年第1期6卷 14-19页

作者： Grant Blashki Hui Yang Leon Piterman Nossal Institute for Global Health and Melbourne Sustainable Society Institute The University of MelbourneParkvilleVictoriaAustralia Shenzhen International Primary Health Care Research Institute ShenzhenGuangdongChina Department of general practice Monash UniversityMelbourneVictoriaAustralia China GP Program Monash Institute of Health and Clinical EducationMelbourneVictoriaAustralia

Our small group of expert GP academic trainers from Monash University and the University of Melbourne have been collaborating over the last decade to develop a GP model training program based in Luohu,Shenzhen,that deeply engages Chinese GPs and seeks to provide personal and professional development of the *** program is closely linked to continuing offshore GP education in Australia,with many trainees of the program having attended intensive training hosted by Monash University in Australia.

关键词： general practice primary care China training

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Unraveling the landscape of pediatric pancreatic tumors:Insights from Japan

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 34-38页

作者： Savvas Lampridis Faculty of Medicine Imperial College LondonLondon SW72AZUnited Kingdom Department of Surgical Oncology 424 General Military Training HospitalThessaloniki 56429Greece

Pediatric pancreatic tumors,though rare,pose significant diagnostic and manage-ment *** recent,22-year nationwide survey on pediatric pancreatic tumors in Japan by Makita et al offers valuable insights into this uncommon enti-ty,revealing striking geographical variations and questioning current treatment *** editorial commentary analyzes the study's key findings,inclu-ding the predominance of solid pseudopapillary neoplasms and their younger age of onset,which contrast sharply with Western *** explores the implications for clinical practice and research,emphasizing the need for population-specific approaches to diagnosis and *** revealed limited institutional expe-rience and surgical management patterns prompt a reevaluation of optimal care delivery for these complex cases,suggesting benefits of centralizing healthcare ***,the commentary advocates for international collaborative studies to elucidate the genetic,environmental,and lifestyle factors influencing the development and progression of pediatric pancreatic tumors across diverse *** also outlines future directions,calling for advancements in precision medicine and innovative care delivery models to improve global patient *** Makita et al's findings within the broader landscape of pediatric oncology can stimulate further research and clinical advancements in managing pancreatic and other rare tumors in children.

关键词： Child Epidemiology Japan Pancreatic endocrine tumors Pancreatic neoplasms Pancreatoblastoma Pediatric oncology Solid pseudopapillary neoplasm Surgical management Survey

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Head injury in a 62-year-old man affected by alcohol

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Family Medicine and Community Health 2013年第3期1卷 55-56页

作者： John Murtagh Department of general practice Faculty of MedicineNursing and Health SciencesMonash UniversityVictoria 3165Australia

History A 62-year-old man was brought to the emer-gency room by his friends because he was intoxicated from alcohol and had sustained injuries from a fall on the *** to this,he had been argumentative and had a fight with two younger *** to his friends,he was a very pleasant and clever public servant,but had a history of binge drinking of beer and *** were par-ticularly concerned about him since he had become uncharacteristically confused and unable to walk *** 1 h previously,and soon after his fall,he had been conversing with them and seemed well-oriented,but gradually became irritable,confused,and disoriented.

关键词： alcohol younger argument

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Offshore teaching in chronic disease management:The Monash- Shenzhen experience

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Family Medicine and Community Health 2018年第1期6卷 10-13页

作者： Leon Piterman Hui Yang Grant Blashki Department of general practice Monash UniversityMelbourneVictoriaAustralia China GP Program Monash Institute of Health and Clinical EducationMelbourneVictoriaAustralia Shenzhen International Primary Health Care Research Institute ShenzhenGuangdongChina Nossal Institute for Global Health and Melbourne Sustainable Society Institute The University of MelbourneParkvilleVictoriaAustralia

The important role of GPs and the high prevalence and burden of chronic disease in China have been discussed in other articles in this series,so there is no need to reiterate this background *** article deals with the pedagogy of chronic disease management as presented to cohorts of Chinese GPs from Shenzhen attending an offshore program at Monash University in *** program,which commenced in 2010,was 7 weeks in duration and has now expanded to 13 weeks,enabling greater coverage of important topics,more site visits,and instruction in teaching and research methods,along with development of research proposals often based on management of a chronic disease.

关键词： Chronic disease general practice education and training

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Survival outcomes and predictors of mortality,re-bleeding and complications for acute severe variceal bleeding requiring balloon tamponade

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World Journal of Hepatology 2022年第8期14卷 1584-1597页

作者： Charlotte Y Keung Aparna Morgan Suong T Le Marcus Robertson Paul Urquhart Michael P Swan Department of Gastroenterology Monash HealthMelbourne 3168VictoriaAustralia Department of Gastroenterology Eastern HealthMelbourne 3128VictoriaAustralia Department of Medicine Monash UniversityMelbourne 3168VictoriaAustralia Monash Digital Therapeutics and Innovation Laboratory Monash UniversityMelbourne 3168VictoriaAustralia

BACKGROUND Acute severe variceal bleeding(AVB)refractory to medical and endoscopic therapy is infrequent but associated with high *** cohort studies from 1970-1980s no longer represent the current population as balloon tamponade is no longer first-line therapy for variceal bleeding;treatments including vasoactive therapies,intravenous antibiotics,endoscopic variceal band ligation are routinely used,and there is improved access to definitive treatments including transjugular intrahepatic portosystemic ***,only a few studies from the current era exist to describe the practice of balloon tamponade,its outcomes,and predictors with a requirement for further updated *** To describe current management of AVB requiring balloon tamponade and identify the outcomes and predictors of mortality,re-bleeding and *** A retrospective multi-centre cohort study of 80 adult patients across two large tertiary health networks from 2008 to 2019 in Australia who underwent balloon tamponade using a Sengstaken-Blakemore tube(SBT)were included for *** were identified using coding for balloon *** primary outcome of this study was all-cause mortality at 6 wk after the index *** outcomes included re-bleeding during hospitalisation and complications of balloon *** of these outcomes were determined using univariate and multivariate binomial *** The all-cause mortality rates during admission and at 6-,26-and 52 wk were 48.8%,51.2%and 53.8%,*** haemostasis was achieved in 91.3%and re-bleeding during hospitalisation occurred in 34.2%.Independent predictors of 6 wk mortality on multivariate analysis included the Model for Endstage Liver disease(MELD)score(OR 1.21,95%CI 1.06-1.41,P=0.006),advanced hepatocellular carcinoma(OR 11.51,95%CI 1.61-82.20,P=0.015)and re-bleeding(OR 13.06,95%CI 3.06-55.71,P<0.001).There were no relevant predictors of re-bleeding but a larg

关键词： Balloon tamponade Acute variceal bleeding Sengstaken-Blakemore tube Mortality Complications Haemostasis

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Chronic heart failure:Role of the GP in management

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Family Medicine and Community Health 2018年第1期6卷 3-9页

作者： Leon Piterman Hui Yang Zhaoxia Yin Department of general practice Monash UniversityMelbourneVictoriaAustralia China GP Program Monash Institute of Health and Clinical EducationMelbourneVictoriaAustralia Shenzhen International Primary Health Care Research Institute ShenzhenGuangdongChina The Third Affiliated Hospital of Shenzhen University Luohu Hospital GroupShenzhenGuangdongChina

The commonest cause of chronic heat failure in China is ischemic heart disease,followed by hypertension and valvular heart *** is essential in establishing a diagnosis as well as helping to identify a cause and to monitor *** includes nonpharmacological as well as pharmacological treatment,and self-care with careful monitoring of salt and fluid intake as well as regular weight *** planning and team-based care are essential in managing patients with chronic heart failure,who often have concurrent multimorbidity and are receiving polypharmacy.

关键词： Chronic heart failure general practice team based care

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Comparison of general practice residents’ attitudes and perceptions about training in two programmes in China: a mixed methods survey

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Family Medicine and Community Health 2019年第4期7卷 64-73页

作者： Siqing Lian Yu Xia Jinzhi Zhang Xiaoning Han Chunhua Chi Michael D Fetters general practice Department Peking University First HospitalPekingXicheng DistrictChina general practice Department Peking University Shenzhen HospitalShenzhenGuangdongChina Cardiology Department Peking University First HospitalPekingXicheng DistrictChina Department of general practice Peking University First HospitalPekingXicheng DistrictChina Department of Family Medicine University of MichiganAnn ArborMichiganUSA

Objective To understand general practice(GP)residents’attitudes about their residency training in *** Mixed methods survey administered *** Two GP training programmes similar in most regards according to current GP training policy of 5 years’undergraduate degree in medicine and 3 years of postgraduate GP residency training-but differing as the Beijing programme has adopted educational innovations beyond the nationally prescribed standard curriculum used by the second Shenzhen *** 105(85%)of eligible GP trainees,35(90%)in the innovative Beijing programme and 70(83%)in the standard training Shenzhen *** Overall,residents felt discrimination because of specialty choice,and that they lacked competency as a general *** residents commented faculty had negative teaching *** residents were more satisfied than Shenzhen residents with their training(p=0.001),and felt teaching faculty had sufficient knowledge(ptraining as well as *** satisfaction with faculty teaching and job optimism in Beijing where GP residents receive training from specifically qualified faculty,and can earn special certification,suggest that the educational innovations enhance training and promote positivity about job *** findings imply that GP residents in China face many training challenges that are similar to other international reports,while also implicating benefits of using an innovative curricular approach.

关键词： programme attitude faculty

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In an interconnected world: joint research priorities for the environment, agriculture and infectious disease

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Infectious Diseases of Poverty 2014年第1期3卷 15-17页

作者： Bianca Brijnath Colin D Butler Anthony J McMichael Department of general practice School of Primary Health CareMonash UniversityBuilding 1270 Ferntree Gully RoadNotting HillVictoria 3168Australia Faculty of Health University of CanberraCanberraAustralia National Centre for Epidemiology and Population Health Australian National UniversityCanberraAustralia

In 2008 the UNICEF/UNDP/World Bank/WHO Special Programme for Research and training in Tropical Diseases(TDR)commissioned ten think-tanks to work on disease-specific and thematic reference groups to identify top research priorities that would advance the research agenda on infectious diseases of poverty,thus contributing to improvements in human *** first of the thematic reference group reports-on environment,agriculture and infectious diseases of poverty-was recently *** this article we review,from an insider perspective,the strengths and weaknesses of this thematic reference group report and highlight key messages for policy-makers,funders and researchers.

关键词： Agriculture Environment Infectious disease Research priorities TDR

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Consensus views on competencies and teaching methods for an interprofessional curriculum on complementary and integrative medicine:A Delphi study

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Journal of Integrative Medicine 2021年第3期19卷 282-290页

作者： Angelika Homberg Katja Krug Nadja Klafke Katharina Glassen Cornelia Mahler Svetla Loukanova Department of general practice and Health Services Research University Hospital HeidelbergHeidelberg69120 HeidelbergGermany Department of Nursing Science University Hospital Tübingen72076 TubingenGermany

Objective:A collaborative team is necessary to help patients achieve their healthcare goals using complementary *** present,healthcare professionals do not feel sufficiently qualified to provide this *** study sought to identify competencies and teaching methods for interprofessional training on complementary and integrative medicine at medical ***:Sixty-five German-speaking experts with various professional backgrounds were invited to take part in a three-round Delphi *** the first round,predefined competencies were assessed on a seven-point Likert scale,and participants were invited to propose additional competencies that would be evaluated in the subsequent *** competencies were ranked based on the participant assessments and were assigned to four relevance *** the second and third rounds,suitable teaching methods were identified using free-text fields and multiple-choice *** a final workshop,participants synthesized the outcomes of the previous sessions and derived key competencies that would be a benefit to undergraduate interprofessional training in complementary and integrative medicine at medical ***:The three rounds plus final worksop were attended by 50,40,36 and 11 *** competencies that these experts determined to be highly relevant to teaching complementary and integrative medicine emphasized,in particular,the respectful treatment of patients and the importance of taking a medical *** these highly relevant competencies,three key targets were agreed upon in the final workshop:students are able to 1)classify and assess complementary medical terms and methods;2)work collaboratively and integrate patients into the interprofessional team;3)involve patients and their relatives respectfully and empathetically in all healthcare *** achieve these competency goals,the following teaching methods were highlighted:students discuss therapy options based on authentic patient c

关键词： Undergraduate education Interprofessional education Complementary medicine Delphi study Curriculum Competency

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