Contraceptive Implanon: Why do GPs get asked to remove it early?

Nineteen women aged 18 to 39 years of age from four Coast City Country GP Training practices were interviewed regarding their experiences with Implanon and the reasons for early removal. All participants were in relationships and approximately half had children

A feasibility study of team-based primary care for chronic disease management training in rural Australia

Increasing rates of chronic disease management (CDM) are projected to contribute to significant effective shortfalls in the primary care workforce in Australia.1 Additionally, rural Australia carries a higher burden of chronic illness2 and has existing medical workforce shortages.3 Therefore, it is imperative that rural primary care maximises the efficiency of the CDM it provides

Patients\u27 attitudes towards chaperone use for intimate physical examinations in general practice

BACKGROUND: The objective of this article is to investigate patients\u27 attitudes to the use of chaperones for intimate physical examinations (IPEs) in a sample of Australian general practices. METHODS: A cross-sectional survey of adult patients from 13 randomly selected general practices in regional New South Wales was conducted between September and November 2012. Generalised linear mixed models were used for analysis. RESULTS: Of 780 surveys distributed, 687 (88%) were returned; the age range was 18-91 years and 356 (52%) were from female patients. Most women had never had a chaperone present for a Papanicolaou (Pap) smear (82.6%). Between 23% and 33% of respondents preferred a chaperone with their usual general practitioner (GP) across IPEs and gender of the respondents. The odds of preference for a chaperone were significantly less with a GP whom the respondents did not know well, compared with their usual GP, for a Pap smear (female) or genital examination (male). DISCUSSION: Individualised discussion regarding chaperone use for IPEs is warranted, especially with patients seeing their usual GP

Panning for gold: unearthing reliable variables for electronic medical data research

Abstract of a poster presentation at the 2015 PHC Research Conference, Adelaide, 29-31 July, 2015

Deficiency of functional mannose-binding lectin is not associated with infections in patients with systemic lupus erythematosus

Infection imposes a serious burden on patients with systemic lupus erythematosus (SLE). The increased infection rate in SLE patients has been attributed in part to defects of immune defence. Recently, the lectin pathway of complement activation has also been suggested to play a role in the occurrence of infections in SLE. In previous studies, SLE patients homozygous for mannose-binding lectin (MBL) variant alleles were at an increased risk of acquiring serious infections in comparison with patients who were heterozygous or homozygous for the normal allele. This association suggests a correlation between functional MBL level and occurrence of infections in SLE patients. We therefore investigated the biological activity of MBL and its relationship with the occurrence of infections in patients with SLE. Demographic and clinical data were collected in 103 patients with SLE. Functional MBL serum levels and MBL-induced C4 deposition were measured by enzyme-linked immunosorbent assay using mannan as coat and an MBL- or C4b-specific monoclonal antibody. The complete MBL-dependent pathway activity was determined by using an assay that measures the complete MBL pathway activity in serum, starting with binding of MBL to mannan, and was detected with a specific monoclonal antibody against C5b-9. Charts were systematically reviewed to obtain information on documented infections since diagnosis of SLE. Major infections were defined as infections requiring hospital admission and intravenous administration of antibiotics. In total, 115 infections since diagnosis of lupus, including 42 major infections, were documented in the 103 SLE patients (mean age 41 ± 13 years, mean disease duration 7 ± 4 years). The percentage of SLE patients with severe MBL deficiency was similar to that in 100 healthy controls: 13% versus 14%, respectively. Although deposition of C4 to mannan and MBL pathway activity were reduced in 21% and 43% of 103 SLE patients, respectively, neither functional MBL serum levels nor MBL pathway activity was associated with infections or major infections in regression analyses. In conclusion, SLE patients frequently suffer from infections, but deficiency of functional MBL does not confer additional risk