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The article discusses the different medical practices of hospitals in Australia during the Christmas to New Year period. It says that general practices usually negotiate with staff about who will work during the holidays since these facilities usually stay open in this period. According to the author, hospitals also need to be organized in order to efficient emergency care services to those who will be needing them.

The article discusses staff betrayal in clinical practices and the systems and protocols that safeguard against fraud. It is said that most cases of fraud among clinical staff involve the most trusted employees. It notes that fraud ranges from pocketing money paid for a consultation to the overbilling and skimming of excess funds. Measures that can be taken to prevent fraud are given which include adopting the Medicare Easyclaim system, taking regular audits, and having written protocols.

The article discusses online medical appointment systems. General practitioners like Australian doctor, Ron Tomlin offer an online booking option allowing patients to bypass the receptionist to book an appointment. Tomlin uses the website provider OzDocsOnline which offers other online services as well. While convenient for patients, the use of online systems face certain issues like security, privacy, resolving patient demand and sorting through the many software applications available.

The article offers advice and tips for medical practitioners on managing their self-managed superannuation funds (SMSF). It points out the need for medical practitioners to regularly review their self-managed superannuation funds. The importance to success of how the fund has been crafted and its long-term investment strategy is emphasized. Six essential issues when establishing and running an SMSF are discussed, including strategy, research and estate planning.

The article discusses how can a medical practice comply with the requirements of the 2011-2012 Medicare Compliance Program in the Australia. According to the country's Department of Human Services general manager Hank Jongen, the program is aimed at ensuring that the right person gets the right compensation at the right time. The opinion of MDA National's Doctor Sara Bird on the issue is also cited.

The article offers outsourcing tips for medical practitioners in Australia. It identifies the activities that are most likely to be outsourced by medical businesses, which include transcribing, information technology (IT), and bookkeeping or accountancy. It discusses how to avoid potential fraud or serious errors and breaches of privacy and confidentiality. It explains why outsourcing is an essential part of medical practice.

The article discusses collaborative arrangements among medical practitioners with midwives and nurse practitioners (NP) in Australia. Doctor Andrew Pesce explains that collaborative arrangements are part of providing care to the community. Midwife Melissa Maimann describes her positive experience collaborating with Pesce. Meanwhile, Doctor Patrick Byrnes notes that Medicare Benefits Schedule's (MBS) fee structure for chronic disease management was not viable.

The article evaluates Medicare Australia's Electronic Claiming and Lodgement Information Processing System (ECLIPSE) online billing system.

The article discusses the advantage of support from family and colleagues to a medical professional who needs to combine overseas volunteer work with the maintenance of a practice. It focuses on the rewards achieved by physicians and surgeons when they participate in overseas volunteer medical programs. It cites the experiences of Doctors Mark Moore, Glenn Guest and Judith Goh while working in Africa, Pakistan and East Timor.

The article discusses the Indigenous-friendly practices of doctors in Australia. It states that welcoming Aboriginal and Torres Strait Islander patients can be professionally and financially rewarding. Dr. Brad Murphy, chair of the Royal Australian College of General Practitioners' (RACGP) National Faculty of Aboriginal and Torres Strait Islander Health advises on how make sure a practice is Indigenous-friendly.

Abstract Aspirations of quality, equitable and respectful care for all women in childbirth have, so far, been unrealised. Sub-optimal care remains the norm in many settings despite decades of substantial investment, the introduction of evidence-based policies, procedures and training programmes. Improving the standard of facility-based care for childbearing women in Afghanistan is an example. This ethnography of a large public Afghan maternity hospital explored the experiences, motivations and constraints of healthcare providers. The aim was to identify barriers and facilitators in the delivery of care. Participant observation, semi-structured interviews, and focus group discussions were used to gather diverse perspectives on childbirth and care between 2010 and 2012. The influences of the sociocultural setting and political economy on facility-based care are discussed in this paper. Under the surface of this maternity hospital, social norms were in conflict with the principles of biomedicine. Contested areas included the control of knowledge, equity and the primary goal of work. The institutional culture was further complicated by pressure from powerful elites. These unseen values and pressures explain much of the disconnection between policy and implementation, education and the everyday behaviours of healthcare providers. Improving the quality of care and equity in Afghan public maternity hospitals will require political will from all stakeholders to acknowledge these issues and find culturally attuned ways to address them. Furthermore, the notion of competing world-views on healthcare has relevance beyond Afghanistan. Highlights • Afghan biomedical practice is being shaped by history, society and politics. • Connections, status or financial gifts were required to access quality care. • Professional knowledge and clinical skills were generally guarded not shared. • Social expectations and pressures were stronger than notions of equity. • Political elites had power and influence over healthcare providers. [ABSTRACT FROM AUTHOR]

The article offers health news briefs. No medicines offer effective pain relief for patients with sciatica. An accurate way to assess patients with brain injury is discovered through the changes of oxygen levels in the brain when forming a mental image. A new step for drug approval called adaptive licensing (AL) is introduced.

The article investigates whether investors should invest in property in Australia. While experts agree it is a buyer's market, a property bargain allegedly can turn into an investment failure if investors do not do their homework. Experts also believe that property remains a sound investment, but only for good quality property held as a long-term investment. Issues to consider when buying for investment include the viability of possible tenants.

The article announces the 100th birthday of former Australian Medical Association (AMA) president Sir Keith Jones on July 7, 2011.

The article focuses on the need to maintain a proper regimen and stock of medicines during travel. Topics include adherence to regimen of medicines, the importance of seeking advice from pharmacists and health professionals regarding intake of medicines, and proper planning for holidays with regards to intake of medicines.

Background: Since 2015, pharmacists have been integrating into English general practices and more recently into primary care networks. General practice-based pharmacists provide a range of patient-facing services, such as medication reviews, management of long-term conditions and minor ailments, prescribing duties and answering queries over the telephone. Literature reports patients' satisfaction with general practice-based pharmacists' services, however, previous research captured only limited experiences. The aim of the current study was to pursue an extensive exploration of patients' experiences of pharmacists in general practice. Methods: General practice-based pharmacists, working in practices in West London, Surrey and Berkshire, handed invitation packs to patients seen during consultations. Patients that wanted to take part in the study were invited to undertake a qualitative, in-depth, face-to-face, semi-structured interview within the practice with which each patient was registered. Interviews lasted from 15 min to more than 1 h and were audio-recorded. Recruitment continued until data saturation. Audio-recordings were transcribed verbatim and transcripts analysed thematically. Results: Twenty participants were interviewed. Four themes were discerned: awareness ("I had been coming to this practice for 24 years and I didn't know that there was a pharmacist"); accessibility ("People ring for a GP [general practitioner] appointment ... it's Monday and they [receptionist] tells you 'We can slot you in on Friday' ... with a pharmacist on board, they can [instantly] look at you"); interactions ("I've always had a really good interaction with them [pharmacists] and they listen and they take on board what I'm trying to say"); and feedback ("It's easier [to collect feedback instantly] because I could have forgotten half of what they [pharmacists] have told me in an hour or so's time"). Conclusions: Findings indicate that pharmacists' integration into general practices could improve accessibility to, and the quality of, care received. The findings will assist policy development to provide general practice-based pharmacists' services as per patients' needs. [ABSTRACT FROM AUTHOR]

Background: In England, since 2015, there has been a formal drive to integrate pharmacists into general practice as a new healthcare service. Research efforts have offered insights into how general practice-based professionals and patients view the service, however, they took no account of community pharmacy teams' opinions. There have been anecdotal statements about opposition from community pharmacies to the service, due to fears of losing business. The aim of the current study was to identify the experiences and perceptions of community pharmacy teams regarding pharmacists' presence in general practice.Methods: The National Health Service Choices website was used to identify community pharmacies within a radius of two miles from eight West London general practices. The search resulted in 104 community pharmacies which were all contacted via telephone. Pharmacy staff who verbally expressed their interest to participate were then provided with the study's documents. Qualitative, face-to-face, semi-structured interviews were conducted inside the pharmacy from which each participant was recruited. Interviews lasted 30 to 45 min and were audio-recorded. Audio-recordings were transcribed verbatim and transcripts analysed thematically.Results: Forty-eight community pharmacy staff participated. Four themes were discerned: awareness ("I knew that [pharmacists] have already been implemented [in general practice] but I haven't really followed it … where does the pharmacist role come?"); interactions ("I'm just so pleased that there's a pharmacist professional in the general practice … because we speak the same language!"); patient care ("if I was a patient knowing that there is a general practitioner and a pharmacist [in general practice], I would … think 'nothing can go wrong at the moment'"); and funding challenges ("if general practices take on the extra responsibility of stop smoking or flu vaccination campaigns … financially, this would affect this pharmacy").Conclusions: The current study revealed the perceived impact of general practice-based pharmacists on community pharmacies would be improved communication between pharmacies and practices. Findings will inform policy so that any future framing of pharmacists' presence in general practice considers the needs of community pharmacies. [ABSTRACT FROM AUTHOR]

Background: Many of aspects of our lives became increasingly commercialised in post-modern society. Although breastfeeding is perhaps a late comer to this process in recent years, it too has seen significant commercialisation facilitated by social media and our obsession with celebrity culture. This paper explores how the commercialisation and commodification of breastfeeding impacts mothers' experiences of breastfeeding. Methods: In a qualitative study, five mothers in the United Kingdom recorded their real-time breastfeeding experiences in video diaries. Using a multi-modal method of analysis, incorporating both visual and audio data, a thematic approach was applied. Findings: Women preparing for breastfeeding are exposed to increasing commercialisation. When things do not go to plan, women are even more exposed to commercial solutions. The impact of online marketing strategies fuelled their need for paraphernalia so that their dependence on such items became important aspects of their parenting and breastfeeding experiences. Conclusions: The audio-visual data demonstrated the extent to which "essential" paraphernalia was used, offering new insights into how advertising influenced mothers' need for specialist equipment and services. Observing mothers in their video diaries, provided valuable insights into their parenting styles and how this affected their breastfeeding experience. [ABSTRACT FROM AUTHOR]

Background: Healthcare providers are the vital link between evidence-based policies and women receiving high quality maternity care. Explanations for suboptimal care often include poor working conditions for staff and a lack of essential supplies. Other explanations suggest that doctors, midwives and care assistants might lack essential skills or be unaware of the rights of the women for whom they care. This ethnography examined the everyday lives of maternal healthcare providers working in a tertiary maternity hospital in Kabul, Afghanistan between 2010 and 2012. The aim was to understand their notions of care, varying levels of commitment, and the obstacles and dilemmas that affected standards.Methods: The culture of care was explored through six weeks of observation, 41 background interviews, 23 semi-structured interviews with doctors, midwives and care assistants. Focus groups were held with two diverse groups of women in community settings to understand their experiences and desires regarding care in maternity hospitals. Data were analysed thematically.Results: Women related many instances of neglect, verbal abuse and demands for bribes from staff. Doctors and midwives concurred that they did not provide care as they had been taught and blamed the workload, lack of a shift system, insufficient supplies and inadequate support from management. Closer inspection revealed a complex reality where care was impeded by low levels of supplies and medicines but theft reduced them further; where staff were unfairly blamed by management but others flouted rules with impunity; and where motivated staff tried hard to work well but, when overwhelmed with the workload, admitted that they lost patience and shouted at women in childbirth. In addition there were extreme examples of both abusive and vulnerable staff.Conclusions: Providing respectful quality maternity care for women in Afghanistan requires multifaceted initiatives because the factors leading to suboptimal care or mistreatment are complex and interrelated. Standards need enforcing and abusive practices confronting to provide a supportive, facilitating environment for both staff and childbearing women. Polarized perspectives such as 'villain' or 'victim' are unhelpful as they exclude the complex realities of human behaviour and consequently limit the scope of problem solving. [ABSTRACT FROM AUTHOR]

Background: Antibiotics are standard treatment for asymptomatic and symptomatic urinary tract infections (UTIs) in pregnancy. Their overuse, however, can contribute to antimicrobial resistance (AMR) and expose the foetus to drugs that might affect its development. Preventative behaviours are currently the best option to reduce incidences of UTIs and to avoid the use of antibiotics in pregnancy. The aim of this study was to explore women's experiences of UTIs in pregnancy to develop an understanding of their concerns and to optimise and encourage behaviours that facilitate appropriate use of antibiotics.Methods: An online pregnancy forum in the United Kingdom (UK) was used to collect data on women's discussions of UTIs. A total of 202 individual threads generated by 675 different usernames were selected for analysis. The data was organised using NVivo 11® software and then analysed qualitatively using inductive thematic analysis.Results: Women's perceptions of UTIs and antibiotic use in pregnancy were driven by their pre-natal attachment to the foetus. UTIs were thought to be common and high risk in pregnancy, which meant that antibiotics were viewed as essential in the presence of suspected symptoms. The dominant view about antibiotics was that their use was safe and of little concern in pregnancy. Women reported an emotional reaction to developing a UTI. They coped by seeking information about behaviour change strategies to assist with recovery and through emotional support from the online forum.Conclusions: Women face dual risks when they experience UTIs; the risk from the infection and the risk from antibiotic treatment. Pre-natal attachment to the foetus is highlighted in the decision making process. The focus is on the shorter term risk from UTIs while undermining the longer term risks from antibiotic use, especially the risk of AMR. A balanced view needs to be presented, and evidence-based infection prevention strategies should be promoted, to women to ensure appropriate antibiotic use in pregnancy, to address the global challenge of AMR. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTIs) are common in pregnancy and account for the highest proportion of primary care antibiotic prescriptions issued to pregnant women in the UK. It is well known that antibiotic use is associated with increased antimicrobial resistance and therefore measures to minimise antibiotic use for UTI prevention have been studied. The efficacy and safety of these measures in pregnancy have not been addressed and therefore the aim of this study was to systematically review the literature to identify and evaluate potential measures to prevent UTIs in pregnant women.Methods: Ten databases (EMBASE, AMED, BNI, CINAHL, Medline, PubMed, PsycINFO, Cochrane Trials, Scopus and Science Direct) were systematically searched in July 2017 for studies reporting non-antibiotic measures to prevent UTIs in pregnancy. The terms ("urinary tract infection" or UTI or bacteriuria or cystitis) AND (prevention) AND (pregnan*) were used. The quality of the publications was appraised using the Critical Appraisal Skills Programme (CASP) checklists for cohort study, case-control study and randomised controlled trial. The results were synthesised using a textual narrative approach.Results: Search results yielded 3276 publications and after reviewing titles and removing duplicates, 57 full text articles were assessed for eligibility and eight were included in the review. Five different approaches (hygiene measures, cranberry juice, immunisation, ascorbic acid and Canephron® N) have been identified, all of which are reported to be safe in pregnancy.Conclusion: The quality of the evidence varied considerably and only hygiene measures were supported by evidence to be recommended in practice. Future work needs to concentrate on strengthening the evidence base through improved design and reporting of studies with a focus on immunisation, ascorbic acid and Canephron® N. [ABSTRACT FROM AUTHOR]

Objective: English general practices have been facing ongoing pressures, arising from complicated health care needs and the recent pandemic. To overcome these pressures and reduce the workload of general practitioners, there have been extensive attempts to integrate pharmacists into general practices. A number of literature reviews, often systematic, have partially explored the topic of general practice-based pharmacists (GPBPs) internationally. Our aim was to further explore the employment/integration models of GPBPs and their actual activities and impact, concepts that have not been thoroughly investigated by previous reviews., Methods: Two databases were searched from inception to June 2021 for studies published in the English language. Results were independently screened by two reviewers to establish eligibility for inclusion. Original research studies, or protocols where results had not been released at the time of search, that reported on services provided by pharmacists with some sort of integration into general practices were included. The studies were analysed using narrative synthesis., Results: Searches identified 3206 studies in total, of which 75 met the inclusion criteria. The included studies were highly heterogeneous in terms of participants involved and methodologies employed. Integration of pharmacists into general practices has occurred in several countries, with funds originating from multiple sources. Several employment models for GPBPs were described - for example, part-time and full-time work and/or coverage of multiple or single practices. GPBP activities, with some exceptions, were comparable between different countries, with medication reviews being the most common task globally. GPBP impact was identified through both observational and/or interventional research methods, by pursuing a large variety of measures (e.g. activity volume, contact with patients, perceptions/experiences, and patient outcomes). Independent, quantifiable outcomes from GPBP activities were all positive but were of varying statistical significance., Conclusions: Our findings suggest that GPBP services can lead to positive, quantifiable outcomes, mainly in relation to medication use. This shows the usefulness of GPBP services. The findings of this review can help policy makers decide how best to implement and fund GPBP services, and how to identify and measure GPBP impact., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Variable rate intravenous insulin infusions (VRIIIs) are widely used to treat elevated blood glucose (BG) in adult inpatients who are severely ill and/or will miss more than one meal. VRIIIs can cause serious harm to the patient if used incorrectly. Recent safety initiatives have embraced the Resilient Health Care (RHC) approach to safety by understanding how VRIIIs are expected to be used (Work as Imagined, 'WAI') and how it is actually used in everyday clinical care (Work as Done, 'WAD')., Objectives: To systematically compare WAI and WAD and analyse adaptations used in situ to develop a model explaining VRIII use., Methods: A qualitative observational study video-recording healthcare practitioners using VRIII. The video data were transcribed and inductively coded to develop a hierarchical task analysis (HTA) to represent WAD. This HTA was compared with a HTA previously developed to represent WAI. The comparison output was used to develop a model of VRIII use., Results: While many of the tasks in the WAD HTA were aligned with the tasks presented in the WAI HTA, some important ones did not. When misalignment was observed, permanent adaptations (e.g. signing as a witness for a changed VRIII's rate without independently verifying whether the new rate was appropriate) and temporary workarounds (e.g. not administering intermediate-acting insulin analogues although the intermediate-acting insulin prescription was not suspended) were the most frequently observed adaptations. The comparison between WAI and WAD assisted in developing a model of VRIII use. The model shed light on strategies used to imagine everyday work (e.g. incident reports, VRIII guidelines), how everyday work was accomplished (e.g. context-dependent adaptations) and how these contributed to both successful and unsuccessful outcomes., Conclusions: This study provided in-depth understanding of the tasks required while using VRIIIs, and responses and adaptations needed to achieve safer care in a complex environment., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Hypertensive disorders are a leading cause of mortality and morbidity during pregnancy. Despite multiple national and international clinical guidelines and a plethora of research in the field of optimising management, there has been limited research describing the perspectives and experiences of pregnant women with the management of hypertensive disorders of pregnancy (HDP). Understanding these perceptions and experiences is imperative to the optimisation of HDP management., Methods: A qualitative study involving face-to-face, in-depth interviews were undertaken with 27 pregnant women diagnosed with and being treated for HDP to explore their perspectives of and experiences with clinical management. Written consent was obtained individually from each participant, and the interviews ranged from 16 to 54 min. Inductive codes were generated systematically for the entire data set. Line-by-line analysis was then performed and nodes were created within NVivo, a qualitative data management software. Data collection was continued until thematic saturation was reached. Thematic analysis was employed to interpret the data., Results: Three major descriptive themes were discerned regarding the women's perspectives on and experiences with the management of HDP: attitudes towards monitoring of HDP, attitudes and perceptions towards development and management of complications, and perceptions of pregnant women with chronic hypertension. Trust in the hospital system, positive attitudes towards close blood pressure monitoring as well as self-monitoring of blood pressure, and a realistic approach to emergency antenatal hospital admissions contributed to a positive attitude towards monitoring of HDP. Women with prior experiences of HDP complications, including pre-eclampsia, were more confident in their clinical management and knew what to expect. Those without prior experience were often in shock when they developed pre-eclampsia. Some women with chronic hypertension displayed limited understanding of the potential risks that they may experience during pregnancy and thus lacked comprehension of the seriousness of the condition., Conclusions: The clinical management experiences of pregnant women with HDP were varied. Many women did not feel that they were well informed of management decisions and had a desire to be more informed and involved in decision-making. Clear, concise information about various facets of HDP management including blood pressure monitoring, prescription of the appropriate antihypertensive agent, and planning for potential early delivery are required., (© 2021. The Author(s).)

Objective: The overall aim of this study was to examine, among individuals living with severe asthma, the role of perceived competence in achieving their goals., Methods: Qualitative research methods were used to conduct in-depth semistructured interviews. Interviews were video and/or audio recorded, transcribed and analyzed inductively and deductively, informed by the self-determination theory construct of perceived competence. Thirty-six face-to-face interviews, lasting 1.5-4 h, were conducted across Australia., Results: Feeling competent to achieve asthma goals played a role in participants' ability to achieve broader goals. Their desire to achieve their broader goals was strongly driven by their perceived ability to master managing their condition, which at times required more than medical strategies. Two main themes were discerned from the analysis: (1) learning how to look after yourself: self-care is important and (2) reaching an agreement with severe asthma: being at one with the illness., Discussion: This study highlighted the influence of perceived competence on self-management and goal achievement in severe asthma. Healthcare providers could explore patients' perceived competence to set and achieve goals, as a self-management strategy. Future research should consider these findings when developing and implementing patient-driven, self-management interventions for those living with severe asthma.