More Support For GP Obstetricians In Rural Areas, Australia

The Australian Government will further improve incentives for GPs providing obstetric services in rural and remote areas.


At present, GPs in some larger rural communities who deliver 20 or more babies per year, or GPs in smaller communities who meet the obstetric requirements of their community, are eligible for an annual bonus procedural payment under the Government's Practice Incentive Program.


The bonus was significantly increased earlier this year. It is comprised of an incentive payment of up to $17,000 per year, with an additional loading depending on rurality. In total these doctors can receive up to $25,500 per annum.


The Government has decided to again improve eligibility by including another category of those GPs who are fully participating in the obstetric roster of the local community. This means that those GPs who may not meet the requirement of delivering 20 babies per year, but are fully involved in the local obstetric roster, may be eligible for a payment.


This change will help maintain access to obstetric services for rural and regional women.


Details about the qualification criteria and payment level will be finalised in consultation with the profession. Information will be provided to rural and remote GPs in the near future.


www.health.au

Persistent Genital Arousal In Women, Doctors Uncover New Syndrome

Doctors have identified a new sexual condition affecting women. Tentatively labelled Persistent Sexual Arousal Syndrome, its primary symptom is relatively constant, unrelieved feelings of genital arousal in the absence of genuine sexual interest or desire.


Writing in the International Journal of STD & AIDS [published by the Royal Society of Medicine], David Goldmeier and Sandra Leiblum said PSAS in women had been unrecognised until now.


"Persistent sexual arousal syndrome occurs when a woman becomes involuntarily aroused for extended periods of time in the absence of sexual desire," said Dr Goldmeier.


"This genital arousal is highly distressing as it is unprovoked and unrelieved by orgasm," he said.


The study said it was unclear what the causes of PSAS were although a link to antidepressants has not been ruled out. Clinical observations of the condition have found evidence of engorgement and oedema of the labia, vulva and clitoris.


"Due to the reluctance of women to come forward we are unsure how common the problem is," said Dr Goldmeier.



"Many women feel embarrassed to talk about the symptoms and those that have come forward have reported a high degree of distress and even sometimes, suicidal thoughts," he said.


A recent internet survey by Dr Leiblum suggests women with PSAS come from a range of backgrounds and age groups.


"Much remains to be elucidated in regard to PSAS including its prevalence, aetiology and management," they write.


"It deserves continued research not only since it is such a distressing and perplexing condition, but also because understanding its aetiology and treatment may lead to greater understanding of other aspects of female sexual response."


Although there is no specific therapy to treat PSAS, Dr Goldmeier has been working with affected women in the UK.


"It is critical that we raise awareness of persistent sexual arousal syndrome amongst clinicians and the general population," said Dr Goldmeier.


"Women should not feel marginalised by this condition and I urge them to seek assistance," he said.


Persistent genital arousal in women - a new syndrome entity [PDF 45k]


'Persistent genital arousal in women - a new syndrome entity' by D Goldmeier and S Leiblum is published in the April issue (Vol. 17) of the International Journal of STD and AIDS.


IJSA is published monthly by the Royal Society of Medicine. Its Editor is Professor Wallace Dinsmore.


ROYAL SOCIETY OF MEDICINE

New Findings May Change The Way Heart Disease Is Detected And Treated In Women, From The 'Harvard Women's Health Watch'

Results of a landmark study
suggest that many women with heart disease don't get a proper diagnosis
because they have a form of the disease that doesn't show up on the usual
diagnostic tests. The new research shows that heart disease is not one but
several disorders and may shed light on why heart disease often behaves
differently in men and women, according to the February 2007 issue of
"Harvard Women's Health Watch."


In the Women's Ischemia Syndrome Evaluation (WISE) study, women with
chronic chest pain underwent standard diagnostic procedures, including
stress tests and coronary angiograms. Earlier studies had found that among
people who show signs of trouble on stress tests, women are far more likely
than men to appear free of blockages on follow-up angiograms. This was also
true in the WISE study. But newer tests, including ultrasound of the blood
vessels, revealed heart problems the angiograms didn't pick up. Many of
these women had a condition called vascular dysfunction, in which the blood
vessels supplying the heart don't expand properly to accommodate increased
blood flow. Vascular dysfunction may affect not only the large coronary
arteries, but also the smaller vessels that serve the heart -- a problem
dubbed microvessel disease.



The WISE results may help explain why women with heart disease are
often underdiagnosed and undertreated. In men, the main problem may be a
blockage in a large coronary artery, which shows up on an angiogram, while
women are more likely to have microvessel disease that can't be seen. With
this in mind, the WISE investigators are working to develop a new system
for screening women for heart disease.



Harvard Health Publications

health.harvard.edu/women

For African-American Women On Hemodialysis, Social Support, Psychological Factors Contribute To Fatigue

African Americans account for approximately 32% of patients diagnosed with ESRD, more than any other racial group in America. While fatigue is a common side effect for ESRD patients, studies have not explored factors contributing to fatigue, especially among African American women with ESRD. In the November-December 2007 issue of Nephrology Nursing Journal, Amy G. Williams, MSN, RN, and co-authors explored physiologic (anemia, uremic malnutrition), psychological (mood disorders) and situational factors (social support) contributing to fatigue in this group in hopes of developing life-improving interventions.



The authors found a correlation between social support and uremic malnutrition; this lack of support can lead to noncompliance in dietary requirements, which in turn leads to fatigue. In addition, Williams and co-authors found correlations between anxiety, depression and fatigue.



The authors recommend further research examining the effect of social support and psychological factors on fatigue. For nephrology nurses, understanding the causes of fatigue in African American Women on hemodialysis will help focus assessments and individualized care plans for this patient population.


Fatigue in African American Women on Hemodialysis
Amy G. Williams, MSN, RN; Patricia B. Crane, PhD, RN, FAHA; Daria Kring, MSN, RN, BC
Nephrology Nursing Journal; November-December 2007
annanurse/journal



Nephrology Nursing Journal is a refereed clinical and scientific resource that provides current information on a wide variety of subjects to facilitate the practice of professional nephrology nursing. Its purpose is to disseminate information on the latest advances in research, practice, and education to nephrology nurses to positively influence the quality of care they provide. For more information, visit annanurse/journal.