Junior doctors' experience of interprofessional shadowing in a palliative care setting.

Interprofessional shadowing, whereby medical students take on the role of another profession, is an effective interprofessional education (IPE) method to promote interprofessional teamwork. Palliative care is an ideal setting for IPE as multidisciplinary teams work together to deliver holistic patient care. This brief report explores junior doctors' experiences in shadowing nurses to provide care to patients in a hospice setting in New Zealand. We conducted semi-structured interviews with six participants to find out the impact that this shadowing experience had on their professional development and feasibility of incorporating this activity into the undergraduate medical curriculum. Inductive thematic analysis revealed that shadowing a nurse for two days increased participants' awareness of the nursing role and gave them the opportunity to develop a personal relationship with their patients, both of which made participants actively reflect on the value of IPE and the way they practice medicine. Participants considered the palliative care setting as conducive to IPE and saw the value of incorporating interprofessional shadowing into the undergraduate medical curriculum.

Atrio-oesophageal fistula: an emergent complication of radiofrequency ablation.

A 72-year-old presented with features of sepsis, neurological sequelae and chest pain after a radiofrequency ablation for AF. Chest CT scan revealed a life-threatening condition not previously reported in emergency medicine journals.

Management of hypertension in the oldest old: a study in primary care in New Zealand.

BACKGROUND: The benefits of blood pressure (BP) lowering are well established except in the oldest old, and suboptimal control of hypertension has been found in many different populations. OBJECTIVE: To assess the frequency of hypertension and its adequacy of management in the oldest old in primary care. DESIGN: a cross-sectional study. SETTING: Sixty-seven general practitioners (GPs) in three urban centres in New Zealand. METHODS: We conducted structured reviews of medical records for all ambulatory people aged > or = 80 years who were registered with a participating GP. Hypertensive status and BP control were classified according to standard criteria. Logistic regression analyses were used to identify independent factors for BP control. RESULTS: Medical records of 3,068 people (mean age 85 years, 64% female) revealed 56% to be hypertensive, of whom 94% were on treatment and 58% had controlled BP levels. Major co-morbid conditions were common among hypertensive people, and half of them had associated target organ damage. Histories of stroke, heart disease and hypercholesterolaemia were independent factors for good BP control. CONCLUSION: A large proportion of the oldest old were currently receiving anti-hypertensive therapy, and most had adequately controlled BP. Previous vascular disease was the most important factor for both BP treatment and control. These findings indicate a high level of uptake of cardiovascular guidelines for older people.