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BACKGROUND: The management of psoriasis by general practitioners (GPs) is vital, given its prevalence, chronicity, and associated physical and psychosocial co-morbidities. However, there is little information on how GPs (including early-career GPs) manage psoriasis. OBJECTIVES: This study assessed the frequency with which Australian specialist GP vocational trainees ('registrars') provide psoriasis care and the associations of that clinical experience. METHODS: A cross-sectional analysis was done of data from the ReCEnT study, an ongoing multi-site cohort study of Australian GP registrars' experiences during vocational training. In ReCEnT, 60 consecutive consultations are recorded 3 times (6-monthly) during each registrar's training. The outcome factor for this analysis was a problem/diagnosis being psoriasis, and independent variables were related to registrar, patient, practice and consultation factors. This study analysed 17 rounds of data collection (2010-2017) using univariate and multivariable regression. RESULTS: Data from 1,741 registrars regarding 241,888 consultations and 377,980 problems/diagnoses were analysed. Psoriasis comprised 0.15% (n=550) of all problems/diagnoses (95% CI, 0.13-0.16). Significant patient multivariable associations of a problem/diagnosis being psoriasis included age, gender, being new to a practice or a registrar, and psoriasis being an existing problem rather than a new diagnosis. Significant registrar associations included seeking in-consultation information/assistance, not scheduling a follow-up appointment, prescribing medication, and generating learning goals. CONCLUSIONS: Australian registrars have modest training exposure to psoriasis and may find psoriasis management challenging. Furthermore, continuity of care (essential for optimal chronic disease management) was modest. The findings have implications for GPs' approaches to the management of psoriasis more widely as well for general practice education and training policies.
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OBJECTIVE: To report a successful case of cochlear implantation and auditory training for the improvement of sound localization in a patient with single-sided deafness. STUDY DESIGN: Case report and literature review. SETTING: Tertiary referral otology practice. PATIENT: Fifty-seven-year-old man receiving cochlear implantation after 8 years of unilateral sensorineural hearing loss. INTERVENTION: Initially, CROS hearing aid, then osseointegrated bone conduction system and finally cochlear implantation and auditory training. MAIN OUTCOME MEASURES: Sound localization tests. RESULT: Sound localization tests after CI and auditory training showed improvement when compared with testing performed after fitting of an osseointegrated bone conduction system. CONCLUSION: Cochlear implantation followed by 3 months of auditory training may have improved sound localization in this patient with single-sided deafness. Further case-controlled studies need to be undertaken to ascertain whether CI alone without formal auditory training will promote the same results.