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Instructions (apply to Assignment 1 & 2) •Each assignment should be 2000 words •Select a patient that has interested you because you were not sure of the best way to diagnose or manage them •Describe the clinical presentation (history, physical examination, investigations) •Consider the setting in which this patient has presented (include the epidemiology of the symptoms/disease for that setting, and the social context) •Identify a clinical issue (or possibly two, but be careful that you do not overload yourself) and construct a clinical question; refer to the PECOT framework •Check with the course co-ordinator that the clinical question is appropriate or answerable. This will be particularly important if you have not completed POPLHLTH 709: Evidence for Best Practice •Using your structured clinical question, perform a literature search of at least 2 relevant databases. describe your search terms, how you used them, the results obtained, and describe the selection criteria that you used to select relevant studies from your search. NOTE: Do not use a single paper as this is likely to be misleading – you will not be able to comment on the strength of the “body of evidence” Try to identify those articles that are most important for providing a current and evidence-based answer to your question. This is what you need to do in real life to make the best decision for your patient. Useful resources for these tasks can be found here •Summarise your findings using evidence tables if necessary, and consider the quality of the evidence that you have selected and the strength of any recommendations. The following article is a useful summary: Siwek J, et al. How to write an evidence-based clinical article review. American Family Physician 2002;65(2):251-8 •Describe how your findings are relevant to your patient’s presentation, and your clinical decision-making •Use a bibliography manager such as EndNote or RefWorks, both available from the Library. If you need help with using these, click here or ask one of the course co-ordinators. The Vancouver format for citations is definitely preferred as this is the industry standard for biomedical publications. Use of a bibliography manager makes the process of writing your assigment much easier and more accurate Instructions (apply to Assignment 1 only) Patient scenario Subjective: Saturday morning at an afterhours clinic. A 14yr old Samoan-NZ girl (P) was seen as a new patient to the afterhours clinic. She was seen with a social worker (SW) and referred by school nurse to see a doctor but there were difficulties getting seen on the Friday, hence the Saturday attendance. She had one week of burning stinging pain on urination, increased urinary frequency, lower abdominal pain, and lower back pain. No fevers, chills, rigors, or haematuria. She was seen by the school nurse last week, and her swabs returned positive for chlamydia, she says knows who she is likely to have got chlamydia from but is unwilling to disclose the partner. She has no known history of urinary tract infection (UTI) or sexually transmitted disease (STD). She has been sexually active since 13yrs and has not used any contraception Her LMP was 21/4/15. She is on no regular medications Social history She lives at home with mum, 4 sisters, 4 brothers, challenging home environment, not close to mum. From SW while patient not present, she has been under CYFs care when younger, has witnessed and been party to domestic abuse, afraid to tell mum diagnosis. Father’s whereabouts unknown. She is in Year 10 at school, signed up to play rugby at school, training twice a week plus one game per week, taking usual subjects at school, enjoys dance. Expelled from previous high school for violence, no problems since starting new school. On weekends goes out with friends Smokes 2/day, alcohol on weekends, gets alcohol from older friends, uses cannabis socially now and again, mum and older sister at home smoke cigarettes but do not know she is smoking. Sexually active for ~1 year, no regular partner. From SW: she has not been able to find out about the sexual partners No thoughts of harming herself. She does not go in cars with friends who drink alcohol. She does not attend church but Mum and younger siblings go to church. Objective: Teenage Samoan female neatly dressed and looks well. Temperature: 36.4, Heart rate, 76 BP 100/60 Dipstick MSU – leukocytes present, trace RBC. Pregnancy test negative Abdomen soft and not tender, no palpable masses, no organomegaly Lab results on report she has in her hand: Vaginal swab positive for chlamydia, negative for gonorrhoea. Your task: Briefly discuss management and develop a clinical question based on this scenario Develop an assignment based on this (management plus clinical question) When both assignments have been completed, use the second one for writing an evidence-based summary

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