Professor Meredith Temple-Smith is the Director of Research Training in the Department of General Practice. Primarily a qualitative researcher, her interests centre on sexual health, hepatitis C, and health services research. She has written or co-written over 100 peer-reviewed publications and two books, and edited three books, used as texts. Address: Victoria, Australia
Miscarriage can cause significant psychological morbidity. Women frequently report dissatisfactio... more Miscarriage can cause significant psychological morbidity. Women frequently report dissatisfaction with healthcare professionals’ support following miscarriage. This pilot study aimed to explore the views and practices of GPs in providing emotional support to women experiencing miscarriage. Eight GPs participated in semi-structured interviews. GPs considered women’s physical care their top priority at the time of miscarriage; however, acknowledged miscarriage could result in significant emotional sequelae. Most GPs felt it was their role to provide emotional support, including expressing empathy, listening and normalising miscarriage to mitigate guilt and self-blame. GPs preferred an individualised approach to emotional support and mostly offered follow-up appointments if a patient requested it or was considered ‘high risk’ for mental health issues. Some GPs believed miscarriage support was within the scope of primary care practice; however, others felt it was the role of social networks and pregnancy loss support organisations. GPs identified several structural and external barriers that precluded enhanced emotional support. Further tools and resources to enhance support care may be of benefit to some GPs. The feasibility of GPs providing follow-up support remains uncertain. Further research is required to determine whether support is best placed within primary care or better served through external organisations.
Background The majority of research on patient-delivered partner therapy (PDPT) has focused on it... more Background The majority of research on patient-delivered partner therapy (PDPT) has focused on its impact on reinfections. This study aimed to systematically review the evidence regarding the acceptability of PDPT by patients and partners for chlamydia infection. Methods Three electronic databases were searched in March 2019 using terms related to PDPT. Studies were included if they reported on patient or partner acceptance of PDPT for chlamydia and were conducted in high-income countries. Actual and perceived acceptabilities of PDPT were assessed. Results Thirty-three studies were included: 24 quantitative, 3 qualitative, and 6 mixed methods. Most were clinic based. Quantitative data showed that participants' perceived willingness to give PDPT to their partner(s) ranged from 44.7% to 96.3% (median, 84%), and 24% to 71% (median, 65%) of people who offered PDPT for their partner(s) accepted it. Partners' perceived willingness to accept ranged from 42.7% to 67% (median, 62%), and actual acceptance ranged from 44.7% to 80% (median, 77%). Those in longer-term relationships were generally more likely to accept PDPT; however, beyond this, we identified few clear trends. Qualitative studies found that convenience of PDPT and assurance of partner treatment were benefits, whereas partners not seeing a health care professional was viewed as a downside. Packaging that appeared legitimate and coaching on delivering PDPT were facilitators. Conclusions Because patients bear responsibility for the success of PDPT, this information is crucial in clinical settings. Acceptance, perceived and real, of PDPT was generally high. Patients are best placed to determine whether PDPT is appropriate for them, and it should be offered as an option.
Objective: The aim of this pilot study was to identify barriers to the taking of a sexual history... more Objective: The aim of this pilot study was to identify barriers to the taking of a sexual history in general practice. Method: In order to canvass the widest range of opinion on this sensitive issue, focus groups of 4-8 general practitioners (GPs) were conducted using a GP facilitator. Groups shared one of the following common interests - considerable experience in sexual history taking, an interest in sexuality, large numbers of patients from a non-English speaking background, rural practice, Family Medicine Program trainee-ship or employment in a 24 hour clinic. Results: GPs identified a range of barriers including lack of time, fear of intrusion, age and sex of both GP and patient, fear of inadequacy, patient's offending behaviours, cultural differences (ethnic, gay and youth) and the presence of a third party. Conclusion: To improve sexual history taking GPs may need assistance in the following areas: education about the range of sexual practices; initiation of a sexual history with both old and new patients; understanding how to deal with their own discomfort and in the use of appropriate and non-judgmental language. GPs need knowledge of resources for further information and referral. Recommendations regarding the minimum strategy for inclusion of a sexual history as part of a standard consultation are made.
Miscarriage occurs in one in four pregnancies in Australia and commonly results in adverse psycho... more Miscarriage occurs in one in four pregnancies in Australia and commonly results in adverse psychosocial sequelae, such as clinically significant levels of depression and anxiety. Women also commonly report a lack of support, understanding and acknowledgement of their loss. Research has shown that poor health care support experiences serve to exacerbate adverse psychosocial outcomes. This study explored the support experiences of women affected by miscarriage and their views on what support is needed, when it is needed and who should provide it, as well as their recommendations for improvement. Sixteen Australian women were purposively sampled to participate in qualitative semi-structured interviews. Interview data was analysed using content analysis. Approximately half the women reported positive experiences with healthcare providers, but, despite this, almost all pointed to areas where support was lacking. Insensitive comments and lack of emotional awareness were common. Participants suggested areas for increased clinician support, including mentioning the possibility of miscarriage earlier in routine pregnancies, offering more information before and at the time of miscarriage, providing emotionally sensitive care and offering follow up and psychological support. Women wanted healthcare providers to be proactive in offering support, information and emotionally sensitive care at the time of miscarriage, rather than having to seek it out themselves. Suggestions to improve support after miscarriage included mentioning the possibility of miscarriage earlier, offering more information about miscarriage and psychological support options.
The long-term health consequences of untreated chlamydia are an increased risk of pelvic inflamma... more The long-term health consequences of untreated chlamydia are an increased risk of pelvic inflammatory disease, ectopic pregnancies and infertility among women. To support increased chlamydia testing, and as part of a randomised controlled trial of a chlamydia intervention in general practice, a chlamydia education and training program for general practice nurses (GPN) was developed. The training aimed to increase GPNs' chlamydia knowledge and management skills. We compared the difference in chlamydia testing between general practices where GPNs received training to those who didn't and evaluated acceptability. Testing rates increased in all general practices over time. Where GPNs had training, chlamydia testing rates increased (from 8.3% to 19.9% (difference=11.6%; 95% CI 9.4-13.8)) and where GPNs did not have training (from 7.4% to 18.0% (difference=10.6%; 95% CI 7.6-13.6)). By year 2, significantly higher testing rates were seen in practices where GPNs had training (treatment effect=4.9% (1.1 - 8.7)), but this difference was not maintained in year 3 (treatment effect=1.2% (-2.5 - 4.9)). Results suggest a GPN chlamydia education and training program can increase chlamydia testing up to 2 years; however, further training is required to sustain the increase beyond that time.
We report the development of a strategy for obtaining a truly voluntary and informed consent for ... more We report the development of a strategy for obtaining a truly voluntary and informed consent for sexual and reproductive health (SRH) research with Burma-born refugees settled in Australia. Using a qualitative descriptive research design, we interviewed 29 providers of refugee services (PRS) including health care professionals (doctors, nurses, midwives), bilingual supporting staff (interpreters, social workers, settlement workers, community liaison officers) and administrative staff (practice managers, reception staff) who provide primary care services to refugees. Interviews were audio recorded, transcribed, and subjected to thematic analysis. Four themes emerged: (a) unique values of Burma-born people, (b) unfamiliarity with Western concepts of research, (c) usefulness of individual consent discussions with potential participants, and (d) need for verification of voluntary participation prior to research interview. Results were used to develop a three-stage process of research co...
Interpreters work with health care professionals to overcome language challenges during sexual an... more Interpreters work with health care professionals to overcome language challenges during sexual and reproductive (SRH) health discussions with people from refugee backgrounds. Disclosures of traumatic refugee journeys and sexual assault combined with refugees’ unfamiliarity with Western health concepts and service provision can increase the interpreting challenges. Published literature provides general guidance on working with interpreters in primary care but few studies focus on interpretation in refugee SRH consults. To address this, we explored the challenges faced by providers of refugee services (PRS) during interpreter mediated SRH consultations with Burma born refugees post settlement in Australia. We used qualitative methodology and interviewed 29 PRS involved with migrants from Burma including general practitioners, nurses, interpreters, bilingual social workers, and administrative staff. The interviews were audio-recorded, transcribed, and subjected to thematic analysis fol...
The focus of this report is on low-urgency paediatric presentations to hospital emergency departm... more The focus of this report is on low-urgency paediatric presentations to hospital emergency departments which could potentially be managed in primary care. The report explores the current available Australian data and evidence on the reasons parents take their children aged 0-9 years with low urgency conditions to emergency, and describes services and models which would need to be in place to reduce rates of such presentaitons
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2020
BackgroundDespite increasing numbers of labiaplasties being performed, there is little quantitati... more BackgroundDespite increasing numbers of labiaplasties being performed, there is little quantitative information on normal labial diversity to guide medical education, patient education and surgical treatment.AimThis scoping review will determine what is known in the published literature about the anatomical basis of normal for labia and female genital cosmetic surgery (FCGS).Materials and methodsThe scoping review identified ten population‐based studies that recorded labial dimensions by searching three electronic databases utilising a Preferred Reporting Items for Systematic Reviews and Meta‐Analyses search strategy. Strict inclusion and exclusion criteria were applied and then reference lists were scrutinised until no further articles that met the criteria were located.ResultsThese studies showed significant variation in labial length (range 5–100 mm) and width (range 1–60 mm). Labia minora were wider in pre‐menopausal women than in post‐menopausal women, protruding labia minora w...
BACKGROUND Schools are the primary setting for the delivery of adolescent HPV vaccination in Aust... more BACKGROUND Schools are the primary setting for the delivery of adolescent HPV vaccination in Australia. Although this strategy has achieved generally high vaccination coverage, gaps persist for reasons that are mostly unknown. This study sought to identify school-level correlates of low vaccination course initiation and completion in New South Wales, Tasmania, and Western Australia to inform initiatives to increase uptake. METHODS Initiation was defined as the number of first doses given in a school in 2016 divided by vaccine-eligible student enrolments. Completion was the number of third doses given in a school in 2015-2016 divided by the number of first doses. Low initiation and completion were defined as coverage ≤ 25thpercentile of all reporting schools. We investigated correlations between covariates using Spearman's rank correlation coefficients. Due to multicollinearity, we used univariable logistic regression to investigate associations between school characteristics and low coverage. RESULTS Median initiation was 84.7% (IQR: 75.0%-90.4%) across 1,286 schools and median completion was 93.8% (IQR: 86.0%-97.3%) across 1,295 schools. There were strong correlations between a number of school characteristics, particularly higher Indigenous student enrolments and lower attendance, increasing remoteness, higher postcode socioeconomic disadvantage, and smaller school size. Characteristics most strongly associated with low initiation in univariate analyses were small school size, location in Tasmania, and schools catering for special educational needs. Low completion was most strongly associated with schools in Tasmania and Western Australia, remote location, small size, high proportion of Indigenous student enrolments, and low attendance rates. CONCLUSION This study provides indicative evidence that characteristics of schools and school populations are associated with the likelihood of low initiation and completion of the HPV vaccination course. The findings will guide further research and help target initiatives to improve vaccination uptake in schools with profiles associated with lower coverage.
BackgroundUrinary tract infections (UTIs) are common in young pre-continent children, but collect... more BackgroundUrinary tract infections (UTIs) are common in young pre-continent children, but collecting urine samples is challenging. Collection methods all have limitations and international guidelines have conflicting recommendations. Choice of method must balance time, resources, invasiveness, reliability, and contamination. Evidence from primary care clinicians is limited regarding barriers and enablers to sample collection, and what factors inform the choice and use of different sample collection methods.AimTo understand the barriers and enablers to collecting urine samples from young pre-continent children in primary care.Design & settingAn exploratory qualitative study performed in primary care in Australia.MethodSemi-structured interviews explored the topic of collecting a urine sample from a child aged 6 months who presented with a fever. The interviews were undertaken with 21 GPs and four practice nurses (PNs) until data saturation was reached. Interviews were audiorecorded, ...
BackgroundMany older adults are sexually active, and STIs are rising amongst this cohort. In prim... more BackgroundMany older adults are sexually active, and STIs are rising amongst this cohort. In primary care, sexual health discussions are limited as health‐care practitioners commonly assume older patients aged 60+ are not sexually active or are unwilling to discuss sex. Studies have either examined patient or clinician views, but not both.ObjectiveThis study investigates sexual health discussions in general practice. It is unique in that it sought perspectives of different groups: older patients, health‐care professionals and key informants.ResultsQualitative interviews revealed that older patients expect clinicians to bring up sexual concerns, whereas clinicians prefer older patients to do so. A simple electronic solution to circumvent this impasse was suggested and discussed.ConclusionsOlder adults would like to discuss sexual concerns with their health‐care providers. Given the rising rates of STIs in later life, sexual health discussions with older patients must become part of r...
Miscarriage can cause significant psychological morbidity. Women frequently report dissatisfactio... more Miscarriage can cause significant psychological morbidity. Women frequently report dissatisfaction with healthcare professionals’ support following miscarriage. This pilot study aimed to explore the views and practices of GPs in providing emotional support to women experiencing miscarriage. Eight GPs participated in semi-structured interviews. GPs considered women’s physical care their top priority at the time of miscarriage; however, acknowledged miscarriage could result in significant emotional sequelae. Most GPs felt it was their role to provide emotional support, including expressing empathy, listening and normalising miscarriage to mitigate guilt and self-blame. GPs preferred an individualised approach to emotional support and mostly offered follow-up appointments if a patient requested it or was considered ‘high risk’ for mental health issues. Some GPs believed miscarriage support was within the scope of primary care practice; however, others felt it was the role of social networks and pregnancy loss support organisations. GPs identified several structural and external barriers that precluded enhanced emotional support. Further tools and resources to enhance support care may be of benefit to some GPs. The feasibility of GPs providing follow-up support remains uncertain. Further research is required to determine whether support is best placed within primary care or better served through external organisations.
Background The majority of research on patient-delivered partner therapy (PDPT) has focused on it... more Background The majority of research on patient-delivered partner therapy (PDPT) has focused on its impact on reinfections. This study aimed to systematically review the evidence regarding the acceptability of PDPT by patients and partners for chlamydia infection. Methods Three electronic databases were searched in March 2019 using terms related to PDPT. Studies were included if they reported on patient or partner acceptance of PDPT for chlamydia and were conducted in high-income countries. Actual and perceived acceptabilities of PDPT were assessed. Results Thirty-three studies were included: 24 quantitative, 3 qualitative, and 6 mixed methods. Most were clinic based. Quantitative data showed that participants' perceived willingness to give PDPT to their partner(s) ranged from 44.7% to 96.3% (median, 84%), and 24% to 71% (median, 65%) of people who offered PDPT for their partner(s) accepted it. Partners' perceived willingness to accept ranged from 42.7% to 67% (median, 62%), and actual acceptance ranged from 44.7% to 80% (median, 77%). Those in longer-term relationships were generally more likely to accept PDPT; however, beyond this, we identified few clear trends. Qualitative studies found that convenience of PDPT and assurance of partner treatment were benefits, whereas partners not seeing a health care professional was viewed as a downside. Packaging that appeared legitimate and coaching on delivering PDPT were facilitators. Conclusions Because patients bear responsibility for the success of PDPT, this information is crucial in clinical settings. Acceptance, perceived and real, of PDPT was generally high. Patients are best placed to determine whether PDPT is appropriate for them, and it should be offered as an option.
Objective: The aim of this pilot study was to identify barriers to the taking of a sexual history... more Objective: The aim of this pilot study was to identify barriers to the taking of a sexual history in general practice. Method: In order to canvass the widest range of opinion on this sensitive issue, focus groups of 4-8 general practitioners (GPs) were conducted using a GP facilitator. Groups shared one of the following common interests - considerable experience in sexual history taking, an interest in sexuality, large numbers of patients from a non-English speaking background, rural practice, Family Medicine Program trainee-ship or employment in a 24 hour clinic. Results: GPs identified a range of barriers including lack of time, fear of intrusion, age and sex of both GP and patient, fear of inadequacy, patient's offending behaviours, cultural differences (ethnic, gay and youth) and the presence of a third party. Conclusion: To improve sexual history taking GPs may need assistance in the following areas: education about the range of sexual practices; initiation of a sexual history with both old and new patients; understanding how to deal with their own discomfort and in the use of appropriate and non-judgmental language. GPs need knowledge of resources for further information and referral. Recommendations regarding the minimum strategy for inclusion of a sexual history as part of a standard consultation are made.
Miscarriage occurs in one in four pregnancies in Australia and commonly results in adverse psycho... more Miscarriage occurs in one in four pregnancies in Australia and commonly results in adverse psychosocial sequelae, such as clinically significant levels of depression and anxiety. Women also commonly report a lack of support, understanding and acknowledgement of their loss. Research has shown that poor health care support experiences serve to exacerbate adverse psychosocial outcomes. This study explored the support experiences of women affected by miscarriage and their views on what support is needed, when it is needed and who should provide it, as well as their recommendations for improvement. Sixteen Australian women were purposively sampled to participate in qualitative semi-structured interviews. Interview data was analysed using content analysis. Approximately half the women reported positive experiences with healthcare providers, but, despite this, almost all pointed to areas where support was lacking. Insensitive comments and lack of emotional awareness were common. Participants suggested areas for increased clinician support, including mentioning the possibility of miscarriage earlier in routine pregnancies, offering more information before and at the time of miscarriage, providing emotionally sensitive care and offering follow up and psychological support. Women wanted healthcare providers to be proactive in offering support, information and emotionally sensitive care at the time of miscarriage, rather than having to seek it out themselves. Suggestions to improve support after miscarriage included mentioning the possibility of miscarriage earlier, offering more information about miscarriage and psychological support options.
The long-term health consequences of untreated chlamydia are an increased risk of pelvic inflamma... more The long-term health consequences of untreated chlamydia are an increased risk of pelvic inflammatory disease, ectopic pregnancies and infertility among women. To support increased chlamydia testing, and as part of a randomised controlled trial of a chlamydia intervention in general practice, a chlamydia education and training program for general practice nurses (GPN) was developed. The training aimed to increase GPNs' chlamydia knowledge and management skills. We compared the difference in chlamydia testing between general practices where GPNs received training to those who didn't and evaluated acceptability. Testing rates increased in all general practices over time. Where GPNs had training, chlamydia testing rates increased (from 8.3% to 19.9% (difference=11.6%; 95% CI 9.4-13.8)) and where GPNs did not have training (from 7.4% to 18.0% (difference=10.6%; 95% CI 7.6-13.6)). By year 2, significantly higher testing rates were seen in practices where GPNs had training (treatment effect=4.9% (1.1 - 8.7)), but this difference was not maintained in year 3 (treatment effect=1.2% (-2.5 - 4.9)). Results suggest a GPN chlamydia education and training program can increase chlamydia testing up to 2 years; however, further training is required to sustain the increase beyond that time.
We report the development of a strategy for obtaining a truly voluntary and informed consent for ... more We report the development of a strategy for obtaining a truly voluntary and informed consent for sexual and reproductive health (SRH) research with Burma-born refugees settled in Australia. Using a qualitative descriptive research design, we interviewed 29 providers of refugee services (PRS) including health care professionals (doctors, nurses, midwives), bilingual supporting staff (interpreters, social workers, settlement workers, community liaison officers) and administrative staff (practice managers, reception staff) who provide primary care services to refugees. Interviews were audio recorded, transcribed, and subjected to thematic analysis. Four themes emerged: (a) unique values of Burma-born people, (b) unfamiliarity with Western concepts of research, (c) usefulness of individual consent discussions with potential participants, and (d) need for verification of voluntary participation prior to research interview. Results were used to develop a three-stage process of research co...
Interpreters work with health care professionals to overcome language challenges during sexual an... more Interpreters work with health care professionals to overcome language challenges during sexual and reproductive (SRH) health discussions with people from refugee backgrounds. Disclosures of traumatic refugee journeys and sexual assault combined with refugees’ unfamiliarity with Western health concepts and service provision can increase the interpreting challenges. Published literature provides general guidance on working with interpreters in primary care but few studies focus on interpretation in refugee SRH consults. To address this, we explored the challenges faced by providers of refugee services (PRS) during interpreter mediated SRH consultations with Burma born refugees post settlement in Australia. We used qualitative methodology and interviewed 29 PRS involved with migrants from Burma including general practitioners, nurses, interpreters, bilingual social workers, and administrative staff. The interviews were audio-recorded, transcribed, and subjected to thematic analysis fol...
The focus of this report is on low-urgency paediatric presentations to hospital emergency departm... more The focus of this report is on low-urgency paediatric presentations to hospital emergency departments which could potentially be managed in primary care. The report explores the current available Australian data and evidence on the reasons parents take their children aged 0-9 years with low urgency conditions to emergency, and describes services and models which would need to be in place to reduce rates of such presentaitons
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2020
BackgroundDespite increasing numbers of labiaplasties being performed, there is little quantitati... more BackgroundDespite increasing numbers of labiaplasties being performed, there is little quantitative information on normal labial diversity to guide medical education, patient education and surgical treatment.AimThis scoping review will determine what is known in the published literature about the anatomical basis of normal for labia and female genital cosmetic surgery (FCGS).Materials and methodsThe scoping review identified ten population‐based studies that recorded labial dimensions by searching three electronic databases utilising a Preferred Reporting Items for Systematic Reviews and Meta‐Analyses search strategy. Strict inclusion and exclusion criteria were applied and then reference lists were scrutinised until no further articles that met the criteria were located.ResultsThese studies showed significant variation in labial length (range 5–100 mm) and width (range 1–60 mm). Labia minora were wider in pre‐menopausal women than in post‐menopausal women, protruding labia minora w...
BACKGROUND Schools are the primary setting for the delivery of adolescent HPV vaccination in Aust... more BACKGROUND Schools are the primary setting for the delivery of adolescent HPV vaccination in Australia. Although this strategy has achieved generally high vaccination coverage, gaps persist for reasons that are mostly unknown. This study sought to identify school-level correlates of low vaccination course initiation and completion in New South Wales, Tasmania, and Western Australia to inform initiatives to increase uptake. METHODS Initiation was defined as the number of first doses given in a school in 2016 divided by vaccine-eligible student enrolments. Completion was the number of third doses given in a school in 2015-2016 divided by the number of first doses. Low initiation and completion were defined as coverage ≤ 25thpercentile of all reporting schools. We investigated correlations between covariates using Spearman's rank correlation coefficients. Due to multicollinearity, we used univariable logistic regression to investigate associations between school characteristics and low coverage. RESULTS Median initiation was 84.7% (IQR: 75.0%-90.4%) across 1,286 schools and median completion was 93.8% (IQR: 86.0%-97.3%) across 1,295 schools. There were strong correlations between a number of school characteristics, particularly higher Indigenous student enrolments and lower attendance, increasing remoteness, higher postcode socioeconomic disadvantage, and smaller school size. Characteristics most strongly associated with low initiation in univariate analyses were small school size, location in Tasmania, and schools catering for special educational needs. Low completion was most strongly associated with schools in Tasmania and Western Australia, remote location, small size, high proportion of Indigenous student enrolments, and low attendance rates. CONCLUSION This study provides indicative evidence that characteristics of schools and school populations are associated with the likelihood of low initiation and completion of the HPV vaccination course. The findings will guide further research and help target initiatives to improve vaccination uptake in schools with profiles associated with lower coverage.
BackgroundUrinary tract infections (UTIs) are common in young pre-continent children, but collect... more BackgroundUrinary tract infections (UTIs) are common in young pre-continent children, but collecting urine samples is challenging. Collection methods all have limitations and international guidelines have conflicting recommendations. Choice of method must balance time, resources, invasiveness, reliability, and contamination. Evidence from primary care clinicians is limited regarding barriers and enablers to sample collection, and what factors inform the choice and use of different sample collection methods.AimTo understand the barriers and enablers to collecting urine samples from young pre-continent children in primary care.Design & settingAn exploratory qualitative study performed in primary care in Australia.MethodSemi-structured interviews explored the topic of collecting a urine sample from a child aged 6 months who presented with a fever. The interviews were undertaken with 21 GPs and four practice nurses (PNs) until data saturation was reached. Interviews were audiorecorded, ...
BackgroundMany older adults are sexually active, and STIs are rising amongst this cohort. In prim... more BackgroundMany older adults are sexually active, and STIs are rising amongst this cohort. In primary care, sexual health discussions are limited as health‐care practitioners commonly assume older patients aged 60+ are not sexually active or are unwilling to discuss sex. Studies have either examined patient or clinician views, but not both.ObjectiveThis study investigates sexual health discussions in general practice. It is unique in that it sought perspectives of different groups: older patients, health‐care professionals and key informants.ResultsQualitative interviews revealed that older patients expect clinicians to bring up sexual concerns, whereas clinicians prefer older patients to do so. A simple electronic solution to circumvent this impasse was suggested and discussed.ConclusionsOlder adults would like to discuss sexual concerns with their health‐care providers. Given the rising rates of STIs in later life, sexual health discussions with older patients must become part of r...
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Papers by Meredith Temple-Smith