Questions related to General Practice
During this time of intense pressure on general practices and local hospitals, could practitioner assistants (equivalent to F1 doctor qualification) and/or practice nurses be employed to contribute to the pharmacy environment with personal, social and therapeutic health management, including being qualified to prescribe some medications and thus be able to support pharmacists and to relieve some of the footfall in General Practices and Emergency Departments of their heavy workload?
The main hurdle to overcome would involve providing financial support to the chemist shops to enable this kind of employment. Also to consider would be the change in culture within the medical professions would be a paradigm shift in the inter professional roles that professionals play in the healthcare environment.
As our general practice in the rice field show increase in yield, and more vegetative growth, what are the constraints and prospects for its wide application and adaptation in rice, horticultural crops, and many more?
During COVID_19 Why antibiotic prescriptive rates are higher in remote consultations than during in person appointments .
Antibiotics ,Prescription,Remote consultations, COVID_19,
Dentistry being the one of the high risk profession for the COVID 19 outbreak transmission. For now we are in the lockdown period and only providing the Emergency dental treatment services with proper PPE. I would like to know the opinion regarding the Dental Practice after lockdown. Can we start our practice in normal way ? Do we need to modify the way how we do our routine dental practice?
I'm looking for a recommendation of a journal with a high word count (above 6,000 words) related to any of the following topics: public health, general practice, primary care, older adults, medications.
Thanks for your advice!
Dear Research Gate community,
I am currently attempting to install a formyl group using the Vilsmer-Haak reaction on a 2,4- substituted thiophene.
The reaction was adapted from a reference, using dry DMF and glassware. I followed the reaction by TLC and LCMS, but did not see any change after 6 h. I am currently working up the reaction. However, I am not confident in the reaction.
I did not notice any fuming of the phosphorous oxychloride upon opening the bottle. Is it general practice to distill POCl3 before use?
Are there any fields known for having an only narrow (and hence not significant) science-practice gap? Management, for instance, has been identified as a field with a rather significant gap (Banks et al, 2016) and I would be interested in counterexamples. My first guess is that in medicine, finance, marketing, or engineering, practitioners at least sometimes enthusiastically implement academic findings. I would grateful to hear about any studies in these regards.
Thanks and cheers
I expect that the question of discharge and recovery may be a contentious issue. Hopefully, the description and supplementary questions below will promote a good debate. Thank You. We all know and accept that mental health is an important part of everyone's life. We can be affected by mental health as individuals or the experience of close family and friends, peers and neighbours. At times the mental health services are involved. It appears that the medical model’s dominance and socio-political discourse, legislation and national policy [in the UK] means that once a patient always a patient is the common school of thought. Once in services it seems that discharge is ubiquitous and quixotic. It is rarely discussed or researched especially from a service user’s perspective. Once you are in the grip of services there is no way out. This may include general practice. You see your family doctor for psoriasis and the questions are focused to your mental state. Recovery is not discharge nor discharge recovery! Recovery orientation has been a part of policy [in the UK] over the past 10 years since the publication of Making Recovery a Reality. Recovery, arguably, isn’t a new model or approach, challenges the dominance of the medical model, and, the paternalistic state, and, Recovery suggests a life beyond the walls of the asylum, and life outside community services. Recovery, arguably, while debated as to a definition [personal, clinical, social, and more recently service defined recovery] personal recovery is accepted as the foundation. The supplementary questions may open up the debate and include:
• What are the barriers and influencers?
• What factors can promote or make discharge possible?
• Does recovery orientation promote discharge?
• Is the ‘danger’ recovery is an ‘excuse’ for discharge?
• Do recovery values and principles underpin change?
• Can recovery promote symbiosis at the heart of a collaborative interdependence between service providers, service providers and service users bring them together? [For example, working in partnership with social care?
All tapes that have been used to address the UH have in common that they compress and cover the umbilicus. We suggest that activating skin around the hernia and not covering the hernia at all might be a cost effective and safe alternative. Please check out this Clinical note on the subject. We are looking forward to hearing your questions and comments. Esther and Martyna
The Critical Incident Technique (or CIT) is a set of procedures used for collecting direct observations of human behavior that have critical significance and meet methodically defined criteria. These observations are then kept track of as incidents, which are then used to solve practical problems and develop broad psychological principles. A critical incident can be described as one that makes a contribution—either positively or negatively—to an activity or phenomenon. Critical incidents can be gathered in various ways, but typically respondents are asked to tell a story about an experience they have had.
Hello, I want to use the Job related affective well being scale from 1999, Paul T. Van Katwyk, Suzy Fox, Paul E. Spector, and E. Kevin Kelloway, http://shell.cas.usf.edu/~pspector/scales/jawspage.html for my master Thesis. I Need a german Version of it. On the page is the german Version from a master Thesis. Is it okay to use this items? Or am i just allowed to translate englisch items to german to use them for my work?
What is the chemical composition to be considered for Consequence modeling for heavier hydrocarbons like crude oil/Vacuum residue/Vaccum gas oil/Diesel,, etc.?
What is the general practice and referance guidelines?
I have a question regarding how researchers use the matrices from the sparse matrix marketplace(https://sparse.tamu.edu/) for solving linear systems of equations.
So given that we have to solve for x in : Ax = b
The matrices from the market are the A for the above equation. But what about the vector b? How do we decide on that? Do we just pre-select some random vector x and multiply A with it to give us the vector b, and use that vector b to recalculate x using some method (that's the focus of the researcher)? Or is it something else.
I've come across some papers where people mention the name of the matrices taken for testing and their initial guess vector x0. But I am confused as to how to they select a vector b? Is there a general practice? Or does it depend from author to author
There must be something I am missing, might be very silly, so I apologize in advance!
Some Papers for reference and example (with page numbers) :
Page 6-7 of:
Page 848 -849 of :
I want to explore if whether a patient was given a medication or not varies depending on their individual characteristics (level 1) and those of their general practice (level 2). Level 1 covariates will be for e.g. education and age while level 2 covaraites will be practice size and urban/rural location.
I anticipate that medication use will vary depending on whether it was a nurse or GP who prescribed the medication. Ideally, I would include the GPs and Nurses as level 2 nested under their practice at level 3. However, the data I am allowed to access does not include individual prescriber id's. Instead, I will just know it was a GP or Nurse who prescribed the medication. With this limited data I cannot include the GP/Nurse prescriber as a level as GP and Nurse are the only 2 options for prescribers (not a random selection of all the possible prescribers.)
Is there any way for me to include the Nurse/GP prescriber information in my model? For each practice there will be Nurses and GPs prescribing medicatons.
I have adapted a survey from another author (with permission), to ask about different methods that nurses use to obtain prescriptions in general practice and the frequency that they use them in different clinical circumstances. I have already got all my 71 responses back. I have tried to use cronbach's alpha on it but get a low score or am informed by SPSS that it couldn't perform it at all due to a negative covariance between items. I have a sneaking suspicion that as my survey has no sets of questions which measure similar things, or at least not in big enough numbers, that I can't perform a reliability analysis on it. Any suggestions on what I can do?
I want to know about the general practice of the reservoir engineering for Shale oil exploitation.
What is the basic industrial practice for the categorization of Shale Oil reserves ?
The general practice I have observed is that a student, caught for the first time, cheating in an examination has the examination paper in the subject in question cancelled. In addition the student offender is given a ‘Z’ grade which is a punishment for life meted to him/ her. Does this practice not suggest the student cannot reform? The student’s examination paper is cancelled and he/ she has to rewrite the paper. He/ she is also given a ‘Z’ for cheating in an examination, Doesn’t this practice amount to punishing the student twice? Considering the roles of Tertiary education in the lives of students in the 21st Century, should the award of ‘Z’ grade be encouraged?
Education, School discipline, Grading, Tertiary institutions
task analysis can be useful for improving preservice or in-service education or regulation of health workers.
Am trying to ascertain the burden of administrative tasks (prescription writing, referral writing, processing of letters etc) on general practice as a way of estimating how harmful errors in these processes are.
There is an elderly patient with idiopathic hypoparathyroidism. Serum calcium levels are from 6.8 to 12.1 mg/dL, and serum intact PTH levels are from 7 to 35 pg/mL. There are no calcification of basal ganglia, no metabolic problems, and no immunological problems.
“Never Events” are medical errors that should not occur if strong preventative measures exist. An example in secondary care is wrong-limb amputation. A list of "Never Events" for primary care is being researched in conjunction with clinicians. As a patient and public engagement activity, from personal experience can you think of any events that should never occur in general practice but have done so?
A local health service has recently introduced a, add on service to assist GPs in offering better service to people with chronic mental illness, after four years, there is need to determine whether that service is having desired outcomes.
In France, the prescription of benzodiazepines (BZD ) is a problem . Care for patients with chronic use is difficult. In terms of public health, it is particularly relevant to avoid this situation by prescribing these treatments wisely. A thesis carried out in 2012 resulted in the design of two brief first prescription of BZD guides , one to complaints for anxiety and the other for insomnia.
How would it be possible to assess the relevance of these guides, in actual practice conditions of general practice (GP) , knowing that the conditions of research in MG do not allow a large-scale intervention study ?
Pain scales exist for procedural pain (heelprick e.g.) or for prolonged pain (intubated babies or post-surgery). This difference should be highlighted
Intrinsic and extrinsic motivation are almost inseparable. At times they work dynamically. However, there are many examples of testing out the intrinsic motivation component in other fields, less so in healthcare. So is it possible to specifically isolate factors to measure intrinsic motivation amongst physicians?
We're looking at mapping out processes of care in the primary care setting. What should integrated care look like in General Practice? And how can we measure the extent of integration?
Patient safety reporting systems despite their limitations are great source of deriving insights into the delivery of safer care. Over the last 10 years, the national reporting and learning system has accrued over 10 million reports of patient safety incidents in England and Wales; most are from hospitals. Why does primary care especially in general practice lag behind?
This may seem like a foolish question and I admit I am a beginner, but it still baffles me how scientists can inject such tiny volumes! For example, there is a study that does the following in a nutshell:
Extract adipose tissue(liposuction)
Isolate Preadipocytes(which are in the SVF)
Inject preadipocytes intradermally into scalp of patient.
My question is simple. How do they even begin to inject such tiny amounts? After isolating the preadipocytes(SVF, which is a tiny pellet!), do they first mix it with PBS before injection? The particular study deals with regrowing hair on bald patients, so what I would like to know, is if you isolate the SVF containing preadipocytes and mix it with PBS, will that be sufficient in terms of cell number to help the bald patient? What volume of PBS would YOU mix the SVF with in this case?
They say for every 20ml's of adipose tissue, there is between 300,000 to 2 million preadipocytes(after full isolation). Would that be enough for a patients entire scalp? Or just one region such as the crown? And how much pbs would YOU mix with the preadipocytes/SVF?
PPIs may interfere with vitamin B12 absorption in food substance. Does it also interfere with oral B12 supplements? Can PPI interfere with gastric intrinsic factors secretions the same way it interferes with acid productions?
Looking at good (and bad!) examples of successful CDSS implementation in primary care/general practice
There has been recent alarm in the UK regarding a rapid increase in ED attendances which I suspect is far wider than just the UK. Any observations from elsewhere in the world?
Clinical reasoning skills are very important in primary care. Currently we use chart-stimulated recall, directly observed consultation skills, videotaped consultation and small group discussions to teach our postgraduates in family medicine. However, I would like to know other effective ways to teach clinical reasoning skills in the outpatient setting, particularly for postgraduates.
Researchers from some developing countries do not work in same conditions as their colleagues from developed countries. They could suffer from bad running rules, poor political system control, weak educational system, laboratory equipment insufficiency or inadequacy, defective laboratory’s (or institute) administration policy or leadership, etc.
A researcher from international or developed laboratory could produce much more research papers with good quality than his/her colleague from substandard laboratory.
Could we measure their research endeavor and effort with same scheme, policy and rules?
Australia is introducing a purpose built screening tool for former members of the Australian Defence Force from July 2014, with a focus on mental health as well as health risks related to specific deployments. My question is about the most successful approach to health screening for younger veterans in primary care/family medicine, e.g. self-report versus face-to-face interview; gender and profession of the interviewer. Insights from research and practice would be appreciated. Thanks in advance.
I am looking for a simple screening tool for sexual dysfunction in general practice, to be administered as part of a comprehensive health assessment for older veterans. Thanks for your help.
The lack of experimental details seems to be a problem for most posts I visit to try to offer advice. There needs to be a policy or standard set of information that is offered up to get proper advice. Check out some of the QA spaces in the computer science realms to see what I mean (eg. stackoverflow). The majority of replies to a post seem to always be clarification questions and then a few people to take a stab at an answer.
I sort of understand most peoples reluctance to provide details as they fear being scooped, but if your want help you have to give a sufficient amount of detail. Most problems stem from experimental artifacts or fundamental misunderstanding of biological principals. For example you can hide the name of a gene but should provide functional details like if it is a transcription factor or a kinase, I think the name of the sequencing platform or details on how a library is prepared are very pertinent pieces of information that will not deluge to the world your research.
The post on this system are too much like twitter. Its fine for quips or to point people at a resource/news article/event, but not okay for any serious conversation.