General Practice - Science topic

Over 300 billion of cells die every day in the human body, producing a large number of endogenous apoptotic extracellular vesicles (apoEVs). Also, allogenic stem cell transplantation, a commonly used therapeutic approach in current clinical practice, generates exogenous apoEVs. It is well known that phagocytic cells engulf and digest apoEVs to main...

Background: While many elaborated treatment protocols focus on post-traumatic stress symptoms, a large number of refugees suffer from a range of mental health problems. Thus, brief and transdiagnostic psychological interventions may be helpful first interventions for help-seeking refugees and asylum seekers in a stepped-care approach. Critically,...

Objective Health scientists strive for a smooth recruitment of physicians for research projects like surveys. Teaching physicians are an easy to approach population that is already affiliated with a university by teaching students in their practice. How do response rates compare between a convenient online survey among teaching physicians and an el...

Background International guidelines do not recommend routine imaging, including magnetic resonance imaging (MRI), and seek to guide clinicians only to refer for imaging based on specific indications. Despite this, several studies show an increase in the use of MRI among patients with low back pain (LBP) and an imbalance between appropriate versus i...

Background: How international migrants access and use primary care in England is poorly understood. We aimed to compare primary care consultation rates between international migrants and non-migrants in England before and during the COVID-19 pandemic (2015-2020). Methods: Using data from the Clinical Practice Research Datalink (CPRD) GOLD, we id...

Thrombotic microangiopathy (TMA) is caused by several diseases, including infections, congenital and autoimmune diseases, and malignancies, usually requiring admission to intensive care. The primary pathophysiology of TMA is microvascular thrombosis, and its diagnosis is based on the presence of hemolysis, thrombocytopenia, schistocytes in a blood...

This paper contains an investigation on the potential decrease of seismic vulnerability related to building replacements for the cities of Sion and Martigny in Switzerland. Those two cities were identified for the present research based on the accuracy of the corresponding available information. Seismic assessment at urban scale was recently achiev...

Background: Nursing is a Profession that incorporates the generous practice of the past with the dynamic truth of today's Health Care Industry. When we speak to Nurses, usually Majority of Nurses expresses saying "I'm thinking why I joined Nursing, I'm not satisfied in the Work I do due to various reasons like Respect, Work Place, Work Stress, Domi...

Background Depression is a major public health concern, which is most pronounced in population segments with a lower social-economic status (SES). E-health interventions for depressive complaints are proven to be effective, but their reach needs to be improved, especially among people with a lower socioeconomic status (SES). Implementing e-health i...

Complete reliance on the fitted model in response surface experiments is risky and relaxing this assumption, whether out of necessity or intentionally, requires an experimenter to account for multiple conflicting objectives. This work provides a methodological framework of a compound optimality criterion comprising elementary criteria responsible f...

Background: Deprived communities are more at risk of poor sexual and reproductive health (SRH) outcomes and access is more challenging in these areas. This is evident from significantly higher rates of unplanned pregnancies, abortions, teenage pregnancies, and higher prevalence of sexually transmitted infection in deprived communities compared to a...

At the very start of medical residency training, entrustment of clinical tasks may be a major challenge, on which current scientific knowledge is scarce. This study therefore aimed to gain insight into the process of supervisors’ decision making underlying the entrustment of clinical tasks at the start of one-on-one supervisor–trainee working relat...

Objective The study aimed to understand the distribution of health problems of a general practice clinic to provide guidance on how to develop primary care in Shenzhen, China. Study design This is a cross-sectional study. Methods Patients' sociodemographic data and diagnoses were recorded from the electronic medical record system of the Universit...

Background: General practitioners and general practice nurses are the most trusted and experienced sources of vaccine information for Australians and are the principal providers of routine immunisation in New South Wales, Australia. This study explored perceived barriers and challenges to the rollout of the COVID-19 immunisation program and contin...

Drawing on a ritual approach to microsociology, I explain how and why aesthetic and moral practices inform each other and evolve as they do. I continue to develop a theory of aesthetic engagement, specifying how it generates the emotional sensibilities that inform moral practices. Examining aesthetic engagement and emotional sensibilities focuses o...

Previous research on general practitioners' (GPs') involvement in end‐of‐life care has largely focused on a specific aspect of care or has provided broad overviews that failed to capture individual variations in patient management. This qualitative study aimed to explore Australian GPs' feedback and reflections on the individual‐level care provided...

Background The pathogenesis of multiple sclerosis (MS) has not yet been fully uncovered. There is increasing evidence that Epstein-Barr-Virus (EBV) infection, which affects over 90% of people during life and causes infectious mononucleosis, leads to an increased incidence of MS, and thus may play a crucial role in the pathophysiology of the disease...

Objective To examine the relative risk of suicide mortality in patients with Huntington’s disease (HD). Methods A case–control study design was used. We used linked electronic records from primary care, secondary care and Office for National Statistics from England from 2001 through 2019. Controls were matched to cases by general practice and suic...

Purpose Health-related quality of life (QoL) is poor after stroke, but may be improved with comprehensive care plans. We aimed to determine the effects of an individualized management program on QoL in people with stroke or transient ischemic attack (TIA), describe changes in QoL over time, and identify variables associated with QoL. Methods This...

Corporate social responsibility (CSR) initiatives are common in the mining industry and have the watchful eye of their stakeholders. However, limited attention has been given to the perceptions of the host communities regarding these initiatives. This paper seeks to explore the perceptions of a host community, located in the north of Chile, regardi...

Background The NHS Diabetes Prevention Programme (DPP) is the first nationwide type 2 diabetes prevention programme targeting people with prediabetes. It was rolled out across England from 2016 in three waves. We evaluate the population level impact of the NHS DPP on incidence rates of type 2 diabetes. Methods We use data from the National Diabete...

Background: Follow-up for cancer typically occurs in secondary care, and improved survival has increased demands on these services. Other care models may alleviate this burden, such as moving (parts of) follow-up care for curatively treated patients from secondary to primary care (care substitution). Aim: To explore the opinions of GPs regarding...

Anni Matthes,1,2 Florian Wolf,1 Jutta Bleidorn,1 Robby Markwart1,2 1Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Thuringia, Germany; 2InfectoGnostics Research Campus Jena, Jena, Thuringia, GermanyCorrespondence: Anni Matthes, Institute of General Practice and Family Medicine, Jena...

Deliberate reflection has been found to foster diagnostic accuracy on complex cases or under circumstances that tend to induce cognitive bias. However, it is unclear whether the procedure can also be learned and thereby autonomously applied when diagnosing future cases without instructions to reflect. We investigated whether general practice reside...

Aims/hypothesis People with type 2 diabetes are at increased risk of developing obstructive sleep apnoea. However, it is not known whether people with type 1 diabetes are also at an increased risk of obstructive sleep apnoea. This study aimed to examine whether people with type 1 diabetes are at increased risk of incident obstructive sleep apnoea c...

Learning communities are often associated with higher student engagement and academic achievement. Few studies to date, however, have examined the impacts of these practices among international students. To address this gap, the following questions led the current study: “To what degree is participation in learning communities associated with inter...

Purpose: The aim of the present study was to determine whether women diagnosed with breast cancer (BC) have an increased incidence of other cancers, e.g., gastric cancer, lung cancer, skin cancer, and so on, compared to healthy women without a breast cancer diagnosis. Methods: This retrospective cohort study was based on data from the Disease An...

Background Previous research has examined prescribing amongst 85-year-olds in English primary care, but less is known about prescribing amongst 95-year-olds in spite of population ageing. Aim We describe the most commonly prescribed medicines in a cohort of 95-year-olds, using 10-year follow-up data from the Newcastle 85+ Study (n = 90). Method A...

Purpose The aim of this retrospective study was to investigate the impact of a broad spectrum of antihypertensive (AH) medications on urinary tract infections (UTI) of outpatients diagnosed in general practices in Germany. Methods This study included a total of 367,960 patients aged ≥ 18 years newly a diagnosed with UTI in 1274 general practices i...

This study aimed to examine the healthcare service environment, patients' experience, and responses toward healthcare services in private general practice (GP) clinics. Self-administered questionnaires were used for collecting data from 367 respondents with prior experience in visiting the general practice clinics in Malaysia. SmartPLS statistical...

Children on the autism spectrum experience difficulties with social interactions, which may result in lower quality of friendships. Playdates are defined as prearranged gatherings between two children at one of their homes and are fundamental to social emotional development in childhood. Playdates provide opportunities for language, empathy, and fr...

Background Data from primary care regarding the prevalence of symptoms of depression and anxiety, and their effect on glycemic control among people with diabetes is lacking in Hungary. The recently introduced Patient Health Record (PHR) requires family doctors to screen for depressive symptoms. Objectives We aimed to investigate the prevalence of...

Understanding the scale of fish movements is essential to establish appropriate fisheries management boundaries. In Florida (USA), Permit (Trachinotus falcatus) is a valued recreational species as a sportfish and as table fare. The Permit fishery in Florida occurs in two geographic sectors: (1) in the Florida Keys and in Biscayne Bay, most anglers...

Objective: To explore patient perceptions regarding doctors' information seeking during consultations. Design and setting: Qualitative interviews with participants from six general practice waiting rooms in South East Queensland, Australia. Participants were asked about their experiences and opinions, and to comment on short videos of simulated...

Objective Transient ischaemic attacks (TIA) serve as warning signs for future stroke, and the impact of TIA on long term survival is uncertain. We assessed the long-term hazards of all-cause mortality following a first episode of a transient ischaemic attack (TIA). Design Retrospective matched cohort study. Methods Cohort study using electronic p...

Introduction La haute autorité de santé (HAS) encourage la pratique d’une activité physique (AP) pendant la grossesse et en post-partum. Il est avancé que 150 minutes d’activité par semaine réparties en trois séances ont des effets bénéfiques sur la santé maternelle, fœtale et néonatale. L’objectif était d’établir une revue systématique de la litté...

Objectives Oral brush biopsies are a well researched index for early detection of oral cancer in specialised centers. But the performance of the exfoliative biopsy is not yet researched in daily dental routine. Methods Private dentists and private oral surgeons in Germany took brush biopsies out of 814 suspicious lesions from 670 patients using th...

Background: There is a lack of evidence around Australian general practitioners' (GPs) views of issues surrounding breast density. The current study aimed to quantitatively assess GPs' current knowledge, understanding, and feelings around breast density information and notification. Methods: This study involved a cross-sectional survey using an...

Engaging with primary care poses several challenges for high-needs whānau. These include cost, transport, childcare, doctor availability and time off work. Supported by the Ministry of Health's Digital Enablement Programme, the UnifyHealth pilot grants 103,744 high-needs whānau/patients access to subsidised online consultations when their general p...

Objectives: To evaluate the prospective cost-effectiveness of the IRIS+ programme using data from the feasibility Design and setting: Cost-utility analysis in UK general practices. Method: A Markov model was constructed to estimate mean costs and quality-adjusted life-years (QALYs) of IRIS+ versus IRIS for patients registered at a general practice...

We presented some early consultation modality results from our insect bite wort as e-poster and print for the RCGP and WONCA conference 2022 in London Excel centre June 2022

Background: The time interval from first symptom and sign until a cancer diagnosis significantly affects the prognosis. Therefore, recognising and acting on signs of cancer, such as anaemia, is essential. Evidence is sparse on the overall risk of cancer and the risk of specific cancer types in persons with new-onset anaemia detected in an unselect...

Background To improve the management of childhood urinary tract infections, it is essential to understand the incidence rates, testing and treatment strategy. Methods A retrospective study using data from 45 to 104 general practices (2000 to 2020) in Flanders (Belgium). We calculated the incidence rates (per 1000 person-years) of cystitis, pyelone...

Objective To compare the effectiveness of the BNT162b2 mRNA (Pfizer-BioNTech) and the ChAdOx1 (Oxford-AstraZeneca) covid-19 vaccines against infection and covid-19 disease in health and social care workers. Design Cohort study, emulating a comparative effectiveness trial, on behalf of NHS England. Setting Linked primary care, hospital, and covid-...

Background With the help of digital tools patients’ medical histories can be collected quickly and transferred into their electronic medical records. This information can facilitate treatment planning, reduce documentation work, and improve care. However, it is still unclear whether the information collected from patients in this way is reliable. I...

Background Back pain is a main driver of disability and the most prevalent reason why people in Demark visit a general practitioner (GP). However, little is known about back pain management in primary care. For new strategies to be sustainable and to accommodate the recommendations for evidence-based practice, patients’ perspectives are paramount t...

Background Evidence is central to all maternal and child health (MCH) decision-making processes, continuously interacting with and influencing our work. There is a growing emphasis in MCH on using evidence-based approaches when addressing public health challenges, but the field lacks a unified understanding of what constitutes evidence. MCH must op...

Background Generic substitution is a good approach to reduce pharmaceutical expenses without compromising healthcare quality. Yet, the practice of generic substitution has been contentious due to concerns on quality and efficacy. Objective This study was aimed to assess knowledge, attitude and practice among pharmacy professionals toward generic s...

Objectives: To determine the factors that motivated GP practice managers in England to employ non-medical roles, and to identify an ideal hypothetical GP practice workforce. Methods: Cross sectional survey of GP practice managers in England (n=1,205). The survey focused on six non-medical roles: advanced nurse practitioner, specialist nurse, health...

The implementation of a new service is often challenging when translating research findings into routine clinical practices. This paper presents the results of the implementation study of a pilot project for a diabetes and cardiovascular diseases risk-assessment service in Belgian community pharmacies. To evaluate the implementation of the service,...

There has been substantial growth in the use of JSON-based grammars, as well as other standard data serialization languages, to create visualizations. Each of these grammars serves a purpose: some focus on particular computational tasks (such as animation), some are concerned with certain chart types (such as maps), and some target specific data do...

Estimation of maximum possible scour depth around spur dike is an important step in the design of spur dike foundations To determine the maximum scour depth in the design of spur dike foundations, the equilibrium scour depth, which is commonly estimated using peak-flow conditions for engineering design of spur dike foundations, are used. In fluvial...

Droplets of mucosalivary ejecta emitted by sneezing or coughing are a major carrier of numerous types of bacterial and viral diseases. This study develops a numerical model to estimate the spread distance for inhalable droplets (1–50 μm) in the air, the inhalability of the particles, and the trajectory as well as velocity of these pathogen-containi...

Background The Danish healthcare system has undergone fundamental organisational changes. In recent years, treatment of most patients with chronic obstructive pulmonary disease (COPD) and type 2 diabetes (T2D) in Denmark has been transferred from specialised hospitals to general practices, and only the most complicated cases are treated at hospital...

Background Sentinel networks composed of general practitioners (GPs) represent a powerful tool for epidemiologic surveillance and ad-hoc studies. Globalization necesitates greater international cooperation among sentinel networks. The aim of this study was to inventory GP sentinel networks involved in epidemiological surveillance on a global scale....

Lumps and bumps are relatively common presenting problems in the primary-care/general practice, and their differential diagnoses diverse with anatomical location. Clinical and imaging diagnosis of soft-tissue lumps are challenging at times, and require partial or total excision for diagnosis and management. Following relevant history and examinatio...

The nature of international private crime requires the enactment of a set of legal principles and provisions that are appropriate to their dangerous nature and the purpose of criminalization and punishment under international criminal law aimed at subjecting the perpetrators of international crime to fair criminal accountability without any restric...

Introduction: Like many countries around the world, Scotland faces a shortage of general practitioners (GPs) due to both recruitment and retention issues. Such workforce shortages are of particular concern in rural areas. There are many reasons why GPs are leaving general practice; however, satisfaction with working life is an important predictor...

Background Prescribed opioid doses > 100 mg oral morphine equivalent (OME) and/or co-prescribing of sedating psychoactive medications increase the risk of unintentional fatal overdose. We describe general practice encounters where opioids are prescribed and examine high-risk opioid prescribing. Methods The 2006–2016 BEACH study data, a rolling nat...

Background Point-of-care testing (POCT) is increasingly used in primary care. The rapid availability of the test result during the patient encounter increases the potential for patients and care providers to make a direct and joint decision on disease management. Our aim was to get insight into the first experiences of patients and healthcare profe...

Background: Rural general practitioners are typically located far from secondary care. As a result, they have to be able to manage many clinical presentations. One pivotal component is the doctor's bag and emergency bag. Aim: To audit the doctor's bag and emergency bag contents of suitable documentation, equipment and medications against standardis...

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Pharmacists have been included in general practice teams to provide non-dispensing services for patients. In Australia, pharmacists’ role in general practice has been slowly expanding. However, there is a paucity of research to explore patients’ opinions toward pharmacist-led services in general practice. This study aimed to assess patient awarenes...

Background General Practitioners (GPs) are central in the care of Dutch older people and in a good position to have Advance Care Planning (ACP) conversations. Interview studies reveal that the doctor-patient relationship is important when initiating ACP conversations and can also be influenced by ACP conversations. We aimed to examine the associati...

Objective: To assess the short term safety of the COVID-19 vaccines Comirnaty (Pfizer-BioNTech BNT162b2) and Vaxzevria (AstraZeneca ChAdOx1) in Australia. Design: Prospective observational cohort study; online surveys by AusVaxSafety, a national active vaccine safety surveillance system, three and eight days after vaccination. Setting, particip...

Background Social problems of patients such as family or work-related conflicts as well as financial difficulties affect the individual health situation and the treatment of diseases in general practice. General practitioners (GPs) would like to have direct access to professionals in social care services. In Germany, there are many different social...