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London Journal of Primary Care

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https://www.readbyqxmd.com/read/29686736/inside-general-practice-ethics-guidelines-and-of-or-for-good-clinical-practice
#1
Andrew Papanikitas, Carey Lunan
The RCGP conference, like other annual healthcare conferences offers a protected space for reflection on ethical aspects of practice. This paper presents a summary and discussion of a fringe session led by the RCGP Committee On Medical Ethics at the 2017 RCGP annual conference in Liverpool. Well thought-out rules offer a potential solution to the burden of responsibility for making every single decision from first principles. But guidelines can be difficult to follow, too numerous to know, may conflict with each-other and may not be appropriate in all circumstances...
March 2018: London Journal of Primary Care
https://www.readbyqxmd.com/read/29686735/wellbeing-in-the-republic-of-macedonia
#2
Nelio Oliveira
No abstract text is available yet for this article.
March 2018: London Journal of Primary Care
https://www.readbyqxmd.com/read/29686734/reflections-on-integrated-care-from-those-working-in-and-leading-integrated-respiratory-teams
#3
Nicola J Roberts, Mike Ward, Irem Patel, Janelle Yorke, Martyn R Partridge
The concept of integrated care has been advocated for many years to address some of the challenges faced by the NHS. This report examines the experiences of respiratory healthcare specialists working in an integrated role. Twelve qualitative telephone interviews were undertaken with a range of integrated respiratory specialists and their teams working in both hospitals and the community. A descriptive and thematic approach to data analysis was adopted. Participants were very enthusiastic about their roles and saw themselves as ambassadors for this new way of working...
March 2018: London Journal of Primary Care
https://www.readbyqxmd.com/read/29686733/towards-a-strategic-alignment-of-public-health-and-primary-care-practices-at-local-levels-the-case-of-severe-and-enduring-mental-illness
#4
Ricky Banarsee, Cornelius Kelly, Austen El-Osta, Paul Thomas, Chris Brophy
The rapidly increasing number of people who have long-term conditions requires a system of coordinated support for self-care throughout the NHS. A system to support self-care needs to be aligned to systems that support shared-care and community development, making it easier for the multidisciplinary teams who provide care to also help patients and populations to help themselves. Public health practitioners need to work closely with clinicians to achieve this. The best place to coordinate this partnership is a community-based coordinating hub, or local health community - a geographic area of about 50,000 population where different contributions to self-care can be aligned...
March 2018: London Journal of Primary Care
https://www.readbyqxmd.com/read/29686732/a-proactive-general-practice-integrating-public-health-into-primary-care
#5
EDITORIAL
Salman Rawaf
No abstract text is available yet for this article.
March 2018: London Journal of Primary Care
https://www.readbyqxmd.com/read/29449891/considering-change
#6
Kate Mtandabari
No abstract text is available yet for this article.
January 2018: London Journal of Primary Care
https://www.readbyqxmd.com/read/29449890/benefits-harms-and-evidence-reflections-from-uk-primary-healthcare
#7
Margaret McCartney
In this paper I examine the relationship between benefits, harms and evidence-based medicine in the context of British primary healthcare. First, I will examine: 'What is a benefit and what is a harm?' Second, what should we know about where the balance of risk and benefit appear to lie? Third, what should we do with this knowledge, particularly in the context of the biopsychosocial gaze of primary care? I conclude that even perfect knowledge about benefits and harms requires to be translated in the context of the individual patient: it also requires to be interpreted according to what that persons' wishes are...
January 2018: London Journal of Primary Care
https://www.readbyqxmd.com/read/29449889/how-primary-care-can-contribute-to-good-mental-health-in-adults
#8
REVIEW
Sunjai Gupta, Rachel Jenkins, John Spicer, Marina Marks, Nigel Mathers, Lise Hertel, Laura Calamos Nasir, Fiona Wright, Baljeet Ruprah-Shah, Brian Fisher, David Morris, Kurt C Stange, Robert White, Gina Giotaki, Tony Burch, Catherine Millington-Sanders, Steve Thomas, Ricky Banarsee, Paul Thomas
The need for support for good mental health is enormous. General support for good mental health is needed for 100% of the population, and at all stages of life, from early childhood to end of life. Focused support is needed for the 17.6% of adults who have a mental disorder at any time, including those who also have a mental health problem amongst the 30% who report having a long-term condition of some kind. All sectors of society and all parts of the NHS need to play their part. Primary care cannot do this on its own...
January 2018: London Journal of Primary Care
https://www.readbyqxmd.com/read/29449888/towards-hope
#9
EDITORIAL
Chris Manning
No abstract text is available yet for this article.
January 2018: London Journal of Primary Care
https://www.readbyqxmd.com/read/29181094/carelli-on-art-the-dali-universe
#10
Francesco Carelli
Interactive and multimedia methods are the future, already developing in teaching and learning modules in Medicine. It happens and has to happen because: 1) It improves tools for the teacher in preparing and showing the bulk of materials on which students must study and learn; it enables interactivity with learners both in formative pathway and in final assessment. 2) It improves attention, interest and involvement of students and learners, and acts as a guideline to progressive broadening in researches, studies, considerations, and information exchanges among different learners...
November 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/29181093/preschool-growth-and-nutrition-service-addressing-common-nutritional-problems-a-community-based-primary-care-led-intervention
#11
Samantha Ross, Charlotte Wright
Childhood obesity has been prioritised by the World Health Organization in a recent report, which calls for a holistic multiagency approach to tackling and reducing future risks of obesity and its associated co-morbidities. This article examines a health service approach to improving recognition and management of pre-school nutritional problems as part of training health care professionals. It explores the practicalities of setting up a local pathway for managing cases in the community with appropriate specialist support...
November 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/29181092/efficacy-of-multisystemic-therapy-in-youths-aged-10-17-with-severe-antisocial-behaviour-and-emotional-disorders-systematic-review
#12
REVIEW
Jia Xuan Tan, Maria Lourdes Restrepo Fajardo
Background: Antisocial behaviour and conduct disorders are the most common behavioural and mental health problems in children and young people globally. An efficacious intervention is needed to manage these antisocial behaviours that have costly consequences. Multisystemic Therapy (MST), an intensive home-based intervention for youths with psychosocial and behavioural problems, is recommended under National Institute for Health and Clinical Excellence guidelines for conduct disorder. However, reviews on the efficacy of MST are mixed...
November 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/29181091/parenting-and-child-mental-health
#13
Rachael Ryan, Christine O'Farrelly, Paul Ramchandani
This paper reviews parenting programmes and their effectiveness with families of young children and highlights additional resources for primary care practitioners. Typically, 30% of GP consultations concern child behaviour problems and established behaviour problems can have lasting effects on children's life chances. These problems can be identified in infancy and toddlerhood.Parenting is a key risk factor in their development and maintenance, yet is also amenable to change. In this paper we consider six parenting programmes that are widely evaluated and/or available in the U...
November 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/29181090/beginner-s-mind
#14
Louise Younie
The concept of 'beginner's mind' invites the expert medical professional to be present to their patients, remaining curious and responsive in the face of the individuality of illness. Each patient is a universe of unknowns, presenting with suffering which cannot always be classified with a diagnosis. Improvisation and openness may not just benefit our patients enduring their patient journeys but may also revive and reconnect us with our own humanity. Why this matters to me: My experience as cancer patient brought home to me the value of encountering a doctor who was present and able to listen and respond to me as an individual...
November 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/29181089/are-we-enabling-the-next-generation-to-thrive
#15
EDITORIAL
Emma McKenzie-Edwards
No abstract text is available yet for this article.
November 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/29081840/scarlet-fever-a-guide-for-general-practitioners
#16
REVIEW
S Basetti, J Hodgson, T M Rawson, A Majeed
There has been an increase in the incidence of scarlet fever with most cases presenting in General Practice and Emergency Departments. Cases present with a distinctive macro-papular rash, usually in children. This article aims to increase awareness of scarlet fever by highlighting key symptoms and stating potential complications if untreated. In patients who have the typical symptoms, a prescription of a suitable antibiotic such as phenoxymethylpenicillin (Penicillin V) should be made immediately to reduce the risk of complications and the spread of infection...
September 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/29081839/absent-monofilament-sensation-in-a-type-2-diabetic-feet
#17
Julia Cheong, K Alexiadou, Senan Devendra
Neuropathy is a common complication which can affect up to 90% of patients with diabetes mellitus. Asymptomatic neuropathy is a common presentation. We present a case that emphasises the importance of foot screening in people with diabetes. It also highlights that patient education is key to prevent development of foot ulceration which can lead to amputations. In addition, pharmacological therapy (as per NICE guidance) can be offered for pain relief. Patients with diabetic neuropathy are at high risk of falling and sustaining fractures...
September 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/29081838/emergency-department-attendances-and-gp-patient-satisfaction
#18
Keith Hurst, Deirdre Kelley-Patterson, Andy Knapton
BACKGROUND: Despite invaluable national data, reasons for the relentless rise in England's emergency department (ED) attendances remain elusive. SETTING: All EDs and general practices in England. QUESTION: Are rising ED attendances related to general practice patient satisfaction, i.e. if patients are unable to get a convenient appointment with their general practitioner (GP), then do they attend their local ED for diagnosis, treatment and care instead? METHOD: GP patient satisfaction and ED attendance data were extracted from national data warehouses and organised into two groups: (i) England clinical commissioning group (CCG) areas and (ii) a London CCG subset...
September 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/29081837/new-ways-of-working-delivering-better-care-for-people-with-long-term-conditions
#19
Victoria Tzortziou Brown, Irem Patel, Nicola Thomas, James Tomlinson, Rachel Roberts, Hugh Rayner, Neil Ashman, Sally Hull
BACKGROUND: The cost-effectiveness of the traditional outpatient model for specialist care provision is increasingly being questioned in view of the changing patient needs, workforce challenges and technological advances. SETTING: This report summarises two RCGP London events showcasing new ways of delivering care for long-term conditions. QUESTIONS: What are the alternative approaches to the traditional outpatient model and do they have common themes? What are the challenges and opportunities of these new models of care? METHODS: Presentation of examples of new ways of long-term condition care delivery and round-table facilitative discussion and reflection on the challenges and solutions around service re-design and implementation, the commissioning and funding of new models of care, the facilitation of system-wide learning and the collection of data for evaluation...
September 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/29081836/introduction-to-ljpc-issue-9-5
#20
EDITORIAL
Paul Thomas
No abstract text is available yet for this article.
September 2017: London Journal of Primary Care
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