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General practitioner

Paul Hilton, Brian S Buckley, Elaine McColl, Denise Howel, Douglas G Tincello, Catherine Brennand
BACKGROUND: The INVESTIGATE-I study was designed to inform a future definitive randomised trial of invasive urodynamic testing, compared to basic clinical assessment with noninvasive tests prior to surgical treatment, in women with stress urinary incontinence or stress-predominant mixed urinary incontinence. In a pilot randomised controlled trial, women from seven participating sites were screened, consented and randomised. Overall, 771 patients were identified from clinic notes and correspondence as being potential recruits and were sent the Patient Information Leaflet...
October 26, 2016: Trials
Virginia Schmied, Rachel Langdon, Stephen Matthey, Lynn Kemp, Marie-Paule Austin, Maree Johnson
BACKGROUND: Poor mental health in the perinatal period can impact negatively on women, their infants and families. Australian State and Territory governments are investing in routine psychosocial assessment and depression screening with referral to services and support, however, little is known about how well these services are used. The aim of this paper is to report on the health services used by women for their physical and mental health needs from pregnancy to 12 months after birth and to compare service use for women who have been identified in pregnancy as having moderate-high psychosocial risk with those with low psychosocial risk...
October 25, 2016: BMC Women's Health
A Ntouva, R Sanatinia, R G Watt
INTRODUCTION: Primary care dentists are in a unique position to screen for alcohol misuse and provide brief advice to patients; however, lack of knowledge and confidence are some of the barriers cited for their reluctance to do so. AIMS: This study describes the evaluation of a novel brief alcohol advice training programme specifically designed and tailored to the needs of NHS general dental practitioners. MATERIALS AND METHODS: The training programme was developed as part of a feasibility trial and included a mixture of theoretical and practical elements...
October 26, 2016: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
Letitia H Burridge, Michele M Foster, Maria Donald, Jianzhen Zhang, Anthony W Russell, Claire L Jackson
As the prevalence of type 2 diabetes continues to escalate, health system reform is seeking better patient outcomes through new models of care that aim to provide the most appropriate care when needed. Patients' experiences of service innovations can shed light on the successes and challenges of implementing change. This paper explores patients' views of a new model of integrated care for patients with type 2 diabetes. A mixed-methods, randomised control trial evaluated a beacon clinic model of care for complex type 2 diabetes led by specialist general practitioners (GPs) in primary care settings in Brisbane, Australia...
October 26, 2016: Health & Social Care in the Community
Kathleen Gray, Fernando J Martin-Sanchez, Guillermo H Lopez-Campos, Manal Almalki, Mark Merolli
OBJECTIVES: The availability of internet-connected mobile, wearable and ambient consumer technologies, direct-to-consumer e-services and peer-to-peer social media sites far outstrips evidence about the efficiency, effectiveness and efficacy of using them in healthcare applications. The aim of this paper is to describe one approach to build a program of health informatics research, so as to generate rich and robust evidence about health data and information processing in self-quantification and associated healthcare and health outcomes...
October 26, 2016: Methods of Information in Medicine
W P J van Oosterhout, J Haan, N D Kruyt
BACKGROUND: Melkersson-Rosenthal syndrome (MRS) is a relatively rare syndrome characterised by the clinical triad of persisting or recurrent facial oedema, recurrent peripheral facial palsy, and a fissured tongue. CASE DESCRIPTION: A 30-year-old male patient presented with a left peripheral facial palsy spreading to the right side of the face. The left-sided facial paralysis recurred twice after initial recovery. The patient had also suffered from oedema of the lip and face, which sometimes occurred simultaneously with the paralysis, and he had always had a fissured tongue...
2016: Nederlands Tijdschrift Voor Geneeskunde
A R J Sanders, J M Bensing, M A L U Essed, T Magnée, N J de Wit, P F M Verhaak
OBJECTIVE: We conducted a clustered randomised controlled trial to study the effects of shared decision making (SDM) on patient recovery. This study aims to determine whether GPs trained in SDM and reinforcing patients' treatment expectations showed more trained behaviour during their consultations than untrained GPs. METHODS: We compared 86 consultations conducted by 23 trained GPs with 89 consultations completed by 19 untrained GPs. The primary outcomes were SDM, as measured by the OPTION scale, and positive reinforcement, as measured by global observation...
October 11, 2016: Patient Education and Counseling
T Kühlein, F Madlo-Thiess, V Wambach, S Schaffer
Background: Quality management (QM) became mandatory for the ambulatory sector of the German health care system 10 years ago. Objectives: The aim of this study was to find out how general practitioners (GPs) perceived the introduction of this measure, how they see it today and what they expect of the future concerning QM. Materials and Methods: In a qualitative study, interviews following a semi-structured guideline with GPs were conducted. Following transcription, interviews were coded in triangulation, first inductively, then deductively until saturation was reached...
October 25, 2016: Das Gesundheitswesen
A Honig, D Sierink, B Verwey
Care provided by consultation-liaison (CL) psychiatry and general hospital (GH) psychiatry varies widely. This means that certain services are almost unrecognisable and therefore less readily available to patients. <br/> AIM: To describe the core tasks of current CL- and GH-psychiatry care and to suggest how these tasks can best be performed and developed in the future.<br/> METHOD: We conducted a selective review of relevant CL- and GH-related literature and combined the information we obtained with the results of a consultation with CL-psychiatrists about how CL- and GL psychiatry should function in the future...
2016: Tijdschrift Voor Psychiatrie
Xiaoshu Lü, Esa-Pekka Takala, Esko Toppila, Ykä Marjanen, Leena Kaila-Kangas, Tao Lu
Exposure to whole-body vibration (WBV) presents an occupational health risk and several safety standards obligate to measure WBV. The high cost of direct measurements in large epidemiological studies raises the question of the optimal sampling for estimating WBV exposures given by a large variation of exposure levels in real worksites. This paper presents a new approach to address this problem. A daily exposure to WBV was recorded for 9 to 24 days among 48 all-terrain vehicle drivers. Four datasets based on root mean squared recordings were obtained from the measurement...
October 25, 2016: Ergonomics
Karin Hammarberg, Rebecca Zosel, Caroline Comoy, Sarah Robertson, Carol Holden, Mandy Deeks, Louise Johnson
Some potentially modifiable factors adversely affect fertility and pregnancy health. To inform a fertility health promotion programme, this study investigated fertility knowledge and information-seeking behaviour among people of reproductive age. This was a qualitative study involving six focus group discussions with women and men who intended to have children in the future and eight paired interviews with couples who were actively trying to conceive. Participants (n = 74) themselves generally claimed 'low' to 'average' levels of knowledge about fertility...
October 25, 2016: Human Fertility: Journal of the British Fertility Society
C P Selinger, I Carbery, V Warren, A F Rehman, C J Williams, S Mumtaz, H Bholah, R Sood, D J Gracie, P J Hamlin, A C Ford
BACKGROUND: Patient education forms a cornerstone of management of inflammatory bowel disease (IBD). The Internet has opened new avenues for information gathering. AIM: To determine the relationship between different information sources and patient knowledge and anxiety in patients with IBD. METHODS: The use of information sources in patients with IBD was examined via questionnaire. Anxiety was assessed with the hospital anxiety and depression scale and disease-related patient knowledge with the Crohn's and colitis knowledge score questionnaires...
October 25, 2016: Alimentary Pharmacology & Therapeutics
Sharon E Card, Heather D Clark, Michelle Elizov, Narmin Kassam
General internal medicine (GIM), like other generalist specialties, has struggled to maintain its identity in the face of mounting sub-specialization over the past few decades. In Canada, the path to licensure for general internists has been through the completion of an extra year of training after three core years of internal medicine. Until very recently, the Royal College of Physicians and Surgeons of Canada (RCPSC) did not recognize GIM as a distinct entity. In response to a societal need to train generalist practitioners who could care for complex patients in an increasingly complex health care setting, the majority of universities across Canada voluntarily developed structured GIM training programs independent of RCPSC recognition...
October 24, 2016: Journal of General Internal Medicine
Aoife Fleming, Louise Barry, Stephen Byrne, Michael Prentice
BACKGROUND: Antimicrobial resistance in long-term care facilities (LTCFs) poses a risk to elderly residents. The aim of this observational study was to investigate recent patterns of antimicrobial susceptibility in urine samples submitted to the Microbiology Laboratory at Cork University Hospital (CUH) from LTCFs in the greater Cork region. The antimicrobial susceptibilities of LTCF and General Practitioner (GP) urine samples sent to CUH, for patients aged over 65 years of age, were compared...
October 24, 2016: European Journal of Public Health
Lindsay Steele, Emma Orefuwa, Petra Dickmann
BACKGROUND: Early detection of infectious disease outbreaks can reduce the ultimate size of the outbreak with lower overall morbidity and mortality due to the disease. Numerous approaches exist with the aim of detecting outbreaks earlier, and methods have been developed to measure progress on timeliness. Understanding why these surveillance approaches work and don't work will elucidate key drivers of early detection, and can guide interventions to achieve earlier detection. Without clarity about necessary conditions for earlier detection and their influencing factors, attempts to improve surveillance will be ad-hoc and unsystematic...
October 21, 2016: International Journal of Infectious Diseases: IJID
Katja Krug, Katharina I Kraus, Kathrin Herrmann, Stefanie Joos
BACKGROUND: In Germany, complementary and alternative medicine (CAM) in primary health care is offered by general practitioners (GPs) and by natural health practitioners, so called 'Heilpraktiker' (HPs). Considering the steadily growing number of unregulated HPs, the aim of the study was to assess characteristics of patients consulting HPs in comparison to patients consulting GPs. METHODS: In a cross-sectional study, patients of randomly selected GPs and HPs were asked to complete a questionnaire about their health care status, health care behavior, and symptoms rated on the Measure Yourself Medical Outcome Profile (MYMOP-D)...
October 24, 2016: BMC Complementary and Alternative Medicine
Melanie J Lewis, Rose Ellis, Sunil K Adusumilli, Ian Cameron
INTRODUCTION: The New South Wales Rural Resident Medical Officer Cadetship Program began in 1988 as a strategy to increase the numbers of junior doctors in rural hospitals. This article outlines the results of an evaluation undertaken in 2014. Specifically, it will look at where former cadets who entered the program between 1989 and 2010 were working in 2014, what training programs they chose and their attitudes toward the program. METHOD: Data were collected using a semi-structured questionnaire sent to all the former cadets who entered the program from 1989 until 2010...
October 2016: Rural and Remote Health
Lisa G Pont, Tessa K Morgan, Margaret Williamson, Flora M Haaijer, Mieke L van Driel
OBJECTIVES: The aim of this study was to assess the validity of a set of European quality indicators for assessing antimicrobial prescribing in Australian General Practice. METHODS: A modified UCLA/RAND appropriateness method was used to assess the validity of 30 antimicrobial prescribing indicators. An expert panel of 12 general practitioners scored the validity of each indicator for measuring quality in Australian general practice. Four quality domains were considered: monitoring antibiotic resistance, benefit to individual patients, value for money and value to policymakers...
October 24, 2016: International Journal of Pharmacy Practice
A P Kassianos, M M Raats, H Gage
This article aims to investigate associations between perceived control and health-related quality of life (HRQOL) with dietary changes after prostate cancer diagnosis and to explore General Practitioners' (GPs) perceptions on the role of diet in prostate cancer post-diagnosis. Ninety-five prostate cancer patients completed measures of dietary change, one for after diagnosis and another for after therapy. They also scored their HRQOL and perceived control. There were discrepancies in dietary changes reported between a general question (28...
October 24, 2016: European Journal of Cancer Care
Alexander Konnopka, Hans-Helmut König, Claudia Kaufmann, Nina Egger, Beate Wild, Joachim Szecsenyi, Wolfgang Herzog, Dieter Schellberg, Rainer Schaefert
BACKGROUND: Collaborative group intervention (CGI) in patients with functional somatic syndromes (FSS) has been shown to improve mental quality of life. OBJECTIVE: To analyse incremental cost-utility of CGI compared to enhanced medical care in patients with FSS. METHODS: An economic evaluation alongside a cluster-randomised controlled trial was performed. 35 general practitioners (GPs) recruited 300 FSS patients. Patients in the CGI arm were offered 10 group sessions within 3months and 2 booster sessions 6 and 12months after baseline...
November 2016: Journal of Psychosomatic Research
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