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general practitioners

Maria Michela Gianino, Jacopo Lenzi, Marco Bonaudo, Maria Pia Fantini, Walter Ricciardi, Gianfranco Damiani
BACKGROUND: This study analyzes the trajectories of antibiotic consumption using different indicators of patients' socioeconomic status, category and age-group of physicians. METHODS: This study uses a pooled, cross-sectional, time series analysis. The data focus on 22 European countries from 2000 to 2014 and were obtained from the European Center for Disease and Control, Organization for Economic Co-operation and Development, Eurostat and Global Economic Monitor...
2018: PloS One
Veerle Foulon, Joke Wuyts, Franciska Desplenter, Anne Spinewine, Valérie Lacour, Dominique Paulus, Jan De Lepeleire
Background and objectives Patients often experience drug-related problems at admission or after discharge from hospital. The objective of this study was to identify the main problems in medication management at transition between settings of care, as experienced by health care professionals (HCPs) and patients. Methods Focus group discussions were organised between December 2009 and February 2010; nine focus groups with primary and secondary care HCPs and patients and two with stakeholders. Focus group discussions were audiotaped and observation files were constructed...
June 22, 2018: Acta Clinica Belgica
G S H Straumann, A Austvoll-Dahlgren, H H Holte, T Wisborg
BACKGROUND: In Norway, each municipality is responsible for providing first line emergency healthcare, and it is mandatory to have a primary care physician/general practitioner on call continuously. This mandate ensures that a physician can assist patients and ambulance personnel at the site of severe injuries or illnesses. The compulsory presence of the general practitioner at the scene could affect different parts of patient treatment, and it might save resources by obviating resources from secondary healthcare, like pre-hospital anaesthesiologists and other specialized resources...
June 22, 2018: Acta Anaesthesiologica Scandinavica
Ildikó Gágyor, Arndt Heßling, Susanne Heim, Andreas Frewer, Friedemann Nauck, Wolfgang Himmel
Background: General practitioners (GPs), nurses and informal caregivers are often jointly involved in healthcare situations in which ethical issues play an important role. Objectives: To describe ethical problems from the perspective of these three groups and to investigate whether there is a common experience of ethical issues in primary care. Methods: We conducted six focus groups with general practitioners, nurses and informal caregivers in Germany...
June 21, 2018: Family Practice
Julie Rotival, Youri Yordanov, Pierre-Clément Thiebaud, Nathalie Pelletier-Fleury, Elsa Jacquet, Erwan Debuc, Dominique Pateron, Diane Naouri
Background: Some studies have demonstrated an association between poor continuity of care, high likelihood of 'inappropriate' use of emergency departments (EDs) and avoidable hospitalization. However, we lack data concerning primary care use after an ED visit. Objective: Identify the determinants of a visit to the general practitioner (GP) after an ED visit. Design: Observational study (single-centre cohort). Setting: One emergency department in Paris, France...
June 21, 2018: Family Practice
Shigeki Kinuhata, Yasuhiko Takemoto, Mariko Senda, Shiho Nakai, Erika Tsumura, Tatsuyuki Otoshi, Sadahiko Hiratani, Kazuo Fukumoto, Hiroki Namikawa, Yoshihiro Tochino, Mina Morimura, Taichi Shuto, Sadahiko Uchimoto
Background: Detecting and treating dementia at an early stage are important. Although the Revised Hasegawa Dementia Scale (HDS-R) is commonly used to detect dementia, it takes about 10 min to complete. In contrast, the 1-min animal test (OMAT) takes only 1 min to complete and may be a helpful screening test for general practitioners in deciding whether to proceed with administering further diagnostic tests such as the HDS-R. We sought to examine the relationship between the OMAT and HDS-R scores, and determine the cut-off OMAT score that balanced the sensitivity and specificity in identifying HDS-R-positive patients...
2018: Asia Pacific Family Medicine
Darren Yap
A 13-year-old girl was referred by her general practitioner with acute worsening exertional dyspnoea and sudden onset of left-sided chest pain. There was no associated trauma, palpitations or syncope. Clinical examination revealed that the left lung was hyper-resonant on percussion with reduced air entry on auscultation. Chest X-ray showed a left tension pneumothorax. She was treated conservatively with chest drain. Follow-up X-ray revealed multiple bullae within her left lung. Unfortunately, she redeveloped a pneumothorax and was sent to a tertiary centre...
June 20, 2018: BMJ Case Reports
Oscar Thabouillot, Julien Le Coz, Nicolas-Charles Roche
A seven-month-old girl was referred to the emergency department (ED) after a general practitioner suspected Steven-Johnson syndrome. Actually, the diagnosis of bullous pemphigoid (BP) was made based on biopsies; BP is a rare, autoimmune skin disease involving the presence of blisters known as bullae. The child was efficiently treated with topical steroids. This case shows the importance of the ED physician's prior knowledge of BP so that a differential diagnosis with other autoimmune diseases (dermatosis, pemphigus) can be made...
June 22, 2018: Prehospital and Disaster Medicine
Mads Aage Toft Kristensen, Ann Dorrit Guassora, Anne Beiter Arreskov, Frans Boch Waldorff, Bibi Hølge-Hazelton
OBJECTIVE: This paper investigated patients' experiences of disease and self-care as well as perceptions of the general practitioner's role in supporting patients with impaired self-care ability. DESIGN: Qualitative interviews with 13 patients with type 2 diabetes, concurrent chronic diseases, and impaired self-care ability assessed by a general practitioner. We analyzed our data using systematic text condensation. The shifting perspectives model of chronic illness formed the theoretical background for the study...
June 22, 2018: Scandinavian Journal of Primary Health Care
Marina Weißenborn, Martin Schulz, Manuel Kraft, Walter E Haefeli, Hanna M Seidling
AIM OF THE STUDY: Collaboration between general practitioners and community pharmacists is essential to ensure safe and effective patient care. However, collaboration in primary care is not standardized and varies greatly. This review aims to highlight projects about professional collaboration in ambulatory care in Germany and identifies promising approaches and successful benchmarks that should be considered for future projects. METHODS: A systematic literature search was performed based on the PRISMA guidelines to identify articles focusing on professional collaboration between general practitioners and pharmacists...
June 21, 2018: Das Gesundheitswesen
C de Baat, R S T Modderman
The behaviour of a 78-year-old, edentulous female resident of a care home, suffering from dementia indicated to her care providers that she was experiencing oral pain. At the left (pre)molar region of the mandibular residual alveolar ridge, an irritated, red-coloured, sharply restricted mucosal area was seen, extending in width from the buccal to the lingual border of the ridge. Eventually it was identified as mucosal irritation, apparently due to hydroxylapatite cones that had previously been inserted to augment the residual alveolar ridge...
June 2018: Nederlands Tijdschrift Voor Tandheelkunde
Yara Mouhamed, Andrey Vishnyakov, Bessi Qorri, Manpreet Sambi, Sm Signy Frank, Catherine Nowierski, Anmol Lamba, Umrao Bhatti, Myron R Szewczuk
With the proposed Canadian July 2018 legalization of marijuana through the Cannabis Act, a thorough critical analysis of the current trials on the efficacy of medicinal marijuana (MM) as a treatment option is necessary. This review is particularly important for primary care physicians whose patients may be interested in using MM as an alternative therapy. In response to increased interest in MM, Health Canada released a document in 2013 for general practitioners (GPs) as an educational tool on the efficacy of MM in treating some chronic and acute conditions...
2018: Drug, Healthcare and Patient Safety
Christy A Braham, Peter J White, Nimalan Arinaminpathy
OBJECTIVE: To assess the quality of tuberculosis (TB) care in Pakistan, through determining comparison of healthcare practitioners' knowledge and practices to national and international TB care guidelines. METHODS: Studies reporting on knowledge, attitudes and practices of public and private practitioners with TB patients were selected through searching electronic databases and grey literature. FINDINGS: Of 1458 reports, 20 full-texts were assessed, of which 11 met the eligibility and quality criteria; all studies focused on private sector care...
2018: PloS One
D E Smith, I J Woolley, D B Russell, F Bisshop, V Furner
As treatment improves, people living with HIV (PLWHIV) can now expect to live longer, which means that the foci of HIV-related care for them and their medical practitioners continue to change. With an increasingly older cohort of patients with HIV infection, practitioners' key considerations are shifting from issues of acute treatment and patient survival to multiple comorbidities, toxicities associated with chronic therapy, and ongoing health maintenance. Within this context, this paper explores the current standard of practice for the management of HIV infection in Australia...
August 2018: HIV Medicine
Roslyn Carmel Giglia, Martyn Symons, Thérèse Shaw
BACKGROUND: In the 2009 National Health and Medical Research Council (NHMRC) Australian Guidelines to Reduce Health Risks from Drinking, a guideline specific to lactating women was included. For the first time the effect of alcohol at this important developmental stage was nationally and internationally acknowledged. AIMS: To determine the degree to which maternal health practitioners adopted an Australian national policy guideline (Guideline 4B) on alcohol and breastfeeding into their everyday health practice and the factors associated with adoption...
June 21, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
A C Chapelle, J M Rakic
Vascular ocular pathologies are common and usually diagnosed in the emergency department by the ophtalmologist. However, it is very important for the physicians and the general practitioners to know these different diseases for improving the visual and vital prognosis. This paper describes the most important ocular and cerebrovascular pathologies.
May 2018: Revue Médicale de Liège
Charlotte Scheerens, Luc Deliens, Simon Van Belle, Guy Joos, Peter Pype, Kenneth Chambaere
Early integration of palliative home care (PHC) might positively affect people with chronic obstructive pulmonary disease (COPD). However, PHC as a holistic approach is not well integrated in clinical practice at the end-stage COPD. General practitioners (GPs) and community nurses (CNs) are highly involved in primary and home care and could provide valuable perspectives about barriers to and facilitators for early integrated PHC in end-stage COPD. Three focus groups were organised with GPs (n = 28) and four with CNs (n = 28), transcribed verbatim and comparatively analysed...
June 20, 2018: NPJ Primary Care Respiratory Medicine
Alessandra Buja, Riccardo Fusinato, Mirko Claus, Rosa Gini, Mario Braga, Mimma Cosentino, Giovanna Boccuzzo, Paolo Francesconi, Vincenzo Baldo, Mariadonata Bellentani, Gianfranco Damiani
BACKGROUND: A major shift in the gender of the medical-doctor workforce is now underway, and all over the world it is expected that an average 65% of the medical workforce will be women by 2030. In addition, an aging population means that chronic diseases, such as diabetes, are becoming more prevalent and the demand for care is rising. There is growing evidence of female physicians performing better than male physicians.AimOur study aimed to investigate whether any differences in diabetes process indicators are associated with gender, and/or the interaction between gender and different organizational models...
June 21, 2018: Primary Health Care Research & Development
Chaiwat Washirasaksiri, Prateep Raksasagulwong, Charoen Chouriyagune, Pochamana Phisalprapa, Weerachai Srivanichakorn
BACKGROUND: Although death certificates (DCs) provide valuable health information which may help to guide local health policies and priorities, there is little information concerning their validity in Thailand. First-year general practitioners (GPs) have a major role in DC completion, especially in provincial general hospitals. The aim of this study was to evaluate the accuracy and factors influencing the accuracy of DCs completed by first-year GPs in Thailand, compared with the cause of death (COD) derived from medical records by experts...
June 20, 2018: BMC Health Services Research
Wei-Yin Lim, Robin M Turner, Rachael L Morton, Marisa C Jenkins, Les Irwig, Angela C Webster, Mbathio Dieng, Robyn P M Saw, Pascale Guitera, Donald Low, Cynthia Low, Katy J L Bell
BACKGROUND: Patients may decide to undertake shared care with a general practitioner (GP) during follow-up after treatment for localised melanoma. Routine imaging tests for surveillance may be commonly used despite no evidence of clinical utility. This study describes the frequency of shared care and routine tests during follow-up after treatment for localised melanoma. METHODS: We randomly sampled 351 people with localised melanoma [American Joint Cancer Committee (AJCC) substages 0 - II] who had not had recurrent or new primary melanoma diagnosed from a total of 902 people diagnosed and treated for localised melanoma at a specialist centre in 2014...
June 20, 2018: BMC Health Services Research
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