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Karine Danno, Gérard Duru, Jean Marie Vetel
BACKGROUND:  The increasing use of psychotropic drugs to treat anxiety and depressive disorders (ADDs) is concerning. According to the study, 'Etude Pharmacoépidémiologique de l'Impact de Santé Publique des modes de prise en charge pour 3 groupes de pathologies' (EPI3)-LASER, adult ADD patients who consult a general practitioner prescribing homeopathic medicines (GP-Ho) report less psychotropic drug use and are marginally more likely to experience clinical improvement than those receiving conventional care...
March 20, 2018: Homeopathy: the Journal of the Faculty of Homeopathy
Marte Meyer Walle-Hansen, Sigurd Høye
Antibiotic consumption varies greatly between Norwegian municipalities. We examine whether this variation is associated with inhabitants' consultation rates or general practitioners' (GP) prescription rates. Our study comprises consultations and antibiotic prescriptions for respiratory tract infections (RTIs) in general practice in all Norwegian municipalities with over 5000 inhabitants in 2014. Data was collected from The Norwegian Prescription Database, The Directorate of Health's system for control and payment of health reimbursements registry and Norway Statistics...
March 20, 2018: Antibiotics
Philip L Richardson, Ewan D Wakefield, Richard A Phillips
Background: Albatrosses and other large seabirds use dynamic soaring to gain sufficient energy from the wind to travel large distances rapidly and with little apparent effort. The recent development of miniature bird-borne tracking devices now makes it possible to explore the physical and biological implications of this means of locomotion in detail. Here we use GPS tracking and concurrent reanalyzed wind speed data to model the flight performance of wandering albatrosses Diomedea exulans soaring over the Southern Ocean...
2018: Movement Ecology
Michelle Farr, Jonathan Banks, Hannah B Edwards, Kate Northstone, Elly Bernard, Chris Salisbury, Jeremy Horwood
OBJECTIVES: To examine patient and staff views, experiences and acceptability of a UK primary care online consultation system and ask how the system and its implementation may be improved. DESIGN: Mixed-method evaluation of a primary care e-consultation system. SETTING: Primary care practices in South West England. METHODS: Qualitative interviews with 23 practice staff in six practices. Patient survey data for 756 e-consultations from 36 practices, with free-text survey comments from 512 patients, were analysed thematically...
March 19, 2018: BMJ Open
Esther T van der Werf, Lorna J Duncan, Paschen von Flotow, Erik W Baars
OBJECTIVE: To determine differences in antibiotic prescription rates between conventional General Practice (GP) surgeries and GP surgeries employing general practitioners (GPs) additionally trained in integrative medicine (IM) or complementary and alternative medicine (CAM) (referred to as IM GPs) working within National Health Service (NHS) England. DESIGN: Retrospective study on antibiotic prescription rates per STAR-PU (Specific Therapeutic group Age-sex weighting Related Prescribing Unit) using NHS Digital data over 2016...
March 5, 2018: BMJ Open
Valérie Zimmerlé, Emeline Laurent, Valérie Tauveron, Annabel Maruani, Emmanuelle Le Bidre, Mahtab Samimi, Laurent Machet
INTRODUCTION: Cutaneous cancers are very common, easily visible on skin. The general practitioner (GP) is in the front line to manage the lesions. He has to recognize malignancy and refer most often to the specialist for excision, or consider that the lesion is benign and in ambiguous cases, offer clinical monitoring. The current low medical density in the Centre Val de Loire area makes access to general practitioners (GP) and dermatologists harder. The aim of this study was to evaluate GPs' everyday practice in cutaneous cancers screening in general, and particularly in melanoma screening, in a rural region of France...
March 16, 2018: La Presse Médicale
Hui Liu, Zhenghu Jia, Chengmao Yang, Mei Song, Zhe Jing, Yapu Zhao, Zhenzhou Wu, Liqing Zhao, Dongsheng Wei, Zhinan Yin, Zhangyong Hong
Aluminum salt (Alum) is one of the most important immune adjuvants approved for use in humans, however it is not suitable for vaccination against various chronic infectious diseases and cancers for not being able to induce cell-mediated (Th1) immunity. Here, we encapsulated an Alum colloid inside β-glucan particles (GPs), which are a type of natural particles derived from the yeast glucan shells, to prepare hybrid GP-Alum (GP-Al) adjuvant particles with a very uniform size of 2-4 μm. These hybrid particles can be used to load antigen proteins through a simple mixing procedure, and can be highly specifically targeted to antigen-presenting cells (APCs) and strongly activate dendritic cells (DCs) maturation and cytokine secretion...
March 12, 2018: Biomaterials
Tanja Schmidt, Jacqueline Kerr, Yan Kestens, Jasper Schipperijn
Daily mobility, defined as the ability to move oneself within one's neighborhood and regions beyond, is an important construct, which affects people as they age. Having a feasible and valid measure of daily mobility is essential to understand how it affects older adults' everyday life. Given the limitations of existing measures, new tools may be needed. The purpose of the study is to assess the feasibility and practicality of using the map-based questionnaire system VERITAS and GPS devices to measure daily mobility in older adults living in a deprived neighborhood in Denmark...
March 15, 2018: Translational Behavioral Medicine
Junko Yasuoka, Keiko Nanishi, Kimiyo Kikuchi, Sumihiro Suzuki, Po Ly, Boukheng Thavrin, Tsutomu Omatsu, Tetsuya Mizutani
BACKGROUND: Maternal morbidity and mortality is still a major public health issue in low- and middle-income countries such as Cambodia. Improving access to antenatal care (ANC) services for pregnant women has been widely recognized as one of the most effective means of reducing maternal mortality and morbidity. As such, this study examined the barriers for pregnant women living in rural, agricultural villages to accessing ANC based on data collected in the Ratanakiri province, one of the least developed provinces in Cambodia, using a combination of a community-based cross-sectional survey and a geographic information system (GIS)...
2018: PloS One
Sandra Grace, Roger Engel, Ian Jalsion
The Australian chiropractic and osteopathic professions underwent a period of significant transformation between 1960 and 2000. This resulted in an improvement in the views held by the medical profession towards the two professions. However, a recent survey of Australian general practitioners (GPs) reported that a number of GPs still hold negative views towards chiropractors and osteopaths. This paper examines these views from the perspective of critical realism and explores the generative mechanisms that can influence the willingness of health practitioners to collaborate over patient care...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Mandy Berndt-Paetz, Luise Herbst, Annett Weimann, Andreas Gonsior, Jens-Uwe Stolzenburg, Jochen Neuhaus
PURPOSE: Muscarinic acetylcholine receptors (mAChRs) regulate a number of important physiological functions. Alteration of mAChR expression or function has been associated in the etiology of several pathologies including functional bladder disorders (e.g bladder pain syndrome/interstitial cystitis - BPS/IC). In a previous study we found specific mAChR expression patterns associated with BPS/IC, while correlation between protein and gene expression was lacking. Posttranslational regulatory mechanisms, e...
March 15, 2018: Acta Histochemica
Anne-Marie Burn, Jane Fleming, Carol Brayne, Chris Fox, Frances Bunn
OBJECTIVES: In 2012-2013, the English National Health Service mandated hospitals to conduct systematic case-finding of people with dementia among older people with unplanned admissions. The method was not defined. The aim of this study was to understand current approaches to dementia case-finding in acute hospitals in England and explore the views of healthcare professionals on perceived benefits and challenges. DESIGN: Qualitative study involving interviews, focus groups and thematic content analysis...
March 17, 2018: BMJ Open
Shannon N Zenk, Stephen A Matthews, Amber N Kraft, Kelly K Jones
This study examined the number of days of global positioning system (GPS) monitoring needed to measure attributes of an individual's routine activity space. Multiple alternative activity space representations (cumulative, mean daily), measures (kernel density, route buffer, convex hull), and attributes (area size, supermarkets, fast food restaurants, parks) were examined. Results suggested wide variability in required GPS days to obtain valid estimates of activity space attributes (1-23 days). In general, fewer days were needed for mean daily activity space representations, kernel density measures, and densities of environmental exposures (vs...
March 7, 2018: Health & Place
Xiaojun Liu, Anran Tan, Samuel D Towne, Zhaoxun Hou, Zongfu Mao
OBJECTIVE: General practitioners (GPs) are highly underutilised in China with many patients going directly to hospitals when seeking routine care. Multiple countries around the world have successfully used GPs in routine care, and as such, China may benefit from the use of GPs. This study examines the status of, and factors associated with, knowledge related to GPs among outpatient populations from China's tertiary hospitals. DESIGN: This is a cross-sectional survey study...
March 16, 2018: BMJ Open
Suzanne Grant, Bruce Guthrie
Patient safety is an increasing concern for health systems internationally. The majority of administrative work in UK general practice takes place in the context of organisational routines such as repeat prescribing and test results handling, where high workloads and increased clinician dependency on administrative staff have been identified as an emerging safety issue. Despite this trend, most research to date has focused on the redistribution of the clinical workload between doctors, nurses and allied health professionals within individual care settings...
March 2, 2018: Social Science & Medicine
Michael J Widener, Leia M Minaker, Jessica L Reid, Zachary Patterson, Tara Kamal Ahmadi, David Hammond
OBJECTIVE: To examine the potential links between activity spaces, the food retail environment and food shopping behaviours for the population of young, urban adults. DESIGN: Participants took part in the Canada Food Study, which collected information on demographics, food behaviour, diet and health, as well as an additional smartphone study that included a seven-day period of logging GPS (global positioning system) location and food purchases. Using a time-weighted, continuous representation of participant activity spaces generated from GPS trajectory data, the locations of food purchases and a geocoded food retail data set, negative binomial regression models were used to explore what types of food retailers participants were exposed to and where food purchases were made...
March 16, 2018: Public Health Nutrition
Rieke Schnakenberg, Lukas Radbruch, Christine Kersting, Friederike Frank, Stefan Wilm, Denise Becka, Klaus Weckbecker, Markus Bleckwenn, Johannes M Just, Michael Pentzek, Birgitta Weltermann
BACKGROUND: Although general practitioners (GPs) are among the preferred contact persons for discussing end-of-life issues including advance directives (ADs), there is little data on how GPs manage such consultations. OBJECTIVES: This postal survey asked German GPs about their counselling for end-of-life decisions. METHODS: In 2015, a two-sided questionnaire was mailed to 959 GPs. GPs were asked for details of their consultations on ADs: frequency, duration, template use, and whether they have own ADs...
December 2018: European Journal of General Practice
V Clergue-Duval, E Pot, J Azuar
BACKGROUND: General practitioners (GPs) are fully concerned with the care of patients suffering from addiction and must have the support of a specialized network. The aim of the study was to evaluate the prevalence of the addict follow-up care by GPs, their use of addictological care facilities and their needs in communicating with specialists. METHODS: Private and salaried GPs working in the 9th, 10th, 18th and 19th districts of Paris were contacted by phone, and a questionnaire was sent to those who agreed to respond...
March 12, 2018: Revue D'épidémiologie et de Santé Publique
Hua Gao, Xiaolong Sun, Wen Li, Qiong Gao, Jing Zhang, Yi Zhang, Yue Ma, Xiai Yang, Xiaogang Kang, Wen Jiang
Objective Stroke due to atrial fibrillation (AF) is common and frequently devastating. However, there is no specific tool to accurately estimate the risk of mortality. This study aims to develop and validate a comprehensive risk score for predicting 30-day mortality in the patients with AF-related stroke. Methods A retrospective multi-center clinical study was performed based on the data from the project of secondary prevention of stroke in patients with nonvalvular AF in Shaanxi province, China. A total of 1077 consecutive patients were randomly classified into derivation (66...
March 16, 2018: Neurological Research
Lee-Fay Low, Margaret McGrath, Kate Swaffer, Henry Brodaty
The aim of this study is to systematically review practitioners' practices and attitudes in regards to communicating a diagnosis of dementia. A systematic search was conducted of Scopus, Web of Science and PubMed for English language original empirical papers. A sequential explanatory mixed studies analysis approach was used. Twenty-five quantitative descriptive, two intervention, six mixed methods descriptive and 21 qualitative studies were included. Pooled analysis showed that 34% of GPs and 48% of specialists usually/routinely tell the person with dementia their diagnosis, and 89% of GPs and 97% specialists usually/routinely tell the family the diagnosis...
January 1, 2018: Dementia
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