Family practice
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A movement is emerging to encourage health providers and health organizations to take action on the social determinants of health. However, few evidence-based interventions exist. Digital tools have not been examined in depth. ⋯ Our study contributes to the evidence based on addressing the social determinants of health in clinical settings. Future approaches could involve routine screening, engaging other members of the team in intervening and following up, and better integration with the electronic health record.
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The incidence of self-harm in young people in primary care is increasing dramatically, and many young people who self-harm visit their GP surgery as a first point of contact for help. ⋯ The type of self-harm young people presented with influenced whether they would see a GP or PN. While self-help materials were welcomed and deemed helpful, young people, GPs and PNs were ambivalent about using these in short consultations where time was an overriding constraint. More research is needed on the feasibility of adopting self-help assisted interventions in GP surgeries.
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Multicenter Study
Effectiveness of individual and group multicomponent interventions for smoking cessation in primary care: a quasi-experimental study.
The efficacy of smoking cessation interventions can be quite diverse in day-to-day clinical practice. ⋯ Our study found that multicomponent group and individual interventions in primary care were associated with an overall quit rate of smoking of 36.9% at 12-month follow-up, with higher probability of success among patients with higher education and those who received the group intervention and drug treatment.
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Most of the patients with gastroenteritis seeking health care services are managed in primary care; yet, little is known about these consultations. Syndromic-based surveillance of gastrointestinal infections is used in several countries, including Norway. ⋯ The proportion of gastroenteritis consultations was higher in the OOH services when compared with daytime general practice. Young children and young adults dominated among the patients. The seasonal variation in consultation frequency is similar to that shown for gastroenteritis caused by norovirus.
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There has been a shift in worldwide disease burden from infections to non-communicable diseases, especially type 2 diabetes (T2D). Behavioural change and self-management are key to optimal T2D control. Several universal models of diabetic care have been proposed to help explain the dimensions of T2D self-care such as medication adherence, physical activity, diet and patient-doctor interaction. These models do not allow an objective and quantifiable measurement of the problems faced by patients in terms of medication compliance. ⋯ The framework developed here could help in the design of policies to optimize T2D control by identifying lapses in patients' intake of diabetic medications. This can be done by exploring the patients' fundamental and unarticulated belief system via a naturalistic approach adopted in this study. The properties of the framework can be replicated in other settings to serve as a benchmark for quality improvement in T2D patient care.