The British journal of general practice : the journal of the Royal College of General Practitioners
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Review Meta Analysis
Association between point-of-care CRP testing and antibiotic prescribing in respiratory tract infections: a systematic review and meta-analysis of primary care studies.
Most patients with respiratory tract infections (RTIs) are prescribed antibiotics in general practice. However, there is little evidence that antibiotics bring any value to the treatment of most RTIs. Point-of-care C-reactive protein testing may reduce antibiotic prescribing. ⋯ POC C-reactive protein testing significantly reduced antibiotic prescribing at the index consultation for patients with RTIs. Further studies are needed to analyse the confounders that lead to the heterogeneity.
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A suitable definition of primary care to capture the variety of prevailing international organisation and service-delivery models is lacking. ⋯ Variation is shown in the strength of primary care across Europe, indicating a discrepancy in the responsibility given to primary care in national and international policy initiatives and the needed investments in primary care to solve, for example, future shortages of workforce. Countries are consistent in their primary care focus on all important structure dimensions. Countries need to improve their primary care information infrastructure to facilitate primary care performance management.
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Randomized Controlled Trial
'Someone batting in my corner': experiences of smoking-cessation support via text message.
The txt2stop trial demonstrated that smoking-cessation support delivered by text message doubles biochemically verified abstinence at 6 months. There was no significant heterogeneity in any of the pre-specified subgroups. ⋯ Although the intervention did stimulate craving in some participants at some times, recipients reported that it also provided emotional support and reinforcement at temporally appropriate moments. It was successful at helping people to quit smoking but could be used together with other forms of smoking-cessation support.
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Comparative Study
GPs' job satisfaction: doctors who chose general practice early or late.
In the UK many practising GPs did not choose general practice as their first choice of career when they originally graduated as doctors. ⋯ Job satisfaction levels were generally high among the late choosers as well as the early choosers. On this evidence, most doctors who turn to general practice, after preferring another specialty in their early career, are likely to have a satisfying career.
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The selection methodology for UK general practice is designed to accommodate several thousand applicants per year and targets six core attributes identified in a multi-method job-analysis study ⋯ In combination, these longitudinal findings provide good evidence of the predictive validity of the selection methods, and are the first reported for entry into postgraduate training. Results show that the best predictor of work performance and training outcomes is a combination of a clinical problem-solving test, a situational judgement test, and a selection centre. Implications for selection methods for all postgraduate specialties are considered.