The British journal of general practice : the journal of the Royal College of General Practitioners
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Multicenter Study
Using the 7-point checklist as a diagnostic aid for pigmented skin lesions in general practice: a diagnostic validation study.
GPs need to recognise significant pigmented skin lesions, given rising UK incidence rates for malignant melanoma. The 7-point checklist (7PCL) has been recommended by NICE (2005) for routine use in UK general practice to identify clinically significant lesions which require urgent referral. ⋯ The Original and Weighted 7PCLs both performed well in a primary care setting to identify clinically significant lesions as well as melanoma. The Weighted 7PCL, with a revised cut-off score of 4 from 3, performs slightly better and could be applied in general practice to support the recognition of clinically significant lesions and therefore the early identification of melanoma.
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There is evidence of an association of medically unexplained physical symptoms (MUPS) between parents and children, but it is unclear whether this association is also present for GP consultations. ⋯ This review provides evidence of an association between GP consultations for MUPS in parents and children, although the evidence is limited by some potential biases and study heterogeneity. GPs need to be aware of this association, which has implications for management of children presenting with MUPS. More longitudinal research focusing on all common MUPS in children, which relies on more precise sources of data, is needed to further investigate this association.
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Are there enough GPs in England to detect hypertension and maintain access? A cross-sectional study.
Fewer patients are recorded by practices as having hypertension than are identified in systematic population surveys. However, as more patients are recorded on practice hypertension registers, mortality from coronary heart disease and stroke declines. ⋯ In order to improve detection of hypertension as part of a strategy to lower mortality from coronary heart disease, the capacity of practices to detect hypertension while maintaining access needs to be improved. Increasing the supply of GPs may be necessary, as well as improvements in efficiency.
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Observational Study
Factors affecting the physician-patient relationship of older veterans with inadequate health literacy: an observational study.
In Taiwan, older veterans typically match the characteristics of a high prevalence of inadequate health literacy, which is a major barrier to effective communication in delivering proper health care. A good physician-patient relationship increases patients' trust and willingness to communicate, so an awareness of the factors that influence this relationship could improve it over time and enhance patients' health. ⋯ Older patients with inadequate health literacy had difficulty becoming actively involved in health care. The GP is in an ideal position to become a key person in helping such patients become involved in health care, and appropriately treating their depression may improve the physician-patient relationship.