The British journal of general practice : the journal of the Royal College of General Practitioners
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The ANA-associated diseases are rare autoimmune diseases (including Systemic lupus erythematosus [SLE], Sjögren's, Scleroderma, autoimmune hepatitis). Interpretation of ANA-tests is difficult, it is frequently positive in patients who do not appear to have an associated disease. In those who are ANA-positive we suspect there are features that can help distinguish those who will later develop disease. ⋯ Defining the test result is difficult. However, there is clear differentiation between the positive and negative/unknown cohorts. Positive-test status is associated with ANA-disease development and mortality. If ANA-positive, most of those who will develop disease are diagnosed soon after testing; male gender and advanced-age reduce the risk of ANA-diseases.
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Randomized Controlled Trial
Experiences of urine collection devices during suspected urinary tract infections: a qualitative study in primary care.
Up to 30% of urine samples from women with suspected urinary tract infection (UTI) are contaminated and need to be repeated, burdening health services and delaying antibiotic prescription. To prevent contamination, midstream urine (MSU) sampling, which can be difficult to achieve, is recommended. Urine collection devices (UCDs) that automatically capture MSU have been proposed as a solution. There are few studies exploring women's experiences of using such devices. ⋯ Most women agreed there was a need for a user- and environmentally-friendly device to improve urine collection. Although using UCDs can be difficult for women experiencing UTI symptoms, they may be appropriate for asymptomatic sampling in other clinical populations.
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Domestic abuse (DA) is underdiagnosed by the medical community. The National Institute for Health and Care Excellence (NICE) does not recommend DA screening in primary care. The enduring use of remote consultations since COVID-19, coupled with the sensitive nature and increasing prevalence of DA, necessitates review of the NICE guideline, which was developed pre-pandemic primarily for face-to-face consultations. ⋯ The routine use of the already established WAST-short in primary care could help identify and potentially tackle DA. Training health and social care professionals in administering the brief, non-threatening DA screening questionnaire would help raise awareness, and identify and support victims.
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Recent policy initiatives seeking to address the workforce crisis in general practice have promoted greater multidisciplinarity. Evidence is lacking on how changes in staffing and the relational climate in practice teams affect the experiences of staff and patients. ⋯ Evidence regarding team composition and team climate in relation to staff and patient outcomes remains limited. Challenges exist when drawing conclusions across different team compositions and differing definitions of team climate. Future research may benefit from exploring the conditions that generate a productive team climate.
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Following the COVID-19 pandemic, the NHS is facing increasing pressures because of growing patient demand and hospital backlogs. With the number of GPs declining, the average number of patients per GP has increased. There are reports of hospital trusts and GP practices introducing doctors' assistants (DAs) to help with clinical and administrative tasks, which has reduced the workload of doctors. As the authors are not aware of any DAs working with GPs locally, Maylands Healthcare (14 000 patients) has introduced this new workforce model by assigning a DA to each clinician's worklist. ⋯ This study demonstrates that the introduction of DAs has helped to manage the administrative workload in primary care, improving efficiency, patient care, and safety.