The British journal of general practice : the journal of the Royal College of General Practitioners
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Existing cardiovascular disease (CVD) risk prediction tools may not be applicable to the Chinese populations because of their development based on the mostly Western cohorts and limited list of covariates. ⋯ P-CARDIAC allows a more personalised approach for recurrent CVD prevention with dynamic baseline risk and concurrent medication effect. Such an approach with the potential for being recalibrated for other ethnicities will be used in primary care for managing CVD risk.
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Identifying and responding to patients affected by domestic violence and abuse (DVA) is vital in primary care. There may have been a rise in the reporting of DVA cases during the COVID-19 pandemic and associated lockdown measures. Concurrently general practice adopted remote working that extended to training and education. IRIS (Identification and Referral to Improve Safety) is an example of an evidence-based UK healthcare training support and referral programme, focusing on DVA. IRIS transitioned to remote delivery during the pandemic. ⋯ The authors recommend a hybrid DVA training model for general practice, including remote information delivery alongside a structured face-to-face element. This has broader relevance for other specialist services providing training and education in primary care.
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GPs regularly prescribe lifelong treatments for long-term conditions, supported by clinical guidelines and encouraged by performance measures. However, GPs have a poor understanding of the absolute benefits and harms of these treatments, impairing their ability to engage in genuine shared decision making or optimally manage polypharmacy. There are few easily accessible and understandable sources of this kind of quantitative information. ⋯ It is possible to communicate quantitative information about the clinical evidence base behind treatments in a way that will be usable in practice and that complements existing clinical guidelines and normative practice. This has the potential to support shared decision making, improve the management of polypharmacy, and increase GPs' confidence in this area of practice.
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Advance care planning is rare among older adults with a migration background because of social, cultural, and religious reasons. ⋯ Healthcare providers in Belgium should provide tailored information about advance care planning to Turkish-origin adults with palliative care needs. Advance care planning discussions should also explore the individual's health-related knowledge and personal values, paying attention to social and religious cues. Healthcare professionals should also recognise the salience of Turkish families in end-of-life care.
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Pelvic floor symptoms, such as lower urinary tract symptoms, defecation problems, sexual dysfunction, pelvic pain, and pelvic organ prolapse in females, are common and frequently co-occur. Despite negatively affecting quality of life, few patients seek help. Most studies assessing help-seeking behaviour have focused on a single pelvic floor symptom. ⋯ Males and females have more similarities than differences in help-seeking behaviour. Healthcare providers should be aware that patients who seek help for one symptom probably have multiple pelvic floor symptoms that the patient has not reported.