The British journal of general practice : the journal of the Royal College of General Practitioners
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Prostate cancer mortality in Black males is disproportionately high. This problem may be overcome by reducing delays in the pathway to diagnosis, particularly those occurring before initial medical help seeking. A greater understanding of symptom appraisal and help seeking could support the development of targeted interventions for improving early presentation among Black males. ⋯ Cognitive biases, cultural stigmas, and everyday interpersonal interactions should be important areas at which to target strategies seeking to reduce delays and improve early presentation in males with possible prostate cancer, particularly Black males.
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There is evidence showing that healthcare organisations that take part in research demonstrate better performance. However, most evidence derives from hospital settings and these findings may not extend to general practice. The relationships between research activity and outcomes across general practices in England were explored. ⋯ Similar to hospital settings, general practice research activity is associated with a range of positive outcomes, although it is difficult to claim that research is causing those improvements. This study identified no negative impacts, suggesting that research activity is something that high-quality practices are able to deliver alongside their core responsibilities. There is a need to explore ways by which additional impacts of research can be maximised.
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Treatment-resistant depression (TRD) is when antidepressants do not work and affects 55% of British primary care users with depression. People with TRD should be referred to secondary care but there are long wait times. This means most people are managed by GPs, but primary care guidelines are not standardised. Thus, how GPs manage people with TRD may vary, and there is limited evidence for how quality care may look. As a result of this variation, an investigation into how GPs manage people might be valuable. ⋯ TRD can be a contested diagnosis in the same way as ADHD, ME, and long-COVID. GP training and continuing professional development may support GP awareness of TRD and help them in confidently making the diagnosis.
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The UK Health Security Agency have established a partnership with the Oxford-Royal College of General Practitioners (RCGP) Clinical Informatics Digital Hub (ORCHID) to provide a new source of primary care data to enhance an existing GP in-hours syndromic surveillance system. ⋯ For decades the RCGP has run sentinel surveillance with integrated virology and now RCGP data are being used for syndromic surveillance. The addition of ORCHID data to the GP in-hours syndromic surveillance system has improved the utility of the system. There is better population coverage, additional syndromic indicators, and greater ability to interrogate the data. The new system will provide enhanced information to support public health in England and highlights the value of GP records for use in protecting the health security of the nation.
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Lyme Disease (LD) is a multisystem zoonosis with uncertain epidemiology. It may be increasing in rural hotspots. GP datasets are weakened by coding and definitions. Public and climate concerns have raised awareness of LD. ⋯ Early data suggests that the Lyme Disease General Practice Sentinel Scheme has improved case ascertainment, epidemiology, and risk factor understanding.