The British journal of general practice : the journal of the Royal College of General Practitioners
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Omission of pelvic examination (PE) has been associated with diagnostic delay in women diagnosed with gynaecological cancer. However, PEs are often not carried out by GPs. ⋯ GPs' reasons for carrying out, or not carrying out, PEs in women with symptoms potentially indicating cancer are complex. The COM-B framework provides a way of understanding this complexity. Interventions to increase the use of PEs, and critics of its non-use, need to consider these multiple factors.
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Weather and seasons, or stressful periods associated with their education could affect young people's mental health. Members of a young person's advisory group asked us to investigate whether there are particular periods in the year when adolescents have more mental health issues. ⋯ There were higher rates of antidepressant prescribing, depression, and anxiety at the start of the school year in adolescents. Support around mental health issues from GPs and schools should be focused during this period. Future studies should examine whether these results apply to younger children and develop interventions to lessen their impacts on adolescents.
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Diverting patients to the community is one of the solutions to mitigate overcrowding in emergency departments, which is the role of the Frailty In-Reach service. ⋯ We successfully improved the triage system within the Frailty In-Reach service with digital technology.
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Problematic polypharmacy is an increasingly common clinical scenario in part due to increasing multimorbidity and application of multiple single condition guidelines. It is a challenging problem requiring a multifaceted management approach. This includes deprescribing, which is the structured dose reduction or stopping of medications. Qualified GPs struggle with deprescribing due to existing barriers, but little is known about how trainee GPs feel about this skill. ⋯ This study explored the complex area of problematic polypharmacy and deprescribing as relating to final year GP trainees. It identified key skills that trainees feel they need to manage this task in practice. Importantly, it also recognises barriers to be overcome before confident deprescribing can be performed. Potential improvements in training are identified with suggestions for educational opportunities.
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Reducing suicide risk in middle-aged males (40-54 years) is a national priority. People have often presented to their GP within 3 months before suicide thus highlighting an opportunity for early intervention. ⋯ Clinical factors were identified that GPs should be alert to when assessing middle-aged males. Personalised holistic management may have a role in preventing suicide in these individuals.