The British journal of general practice : the journal of the Royal College of General Practitioners
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The use of aloe vera is being promoted for a large variety of conditions. Often general practitioners seem to know less than their patients about its alleged benefits. ⋯ Even though there are some promising results, clinical effectiveness of oral or topical aloe vera is not sufficiently defined at present.
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Colour is often used as a sign in medicine, yet there have been few studies into the effects of a colour vision deficiency (CVD) on doctors' medical skills. Using a literature search, the results indicate the prevalence of CVD in the medical profession and its effects on medical skills. For the congenital form among male doctors in the United Kingdom, the prevalence is shown to be probably about the same as for the population at large; i.e. 8%. ⋯ The effect on skills is also shown. Because of certain features of their work, general practitioners may have special problems. Thus, it is concluded that medical students and doctors should be screened for the deficiency and advised about it, and that there should be more study of the effects of CVD on decision-making in general practice and some specialties.
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Systematic reviews and meta-analyses are becoming increasingly important in informing clinical practice and commissioning. Two systematic reviews of a treatment for low back pain and sciatica using epidural steroid injections, published in the same year, arrived at conflicting conclusions. Only one was reported in a digest for evidence-based medicine. ⋯ Estimation of summary odds ratios in one review led to stronger conclusions about effectiveness. In conclusion, the choice of methods for systematic review may alter views about the current state of evidence. Users should be aware that systematic reviews include an element of judgement, whatever method is used.
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The United Kingdom (UK) cervical screening programme has been successful in securing participation of a high proportion of targeted women, and has seen a fall in mortality rates of those suffering from cervical cancer. There remains, however, a significant proportion of unscreened women and, of women in whom an abnormality is detected, many will not attend for colposcopy. The present work reviews the psychological consequences of receiving an abnormal cervical smear result and of secondary screening and treatment, and examines reasons for women's non-participation in the screening programme. ⋯ The receipt of an abnormal result and referral for colposcopy cause high levels of distress owing to limited understanding of the meaning of the smear test; many women believe the test aims to detect existing cervical cancer. The quality of the cervical screening service can be enhanced by the provision of additional information, by improved quality of communication, and by consideration of women's health beliefs. This may result in increased participation in, and satisfaction with, the service.
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In the United Kingdom (UK), 9% of adults consult their doctor annually with back pain. The treatment recommendations are based on orthopaedic teaching, but the current management is causing increasing dissatisfaction. Many general practitioners (GPs) are confused about what constitutes effective advice. ⋯ A simple but fundamental change from the traditional prescription of bed rest to positive advice about staying active could improve clinical outcomes and reduce the personal and social impact of back pain.