Family practice
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Heart failure (HF) is the most frequent cardiovascular pathology in primary care. Echocardiography is the gold standard for diagnosis, follow-up, and prognosis of HF. Point-of-care ultrasound (POCUS) is of growing interest in daily practice. ⋯ The use of cPOCUS by non-expert physicians after a short training course appears to be an accurate complementary tool for LVEF assessment in daily practice. Its diffusion in primary care could optimize patient management, without replacing specialist assessment.
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Asthma is one of the most frequent reasons children visit a general practitioner (GP). The diagnosis of childhood asthma is challenging, and a variety of diagnostic tests for asthma exist. GPs may refer to clinical practice guidelines when deciding which tests, if any, are appropriate, but the quality of these guidelines is unknown. ⋯ The variable quality of guidelines, lack of good quality evidence, and inconsistent recommendations for diagnostic tests may contribute to poor clinician adherence to guidelines and variation in testing for diagnosing childhood asthma.
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General practitioners (GPs) need robust, up-to-date evidence to deliver high-quality patient care. There is limited literature regarding the role of international GP professional organizations in developing and publishing clinical guidelines to support GPs clinical decision making. ⋯ Open Science Framework: https://doi.org/10.17605/OSF.IO/JXQ26.
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Physicians are likely to be asked to provide medical care to relatives or friends. Evidence suggests that most physicians treat loved ones during their active years. However, in the academic literature, critical approaches to the matter are dominating. Ethical guidelines often discourage physicians from treating family members and friends outside of exceptional circumstances. ⋯ This systematic review shows that the discourse of physicians treating loved ones is held predominantly in the context of personal experiences. The majority of authors seem to have a rather pragmatic interest in the topic, and systematic or analytic approaches are rare. While most authors mention various codes of ethics, several publications criticize these or consider them insufficient.
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Associated with both socioeconomic position and health outcomes, health literacy (HL) may be a mechanism contributing to social disparities. However, it is often difficult for general practitioners (GPs) to assess their patients' HL level. ⋯ The lower the patient's place on the social ladder, the greater the gap between the patient's and doctor's opinion of the patient's HL. This greater gap may contribute to the reproduction or maintenance of social disparities in care and health.