Family practice
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Review articles play an important role in synthesizing primary research for dissemination to clinicians. In a previous study it was found that many review articles appearing in leading peer-reviewed general medical journals are not prepared systematically. Given that review articles feature prominently in primary care journals, this study assessed the extent to which review articles published in the seven main primary care journals during 1991 had been assembled using a systematic and scientific approach. ⋯ However, when standard criteria were used to assess their methodological rigour, only 25% of the articles had a total score of more than 8 points (out of a possible 16). The validity of any conclusions or recommendations made in a poorly assembled review need to be carefully examined. Improving the methodological standards by which reviews are assembled in primary care journals should be seen as both a challenge and a priority.
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Chronic fatigue syndrome (CFS) is a symptom complex which while mild in some cases is severely debilitating in others. Long-term ill health leads to greater use of resources but in the case of long-term CFS the anecdotal evidence suggested a low compliance with the available options and a high level of both patient and general practitioner dissatisfaction. This pilot study sought through repeated action research cycles to start to identify culturally and contextually sensitive forms of language and models for service delivery suitable for people with CFS in a general practice setting. It worked through a number of action research cycles, to initiate the identification of conceptual models acceptable to both doctors and to patients suffering from CFS, self-management options which encouraged the body's ability to heal itself and services and delivery mechanisms which met patient needs within health provider options.
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A group of individuals who had granted or refused permission to have organs removed from a decreased relative for transplantation were interviewed. Organ donation was found to be a very delicate subject: the request for organ donation often comes unexpectedly and most relatives are not aware of the wishes of the decreased (donor codicil), which complicates the decision process. ⋯ The position of the member of staff who asks for permission is complicated. Suggestions are presented to improve the procedure.
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Case Reports Comparative Study
Perceptions of psychological problems in general practice: a comparison of general practitioners and psychiatrists.
All general practitioners and psychiatrists working in a single health district were sent a questionnaire on their perceptions of the prevalence of psychological problems among patients consulting in general practice. One hundred and twenty-one GPs (75%) and 10 (83%) psychiatrists responded. ⋯ GPs, however, believed non-specific psychological problems to be significantly less common than did psychiatrists. This expectation may help explain the reported failure of GPs to diagnose all psychological problems identified by formal psychiatric instruments.