The British journal of general practice : the journal of the Royal College of General Practitioners
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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.
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People who experience severe and multiple disadvantage (SMD - including combinations of homelessness, substance misuse, violence and abuse, and poor mental health) have high health need and poor access to primary care. Access to care requires the 'human fit' between the patient and healthcare staff. ⋯ Co-produced service-improvements to improve access to primary care for marginalised patients were valued, possible, and of benefit to patients, staff, and services. This study offers valuable insight into how we can better include and care for marginalised patients in primary care.
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Depression in elderly people is an ongoing concern, contributing to comorbidities and increasing deaths from suicide. Alternative treatments for the elderly are needed due to risks from polypharmacy and unwanted side effects. Therefore, we considered music therapy and its evidence base as a possible management modality. ⋯ Depression in the elderly is a serious illness that can lead to reduced quality of life and poor health status. Non-pharmacological treatments need to be identified and music therapy can be an accessible way of doing this, with numerous benefits demonstrated.
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IMG's experience disproportionally worse outcomes in GP Specialty Training when compared to their peers.1 This disparity in outcomes is not explained by any single identifiable trainee factor such as the academic ability, or trainee motivation and is called Differential Attainment.2Woolfe et al (2016) found factors such as lack of autonomy about the geographical location of work, combined with poor work-life balance can leave trainees unsupported, isolated, and vulnerable to anxiety, depression and other mental health conditions 3 coupled with potential stigma of supplementary help, anxiety about the increased probability of exam failure, visa difficulties and costs, all impact on the trainees' chances of progressing through training. 3 AIM: An evaluation of The Social Prescribing Scheme Pilot for International Medical Graduate GP Trainees in Yorkshire and the Humber. ⋯ Human factors such as accommodation and financial worries can have a huge impact on trainees' wellbeing and progression and should not be underestimated.
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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.