The British journal of general practice : the journal of the Royal College of General Practitioners
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The NHS App was launched as a 'front door' to digitally enabled health services, offering a range of services including appointment booking and ordering prescriptions. The extent of App use and its impacts on digital inclusion is under-explored. ⋯ There is high uptake of the NHS App but there are differences in adoption rates among different population groups and issues of relevance and accessibility, that warrant further work.
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The ANA-associated diseases are rare autoimmune diseases (including Systemic lupus erythematosus [SLE], Sjögren's, Scleroderma, autoimmune hepatitis). Interpretation of ANA-tests is difficult, it is frequently positive in patients who do not appear to have an associated disease. In those who are ANA-positive we suspect there are features that can help distinguish those who will later develop disease. ⋯ Defining the test result is difficult. However, there is clear differentiation between the positive and negative/unknown cohorts. Positive-test status is associated with ANA-disease development and mortality. If ANA-positive, most of those who will develop disease are diagnosed soon after testing; male gender and advanced-age reduce the risk of ANA-diseases.
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Benign paroxysmal positional vertigo (BPPV) is a prevalent and disabling pathology. Its diagnosis and treatment according to clinical practice guidelines is carried out through canalicular repositioning maneuvers, but these maneuvers are not performed routinely in primary care consultations. ⋯ The majority of diagnostic records related to vertigo/dizziness were non-specific (9 out of 10). The number of prescriptions for betahistine, and referrals, mainly to an otolaryngologist, are considerable and an avoidable expense. Better knowledge about vertigo/dizziness in care could improve the diagnostic and therapeutic accuracy of this pathology as well as the social and health costs it produces.
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Smoking is a major international public health problem. ⋯ People who smoke but who also use NRT reported smoking less heavily than when solely smoking, and when NRT was used as 'preloading' this reported smoking reduction was biochemically confirmed. There was no evidence concurrent smoking and NRT use resulted in greater nicotine exposure than smoking.