The British journal of general practice : the journal of the Royal College of General Practitioners
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There is evidence showing that healthcare organisations that take part in research demonstrate better performance. However, most evidence derives from hospital settings and these findings may not extend to general practice. The relationships between research activity and outcomes across general practices in England were explored. ⋯ Similar to hospital settings, general practice research activity is associated with a range of positive outcomes, although it is difficult to claim that research is causing those improvements. This study identified no negative impacts, suggesting that research activity is something that high-quality practices are able to deliver alongside their core responsibilities. There is a need to explore ways by which additional impacts of research can be maximised.
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Lyme Disease (LD) is a multisystem zoonosis with uncertain epidemiology. It may be increasing in rural hotspots. GP datasets are weakened by coding and definitions. Public and climate concerns have raised awareness of LD. ⋯ Early data suggests that the Lyme Disease General Practice Sentinel Scheme has improved case ascertainment, epidemiology, and risk factor understanding.
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Multiple long-term conditions (MLTC) are the co-occurrence of two or more chronic long-term conditions. While numerous studies have examined health and social care needs associated with MLTC, there has been limited research exploring both clinical and non-clinical care needs of this patient cohort from a range of perspectives. ⋯ MLTC patients often have a complex range of clinical and non-clinical care needs. This requires a holistic and coordinated care approach, enabling care to be tailored to personal care needs of individuals with MLTC.
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Haematological malignancies are the fifth most common cancer in the UK. Aggressive subtypes are potentially curable; chronic variants (the most frequent diagnoses) are incurable, although can be successfully managed for many years with observation, interspersed with treatment if required, or with long-term oral therapy. Chronic subtypes involve uncertain pathways, long-term symptoms and psychological distress, which may emerge in primary care. ⋯ Given the rising prevalence of haematological malignancies, pressure on acute services and UK survivorship policy, care may be increasingly shared between secondary and primary care-settings. Challenges include complex shared-care models that lack guidance, workforce issues, and knowledge of haematological malignancies. However, the value patients placed on primary care, coupled with difficulties experienced in hospital clinics, indicate shared care could succeed.
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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.