The British journal of general practice : the journal of the Royal College of General Practitioners
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In the summer of 2021, after 18 months of the COVID-19 pandemic, there were still no clear evidence-based interventions for COVID-19 infection in the community. Recruiting large numbers at pace was a challenge to urgently generate the evidence needed to inform care within the pandemic. ⋯ Large-scale, at-pace recruitment supported by the English CRN and equivalent networks across the UK, is achievable in a pandemic situation, producing potentially game-changing results of national and international importance.
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The diagnosis and management of psychogenic non-epileptic seizures (PNES) is often challenging. This literature review was done to investigate available data on PNES to make recommendations for its management. ⋯ The unmasking of the masquerade of PNES is challenging for clinicians in primary and tertiary care. Raising awareness of the condition reduces the burden on health care. Definitive guidelines and more control trials are required. Provocative measures to establish the diagnosis are limited. The feasibility of using the tilt table as a provocative measure is discussed.
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GPs have been shown to be important providers of medical care during pregnancy, however, little evidence exists on their awareness of pregnancy when prescribing medication to women. ⋯ Results of this study indicate a potential issue with GP awareness about pregnancy status at the time medication with potential safety risks is prescribed. Although pregnancy registration by GPs improved over the years, inadequate use still seems to be made of the available information systems for appropriate drug surveillance.
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Children with pre-symptomatic type 1 diabetes can be identified through testing for circulating islet autoantibodies. Identifying children at risk reduces the rates of diabetic ketoacidosis at presentation and allows participation in clinical trials for type 1 diabetes prevention. ⋯ Social media has been an effective route to recruitment. Community outreach to schools and general practices will be implemented as this study evolves, to explore optimal recruitment modalities and acceptability.
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Social prescribing link workers are being employed in primary care through the Additional Roles Reimbursement Scheme. ⋯ Dominance of a medical model approach to service delivery may not be conducive to uncovering and supporting people with their non-medical problems, or to promoting a wider understanding of health. Tensions between fitting into a setting dominated by medical discourse and practices, compared to feeling they belong, is something that link workers can encounter when providing social prescribing services in primary care.