The British journal of general practice : the journal of the Royal College of General Practitioners
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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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GPs in the UK are at increasing risk of burnout. Peer support (PS) is defined as resources provided by colleagues, such as informational or emotional support, which is either organisationally mandated (formal) or informal. PS has been described in the literature as a method of mitigating burnout. However, little is known about how GPs support one another and what optimises PS in primary care. ⋯ This qualitative research fills a literature gap regarding moderating factors for engaging with PS in GPs and highlights the unique interactions of these factors. The proposition of a novel model to visualise the interplay of moderators provides basis for evidence-based interventions to test, target, and facilitate better PS in primary care.
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Transgender and gender diverse (TGD) individuals experience an incongruence between their assigned birth sex and gender identity. They may have a higher prevalence of health conditions associated with cancer risk than cisgender people. ⋯ Multiple cancer risk factors are more prevalent among TGD individuals compared with cisgender individuals. Future research should examine how minority stress contributes to the increased prevalence of cancer risk factors in this population.
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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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Medication reviews are considered an opportunity for reducing polypharmacy. However, there is little evidence about their impact in a real-world setting. ⋯ Although a majority (>50%) of people had a recorded medication review in 2019, these reviews had a small overall impact on polypharmacy in this study population.