The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial
Experiences of urine collection devices during suspected urinary tract infections: a qualitative study in primary care.
Up to 30% of urine samples from women with suspected urinary tract infection (UTI) are contaminated and need to be repeated, burdening health services and delaying antibiotic prescription. To prevent contamination, midstream urine (MSU) sampling, which can be difficult to achieve, is recommended. Urine collection devices (UCDs) that automatically capture MSU have been proposed as a solution. There are few studies exploring women's experiences of using such devices. ⋯ Most women agreed there was a need for a user- and environmentally-friendly device to improve urine collection. Although using UCDs can be difficult for women experiencing UTI symptoms, they may be appropriate for asymptomatic sampling in other clinical populations.
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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.
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Domestic abuse (DA) is underdiagnosed by the medical community. The National Institute for Health and Care Excellence (NICE) does not recommend DA screening in primary care. The enduring use of remote consultations since COVID-19, coupled with the sensitive nature and increasing prevalence of DA, necessitates review of the NICE guideline, which was developed pre-pandemic primarily for face-to-face consultations. ⋯ The routine use of the already established WAST-short in primary care could help identify and potentially tackle DA. Training health and social care professionals in administering the brief, non-threatening DA screening questionnaire would help raise awareness, and identify and support victims.
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Following the COVID-19 pandemic, the NHS is facing increasing pressures because of growing patient demand and hospital backlogs. With the number of GPs declining, the average number of patients per GP has increased. There are reports of hospital trusts and GP practices introducing doctors' assistants (DAs) to help with clinical and administrative tasks, which has reduced the workload of doctors. As the authors are not aware of any DAs working with GPs locally, Maylands Healthcare (14 000 patients) has introduced this new workforce model by assigning a DA to each clinician's worklist. ⋯ This study demonstrates that the introduction of DAs has helped to manage the administrative workload in primary care, improving efficiency, patient care, and safety.
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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.