Bmc Fam Pract
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Tiredness is one of the most frequent complaints in primary care. Although often self-limiting and frequently associated with psychosocial stress, patients but also their physicians are often uncertain regarding a serious cause and appropriate diagnostic work-up. We conducted a systematic review and meta-analysis of studies reporting on differential diagnosis of fatigue in primary care. ⋯ Serious somatic disease is rare in patients complaining of tiredness. Since prevalence is similar in patients without tiredness, the association may not be causal. Extensive investigations are only warranted in case of specific findings from the history or clinical examination. Instead, attention should focus on depression and psychosocial problems.
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We aimed to determine the degree to which control targets of glycaemia and cardiovascular risk factors were achieved among patients with type 2 diabetes and to investigate sex- and age-related differences in this population. ⋯ There are differential gaps in the control results of female patients and younger patients, which should prompt improvements in case management and care. There is room for further improvement in the cardiometabolic control of patients with type 2 diabetes.
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Evaluation is a fundamental component in building quality primary care and is ideally situated to support individual, team and organizational learning by offering an accessible form of participatory inquiry. The evaluation literature has begun to recognize the unique features of KT evaluations and has described attributes to consider when evaluating KT activities. While both disciplines have focused on the evaluation of KT activities neither has explored the role of evaluation in KT. The purpose of the paper is to examine how participation in program evaluation can support KT in a primary care setting. ⋯ Program evaluation facilitated individual, team and organizational learning. The use of evaluation to support KT is ideally suited to a primary care setting by offering relevant and applicable knowledge to primary care team members while being sensitive to local context.
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Multicenter Study
Developing physical activity counselling in primary care through participatory action approach.
Many adults are insufficiently physically active for health. Counselling is the main method to promote physical activity (PA) in primary care but often implemented inadequately. The aim of this study was to increase health professionals' i) know-how about health-related PA and PA counselling, ii) implementation and quality of PA counselling, iii) familiarity with and use of Physical Activity Prescription (PAP), iv) internal and external collaboration and v) use of electronic patient record system in PA counselling. ⋯ The study was able to achieve some improvements in the familiarity with and use of PAP and to lesser extent in the know-how of health-related PA and PA counselling. To observe changes in other goals, which targeted more at organisational, inter-professional and multi-sectorial level, may have required more long-term actions.
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The aim of this study was to use secondary analysis to interrogate a qualitative data set to explore the experiences of patients living with heart failure. ⋯ Living with heart failure causes disruption to the lives of sufferers. Facilitation of access to healthcare, through good communication between services and having a strong support network of both family and clinicians can reduce the impact of heart failure on the lives of the patient and those around them.