Articles: ninos.
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Meta Analysis
Weaning From Tobacco with Nicotine or Varenicline in Severe and Mild Tobacco Dependence—Findings of a Meta-Analysis.
Systematic reviews have documented the beneficial effects of bupropion, cytisine, nicotine, and varenicline as aids to permanent smoking cessation. We investigated the question whether the effect of treatment depends on the severity of tobacco dependence. ⋯ The benefit of varenicline and nicotine as aids to smoking cessation is independent of the severity of tobacco dependence.
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Approximately 1.4 % of the German population aged 35 to 74 suffers from glaucoma, which is one of the more common causes of blindness. The only evidence-based treatment option at present is lowering the intraocular pressure. Modern minimally invasive surgical procedures hold out the prospect of lowering the intraocular pressure without the risk of serious complications. ⋯ There are robust data documenting the effect of iStent and Hydrus Microshunt in lowering the intraocular pressure and lessening the need for eyedrops. High-quality controlled trials are still needed to test the efficacy of other procedures.
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Randomized Controlled Trial
App-Based Psychotherapy of Panic Disorder with Self-Guided Exposure in Virtual Reality—a Randomized, Controlled Trial.
Patients with panic disorder often suffer from temporary unavailability of care. The smartphone app Invirto (IVT) provides a digital treatment for panic disorder involving self-guided exposure in virtual reality. In this trial, we studied the efficacy of Invirto. ⋯ A digital treatment with virtual exposure can lessen anxiety, panic, and depressive symptoms and improve mental flexibility. In further studies, IVT should be compared with an active control group.
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In 2019, the Additional Roles Reimbursement Scheme (ARRS) was introduced in England as a crucial component of the government's manifesto pledge to enhance access to general practice. The primary objective was to recruit 26 000 extra personnel through new roles into general practice. ⋯ This study suggests that the ARRS has the potential to have a positive role in primary care, notably through reduced prescription rates and improved patient satisfaction. Further research is needed to explore the long-term effects of the ARRS on primary care, including patient outcomes and healthcare costs, and the potential barriers to its implementation.
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Multicenter Study
What are the challenges to quality in modern, hybrid general practice? A multi-site longitudinal study.
Since 2022, general practice has shifted from responding to the acute challenges of COVID-19 to restoring full services using a hybrid of remote, digital, and in-person care. ⋯ Contemporary hybrid general practice features changes (digitalisation, physical distancing, extension of roles, and protocolisation) that have had the unintended effect of dehumanising, compromising, and fragmenting care. Policymakers and practices should urgently address the risks to patients and the traditional core values of general practice should be urgently addressed.