No / General practices in the UK are increasingly hosting welfare advice services on their premises to address patients' social and economic needs. In this paper, the authors present the outcomes of a service providing welfare advice across 30 general practices in inner-city Bradford. A retrospective study of all patients referred for advice during the initial 24 months of the project was conducted. The following information was collected: patient demographics, source of referrals, advice issues raised and income generated through benefit claims. The advice workers saw 2484 patients dealing with over 4000 welfare advice issues. Demand for the service varied widely across practices, reflecting practice list size and engagement with the service by practice staff. The main source of referrals was general practitioners (28%), and disability-related welfare benefits constituted the largest category of advice issues. Sixty-nine per cent of patients seen for advice were of south Asian ethnic origin. The advice workers raised £2 389 255 in welfare benefit claims for patients, primarily through disability-related benefits. Approximately one in four patients referred for advice benefited financially. It is concluded that the service is an excellent strategy by which primary care organisations address the social, economic and environmental influences on the health of their population.

Yes / Background: General Practitioners (GPs) play an increasingly important role in proactively preventing dementia. 40% of dementia cases could be prevented or delayed by targeting 12 modifiable risk factors throughout life. However, little is known about how GPs perceive their role in dementia prevention and associated barriers. Aims: To explore the role of GPs in dementia prevention. Design and Setting: A qualitative study among UK GPs. Method: Semi-structured online interviews with 11 UK GPs exploring their views regarding their role in dementia prevention. Data were analysed using thematic analysis. Results: GPs reported that they never explicitly discuss dementia risk with patients, even when patients are presenting with risk factors, but acknowledge that dementia prevention should be part of their role. They advocate for adopting a whole team approach to primary care preventative practice, using long-term condition/medication reviews or NHS health checks as a platform to enable dementia risk communication targeting already at-risk individuals. Barriers included a lack of time, an absence of knowledge and education about the modifiable dementia risk factors, as well as a reluctance to use dementia as a term within the appointment for fear of causing health anxiety. Brain health was perceived as offering a more encouraging discursive tool for primary care practitioners, supporting communication and behaviour change. Conclusion: There needs to be whole systems shift towards prioritising brain health and supporting primary care professionals in their preventative role. Education is key to underpinning this role in dementia prevention.

Thesis (MEdPsych (Educational Psychology))--University of Stellenbosch, 2006. / Attention-Deficit Hyperactivity Disorder (ADHD) is a common disorder affecting 4% to 5% of South African children. Recent studies revealed that 30% to 70% of children continue to experience problems related to ADHD in adulthood. Adults are becoming increasingly more aware of adult ADHD as a result of public awareness campaigns in the media. Their first line of action is to visit their family physician, but the question arises whether these practitioners are ready to take on the patients with ADHD. The aims of this study were to determine the familiarity, attitudes and practices of general practitioners in South Africa with regard ADHD in both children and adults and whether there are differences in children and adults with regard to depression and generalised anxiety disorders as comorbid disorders. The study also briefly explored the training models of general practitioners in South Africa. The research questions are addressed by means of a survey approach, using quantitative measures. An email message with a cover letter, explaining the purpose of the research project, provided a link to a Web-based questionnaire. It was broadcast to 6704 general practitioners on the database of the company MEDpages, who managed the broadcast. A questionnaire attached to an e-mail message was sent to all Departments of Family Health at universities in the country to obtain information with regard to the training models of general practitioners. This was followed up with structured telephone interviews if no response was received. The questionnaire was completed by 229 respondents. The data were statistically analysed using Statistica Version 7.0. The results revealed a significant need among general practitioners to increase their knowledge base with regard to ADHD, more so with regard to adults. Their knowledge and training with regard to depression and generalised anxiety disorders were significantly more extensive with regard to adults as opposed to children. Training with regard to ADHD in adults was almost non-existent. It was recommended that the limited knowledge base of general practitioners with regard to ADHD should be addressed by adapting the curriculum of undergraduate medical students and providing opportunities for continued medical education that focus on the diagnosis and management of ADHD in both children and adults. General practitioners should acknowledge the educational psychologist as an equal partner within a multi-disciplinary team

Abstract not available

Thesis (Ph.D.)--University of Melbourne, Dept. of General Practice and Centre for Health and Society, 2007. / Typescript. Includes bibliographical references (leaves 252-278).

Abstract not available

Thesis (Ph.D.) -- La Trobe University, 2003. Submitted to the School of Public Health, Faculty of Health Sciences. / Includes bibliographical references (leaves 341-378).

Objective: Chest pain is a common reason for an encounter in general practice. The present investigation was set out to characterize the consultation rate of chest pain, accompanying symptoms, frequency of diagnostic and therapeutic interventions, and results of the encounter. Materials and Methods: Cross‑sectional data were collected from randomly selected patients in the German Sächsische Epidemiologische Studie in der Allgemeinmedizin 2 (SESAM 2) and analyzed from the Dutch Transition Project. Results: Overall, 270 patients from the SESAM 2 study consulted a general practitioner due to chest pain (3% of all consultations). Chest pain was more frequent in people aged over 45 years. The most common diagnostic interventions were physical examination, electrocardiogram at rest and analysis of blood parameters. For the majority of cases, the physicians arranged a follow‑up consultation or prescribed drugs. The transition project documented 8117 patients reporting chest pain with a frequency of 44.5/1000 patient years (1.7% of all consultations). Physical examination was also the most common diagnostic intervention, and physician’s advice the most relevant therapeutic one. Conclusion: The most common causes for chest pain were musculoskeletal problems followed by cardiovascular diseases. Ischemic heart disease, psychogenic problems, and respiratory diseases each account for about 10% of the cases. However, acutely dangerous causes are rare in general practice.

Bakgrunn: Røyking blir fortsatt betraktet som den viktigste forebyggbare årsak til død i ge land. Praktiserende leger er nøkkelpersoner innen tobakksforebygging. Enkel rådgiving, som minimal intervensjon, gitt av allmennleger øker andelen røykfrie pasienter signifikant. Kan en oppsøkende intervensjon gjennomført av en likemann være en egnet metode for å få leger til å ta opp tobakksbruk oftere og på en bedre måte, og kan denne undersøkelsen påvise dette? Hensikt: Hensikten med denne studien er: 1) Vurdere om primærlegene i Agder har endret praksis i perioden 2001-2004 med hensyn til hvor ofte og hvordan de tar opp tobakksbruk med sine pasienter og eventuelle hindringer for dette. 2) Undersøke om oppsøkende intervensjon er en egnet metode for å få leger til å endre praksis ved at de bidrar mer og bedre med individuell røykeintervensjon. Metode: Randomisert kontrollert studie for å undersøke om oppsøkende intervensjon er en egnet metode for å få leger til å endre praksis. Denne studien er sett i lys av en sammenliknende analyse av legenes røykeintervensjon og hindringer for dette i perioden 2001-2004. Resultat: Allmennlegene i Agder har endret praksis i perioden 2001 til 2004. Legene tar oftere opp tobakksbruk uten av pasientene har røykerelaterte symptomer, og det er færre hindringer både for å spørre om røykevaner og for å tilby hjelp til røykeslutt. Studien kan ikke bekrefte at oppsøkende intervensjonen er en egnet metode for å få leger til endre praksis ved at de bidrar mer og bedre med individuell røykeintervensjon. Konklusjon: I perioden 2001-2004 har det vært en signifikant endring i legenes røykeintervensjon og hindringer for dette. Studien kan ikke påvise at legene som fikk opplæringen ”Røykeslutt i praksis” bidrar mer med individuell røykeintervensjon enn kontrollgruppen, og det er heller ikke signifikante forkjeller på hindringer for en slik intervensjon / Background: Cigarette smoking is still considered the leading preventable cause of death in the western world. Physicians constitutes a key personnel in tobacco prevention. Brief advising, such as minimal intervention, performed by general practitioners, GPs, increases the number of smoke free patients significantly. The potential effect of outreach visits performed by a peer educator is a question to be studied. Objective: The objective of this study is: 1) Assesswhether the primary physicians in Agder, during the period 2001 to 2004, have changed their professional practice as tohow often and in which way they discuss smoking habits with their patients and possible barriers to stop them. 2) The study also seeks to determine whether outreach visits constitute an effective method to make GPs change their professional practice by contributing more and better to individual smoking cessation. Method: Randomised controlled study to determine whether outreach visits constitute an effective method to make GPs change their practice. This study is also viewed in the light of a comparative analysis of doctors’ attitude to tobacco prevention over the period 2001-2004. Result: During the period 2001-2004 the GPs in Agder have changed their professional practice. They discuss more frequently tobacco use with patients without smoke-related symptoms, and there are fewer barriers that keep them from asking about smoking habits and from offering assistance with smoking cessation. The effect of outreach visits in improving professional practice cannot be ascertained through this study. Conclusion: During the period 2001-2004 there has been a significant change in the GPs intervention work and fewer barriers to stop them. The GPs who received training through the program “Røykeslutt i praksis” do not contribute to individual smoke intervention any more than the control group. We were unable to detect any significant differences regarding barriers to such intervention / <p>ISBN 91-7997-153-9</p>

Background. There are a number of studies showing that general practice is oneof the most stressful workplaces for health care workers. Since the Baltic States regained independence in 1990, a reform of the health care systems took place in which a new role and more responsibilities were allocated to general practitioners. This study aimed to explore the psychosocial stress level among Lithuanian general practitioners (GPs) and examine the relationship between their psychosocial stress and work characteristics. Methods. A cross-sectional study was madeof 300 Lithuanian general practitioners. Psychosocial stress was investigated with a questionnaire based on the Reeder scale. Job demands were investigated with the Karasek scale. The analyses included descriptive statistics, interrelationship analysis between the different characteristics, and multivariate logistic regression to estimate odd ratios for each of the independent variables in the model. Results. The study shows that 48% of the respondents could be classified as suffering from work related psychosocial stress by the Reeder scale. The highest job strain prevalence was among widowed, single and female GPs. The lowest job strain prevalence was among males and GPs of older age. Job strain occurs when job demands are high and jobdecision latitude is low. Conclusions. The greatest risk tophysical and mental health from stress occurs to general practitioners facing high psychological workload demands combined with low decision latitude in meeting those demands. High job demands, patient load more than 18 patients per day and young age of general practitioners can predict a statistically significant effect on job strain. / <p>ISBN 91-7997-095-8</p>