Subjects -> MEDICAL SCIENCES (Total: 8667 journals)
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MEDICAL SCIENCES (2404 journals)            First | 1 2 3 4 5 6 7 8 | Last

Showing 201 - 400 of 3562 Journals sorted alphabetically
Asian Biomedicine     Open Access   (Followers: 2)
Asian Journal of Cell Biology     Open Access   (Followers: 6)
Asian Journal of Health     Open Access   (Followers: 3)
Asian Journal of Medical and Biological Research     Open Access   (Followers: 5)
Asian Journal of Medical and Pharmaceutical Researches     Open Access   (Followers: 2)
Asian Journal of Medical Sciences     Open Access   (Followers: 2)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Asian Journal of Research in Medical and Pharmaceutical Sciences     Open Access   (Followers: 1)
Asian Journal of Scientific Research     Open Access   (Followers: 3)
Asian Journal of Transfusion Science     Open Access   (Followers: 1)
Asian Medicine     Hybrid Journal   (Followers: 5)
Asian Pacific Journal of Cancer Prevention     Open Access  
Asian Pacific Journal of Health Sciences     Open Access   (Followers: 7)
ASPIRATOR : Journal of Vector-borne Disease Studies     Open Access  
Astrocyte     Open Access  
Atención Familiar     Open Access  
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access   (Followers: 1)
Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche     Open Access  
Audiology - Communication Research     Open Access   (Followers: 10)
AUP Advances     Open Access   (Followers: 7)
Auris Nasus Larynx     Full-text available via subscription  
Australasian Journal of Ultrasound in Medicine (AJUM)     Hybrid Journal   (Followers: 1)
Australian Coeliac     Full-text available via subscription   (Followers: 2)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Journal of Medical Science     Full-text available via subscription   (Followers: 3)
Autopsy and Case Reports     Open Access  
Avicenna     Open Access   (Followers: 3)
Avicenna Journal of Clinical Medicine     Open Access  
Avicenna Journal of Medicine     Open Access   (Followers: 1)
Bangabandhu Sheikh Mujib Medical University Journal     Open Access   (Followers: 1)
Bangladesh Journal of Anatomy     Open Access   (Followers: 2)
Bangladesh Journal of Bioethics     Open Access  
Bangladesh Journal of Medical Biochemistry     Open Access   (Followers: 4)
Bangladesh Journal of Medical Education     Open Access   (Followers: 2)
Bangladesh Journal of Medical Microbiology     Open Access   (Followers: 4)
Bangladesh Journal of Medical Physics     Open Access   (Followers: 1)
Bangladesh Journal of Medical Science     Open Access  
Bangladesh Journal of Medicine     Open Access   (Followers: 1)
Bangladesh Journal of Physiology and Pharmacology     Open Access  
Bangladesh Journal of Scientific Research     Open Access   (Followers: 1)
Bangladesh Medical Journal     Open Access  
Bangladesh Medical Journal Khulna     Open Access  
Basal Ganglia     Hybrid Journal  
Basic Sciences of Medicine     Open Access   (Followers: 1)
Batı Karadeniz Tıp Dergisi / Medical Journal of Western Black Sea     Open Access  
Baylor University Medical Center Proceedings     Hybrid Journal  
BBA Clinical     Open Access  
BC Medical Journal     Free  
Benha Medical Journal     Open Access  
Beni-Suef University Journal of Basic and Applied Sciences     Open Access   (Followers: 3)
Bijblijven     Hybrid Journal  
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Bio-Algorithms and Med-Systems     Hybrid Journal   (Followers: 2)
BioDiscovery     Open Access   (Followers: 2)
Bioelectromagnetics     Hybrid Journal   (Followers: 2)
Bioelectronic Medicine     Open Access   (Followers: 1)
Bioengineering & Translational Medicine     Open Access  
Bioethics     Hybrid Journal   (Followers: 19)
Bioethics Research Notes     Full-text available via subscription   (Followers: 15)
Biologics in Therapy     Open Access  
Biology of Sex Differences     Open Access   (Followers: 2)
Biomarker Research     Open Access   (Followers: 3)
Biomarkers in Medicine     Hybrid Journal   (Followers: 2)
BioMed Research International     Open Access   (Followers: 5)
Biomédica     Open Access  
Biomedical & Life Sciences Collection     Full-text available via subscription   (Followers: 3)
Biomedical and Biotechnology Research Journal     Open Access   (Followers: 1)
Biomedical Engineering     Hybrid Journal   (Followers: 16)
Biomedical Engineering and Computational Biology     Open Access   (Followers: 13)
Biomedical Engineering Letters     Hybrid Journal   (Followers: 6)
Biomedical Engineering Research     Open Access   (Followers: 7)
Biomedical Informatics Insights     Open Access   (Followers: 9)
Biomedical Journal     Open Access   (Followers: 4)
Biomedical Materials     Hybrid Journal   (Followers: 7)
Biomedical Microdevices     Hybrid Journal   (Followers: 9)
Biomedical Optics Express     Open Access   (Followers: 6)
Biomedical Photonics     Open Access  
Biomedical Reports     Full-text available via subscription  
Biomedical Research Reports     Full-text available via subscription   (Followers: 2)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 9)
Biomedical Science and Engineering     Open Access   (Followers: 7)
BioMedicine     Open Access  
Biomedicine Hub     Open Access  
Biomedicines     Open Access   (Followers: 1)
Biomedika     Open Access  
Biomolecular and Health Science Journal     Open Access   (Followers: 1)
Biophysics Reports     Open Access  
BioPsychoSocial Medicine     Open Access   (Followers: 8)
Biosafety and Health     Open Access   (Followers: 2)
Biosalud     Open Access   (Followers: 1)
Biostatistics & Epidemiology     Hybrid Journal   (Followers: 2)
Birat Journal of Health Sciences     Open Access  
BIRDEM Medical Journal     Open Access   (Followers: 1)
Birth Defects Research     Hybrid Journal  
Birth Defects Research Part A : Clinical and Molecular Teratology     Hybrid Journal   (Followers: 3)
Birth Defects Research Part C : Embryo Today : Reviews     Hybrid Journal  
BJR|Open     Open Access   (Followers: 1)
BJS Open     Open Access   (Followers: 1)
Black Sea Journal of Health Science     Open Access  
BLDE University Journal of Health Sciences     Open Access  
Blickpunkt Medizin     Hybrid Journal  
BMC Biomedical Engineering     Open Access  
BMC Medical Ethics     Open Access   (Followers: 22)
BMC Medical Research Methodology     Open Access   (Followers: 9)
BMC Medicine     Open Access   (Followers: 14)
BMC Obesity     Open Access   (Followers: 7)
BMC Proceedings     Full-text available via subscription   (Followers: 2)
BMC Research Notes     Open Access   (Followers: 4)
BMC Sports Science, Medicine and Rehabilitation     Open Access   (Followers: 34)
BMH Medical Journal     Open Access   (Followers: 2)
BMI Journal : Bariátrica & Metabólica Iberoamericana     Open Access  
BMJ     Hybrid Journal   (Followers: 1884)
BMJ Case Reports     Hybrid Journal   (Followers: 28)
BMJ Evidence-Based Medicine     Hybrid Journal   (Followers: 4)
BMJ Global Health     Open Access   (Followers: 3)
BMJ Innovations     Hybrid Journal   (Followers: 6)
BMJ Leader     Hybrid Journal  
BMJ Open     Open Access   (Followers: 44)
BMJ Open Quality     Open Access   (Followers: 19)
BMJ Open Science     Open Access   (Followers: 1)
BMJ Sexual & Reproductive Health     Hybrid Journal   (Followers: 2)
BMJ Surgery, Interventions, & Health Technologies     Open Access  
Bodine Journal     Open Access  
Boletín del Consejo Académico de Ética en Medicina     Open Access  
Boletín del ECEMC     Open Access  
Boletin Médico de Postgrado     Open Access  
Boletín Médico del Hospital Infantil de México     Open Access  
Bone     Hybrid Journal   (Followers: 18)
Bone and Tissue Regeneration Insights     Open Access   (Followers: 2)
Bone Marrow Research     Open Access   (Followers: 2)
Bone Reports     Open Access  
Bosnian Journal of Basic Medical Sciences     Open Access  
Bozok Tıp Dergisi / Bozok Medical Journal     Open Access  
Brachytherapy     Full-text available via subscription   (Followers: 6)
Brain and Development     Full-text available via subscription   (Followers: 5)
Brain Communications     Open Access   (Followers: 2)
Brain Connectivity     Hybrid Journal   (Followers: 5)
Brain Impairment     Full-text available via subscription   (Followers: 2)
Brazilian Journal of Medical and Biological Research     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
Brazilian Journal of Pain (BrJP)     Open Access  
Brazilian Journal of Physical Therapy     Open Access   (Followers: 2)
Breastfeeding Review     Full-text available via subscription   (Followers: 19)
British Journal of Biomedical Science     Full-text available via subscription   (Followers: 7)
British Journal of General Practice     Full-text available via subscription   (Followers: 39)
British Journal of Hospital Medicine     Full-text available via subscription   (Followers: 16)
British Medical Bulletin     Hybrid Journal   (Followers: 6)
Buddhachinaraj Medical Journal     Open Access  
Bulletin Amades     Open Access  
Bulletin de la Société de pathologie exotique     Hybrid Journal   (Followers: 1)
Bulletin of Legal Medicine     Open Access  
Bulletin of Medical Sciences     Open Access  
Bulletin of the History of Medicine     Full-text available via subscription   (Followers: 20)
Bulletin of the Menninger Clinic     Full-text available via subscription  
Bulletin of The Royal College of Surgeons of England     Free  
Bulletin of the Scientific Centre for Expert Evaluation of Medicinal Products     Open Access  
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz     Hybrid Journal   (Followers: 6)
Burapha Journal of Medicine     Open Access  
Burns     Hybrid Journal   (Followers: 10)
Cadernos de Naturologia e Terapias Complementares     Open Access   (Followers: 1)
Calcified Tissue International     Hybrid Journal   (Followers: 2)
Canadian Bulletin of Medical History     Hybrid Journal  
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Pain     Open Access   (Followers: 2)
Canadian Journal of Rural Medicine     Full-text available via subscription   (Followers: 1)
Canadian Medical Association Journal     Open Access   (Followers: 18)
Canadian Medical Education Journal     Open Access   (Followers: 10)
Canadian Prosthetics & Orthotics Journal     Open Access  
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Cardiac Electrophysiology Clinics     Full-text available via subscription   (Followers: 1)
Care Management Journals     Hybrid Journal   (Followers: 5)
Case Reports     Open Access  
Case Reports in Acute Medicine     Open Access   (Followers: 2)
Case Reports in Clinical Medicine     Open Access   (Followers: 2)
Case Reports in Clinical Nutrition     Open Access   (Followers: 1)
Case Reports in Clinical Pathology     Open Access   (Followers: 1)
Case Reports in Medicine     Open Access   (Followers: 3)
Case Reports in Transplantation     Open Access  
Case Reports in Vascular Medicine     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Study and Case Report     Open Access   (Followers: 5)
CASUS : Revista de Investigación y Casos en Salud     Open Access   (Followers: 1)
CBU International Conference Proceedings     Open Access   (Followers: 3)
Cell & Bioscience     Open Access   (Followers: 6)
Cell Adhesion & Migration     Open Access   (Followers: 9)
Cell and Molecular Response to Stress     Full-text available via subscription   (Followers: 2)
Cell and Tissue Transplantation and Therapy     Open Access   (Followers: 2)
Cell Cycle     Full-text available via subscription   (Followers: 6)
Cell Death and Differentiation     Hybrid Journal   (Followers: 8)
Cell Death Discovery     Open Access   (Followers: 1)
Cell Health and Cytoskeleton     Open Access   (Followers: 1)
Cell Medicine     Open Access   (Followers: 6)
Cell Research     Hybrid Journal   (Followers: 8)
Cell Transplantation     Open Access   (Followers: 4)
CEN Case Reports     Hybrid Journal  
Central African Journal of Medicine     Full-text available via subscription  
Cephalalgia Reports     Open Access   (Followers: 2)
Ceylon Journal of Medical Science     Open Access  

  First | 1 2 3 4 5 6 7 8 | Last

Similar Journals
Journal Cover
British Journal of General Practice
Journal Prestige (SJR): 0.906
Citation Impact (citeScore): 1
Number of Followers: 39  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 0960-1643 - ISSN (Online) 1478-5242
Published by RCGP Homepage  [1 journal]
  • Combating COVID-19: East meets West
    • Authors: Donald Li; Chak-sing Lau
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710753
      Issue No: Vol. 70, No. 696 (2020)
       
  • Oseltamivir for coronavirus illness: post-hoc exploratory analysis of an
           open-label, pragmatic, randomised controlled trial in European primary
           care from 2016 to 2018
    • Authors: Samuel Coenen; Alike W van der Velden, Daniela Cianci, Herman Goossens, Emily Bongard, Benjamin R Saville, Nina Gobat, Muireann de Paor, Margareta Ieven, Theo J Verheij, Christopher C Butler
      Abstract: BackgroundPatients infected with the novel coronavirus (SARS-CoV-2) are being treated empirically with oseltamivir, but there is little evidence from randomised controlled trials to support the treatment of coronavirus infections with oseltamivir.AimTo determine whether adding oseltamivir to usual care reduces time to recovery in symptomatic patients who have tested positive for coronavirus (not including SARS-CoV-2).Design and settingExploratory analysis of data from an open-label, pragmatic, randomised controlled trial during three influenza seasons, from 2016 to 2018, in primary care research networks, in 15 European countries.MethodPatients aged ≥1 year presenting to primary care with influenza-like illness (ILI), and who tested positive for coronavirus (not including SARS-CoV-2), were randomised to usual care or usual care plus oseltamivir. The primary outcome was time to recovery defined as a return to usual activities, with minor or absent fever, headache, and muscle ache.ResultsCoronaviruses (CoV-229E, CoV-OC43, CoV-KU1 and CoV-NL63) were identified in 308 (9%) out of 3266 randomised participants in the trial; 153 of these were allocated to usual care and 155 to usual care plus oseltamivir; the primary outcome was ascertained in 136 and 147 participants, respectively. The median time to recovery was shorter in patients randomised to oseltamivir: 4 days (interquartile range [IQR] 3–6) versus 5 days (IQR 3–8; hazard ratio 1.31; 95% confidence interval = 1.03 to 1.66; P = 0.026).ConclusionPrimary care patients with ILI testing positive for coronavirus (not including SARS-CoV-2) recovered sooner when oseltamivir was added to usual care compared with usual care alone. This may be of relevance to the primary care management of COVID-19.
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X711941
      Issue No: Vol. 70, No. 696 (2020)
       
  • Prioritisation of treatment goals among older patients with non-curable
           cancer: the OPTion randomised controlled trial in Dutch primary care
    • Authors: Mariken E Stegmann; Daan Brandenbarg, An KL Reyners, Wouter H van Geffen, T Jeroen N Hiltermann, Annette J Berendsen
      Abstract: BackgroundOlder patients with cancer often find it difficult to take part in shared decision making.AimTo assess the utility of the Outcome Prioritisation Tool (OPT), designed to aid discussion with a patient in regards to their treatment goals, to empower patients with cancer through structured conversations about generic treatment goals with GPs.Design and settingA randomised controlled trial of 114 Dutch participants recruited between November 2015 and January 2019, aged ≥60 years with non-curable cancer who had to make a treatment decision with an oncologist. The intervention group used the OPT while the control group received care as usual.MethodThe primary outcome was patient empowerment using the score on the decision self-efficacy (DSE) scale. Secondary outcomes were symptoms measures of fatigue, anxiety, and depression. The experiences of participants were also explored.ResultsNo effect was found on patient empowerment between the OPT group (n = 48; DSE 86.8; standard deviation [SD] = 18.2) and the control group (n = 58; DSE 84.2; SD = 17.6; P = 0.47). In the OPT group, although statistically non-significant, fewer patients had low empowerment (18.8%, n = 9 versus 24.1%, n = 14; P = 0.50), but they did have statistically significant lower mean anxiety scores (6.0, SD = 4.6 versus 7.6, SD = 4.4; P
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710405
      Issue No: Vol. 70, No. 696 (2020)
       
  • Microcytosis as a risk marker of cancer in primary care: a cohort study
           using electronic patient records
    • Authors: Rhian Hopkins; Sarah ER Bailey, William T Hamilton, Elizabeth A Shephard
      Abstract: BackgroundMicrocytosis (smaller than normal red blood cells) has previously been identified as a possible early risk marker for some cancers. However, the role of microcytosis across all cancers has not been fully investigated.AimTo examine cancer incidence in a cohort of patients with microcytosis, with and without accompanying anaemia.Design and settingCohort study of patients aged ≥40 years using UK primary care electronic patient records.MethodThe 1-year cancer incidence was compared between cohorts of patients with a mean red cell volume of
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X709577
      Issue No: Vol. 70, No. 696 (2020)
       
  • Delays in referral from primary care worsen survival for patients with
           colorectal cancer: a retrospective cohort study
    • Authors: Chanpreet S Arhi; Elaine M Burns, Alex Bottle, George Bouras, Paul Aylin, Paul Ziprin, Ara Darzi
      Abstract: BackgroundDelays in referral for patients with colorectal cancer may occur if the presenting symptom is falsely attributed to a benign condition.AimTo investigate whether delays in referral from primary care are associated with a later stage of cancer at diagnosis and worse prognosis.Design and settingA national retrospective cohort study in England including adult patients with colorectal cancer identified from the cancer registry with linkage to Clinical Practice Research Datalink, who had been referred following presentation to their GP with a ‘red flag’ or ‘non-specific’ symptom.MethodThe hazard ratios (HR) of death were calculated for delays in referral of between 2 weeks and 3 months, and>3 months, compared with referrals within 2 weeks.ResultsA total of 4527 (63.5%) patients with colon cancer and 2603 (36.5%) patients with rectal cancer were included in the study. The percentage of patients presenting with red-flag symptoms who experienced a delay of>3 months before referral was 16.9% of those with colon cancer and 13.5% of those with rectal cancer, compared with 35.7% of patients with colon cancer and 42.9% of patients with rectal cancer who presented with non-specific symptoms. Patients referred after 3 months with red-flag symptoms demonstrated a significantly worse prognosis than patients who were referred within 2 weeks (colon cancer: HR 1.53; 95% confidence interval [CI] = 1.29 to 1.81; rectal cancer: HR 1.30; 95% CI = 1.06 to 1.60). This association was not seen for patients presenting with non-specific symptoms. Delays in referral were associated with a significantly higher proportion of late-stage cancers.ConclusionThe first presentation to the GP provides a referral opportunity to identify the underlying cancer, which, if missed, is associated with a later stage in diagnosis and worse survival.
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710441
      Issue No: Vol. 70, No. 696 (2020)
       
  • Systolic inter-arm blood pressure difference and risk of cognitive decline
           in older people: a cohort study
    • Authors: Christopher E Clark; Daniel Thomas, David J Llewellyn, Luigi Ferrucci, Stefania Bandinelli, John L Campbell
      Abstract: BackgroundSystolic inter-arm difference in blood pressure (IAD) and cognitive decline are both associated with cardiovascular disease; therefore, it was hypothesised that IAD may be predictive of cognitive decline.AimTo examine associations of IAD with cognitive decline in a community population.Design and settingA prospective study of older Italian adults enrolled in the InCHIANTI study.MethodUnivariable and multivariable associations of IAD were explored with declines in mini mental state examination (MMSE) scores, Trail Making Test A and B scores, and a composite outcome representing substantial decline in any of these scores. Backward stepwise regression was used to adjust observed associations of IAD with cognitive decline.ResultsThe rate of decline for MMSE scores in 1133 participants was greater with IAD ≥5 mmHg or ≥10 mmHg. On univariable analyses continuous IAD was associated with the composite outcome (odds ratio [OR] 1.16 per 5 mmHg of IAD, 95% confidence interval [CI] = 1.02 to 1.31). Substantial decline in MMSE score was seen with IAD ≥5 mmHg (OR 1.41, 95% CI = 1.03 to 1.93), and in the composite outcome with IAD ≥5 mmHg (OR 1.44, 95% CI = 1.10 to 1.89) or ≥10 mmHg (OR 1.39, 95% CI = 1.03 to 1.88). After multivariable adjustment, an IAD ≥ 5 mmHg remained associated with reductions in the composite outcome, reflecting declining cognitive performance (OR 1.46, 95% CI = 1.05 to 2.03).ConclusionAn IAD ≥5 mmHg is associated with cognitive decline in a representative older population. Given that systolic inter-arm differences in blood pressure are easily measured, confirmation of these findings could inform individualised treatment for the prevention of cognitive decline and dementia.
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X709589
      Issue No: Vol. 70, No. 696 (2020)
       
  • Trends and variation in unsafe prescribing of methotrexate: a cohort study
           in English NHS primary care
    • Authors: Brian MacKenna; Helen J Curtis, Alex J Walker, Richard Croker, Seb Bacon, Ben Goldacre
      Abstract: BackgroundPrescribing high doses of methotrexate increases the potentially fatal risk of toxicity. To minimise risk, it is recommended that only 2.5 mg tablets are used.AimTo describe trends in GP prescribing of methotrexate over time; the harm associated with methotrexate errors at a national level; ascertain variation between practices and clinical commissioning groups (CCGs) in their implementation of the safety guidance; and map current variations at CCG and practice level.Design and settingA retrospective cohort study of English GP prescribing data (August 2010–April 2018), and data acquired via freedom of information (FOI) requests.MethodThe main outcome measures were: variation in ratio of non-adherent/adherent prescribing, geographically and over time, between practices and CCGs; and description of responses to FOI requests.ResultsOf 7349 practices in England, 1689 prescribed both 2.5 mg and 10 mg tablets to individual patients in 2017, breaching national guidance. In April 2018, 697 practices (≥90th percentile) prescribed>14.3% of all methotrexate as 10 mg tablets, likewise breaching national guidance. The 66 practices at ≥99th percentile gave>52.4% of all prescribed methotrexate in the form of 10 mg tablets. The prescribing of 10 mg tablets fell during the study period, with 10 mg tablets as a proportion of all prescribed methotrexate tablets falling from 9.1% to 3.4%. Twenty-one deaths caused by methotrexate poisoning were reported from 1993–2017 in England and Wales.ConclusionThe prevalence of unsafe methotrexate prescribing has reduced but remains common, with substantial variation between practices and CCGs. The authors recommend investment in better strategies around implementation. As 21 deaths that occurred from 1993–2017 in England and Wales were attributed to methotrexate poisoning, the coroners’ reports for these deaths should be reviewed to identify recurring themes.
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710993
      Issue No: Vol. 70, No. 696 (2020)
       
  • A real-time measurement of general practice workload in the Republic of
           Ireland: a prospective study
    • Authors: Brendan Crosbie; Michael Edmund O’Callaghan, Stuart O’Flanagan, David Brennan, Gavin Keane, William Behan
      Abstract: BackgroundDemand for GP services in the Republic of Ireland (RoI) is increasing, and the resultant escalation in workload demands is an issue of growing concern. Accordingly, the accurate measurement and description of GP workload is essential to inform future healthcare planning.AimTo provide a real-time measurement of GP workload with respect to hours worked and of proportional time expenditure on typical workload activities.Design and settingA prospective study among GPs in the RoI that took place from January 2019 to March 2019.MethodParticipants were invited to enrol in the study by direct email invitation and via notifications posted within GP-specific monthly journals; online forums; and a social media platform. Participants used a time-management software program to self-record workload activity in real time over 6 weeks.ResultsIn total, 123 GPs were included for final analyses with a total of 8930 hours of activity recorded. The mean duration of a two-session day (excluding break-time) was 9.9 hours (95% confidence interval [CI] = 9.7 to 10.0; interquartile range [IQR] 7.9 to 13.9). Of this time, 64% was spent on clinical consultations. In total, 25.4% of activity was recorded outside the hours of 9.00 am and 5.00 pm. An average of 12.4 face-to-face consultations were completed per session of activity. The mean duration of a 10-session week was greatest for the partner (50.8 hours; 95% CI = 49.8 to 51.9) and>55-year-old (50.8 hours; 95% CI = 49.3 to 52.2) demographics, relative to their respective colleagues.ConclusionTo the authors’ knowledge, this is the first study to provide an objective, accurate, and granular real-time measurement of GP workload in the RoI, demonstrating the significant volume and variety of work undertaken by GPs in the RoI.
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710429
      Issue No: Vol. 70, No. 696 (2020)
       
  • Improving access to organ donor registration in general practice: a
           feasibility study
    • Authors: Catrin P Penn-Jones; Chris Papadopoulos, Gurch Randhawa, Zeeshan Asghar
      Abstract: BackgroundOrgan donor registration helps guide decision making for families. UK general practice provides the facility to register on the NHS Organ Donor Register, but only to new patients. An intervention was developed to present a registration opportunity to existing patients in this setting.AimTo assess the feasibility and acceptability of an organ donation intervention implemented in UK general practice.Design and settingThe intervention ran in a large practice in Luton in the UK, for 3 months in 2018. A single practice feasibility study was conducted using an embedded experimental mixed methods design.MethodStaff were trained to ask patients in consultations if they wished to join the register, and leaflets and posters were displayed in the waiting room. Data on feasibility and acceptability were captured using SystmONE questionnaires, surveys, and focus groups.ResultsOver 3 months, in 12.4% of face-to-face consultations, patients were asked if they would like to join the register (812 of 6569), and 244 (30.0%) of these patients joined the register. Common reasons staff did not ask patients were due to telephone consultations, lack of time, and it not being appropriate. Nurses and healthcare assistants performed prompted choice more than doctors (23.4%, 17.1%, and 1.6% respectively). Certain clinic types, such as phlebotomy or routine clinics, facilitated asking compared to those where patients presented with unknown or more serious issues.ConclusionThe intervention was found to be feasible and acceptable by some staff and patients. Feasibility criteria were met; therefore, the intervention can progress to further testing.
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X709601
      Issue No: Vol. 70, No. 696 (2020)
       
  • C-reactive protein-guided antibiotic prescribing for COPD exacerbations: a
           qualitative evaluation
    • Authors: Rhiannon Phillips; Helen Stanton, Amina Singh-Mehta, David Gillespie, Janine Bates, Micaela Gal, Emma Thomas-Jones, Rachel Lowe, Kerenza Hood, Carl Llor, Hasse Melbye, Jochen Cals, Patrick White, Christopher Butler, Nick Francis
      Abstract: BackgroundAntibiotics are prescribed to>70% of patients presenting in primary care with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The PACE randomised controlled trial found that a C-reactive protein point-of-care test (CRP-POCT) management strategy for AECOPD in primary care resulted in a 20% reduction in patient-reported antibiotic consumption over 4 weeks.AimTo understand perceptions of the value of CRP-POCT for guiding antibiotic prescribing for AECOPD; explore possible mechanisms, mediators, and pathways to effects; and identify potential barriers and facilitators to implementation from the perspectives of patients and clinicians.Design and settingQualitative process evaluation in UK general practices.MethodSemi-structured telephone interviews with 20 patients presenting with an AECOPD and 20 primary care staff, purposively sampled from the PACE study. Interviews were audio-recorded, transcribed, and analysed using framework analysis.ResultsPatients and clinicians felt that CRP-POCT was useful in guiding clinicians’ antibiotic prescribing decisions for AECOPD, and were positive about introduction of the test in routine care. The CRP-POCT enhanced clinician confidence in antibiotic prescribing decisions, reduced decisional ambiguity, and facilitated communication with patients. Some clinicians thought the CRP-POCT should be routinely used in consultations for AECOPD; others favoured use only when there was decisional uncertainty. CRP-POCT cartridge preparation time and cost were potential barriers to implementation.ConclusionCRP-POCT-guided antibiotic prescribing for AECOPD had high acceptability, but commissioning arrangements and further simplification of the CRP-POCT need attention to facilitate implementation in routine practice.
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X709865
      Issue No: Vol. 70, No. 696 (2020)
       
  • Perceptions, experiences, and understandings of cluster headache among GPs
           and neurologists: a qualitative study
    • Authors: Alina Buture; Fayyaz Ahmed, Yachna Mehta, Koen Paemeleire, Peter J Goadsby, Lisa Dikomitis
      Abstract: BackgroundCluster headache is a severe primary headache with a similar prevalence to that of multiple sclerosis. Cluster headache is characterised by unilateral trigeminal distribution of pain, ipsilateral cranial autonomic features, and a tendency to circadian and circannual periodicity.AimTo explore the perceptions, experiences, and understandings of cluster headache among GPs and neurologists.Design and settingQualitative interview study in primary care surgeries and neurology departments in the north of England.MethodSemi-structured interviews were conducted with GPs and neurologists, recorded, and transcribed. A thematic analysis was applied to the dataset.ResultsSixteen clinicians participated in this study: eight GPs and eight neurologists. Four main themes were identified following thematic analysis: challenges with the cluster headache diagnosis; impact of cluster headache; challenges with treatment; and appropriateness of referrals to secondary care. Clinicians recognised the delays in the diagnosis of cluster headache, misdiagnosis, and mismanagement, and were aware of the potential impact cluster headache can have on patients’ mental health and ability to remain in employment. Findings highlighted tensions between primary and secondary care around the cost of medication and the remit of prescribing treatment regimens. Patients’ anxiety, their need for reassurance, and their insistence about seeing a specialist are some of the reasons for referrals.ConclusionClinicians acknowledged delays in diagnosis, misdiagnosis, and mismanagement of cluster headache. The responsibility of prescribing causes ongoing tensions between primary and secondary care. Clear referral and management pathways for primary headaches are required to improve patient outcomes and healthcare costs.
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710417
      Issue No: Vol. 70, No. 696 (2020)
       
  • Highlights
    • Pages: 315 - 315
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710741
      Issue No: Vol. 70, No. 696 (2020)
       
  • Asking Questions
    • Authors: Domhnall MacAuley
      Pages: 315 - 315
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710981
      Issue No: Vol. 70, No. 696 (2020)
       
  • Five principles for pandemic preparedness: lessons from the Australian
           COVID-19 primary care response
    • Authors: Michael R Kidd
      Pages: 316 - 317
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710765
      Issue No: Vol. 70, No. 696 (2020)
       
  • The future of diagnosis in general practice
    • Authors: William Hamilton
      Pages: 319 - 320
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710777
      Issue No: Vol. 70, No. 696 (2020)
       
  • Investigating cancer symptoms in older people: what are the issues and
           where is the evidence'
    • Authors: Daniel Jones; Erica di Martino, Nathaniel L Hatton, Claire Surr, Niek de Wit, Richard D Neal
      Pages: 321 - 322
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710789
      Issue No: Vol. 70, No. 696 (2020)
       
  • Is there a place for point-of-care ultrasound in UK primary care'
    • Authors: Erica di Martino; Camilla Aakȷar Andersen, Troels Mengel–Jorgensen, Martin Bach Jensen, Stephen Bradley, Richard D Neal
      Pages: 323 - 324
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710801
      Issue No: Vol. 70, No. 696 (2020)
       
  • Just another GP crisis: the Collings report 70 years on
    • Authors: Martin Roland
      Pages: 325 - 326
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710813
      Issue No: Vol. 70, No. 696 (2020)
       
  • Triage of patients with COVID-19
    • Authors: Alex Manning
      Pages: 327 - 327
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710825
      Issue No: Vol. 70, No. 696 (2020)
       
  • COVID-19 cumulative mortality rates for frontline healthcare staff in
           England
    • Authors: Louis S Levene; Briana Coles, Melanie J Davies, Wasim Hanif, Francesco Zaccardi, Kamlesh Khunti
      Pages: 327 - 328
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710837
      Issue No: Vol. 70, No. 696 (2020)
       
  • Reduction in face-to-face GP consultations
    • Authors: Denis Pereira Gray; Kate Sidaway-Lee, Alex Harding, Philip Evans
      Pages: 328 - 328
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710849
      Issue No: Vol. 70, No. 696 (2020)
       
  • Video consultations: quality, access, and equity in COVID and post-COVID
           general practice
    • Authors: James Matheson; on behalf of the RCGP Health Inequalities Standing Group
      Pages: 329 - 329
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710861
      Issue No: Vol. 70, No. 696 (2020)
       
  • Domestic violence during COVID-19: the GP role
    • Authors: Jeremy Gibson
      Pages: 340 - 340
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710477
      Issue No: Vol. 70, No. 696 (2020)
       
  • Domestic abuse in the time of coronavirus
    • Authors: Anonymous
      Pages: 341 - 341
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710489
      Issue No: Vol. 70, No. 696 (2020)
       
  • Treating the pandemic of fear
    • Authors: Samar Razaq
      Pages: 342 - 342
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710501
      Issue No: Vol. 70, No. 696 (2020)
       
  • A hard time to die: grief and the coronavirus
    • Authors: Mary Jane Boland
      Pages: 343 - 343
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710513
      Issue No: Vol. 70, No. 696 (2020)
       
  • Doing the day’s work well: my unlikely COVID-19 renaissance
    • Authors: Anupma Parihar
      Pages: 344 - 344
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710525
      Issue No: Vol. 70, No. 696 (2020)
       
  • Looking after you too
    • Authors: Katie Barnett
      Pages: 345 - 345
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710537
      Issue No: Vol. 70, No. 696 (2020)
       
  • The other Self: a note on counselling practice
    • Authors: Stuart Hannabuss
      Pages: 346 - 346
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710549
      Issue No: Vol. 70, No. 696 (2020)
       
  • Moving on
    • Authors: Amar Rughani
      Pages: 347 - 347
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710561
      Issue No: Vol. 70, No. 696 (2020)
       
  • Yonder: Vitamin D screening, startups, social distancing, and world
           leaders on Twitter
    • Authors: Ahmed Rashid
      Pages: 348 - 348
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710573
      Issue No: Vol. 70, No. 696 (2020)
       
  • Trust me — I’m a millennial GP
    • Authors: Sophie Lumley
      Pages: 349 - 349
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710585
      Issue No: Vol. 70, No. 696 (2020)
       
  • Books: The Hands-on Guide to Clinical Reasoning in Medicine
    • Authors: Bernadeta Bridgwood
      Pages: 350 - 350
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710597
      Issue No: Vol. 70, No. 696 (2020)
       
  • Books: Please Read This Leaflet Carefully
    • Authors: Lesley Morrison
      Pages: 350 - 350
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710621
      Issue No: Vol. 70, No. 696 (2020)
       
  • Books: Love Until It Hurts
    • Authors: Dougal Jeffries
      Pages: 350 - 351
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710633
      Issue No: Vol. 70, No. 696 (2020)
       
  • Books: Intelligent Kindness: Rehabilitating the Welfare State. 2nd edition
    • Authors: Gervase Vernon
      Pages: 351 - 351
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710609
      Issue No: Vol. 70, No. 696 (2020)
       
  • Books: Tackling Causes and Consequences of Health Inequalities: A
           Practical Guide
    • Authors: Amanda Howe
      Pages: 352 - 352
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710645
      Issue No: Vol. 70, No. 696 (2020)
       
  • Winter 2020
    • Authors: Saul Miller
      Pages: 353 - 353
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710657
      Issue No: Vol. 70, No. 696 (2020)
       
  • SAFER diagnosis: a teaching system to help reduce diagnostic errors in
           primary care
    • Authors: Paul Silverston
      Pages: 354 - 355
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710669
      Issue No: Vol. 70, No. 696 (2020)
       
  • An Australian reflects on the Collings report 70 years on
    • Authors: Gerard Gill
      Pages: 356 - 357
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710681
      Issue No: Vol. 70, No. 696 (2020)
       
  • COVID-19 with abdominal symptoms and acute abdominal pain: a guide to
           identification for general practice
    • Authors: Lu-Lu Zhai; Wei Wang, Lun Wu, Zhi-Gang Tang
      Pages: 358 - 359
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710693
      Issue No: Vol. 70, No. 696 (2020)
       
  • The atypical presentation of COVID-19 as gastrointestinal disease: key
           points for primary care
    • Authors: John Ong; Yock Young Dan, Jenny G Low
      Pages: 360 - 361
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710705
      Issue No: Vol. 70, No. 696 (2020)
       
  • Hyperparathyroidism (primary) NICE guideline: diagnosis, assessment, and
           initial management
    • Authors: Imran Jawaid; Sharangini Rajesh
      Pages: 362 - 363
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710717
      Issue No: Vol. 70, No. 696 (2020)
       
  • How to manage low testosterone level in men: a guide for primary care
    • Authors: Ahmed Al-Sharefi; Scott Wilkes, Channa N Jayasena, Richard Quinton
      Pages: 364 - 365
      PubDate: 2020-06-25T16:05:26-07:00
      DOI: 10.3399/bjgp20X710729
      Issue No: Vol. 70, No. 696 (2020)
       
 
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