BackgroundMost people with type 2 diabetes receive treatment in primary care by GPs who are not specialised in diabetes. Thus, it is important to uncover the most essential information needs regarding type 2 diabetes in general practice.AimTo identify information needs related to type 2 diabetes for GPs.Design and settingSystematic review focused on literature relating to Western countries.MethodMEDLINE, Embase, PsycInfo and CINAHL were searched from inception to January 2024. Two researchers conducted the selection process, and citation searches were performed to identify any relevant articles missed by the database search. Quality appraisal was conducted with the Mixed Methods Appraisal Tool. Meaning units were coded individually, grouped into categories, and then studies were summarised within the context of these categories using narrative synthesis. An evidence map was created to highlight research gaps.ResultsThirty-nine included studies revealed eight main categories and 36 subcategories of information needs. Categories were organised into a comprehensive hierarchical model of information needs, suggesting ‘Knowledge of guidelines’ and ‘Reasons for referral’ as general information needs alongside more specific needs on ‘Medication’, ‘Management’, ‘Complications’, ‘Diagnosis’, ‘Risk factors’, and ‘Screening for diabetes’. The evidence map provides readers with the opportunity to explore the characteristics of the included studies in detail.ConclusionThis systematic review provides GPs, policymakers, and researchers with a hierarchical model of information and educational needs for GPs, and an evidence map showing gaps in the current literature. Information needs about clinical guidelines and reasons for referral to specialised care overlapped with needs for more specific information.

BackgroundIncident benzodiazepine prescriptions in primary care for anxiety decreased between 2003 and 2018. However, from 2008, incident prescribing of benzodiazepines for anxiety increased among those aged 18–34 years. There are increasing concerns around prescribing of benzodiazepines. Further, although guidelines state benzodiazepines should only be prescribed short term, in 2017, 44% of incident prescriptions were prescribed for longer than the recommended duration of 2–4 weeks.AimTo understand when and why GPs prescribe benzodiazepines for anxiety in young adults.Design and settingA qualitative study was undertaken using in-depth interviews with 17 GPs from 10 general practices in South West England.MethodInterviews were conducted by telephone or videocall. A topic guide was used to ensure consistency across interviews. Interviews were audio-recorded, transcribed verbatim, and data analysed using reflexive thematic analysis.ResultsGPs described caution in prescribing benzodiazepines for anxiety in young adults, but thought they had an important role in acute situations. GPs described caution in prescribing duration, but some thought longer-term prescriptions could be appropriate. In light of these views, some GPs questioned whether primary care needs to revisit how clinicians are using benzodiazepines. GPs perceived that some young adults requested benzodiazepines and suggested this might be because they wanted quick symptom relief. GPs noted that refusing to prescribe felt uncomfortable and that the number of young adults presenting to general practice, already dependent on benzodiazepines, had increased.ConclusionPatient-driven factors for prescribing benzodiazepines suggest there are current unmet treatment needs among young adults with anxiety. Given increases in prescribing in this age group, it may be timely to revisit the role of benzodiazepines in the management of people with anxiety in primary care.

BackgroundBetween 2003 and 2018, incident prescriptions of beta-blockers for anxiety increased substantially, particularly for young adults. National Institute for Health and Care Excellence guidance for anxiety does not recommend beta-blockers, probably due to a lack of evidence to support such use. Recent reports have highlighted the potential risks of beta-blockers.AimTo understand when and why GPs prescribe beta-blockers for people with anxiety.Design and settingIn-depth interviews with 17 GPs in Bristol and the surrounding areas.MethodInterviews were held by telephone or video call. A topic guide was used to ensure consistency across interviews. Interviews were audio-recorded, transcribed verbatim, and analysed thematically.ResultsMany GPs viewed beta-blockers as ‘low risk’, particularly for young adults. Some GPs viewed beta-blockers as an alternative to benzodiazepines, acting quickly and not leading to dependence. GPs reflected that some patients appeared to want an ‘immediate fix’ to their symptoms, which GPs thought beta-blockers could potentially offer. This is salient in light of substantial waiting lists for talking therapies and delays in antidepressants taking effect. GPs described how some patients seemed more willing to try beta-blockers than antidepressants, as patients did not perceive them as ‘mental health drugs’ and therefore viewed them as potentially more acceptable and less stigmatising. Further, GPs viewed beta-blockers as ‘patient-led’, with patients managing their own dose and frequency, without GP input.ConclusionMany GPs believe that beta-blockers have a role to play in the management of anxiety. Given recent increases in the prescribing of these drugs in primary care, there is a need to assess their safety and effectiveness as a treatment for people with anxiety disorders.

BackgroundThere has been significant investment in pharmacists working in UK general practice to improve the effective and safe use of medicines. However, evidence of how to optimise collaboration between GPs and pharmacists in the context of polypharmacy (multiple medication) is lacking.AimTo explore GP and pharmacist views and experiences of in-person, interprofessional collaborative discussions (IPCDs) as part of a complex intervention to optimise medication use for patients with polypharmacy in general practice.Design and settingA mixed-method process evaluation embedded within the Improving Medicines use in People with Polypharmacy in Primary Care (IMPPP) trial conducted in Bristol and the West Midlands, between February 2021 and September 2023.MethodAudio-recordings of IPCDs between GPs and pharmacists, along with individual semi-structured interviews to explore their reflections on these discussions, were used. All recordings were transcribed verbatim and analysed thematically.ResultsA total of 14 practices took part in the process evaluation from February 2022 to September 2023; 17 IPCD meetings were audio-recorded, discussing 30 patients (range 1–6 patients per meeting). In all, six GPs and 13 pharmacists were interviewed. The IPCD was highly valued by GPs and pharmacists who described benefits, including: strengthening their working relationship; gaining in confidence to manage more complex patients; and learning from each other. It was often challenging, however, to find time for the IPCDs.ConclusionThe model of IPCD used in this study provided protected time for GPs and pharmacists to work together to deliver whole-patient care, with both professions finding this beneficial. Protected time for interprofessional liaison and collaboration, and structured interventions may facilitate improved patient care.

PURPOSE

Despite being key to better health outcomes for patients from racial and ethnic minority groups, the proportion of underrepresented in medicine (URiM) physicians remains low in the US health care system. This study linked a nationally representative sample of family physicians (FPs) with Medicaid claims data to explore the relative contributions to care of Medicaid populations by FP race and ethnicity.

Writer-director partners Scott Beck and Bryan Woods dive into the biggest spoilers of their new Hugh Grant thriller.

Cassian's on a new mission to steal a familiar ship in the next season of his self-titled Star Wars show.

HBO's Casey Bloys was asked about the Game of Thrones author's spicy take on House of the Dragon season two.

This is not a joke, the subscription to ExpressVPN is at an unprecedented price. We'll tell you everything you need to know so you don't miss out on its Black Friday offer.

Netflix's mega-violent mega-hit series returns December 26.

Jade Ho explains what is possible for university students when they are given opportunities to learn about –and get involved with– social justice and labour issues in their own communities.

The post Students can be agents of change: Talking about activism in universities with Jade Ho appeared first on rabble.ca.

David Parker, TBA’s founder, chief ideologist and chief executive, tweeted “Veni, vedi, vici” last night. Just remember, Caesar said it first, and it sounded like “Weenie, Weedy, Weakie.”

The post Take Back Alberta completes take over of UCP board appeared first on rabble.ca.

With 420,000 Quebec public sector workers on strike on Monday, and with little progress in negotiations, the Front Commun promises further strike action.

The post Hundreds of thousands of Quebec public sector workers vow further strike action appeared first on rabble.ca.

The beast was awakened. Indeed, it might have just stirred from a slumber but it was instantly on the alert.

Pressure from 10 clubs could change the AFL’s competitive balance mechanism.

UPDATES: Senator Nick Xenophon said it doesn’t make sense for the agreement between the Liberal and National parties to be kept as a private secret.

A national review of social work in Scotland has been launched in a bid to address ‘systemic racism’ within the sector.

"Kate Forbes still has her own leadership ambitions, setting them aside this Spring in the interest of party unity to accept Mr Swinney's offer to become Deputy First Minister."

New research to better understand the biological factors of suicidal behaviour Researchers at the University of Glasgow are embarking on two new PhD projects to better understand the impact that biological factors may have on suicidal behaviour.

What does 2023's Scottish Health Survey tell us about Scotland's population - from smoking rates to obesity, and alcohol consumption?

A new Nordic-style Open Kindergarten will be trialled in part of Scotland ahead of a potential roll-out across the country.

The SNP's Westminster leader has announced he is to contest a seat at Holyrood – and will ‘double-job’ as an MP and MSP if he wins.

A baroque fiddle believed to have been played by Robert Burns will be performed live on stage in the United States for the first time.

There's not a ton of news right now, which isn't a big surprise considering the current challenges of making games. Instead we deep dive into our current games, with Jonathan, Josh, Kelley and Peter leading the charge. Anna Marie and Chris share hosting duties to wrap up this week's panel.

The post RPG Cast – Episode 542: “Hell House? Hold My Beer” appeared first on RPGamer.

Robert joins the cast again as Alex, Anna Marie, and Chris get ready for Extra Life 2020! There’s a lot of embargoed gaming going on this week, but we still manage to round up all the important news of the week for your entertainment. We’re counting down to November 7th with plenty of enthusiasm.

The post RPG Cast – Episode 559: “He Doesn’t Seem to Be Dead?” appeared first on RPGamer.

There's one cat in the mouse, but five folks on the cast. Alex apologizes for rocks. Kelley learns things by watching mew. Chris is watching RPGmaniacs. Anna Marie has started embalming ship girls. And Pascal flips coins to decide whether or not to open a site indexing body mutilation in films.

The post RPG Cast – Episode 564: “Paws Is Best Lederhosen” appeared first on RPGamer.

Chris does an Xbox 180 while Josh steals Anna Marie's needle. Robert gets the snotty kleenex award because he can't figure out how to stream Suikoden. And Kelley is too busy fawning over Revali to notice.

The post RPG Cast – Episode 570: “Kmart Cowboy Bebop” appeared first on RPGamer.

Robert tells us who the babby daddy is. Kelley plays Dark Souls Tetris. Chris designs a very special bidet. And you get to breed with a ditto. Have fun!

The post RPG Cast – Episode 611: “All the Bidoofs I Released Before” appeared first on RPGamer.

On this week's show, Chris gets run over by a wheat thresher, Robert throws his phone at a car, Kelley's cat gets offended at being a prop for gaming, and Josh goes kart racing in Horizon Forbidden West.

The post RPG Cast – Episode 620: “I Just Got Barbecued in a Grave Pit” appeared first on RPGamer.

This week on RPG Cast, Kelley falls asleep for four years and misses the announcement of Kingdom Hearts 4. Chris is a five year old with beefy fists. Sam tells us how her video game marriage life works. And we all agree that Bidoof is our buddy.

The post RPG Cast – Episode 627: “Maybe His Feet Are Nobodies” appeared first on RPGamer.

Anna gets her tentacle on, but doesn't notice any performance issues. Chris learns what a wheelbarrow is while putting his sink on the ceiling. And Kelley covers Vahn with cats and steals the unexpected Dragon Age: Inquisition!

The post RPG Cast – Episode 634: “That Bea Arthur Wig Gives Me a +5 to Int” appeared first on RPGamer.

Chris's 3DS battery is swol. Johnathan educates us on the retro market. Kelley poopsocks like a three-legged kitten. While Josh waxes poetic about his Madden otome dating sim.

The post RPG Cast – Episode 640: “Does Your Task Bar Need Fiber?” appeared first on RPGamer.

Josh is bringing Rabbids back. Also, RIP Kelley as her kitty goes on a rampage. Chris is a human in real life, but still has MMO sickness.

The post RPG Cast – Episode 652: “Because Dragons” appeared first on RPGamer.

It's one final week of JCServant "Phil-ing" in! Chris plays Podcast: Painkiller Enhanced Edition, and probably needs a nap. Anna Marie picnics with some ham sandwiches, while her Pokémon are gettin' busy.

The post RPGCast – Episode 657 : “Well-Seasoned Blobber” appeared first on RPGamer.

Chris hugs a bear. Kelley's kitten almost Leeroy Jenkins into a toilet. Matt knocks everyone out in Octopath. And Jason goes round right round with his turntable.

The post RPG Cast – Episode 666: “A Beast of a Show” appeared first on RPGamer.

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The post RPG Cast – Episode 684: “Remember What I Said at the Fazoli’s Drive Thru?” appeared first on RPGamer.

Kelley tries to capture a goat. Robert is trapped in a corner by the nightmares. Josh upgrades his tank and hopes to get a good ending this time. Will Chris beat FFXVI this week?

The post RPG Cast – Episode 685: “You Erased My Save, Now You Have to Beat It” appeared first on RPGamer.

Kelley dishonors herself in Baldur's Gate 3 and retreats to Vampire Survivors. Chris goes on the hunt for Dr. Robotminsc. Robert hits level 50 before the third scripted battle.

The post RPG Cast – Episode 690: “Spay and Neuter Your Owlbear Cubs” appeared first on RPGamer.

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The post RPG Cast – Episode 695: “Jason Statham Is the Best Dinosaur” appeared first on RPGamer.

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The post RPG Cast – Episode 737: “India’s Best Divorce Lawyer” appeared first on RPGamer.

Reverb features new works by Es Devlin and Theaster Gates, plus Devon Turnbull's Listening Room.

The post The Vinyl Factory: Reverb exhibition extended until 22 December appeared first on Fact Magazine.

IMAGINE if you’d spent a grand on a single Berkshire Hathaway share 31 years ago. That stock just passed $US200,000 and is still climbing.

THE Federal Bureau of Investigation is probing a possible computer hacking attack on J.P. Morgan Chase & Co.