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BMC Pregnancy and Childbirth Dec 2023General Practitioners (GPs) are involved in preconception, pregnancy, and postnatal care. Overall, mental health remains a significant contributor to disease burden... (Review)
Review
BACKGROUND
General Practitioners (GPs) are involved in preconception, pregnancy, and postnatal care. Overall, mental health remains a significant contributor to disease burden affecting 1 in 4 pregnant women. Psychotropic medication prescribing occurs in almost 1 in 12 pregnancies, and appears to be increasing, along with the prevalence of mental health disorders in women of reproductive age. Perinatal mental health management is therefore not an unlikely scenario within their clinical practice. This scoping review aims to map current research related to GPs perceptions and experiences of managing perinatal mental health.
METHOD
A comprehensive search strategy using nine electronic databases, and grey literature was undertaken between December 2021 and February 2023. Relevant studies were sourced from peer review databases using key terms related to perinatal mental health and general practitioners. Search results were screened on title, abstract and full text to assess those meeting inclusion criteria and relevance to the research question.
RESULTS
After screening, 16 articles were included in the scoping review. The majority focused on perinatal depression. Findings support that GPs express confidence with diagnosing perinatal depression but report issues of stigma navigating a diagnosis. Over the last two decades, prescribing confidence in perinatal mental health remains variable with concerns for the safety profile of medication, low level of confidence in providing information and a strong reliance on personal experience. Despite the establishment of perinatal guidelines by countries, the utilisation of these and other existing resources by GPs appears from current literature to be infrequent. Many challenges exist for GPs around time pressures, a lack of information and resources, and difficulty accessing referral to services.
CONCLUSION
Recommendations following this scoping review include targeted perinatal education programs specific for GPs and embedded within training programs and the development of practice guidelines and resources specific to general practice that recognises time, services, and funding limitations. To achieve this future research is first needed on how guidelines and resources can be developed and best delivered to optimise GP engagement to improve knowledge and enhance patient care.
Topics: Female; Humans; Pregnancy; Mental Health; General Practitioners; Mental Disorders; Pregnant Women; General Practice
PubMed: 38042768
DOI: 10.1186/s12884-023-06156-6 -
The European Journal of General Practice Dec 2023
Topics: Humans; Climate Change; General Practitioners
PubMed: 37982393
DOI: 10.1080/13814788.2023.2277569 -
Patterns (New York, N.Y.) Jul 2023Machine learning (ML) practitioners are increasingly tasked with developing models that are aligned with non-technical experts' values and goals. However, there has been... (Review)
Review
Machine learning (ML) practitioners are increasingly tasked with developing models that are aligned with non-technical experts' values and goals. However, there has been insufficient consideration of how practitioners should translate domain expertise into ML updates. In this review, we consider how to capture interactions between practitioners and experts systematically. We devise a taxonomy to match expert feedback types with practitioner updates. A practitioner may receive feedback from an expert at the observation or domain level and then convert this feedback into updates to the dataset, loss function, or parameter space. We review existing work from ML and human-computer interaction to describe this feedback-update taxonomy and highlight the insufficient consideration given to incorporating feedback from non-technical experts. We end with a set of open questions that naturally arise from our proposed taxonomy and subsequent survey.
PubMed: 37521050
DOI: 10.1016/j.patter.2023.100780 -
Journal of Plastic, Reconstructive &... Nov 2023The United Kingdom (UK) injectables market has been growing rapidly with a lack of robust regulation and to date, no information regarding the profile of practitioners...
INTRODUCTION
The United Kingdom (UK) injectables market has been growing rapidly with a lack of robust regulation and to date, no information regarding the profile of practitioners has been published.
AIM
We aim to provide a descriptive and qualitative analysis of the advertised practitioners in the United Kingdom.
METHODS
We performed a systematic search using the internet search engine Google to perform a qualitative descriptive analysis of aesthetic practitioners in the UK. For each contiguous country in the UK: England, Scotland, and Wales, five searches were performed. The list of practitioners was then cross-referenced with professional regulatory bodies, with extraction of registration number, date of registration and presence or absence from the Specialist Register or General Practitioner Register.
RESULTS
3000 websites were visited and evaluated. 1224 independent clinics with 4405 practitioners were identified. 738 were identified as those in business support functions and the remaining 3667 practitioners were undertaking injectable practice. The profile of professions were doctors 32%, nurses 13%, dentists 24% and dental nurses 8%. Of the 1163 doctors identified 481 were on the specialist register (41%) and 219 were on the GP register (19%). 27 specialties were represented in this cohort analysis. Plastic Surgery formed the majority of those who were on the specialist register at 37%, followed by Dermatology at 18%.
CONCLUSION
This paper is the first to describe the range of practitioners, their professional backgrounds and experience who perform non-surgical aesthetic interventions. The range of backgrounds may have an impact on the potential risks to patients and will be an important consideration in proposed legislation to introduce licensing to the industry.
Topics: Humans; United Kingdom; England; Physicians; Plastic Surgery Procedures; Cohort Studies
PubMed: 37717299
DOI: 10.1016/j.bjps.2023.06.057 -
Australian Journal of General Practice Sep 2023Insomnia and obstructive sleep apnoea are the two most common sleep disorders and frequently co-exist. Patients with comorbid insomnia and sleep apnoea experience worse... (Review)
Review
BACKGROUND
Insomnia and obstructive sleep apnoea are the two most common sleep disorders and frequently co-exist. Patients with comorbid insomnia and sleep apnoea experience worse daytime function, mental health and physical health than patients with either disorder alone. General practitioners may face unique challenges in the assessment and management of this prevalent and debilitating condition.
OBJECTIVE
This article aims to provide an overview of the prevalence, consequences, assessment and management of patients with comorbid insomnia and sleep apnoea in Australian general practice.
DISCUSSION
Patients with either insomnia or sleep apnoea should be assessed for both conditions. Treatments for both disorders should be offered to patients with both conditions. The recommended treatment for insomnia is cognitive behavioural therapy, whereas the recommended first-line treatment for moderate and severe obstructive sleep apnoea is lifestyle/weight management advice (where relevant) and continuous positive airway pressure therapy.
Topics: Humans; Australia; General Practitioners; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Sleep Initiation and Maintenance Disorders
PubMed: 37666781
DOI: 10.31128/AJGP-12-22-6648 -
Nurse Education Today Dec 2023Indonesia and Australia are neighbouring countries; however, their nursing systems are very different and there is limited migration between countries. (Review)
Review
BACKGROUND
Indonesia and Australia are neighbouring countries; however, their nursing systems are very different and there is limited migration between countries.
AIM
As part of a larger study, the aim was to undertake a comparative analysis of postgraduate nurse education in Indonesia and Australia.
DESIGN
Detailed literature review across academic and grey literature and semi-structured interviews with key stakeholders in Indonesia (n = 52) and Australia (n = 13) representing education, governments, professional nursing organisations, and rural, remote and urban health care providers.
FINDINGS
Three key categories of comparison were identified: Higher Education System, Education Offerings, and Specialist practice and education standards. Regulation of higher education was found to generally be comparable. Postgraduate nursing specialisations are available in both countries, but there are currently more offerings in Australia. Furthermore, nurse practitioner education and graduate entry pathways into nursing are only currently available in Australia. Journal publications are required for graduation from masters and doctoral programmes in Indonesia, but not Australia.
CONCLUSIONS
While there are many areas of similarity, postgraduate nurse education is more diverse in Australia, while there are growing opportunities for new developments in Indonesia. This analysis identifies areas for future consideration around postgraduate education development in both countries, along with possibilities for future collaboration. Furthermore, comparative analysis provided a useful foundation on mapping key elements.
Topics: Humans; Australia; Education, Nursing, Graduate; Educational Status; Indonesia; Nurse Practitioners
PubMed: 37703747
DOI: 10.1016/j.nedt.2023.105954 -
European Archives of Paediatric... Dec 2023Molar incisor hypomineralization (MIH) is playing an increasingly important role in dental practice. MIH is defined as hypomineralization of systemic origin of one to...
PURPOSE
Molar incisor hypomineralization (MIH) is playing an increasingly important role in dental practice. MIH is defined as hypomineralization of systemic origin of one to four permanent first molars, often associated with affected incisors. Affected teeth are more susceptible to caries and post-eruptive enamel loss and should be diagnosed and treated as early as possible. In 2016, the Würzburg concept was developed for German-speaking countries including a classification index-the MIH Treatment Need Index (MIH-TNI)-and a treatment plan based on it for the use in daily practice. In the meantime, the concept has also gained international recognition. The aim of this paper is to update part 2 of the Würzburg concept, the treatment plan, as knowledge about MIH has increased and the disease has been studied more extensively in the last years. Other treatment approaches are now available and therefore need to be included in the concept. Although, the evidence of the different treatment options is still weak, practitioners need guidance in their daily practice.
METHODS
The authors reviewed the available literature, including clinical and laboratory studies and published guidelines.
RESULTS
The updated version of the Würzburg concept includes additional non-invasive strategies and temporary therapy options, as well as treatment approaches for incisors. It therefore covers currently available treatment modalities for MIH-affected teeth, ranging from prophylaxis, non-invasive treatment to restorative approaches and possibly even extraction.
CONCLUSIONS
This is intended to help guide the practitioner and will need to be further validated by clinical trials.
Topics: Humans; Dental Enamel Hypoplasia; Molar Hypomineralization; Dental Enamel; Incisor; Molar; Prevalence
PubMed: 37856065
DOI: 10.1007/s40368-023-00848-5 -
African Journal of Emergency Medicine :... Sep 2023Psychomotor agitation and aggressive behaviour (AAB) have the potential to occur in any healthcare setting, including those in which Emergency Medical Services (EMS)... (Review)
Review
BACKGROUND
Psychomotor agitation and aggressive behaviour (AAB) have the potential to occur in any healthcare setting, including those in which Emergency Medical Services (EMS) operate. This scoping review aimed to examine the available literature on physical restraint of patients within the prehospital setting and to identify guidelines and their effectiveness, safety to patients and health care practitioners and strategies relating to physical restraint when used by EMS.
METHODS
We performed our scoping review using the methodological framework described by Arksey and O'Malley augmented by that of Sucharew and Macaluso. Several steps guided the review process: identification of the research question, eligibility criteria, information sources (CINAHL, Medline, Cochrane and Scopus), search, selection and data collection, ethical approval, collation, summarizing and reporting on the results.
RESULTS
The population of interest, in this scoping review was prehospital physically restrained patients, however, there was a reduced research focus on this population in comparison to the larger emergency department.
CONCLUSION
The limitation of informed consent from incapacitated patients may relate to the lack of prospective real-world research from previous and future studies. Future research should focus on patient management, adverse events, practitioner risk, policy, and education within the prehospital setting.
PubMed: 37334175
DOI: 10.1016/j.afjem.2023.03.006 -
Journal of the American Medical... Nov 2023This work aims to explore the value of Dutch unstructured data, in combination with structured data, for the development of prognostic prediction models in a general...
OBJECTIVE
This work aims to explore the value of Dutch unstructured data, in combination with structured data, for the development of prognostic prediction models in a general practitioner (GP) setting.
MATERIALS AND METHODS
We trained and validated prediction models for 4 common clinical prediction problems using various sparse text representations, common prediction algorithms, and observational GP electronic health record (EHR) data. We trained and validated 84 models internally and externally on data from different EHR systems.
RESULTS
On average, over all the different text representations and prediction algorithms, models only using text data performed better or similar to models using structured data alone in 2 prediction tasks. Additionally, in these 2 tasks, the combination of structured and text data outperformed models using structured or text data alone. No large performance differences were found between the different text representations and prediction algorithms.
DISCUSSION
Our findings indicate that the use of unstructured data alone can result in well-performing prediction models for some clinical prediction problems. Furthermore, the performance improvement achieved by combining structured and text data highlights the added value. Additionally, we demonstrate the significance of clinical natural language processing research in languages other than English and the possibility of validating text-based prediction models across various EHR systems.
CONCLUSION
Our study highlights the potential benefits of incorporating unstructured data in clinical prediction models in a GP setting. Although the added value of unstructured data may vary depending on the specific prediction task, our findings suggest that it has the potential to enhance patient care.
Topics: Humans; General Practitioners; Electronic Health Records; Language; Algorithms; Software; Natural Language Processing
PubMed: 37587084
DOI: 10.1093/jamia/ocad160