Communities of practice - quality improvement or research in general practice.

Background: A 'communities of practice' (CoP) approach has the potential to address quality improvement issues and facilitate research in general practice by engaging those most intimately involved in delivering services - the health professionals.

Objective: This article outlines the CoP approach and discusses some of the challenges involved in using this approach to raise standards in general practice and how these challenges might be addressed.

Discussion: General practitioner insight needs to be harnessed in order to develop solutions that are conceived in, and informed by, clinical practice.

Procedural skills in general practice vocational training - what should be taught?

Background: A list of procedural skills is an important component of a curriculum for general practice vocational training. This study aimed to establish an up-to-date list of core procedural skills that doctors undergoing general practice vocational training should be taught.

Method: A Delphi process was used to rank the importance of 185 general practice procedures.

General practice as a fortress - occupational violence and general practice receptionists.

Background: Occupational violence is well documented among general practice receptionists, who are singularly vulnerable because they are placed in the general practice 'frontline'. One response to this threat has been to physically isolate reception staff from waiting room patients by having a perspex shield at the reception desk and a locked door between waiting room and staff areas.

Method: A qualitative study employing semistructured interviews, an inductive approach and a thematic analysis.

Patient attitudes - training students in general practice.

Background: While evidence from Australian studies is lacking, evidence from overseas suggests that patients are generally willing to have a medical student present during general practitioner consultations. This willingness, however, may be contingent upon factors related to the patient, student or consultation.

Method: Focus groups and two cross sectional surveys of 296 patients attending 16 general practices in New South Wales.

Sex and the skin: a qualitative study of patients with acne, psoriasis and atopic eczema.

Quantitative questionnaire-based research has suggested a considerable effect of skin disease on the sexual life of sufferers. In this study, we explored the effects of acne, psoriasis and atopic eczema upon sexual functioning and sexual relationships in the context of a wider exploration of the psychological sequelae of these diseases. We employed a qualitative methodology employing in-depth semi-structured interviews and involving thematic analysis and constant comparison.

General practice research - training and capacity building.

The Lancet in 1999 suggested that 'neglect of research has made primary care one of the most intellectually underdeveloped disciplines in medicine' and later labelled general practice research 'a lost cause'. According to the Medical Journal of Australia, this underdevelopment 'stems from a lack of research culture, a heavy service commitment and the late arrival of academic GPs'.

The relationship between psychiatric illnesses and skin disease: a longitudinal analysis of young Australian women.

Objective: To examine longitudinally the relationship between skin disease and psychological morbidity in young women, testing the hypothesis that psychological morbidity (depression, anxiety, and stress) is a factor in the causation of skin disease.

Design: The Australian Longitudinal Study on Women's Health was designed to investigate multiple factors affecting the health and well-being of women over a 20-year period. Data from 3 surveys (conducted in 2000, 2003, and 2006) were analyzed.

Receptionists' experiences of occupational violence in general practice: a qualitative study.

Background: The significance of occupational violence in general practice is well established, but research has focused almost exclusively on the experiences of GPs. Only limited research has examined the role of general practice receptionists despite their acknowledged vulnerability to violent patient behaviour. No qualitative research has explored this problem.

Acne's relationship with psychiatric and psychological morbidity: results of a school-based cohort study of adolescents.

Background: There is a considerable number of studies linking acne with psychological and psychiatric morbidities, although this literature is not entirely consistent and is largely cross-sectional in methodology.

Objective: This study aims to establish the relationship of acne and psychological and psychiatric morbidity in adolescents in a community setting and, via a longitudinal methodology, provide evidence for causality in the relationship.

Methods: The study was a 12-month cohort study.

Stroke patients' experience with the Australian health system: a qualitative study.

Background: Consumer feedback about experiences with the health system is integral to service planning and is consistent with growing interest in patient-centred care.

Purpose: To explore the experiences of community-dwelling stroke survivors at one, three and five years using a community-based, cross-sectional study.

Methods: The quantitative study was comprised of 90 participants post-stroke (3 cohorts, each including 30 participants).

Patients with skin disease and their relationships with their doctors: a qualitative study of patients with acne, psoriasis and eczema.

Objective: To explore the experiences of patients with acne, psoriasis or atopic eczema in their relationships with their treating doctors.

Design: Qualitative study, using semi-structured interviews conducted between January 2004 and April 2005, thematic analysis and modified grounded theory methodology.

Setting And Participants: Participants were patients with acne, psoriasis or atopic eczema recruited from urban general practices and urban dermatology practices.

The psychological sequelae of psoriasis: results of a qualitative study.

Psoriasis is a common condition with recognised psychological comorbidity in specialist practice. The objective of this study was to investigate the psychological comorbidities in psoriasis in patients from general (family) practices and specialist dermatology practices, using a qualitative methodology. This was a qualitative study, utilising semi-structured interviews and thematic analysis.

Desire for research in general practice.

If you have considered participating in general practice research, the chances are that a combination of inherent interest and potential satisfaction drew you toward it. You may want to see the evidence base of general practice expanded; you probably enjoy an intellectual challenge; and you are likely to take pleasure in the sense of achievement this can bring.

Integrated models or mayhem? Lessons learnt from three integrated primary health care entities in regional New South Wales.

While "integration" may be a policy imperative at present, the reality of integrating services whilst managing the business of service delivery and best patient outcomes is both challenging and unfamiliar territory for most general practitioners. Recent policy changes in general practice have challenged traditional financial and governance models. This paper reviews three integrated general practice entities, all under the auspice of the University of Newcastle, for commonalities and concerns.

Experiences of appearance-related teasing and bullying in skin diseases and their psychological sequelae: results of a qualitative study.

Acne, psoriasis and atopic eczema are common diseases and have been consistently associated with adverse psychological sequelae including stigmatization. Being teased on the basis of appearance has been associated with psychiatric morbidity in children and adolescents. The objective of this qualitative study was to explore the experiences of teasing and bullying in patients with acne, psoriasis and eczema, and the role of appearance-related teasing and bullying as mediators of psychological morbidity in these patients.

Leaders, leadership and future primary care clinical research.

Background: A strong and self confident primary care workforce can deliver the highest quality care and outcomes equitably and cost effectively. To meet the increasing demands being made of it, primary care needs its own thriving research culture and knowledge base.

Methods: Review of recent developments supporting primary care clinical research.

Journal impact factor and its importance for AFP.

Background: In 2008, Australian Family Physician (AFP) was accepted on the list of journals listed in Science Citation Index Expanded and, thus, will generate an impact factor over the next 2 years. Impact factor is important to authors from research and academic backgrounds and will make AFP an increasingly attractive journal in which to publish.

Aim: To describe the impact factor, its method of calculation, and its flaws.

Violence in general practice: perceptions of cause and implications for safety.

Objective: To explore GPs' opinions about the causes of occupational violence in general practice.

Design: A cross-sectional qualitative study.

Setting: Three urban divisions of general practice in New South Wales, Australia.

Exploring poststroke mood changes in community-dwelling stroke survivors: a qualitative study.

Objective: To explore the long-term experience of mood changes in community-dwelling stroke survivors at 1, 3, and 5 years after stroke.

Design: A qualitative study using a modified grounded theory approach. The primary data collection method was semi-structured interviewing.

A cross-sectional study of psychological morbidity in patients with acne, psoriasis and atopic dermatitis in specialist dermatology and general practices.

Background: There is considerable evidence for an association of skin diseases with psychological morbidity. This relationship is best established for acne, psoriasis and atopic eczema. Previous studies have mostly been performed in specialist dermatological practice, and there is a lack of studies that include patients from general practice and a lack of controlled studies employing multivariate analysis.

Is your prescription of distance running shoes evidence-based?

Objectives: To determine whether the current practice of prescribing distance running shoes featuring elevated cushioned heels and pronation control systems tailored to the individual's foot type is evidence-based.

Data Sources: MEDLINE (1950-May 2007), CINAHL (1982-May 2007), EMBASE (1980-May 2007), PsychInfo (1806-May 2007), Cochrane Database of Systematic Reviews (2(nd) Quarter 2007), Cochrane Central Register of Controlled trials (2(nd) Quarter 2007), SPORTSDiscus (1985-May 2007) and AMED (1985-May 2007).

Review Methods: English language articles were identified via keyword and medical subject headings (MeSH) searches of the above electronic databases.

General practitioners' assessment of risk of violence in their practice: results from a qualitative study.

Rationale, Aims And Objectives: Clinicians' means of stratification of risk of violence has been previously studied in health settings, but not in general practice. This study aimed to investigate the means by which general practitioners (GPs) assess risk of violence in their clinical practice.

Method: A qualitative design using focus group interviews and written responses on a subsequent questionnaire.