What's been tried: a curated catalogue of efforts to improve access to general practice.

Background: Although increasing numbers of appointments are being provided, public satisfaction with access to UK general practice is declining. Previous attempts to improve access have not been systematically collated.

Aim: We aimed to identify interventions to improve access to general practice in the UK, to organise these interventions into thematic categories, and to identify which aspects of access are targeted.

The visual experience dataset: Over 200 recorded hours of integrated eye movement, odometry, and egocentric video.

We introduce the Visual Experience Dataset (VEDB), a compilation of more than 240 hours of egocentric video combined with gaze- and head-tracking data that offer an unprecedented view of the visual world as experienced by human observers. The dataset consists of 717 sessions, recorded by 56 observers ranging from 7 to 46 years of age. This article outlines the data collection, processing, and labeling protocols undertaken to ensure a representative sample and discusses the potential sources of error or bias within the dataset.

Late-Onset Postpartum Hypertension After Normotensive Pregnancy.

To better inform efforts to improve and extend postpartum care, we sought to estimate the incidence of de novo hypertension up to 6 months postpartum in patients without evidence of hypertension during pregnancy or immediately postpartum. This retrospective cohort study included all patients delivering within an academic health care system. All blood pressure (BP) measurements from fertilization to 6 months postpartum were obtained from the electronic medical record and used to identify patients who remained normotensive throughout pregnancy and in the first 6 weeks postpartum.

Understanding access to general practice through the lens of candidacy: a critical review of the literature.

Background: Dominant conceptualisations of access to health care are limited, framed in terms of speed and supply. The Candidacy Framework offers a more comprehensive approach, identifying diverse influences on how access is accomplished.

Aim: To characterise how the Candidacy Framework can explain access to general practice - an increasingly fraught area of public debate and policy.

Design as a quality improvement strategy: The case for design expertise.

Bad design in safety-critical environments like healthcare can lead to users being frustrated, excluded or injured. In contrast, good design can make it easier to use a service correctly, with impacts on both the safety and efficiency of healthcare delivery, as well as the experience of patients and staff. The participative dimension of design as an improvement strategy has recently gained traction in the healthcare quality improvement literature.

Operational failures in general practice: a consensus-building study on the priorities for improvement.

Background: System problems, known as operational failures, can greatly affect the work of GPs, with negative consequences for patient and professional experience, efficiency, and effectiveness. Many operational failures are tractable to improvement, but which ones should be prioritised is less clear.

Aim: To build consensus among GPs and patients on the operational failures that should be prioritised to improve NHS general practice.

Increased Rates of Hypertensive Disorders of Pregnancy during the COVID-19 Pandemic.

Objective: Hypertensive disorders of pregnancy (HDP) are common complications associated with severe maternal and neonatal morbidity. One goal of prenatal care, especially at term, is to screen for HDP. As treatment of HDP centers on delivery when appropriate, timely diagnosis is crucial.

Great expectations? GPs' estimations of time required to deliver BMJ's '10 minute consultations'.

Objectives: To estimate the time required to undertake consultations according to BMJ's 10-minute consultation articles.To quantify the tasks recommended in 10-minute consultation articles.To determine if, and to what extent, the time required and the number of tasks recommended have increased over the past 22 years.

Tackling the crisis in general practice.

Support to develop better systems will go a long way

Living with epilepsy during COVID-19 pandemic restrictions: A longitudinal perspective.

The purpose of our study was to explore how people with epilepsy fared during two of the most stringent 4-month society-wide COVID-19-related pandemic restrictions in Ireland, in 2020 and one year later in 2021. This was in the context of their seizure control, lifestyle factors, and access to epilepsy-related healthcare services. A 14-part questionnaire was administered to adults with epilepsy during virtual specialist epilepsy clinics in a University Hospital in Dublin, Ireland at the end of the two lockdowns.

Natural statistics of human head orientation constrain models of vestibular processing.

Head orientation relative to gravity determines how gravity-dependent environmental structure is sampled by the visual system, as well as how gravity itself is sampled by the vestibular system. Therefore, both visual and vestibular sensory processing should be shaped by the statistics of head orientation relative to gravity. Here we report the statistics of human head orientation during unconstrained natural activities in humans for the first time, and we explore implications for models of vestibular processing.

Case series of tubo-ovarian abscesses after saline infusion sonohysterography: reconsidering antibiotic prophylaxis.

Saline infusion sonohysterography (SIS) is useful for evaluating intrauterine pathology, particularly for patients with abnormal uterine bleeding and during assessment of infertility. Infectious complications are relatively rare, and tubo-ovarian abscess (TOA) after SIS has only been reported once in the literature. We present two additional cases of TOA after SIS that presented to our institution.

Natural statistics of human head orientation constrain models of vestibular processing.

Head orientation relative to gravity determines how gravity-dependent environmental structure is sampled by the visual system, as well as how gravity itself is sampled by the vestibular system. Therefore, both visual and vestibular sensory processing should be shaped by the statistics of head orientation relative to gravity. Here we report the statistics of human head orientation during unconstrained natural activities in humans for the first time, and we explore implications for models of vestibular processing.

The multimorbidity collaborative medication review and decision making (MyComrade) study: a pilot cluster randomised trial in two healthcare systems.

Background: While international guidelines recommend medication reviews as part of the management of multimorbidity, evidence on how to implement reviews in practice in primary care is lacking. The MyComrade (MultimorbiditY Collaborative Medication Review And Decision Making) intervention is an evidence-based, theoretically informed novel intervention which aims to support the conduct of medication reviews for patients with multimorbidity in primary care.

Aim: The pilot study aimed to assess the feasibility of a definitive trial of the MyComrade intervention across two healthcare systems (Republic of Ireland (ROI) and Northern Ireland (NI)).

Impact of a Hybrid Model of Prenatal Care on the Diagnosis of Fetal Growth Restriction.

Objective: Fetal growth restriction (FGR) is associated with poor neonatal outcomes and stillbirth, and screening via fundal height or ultrasound is routinely performed. During the novel coronavirus disease 2019 (COVID-19) pandemic, we developed a hybrid model of prenatal care which decreased the frequency of in-person visits and incorporated telemedicine visits. We sought to determine if prenatal FGR diagnoses decreased with this hybrid model compared with routine prenatal care.

The MultimorbiditY COllaborative Medication Review And DEcision Making (MyComrade) study: a protocol for a cross-border pilot cluster randomised controlled trial.

Background: While international guidelines recommend medication reviews as part of the management of multimorbidity, evidence on how to implement reviews in practice in primary care is lacking. The MultimorbiditY Collaborative Medication Review And Decision Making (MyComrade) intervention is an evidence-based, theoretically informed novel intervention which aims to support the conduct of medication reviews for patients with multimorbidity in primary care. Our aim in this pilot study is to evaluate the feasibility of a trial of the intervention with unique modifications accounting for contextual variations in two neighbouring health systems (Republic of Ireland (ROI) and Northern Ireland (NI)).

Identifying how GPs spend their time and the obstacles they face: a mixed-methods study.

Background: Although problems that impair task completion - known as operational failures - are an important focus of concern in primary care, they have remained little studied.

Aim: To quantify the time GPs spend on different activities during clinical sessions; to identify the number of operational failures they encounter; and to characterise the nature of operational failures and their impact for GPs.

Design And Setting: Mixed-method triangulation study with 61 GPs in 28 NHS general practices in England from December 2018 to December 2019.

A Comparison of BREAST-Q Scores between Prepectoral and Subpectoral Direct-to-Implant Breast Reconstruction.

Background: Subpectoral breast implant placement has in recent history predominated in breast reconstruction, but there has been more recent adoption of prepectoral implant reconstruction. There has been limited study to date of patient-reported outcomes comparing the two techniques.

Methods: Patients who underwent direct-to-implant breast reconstruction between 2013 and 2018 were included in this retrospective cohort study.

Investigating Decreased Rates of Nulliparous Cesarean Deliveries during the COVID-19 Pandemic.

Objective: Preventing the first cesarean delivery (CD) is important as CD rates continue to rise. During the novel coronavirus disease 2019 (COVID-19) pandemic, quality improvement metrics at our hospital identified lower rates of CD. We sought to investigate this change and identify factors that may have contributed to the decrease.

Evaluation of the Intel RealSense T265 for tracking natural human head motion.

Accurate and robust tracking of natural human head motion in natural environments is important for a number of applications including virtual and augmented reality, clinical diagnostics, as well as basic scientific research. IMU provide a versatile solution for recording inertial data including linear acceleration and angular velocity, but reconstructing head position is difficult or impossible. This problem can be solved by incorporating visual data using a technique known as visual-inertial simultaneous localization and mapping (VI-SLAM).

GPs' mindlines on deprescribing antihypertensives in older patients with multimorbidity: a qualitative study in English general practice.

Background: Optimal management of hypertension in older patients with multimorbidity is a cornerstone of primary care practice. Despite emphasis on personalised approaches to treatment in older patients, there is little guidance on how to achieve medication reduction when GPs are concerned that possible risks outweigh potential benefits of treatment. Mindlines - tacit, internalised guidelines developed over time from multiple sources - may be of particular importance in such situations.

The Impact of Premastectomy Versus Postmastectomy Radiation Therapy on Outcomes in Prepectoral Implant-Based Breast Reconstruction.

Purpose: Prepectoral implant-based breast reconstruction is being increasingly performed over subpectoral reconstruction because of the reduced invasiveness of the procedure, postoperative pain, and risk of animation deformity. Radiation therapy is a well-known risk factor for complications in implant-based breast reconstruction. The effect of premastectomy versus postmastectomy radiation therapy on outcomes after prepectoral breast reconstruction has not been well-defined.

Outcomes After Central Wedge Labiaplasty Performed Under General Versus Local Anesthesia.

Purpose: Interest in labiaplasty as a way to alter and improve genital appearance has been on the rise. Labiaplasty procedures can be performed in the office setting under local anesthesia. However, these procedures are often performed under general anesthesia for patient comfort and to facilitate the operative technique and to potentially improve outcomes.