Medical Centre

Primary care is a major component of England’s National Health Service , providing around 300 million consultations per year with GPs in England. In addition to providing healthcare to their patients, GPs are also charged with coordination and gatekeeping of access to services provided by secondary care, tertiary care and other allied healthcare providers; a responsibility that will become more important now that GPs will be undertaking the commissioning of health care. This new responsibility for GPs provides an opportunity to re-model care delivery to maximize outcomes, cost efficiency and patient access by focusing on diseases that are most amenable to management in primary care. In a paper published in the Journal of the Royal Society of Medicine , Daniel Gibbons and Colleagues review the evidence on what conditions are most sensitive to management in primary care – commonly referred to as primary care sensitive conditions (PCSCs) or ambulatory care sensitive conditions. Such de...

In a systematic review published in JRSM Short Reports , Josip Car and colleagues collated and critically evaluate the available scientific evidence on the negative health system effects of global health initiatives in developing countries. They identified 24 studies commenting on adverse effects on health systems arising from Global Fund investments. Sixteen were quantitative studies, six were qualitative and two used both quantitative and qualitative methods, but none explicitly stated that the studies were originally designed to capture or to assess health system effects (positive or negative). Only anecdotal evidence or authors’ perceptions/interpretations of circumstances could be extracted from the included studies. Dr Car and colleagues concluded that that much of the currently available evidence generated between 2002 and 2009 on global health initiatives potential negative health system effects is not of the quality expected or needed to best serve the academic or broader c...

In a paper published in the journal JRSM Short Reports , Layla Alhyas and colleagues examined the quality of type 2 diabetes mellitus (T2DM) care in Al-Ain, a diabetes centre located in a tertiary care hospital, in the United Arab Emirates (UAE). They carried out a a retrospective cohort study from 2008 to 2010. 382 Emirates patients with T2DM were included in the analysis. Overall in 2010, proportions of people with T2DM reaching the following targets were: glycated haemoglobin (HbA1c) 41%, low-density lipoprotein (LDL) 72%, systolic and diastolic blood pressure (SBP/DBP) 47% and 73%, respectively. There was a significant improvement from 2008 to 2010 in HbA1c, LDL, and SBP control. Alhyas and colleagues concluded that there had been encouraging progress in diabetes care in Al-Ain, UAE as reflected by the overall improvement in key intermediate outcome measures, exemplified by the increase in the percentage if patients reaching the target for these indicators from ...

During the past decade, national governments and international agencies have strengthened the implementation of prevention of mother-to-child HIV transmission (PMTCT) programmes. However, many women still do not access these services. In 2010, there were 390,000 new HIV infections in children, 90% of which were infected through vertical transmission.  The fear of violence or abandonment by male partners, cultural gender rules and disparate decision making power for women are among the main reasons that women do not access PMTCT services. Hence, interventions should focus on promoting gender equality and improving male awareness and engagement in their families’ health in order to improve uptake of PMTCT services. In a systematic review published in the Cochrane Library ,  Serena Brusamento and colleagues assessed the effectiveness of male involvement interventions on women’s uptake of PMTCT services in developing countries. They concluded that we need more studies assessing d...