Primary care is an important area in which to confront situations of food and nutrition insecurity. To undertake action in this area, well-prepared professionals are necessary. Courses of health training are not yet, however, equipped to offer the necessary preparation.

To analyse the topics taught in nutrition graduation courses related to the abilities and competencies demanded by professional work in this area.

The curricula of the nutrition courses offered in the municipality of São Paulo, Brazil were analysed. Nutritionists and teachers were interviewed. The triangulation of the data obtained was undertaken by means of a qualitative approach taking the theory of social representations as the frame of reference.

The concepts necessary to act within the context of food and nutrition security are related to a humanistic approach, the unity of theory and practice, the nutritionist’s role as educator, teamwork and reflection on public health.

The home-based Otago Exercise Programme has been shown to increase sustained physical-activity levels in older people recruited through primary care, when supported by health professionals. The ProAct65+ trial is testing this programme using volunteer peer mentors to support behaviour change. This qualitative study explored how these peer mentors experienced their role.

Ten peer mentors from the ProAct65+ trial were interviewed. Semi-structured interviews were audio-recorded, transcribed verbatim and thematically analysed.

Peer mentors reported positive experiences including meeting new people, watching mentees progress, developing friendships and being shown gratitude for their support. Key barriers and facilitators to the mentoring process included the home and telephone as settings for support, geography and making contact with mentees.

Findings from this study can help the development of peer mentor programmes in primary care for older people. Future programmes should recruit peer mentors who are local to where mentoring is needed to reduce travel difficulties.

Appropriate communication between general practitioners (GPs) and physiotherapists is vital for providing optimal care. Differing opinions exist as to key inclusion in this communication. This study aims to identify the key components that both GPs and physiotherapists would include in inter-professional communication.

Qualitative study design, using 14 in-depth, semi-structured telephone interviews.

Physiotherapists identified relevant past medical history, psycho-social history, yellow flags, anticipated time frame for follow-up and objective measures of current function as the more useful inclusions in written communication. GPs identified the inclusion of a working diagnosis, treatment summary and likely long-term outcomes as the key components to effective communication.

Effective interprofessional communication requires the provision of information that is both succinct and relevant. While there are individual preferences, this study suggests that certain key characteristics exist, and the inclusion of these in interprofessional communication may lead to improved communication and patient outcomes.

To establish how people with psoriasis in the United Kingdom today experience living with their condition including diagnosis, treatment, healthcare provision and impact on daily life.

Psoriasis is a debilitating long-term inflammatory skin disease which can result in severe itching, discomfort and soreness, and may be associated with problems beyond the specific symptoms related to the skin. For many it is accompanied by difficult-to-manage treatment regimes, emotional distress and a negative impact on their quality of life and psychosocial functioning. To date there is little published information about the health experiences of people in the United Kingdom with psoriasis.

A postal self-administered questionnaire was completed by members of the Psoriasis Association and the responses analysed (n=1564).

The findings suggest some similarities to surveys in other nations, but specifically highlighted that patients feel under-informed and are dissatisfied with current treatment regimes. Responses provided an insight into aspects of the condition that treatments should be targeting. Specific areas of negative impact on psychosocial functioning were identified, including the lack of available support for those experiencing emotional distress. The research provides important information about how the care of patients with psoriasis can be improved, especially at primary care level. This includes: improved training in psoriasis knowledge and awareness at general practitioner level and greater use of dermatology specialist nurses in primary care settings; more effective and manageable treatment regimes that target visible areas and general well-being; greater support for emotional distress and psychosocial functioning.

The study objective was to evaluate an eight-week Mindfulness-Based Stress Reduction (MBSR) treatment group for chronic pain in terms of effects on pain disability, subjective ratings of pain and psychological distress related to pain, and activity level and willingness to experience pain. This pilot study evaluated the impact of two eight-week MBSR treatment groups that were delivered in a clinic in Winnipeg, Manitoba.

Chronic pain is one of the most common presenting problems in primary care settings.

Adult patients with chronic pain were recruited from 20 clinics that are part of a collaborative care programme and outcome measures were administered at baseline and programme completion.

Despite a modest attendance rate and the short length of programme, a pre–post evaluation involving 17 patients revealed significant and/or clinically relevant improvements in level of pain disability, psychological distress, engagement in life activities, willingness to experience pain, and subjective rating of current pain.

To determine what diagnostic terms are utilized by general practitioners (GPs) when seeing patients with mixed emotional and physical symptoms.

Prototype cases of depression, anxiety, hypochondriasis, somatization and undifferentiated somatoform disorders were sourced from the psychiatric literature and the author’s clinical practice. These were presented, in paper form, to a sample of GPs and GP registrars who were asked to provide a written diagnosis.

Fifty-two questionnaires were returned (30% response rate). The depression and anxiety cases were identified correctly by most participants. There was moderate identification of the hypochondriasis and somatization disorder cases, and poor identification of the undifferentiated somatoform case.

Somatization and undifferentiated somatoform disorders were infrequently recognized as diagnostic categories by the GPs in this study. Future research into the language and diagnostic reasoning utilized by GPs may help develop better diagnostic classification systems for use in primary care in this important area of practice.

Obesity is a major public health issue and primary care practitioners are well placed to opportunistically raise the issue of overweight or obesity with their patients.

This study investigated the prevalence of weight discussion in primary care consultations with overweight and obese patients, in a practice in Fife, Scotland, and described weight-related communication using video analysis.

Weight was raised in 25% of consultations with overweight and obese patients. GPs initiated weight discussion more often than patients; however, these attempts were often blocked by patients. Weight-related outcomes were more common when patients initiated the weight discussion. This study confirms the potential of video analysis for understanding primary care weight discussion. It also suggests that GPs may benefit from a communication-based intervention to tackle patient blocking behaviours and contributes to the evidence suggesting that interventions targeted to increase the prevalence of weight-related discussions with their patients are needed.

To explore GPs’ perceptions of their role in primary prevention, barriers experienced and willingness to accommodate an automated, computer-tailored intervention.

General practice is an attractive setting for primary prevention of chronic disease. Due to constraints in time and knowledge it is underutilised.

Telephone interviews of 13 GPs in Brisbane, Australia, whose patients were previously involved in a lifestyle change research project. Qualitative responses were grouped into themes.

GPs perceived their role in lifestyle change as ‘educators’, ‘supporters’ and ‘prompters’. Smoking and physical activity were addressed more often than alcohol and salt intake. Longer lifestyle-focussed consultations and computer-generated reminders were suggested to overcome barriers. A computer-tailored approach was appreciated due to its minimal impact on practice routine. GPs understand their role in primary prevention but need help to overcome barriers. GP initiated consultations focusing on lifestyle and prevention along with computer support systems could improve capability for prevention in general practice.