Medical schools
Like many other countries, the US faces a chronic shortage of primary care physicians that negatively impacts population health and contributes to rising healthcare costs. This prompted a research team from Michigan to conduct a scoping review to synthesise literature on institutional practices and interventions that support medical students’ choices of primary care specialties.1 They reviewed 8083 articles and identified 199 articles meeting inclusion criteria and 41 related articles. As a group, studies were of low quality, mostly used quantitative methodologies, rarely examined planning or piloting, and seldom looked at workforce outcomes. The authors suggest future studies should employ stronger theoretical grounding, greater investment in planning and piloting, consistent use of language, and more qualitative methods. They also challenge policymakers to consider building more robust funding mechanisms to support impactful medical education research focused on primary care.
Nocturnal pain
Nocturnal pain is an important part of the pain experience in osteoarthritis (OA) and highlighted as a key concern by patients with hip and knee OA. It’s also a highly ranked determinant in decisions about whether a patient should undergo joint replacement surgery. Using an online survey, researchers from Rotterdam found that nocturnal pain was reported by 76/101 (75%) participants.2 Comparison between participants with and without nocturnal pain showed that participants with nocturnal pain were affected by intermittent, constant, and radiating pain. Pain had more impact on their sleep and they scored their pain at its worst higher compared with participants without nocturnal pain. The authors conclude that we desperately need more research about nocturnal pain to help GPs provide improved explanations and interventions to patients with OA.
Alopecia areata
Despite being a relatively common condition, robust and recent epidemiology data for alopecia areata (AA) are lacking, prompting researchers from across the UK to complete a population-based cohort study of 4.16 million adults and children using electronic primary care records.3 The AA incidence rate was 0.26 per 1000 person-years, and point prevalence in 2018 was 0.58% in adults. AA onset peaked at age 25–29 years for both sexes, although the peak was broader in females. People of non-white ethnicity were more likely to present with AA, especially those of Asian ethnicity. Higher AA incidence was associated with social deprivation and urban living. Understanding the variation in AA onset between different population groups, the authors suggest, may give insight into the pathogenesis of AA and its management.
# bodypositive
The body-positive movement (#bodypositive, #bopo, #bodypositivity) has amassed a considerable presence on the social media platform Instagram. The movement developed to combat and resist the #thinspiration and #fitspiration content that predominates on social media. As the movement recently surpassed 1 billion engagements on Instagram, a team from New Zealand sought to mark this milestone by highlighting the problem, the promise, and the peril of image-focused movements on Instagram.4 They argue, on balance, that #bodypositive content on social media such as Instagram must be viewed positively. Potential perils aside, the growing movement reflects the changing nature of media, with user-generated content providing an avenue to display body sizes and shapes that have been excluded by traditional media.
Podcast of the month
I have finally succumbed to intense peer pressure and joined The Rest is Politics bandwagon. It really is as good as they’re all saying. https://alastaircampbell.org/podcast/
- © British Journal of General Practice 2022