This study examines firstly if participation in a three-month intervention at Norwegian Healthy Life Centres (HLCs) improved self-reported physical activity (SR-PA), and secondly to what extent physical activity (PA) status at six months and changes from baseline were associated with demographic and motivational predictors.

Regular PA is promoted as a central component of public health initiatives aimed at preventing noncommunicable diseases.

This randomized controlled trial included 118 participants (57 in the intervention group) recruited from HLCs in South-western Norway. The intervention effect was assessed by comparing the intervention group with the waiting-list control group after six months. We examined sociodemographic and motivational predictors of change combining both groups into a single cohort. This trial was registered at ClinicalTrials.gov (ID: NCT02247219).

At six-month follow-up, participants in the intervention group reported higher levels of SR-PA compared with the control group. The estimated effect was modest (B = 0.26, 95% CI −0.01 to 0.53), equivalent to ≈0.37 SD. Although the confidence interval included zero, the estimate remained compatible with a modest positive effect. Autonomous motivation and social support were positively associated with SR-PA after 6 months, while psychological defiance showed a negative association. Autonomous motivation and psychological defiance impacted PA change during the 6-month period in opposite directions.

Pregnancy is a critical period when women are particularly vulnerable to nutritional deficiencies. However, limited evidence exists on nutritional knowledge, dietary practices, and associated factors among pregnant women in the study area.

To assess nutritional knowledge, dietary practice, and associated factors among pregnant women in Halaba town.

A concurrent mixed-methods cross-sectional study was conducted in Halaba Town from August 2 to November 25, 2025. Quantitative data were collected from 403 randomly selected pregnant women, while qualitative data were obtained from five FGDs with 35 purposively selected participants. Data were collected through face-to-face interviews and analyzed using descriptive and thematic analyses.

Of the 403 selected participants, 398 pregnant women completed the study, yielding a response rate of 97.7%. Half of the respondents (51%) had good nutritional knowledge, yet only 42.4% of pregnant women reported practicing healthy dietary behaviors. Educational status (AOR: 2.0; 95% CI: 1.3–4.2), pregnancy status (AOR: 2.3; 95% CI: 1.5–4.5), and nutritional information (AOR: 3.1; 95% CI: 1.5–4.9) were significantly associated with nutritional knowledge. Educational status (AOR: 1.9; 95% CI: 1.4–4.3), nutritional information (AOR: 3.9; 95% CI: 2.5–7.9), occupational status (AOR: 1.7; 95% CI: 1.3–4.1), and food security status (AOR: 1.9; 95% CI: 1.5–5.4) were significantly associated with dietary practices. Qualitative findings showed that cultural food taboos and economic constraints limited dietary diversity, while spousal support, shared decision-making, and home gardening promoted healthier dietary practices.

To describe the incidence, indications and outcomes of percutaneous image-guided pain procedures (PIGPPs) for low back pain (LBP) in an Australian suburban primary care centre.

PIGPPs are widely used in secondary and tertiary care for LBP but there is little information about their use in primary care.

A retrospective audit in an Australian city suburban primary care centre, during 2022.

Of 2828 patients coded with terms relating to LBP 673 had a consultation for LBP and 90 (13%: 95% CI 11–16%) had a PIGPP. These patients were significantly (p < 0.001) older and more likely (p < 0.001) to have chronic lower limb pain. Outcome documentation by GPs was high (87%: 95% CI 75–95%) but subjective. Future studies of PIGPPs for LBP in primary care should address deficiencies in objective patient assessment to facilitate evaluation of their appropriateness and both clinical and cost effectiveness

To examine how co-located community and health services in primary care could support disadvantaged groups.

Co-locating services is thought to improve access, collaboration, and patient outcomes. There are thousands of primary care premises across the UK. At a time of stagnating or widening health inequalities, they present an ideal opportunity to support communities, especially in disadvantaged areas.

We conducted a systematic umbrella review. Articles were retrieved from Ovid MEDLINE and Ovid Embase with supplementary snowball and grey literature searches. Reviews of co-located services supporting disadvantaged groups in primary care between 2010 and February 2024 were included. Quality and risk of bias were assessed using the Joanna Briggs Institute checklist. Two reviewers assessed eligibility, extracted data and assessed quality. Outcomes relating to health, welfare, healthcare utilization, and activity and processes were assessed. Data were narratively synthesized using a convergent integrated approach.

2626 studies were screened, supplemented by snowball and grey literatures searches. Thirteen reviews were included for synthesis. One review included meta-analysis. Three models of care were identified; legal advice, welfare advice, and complementary health care. Data were synthesized according to themes: access and engagement, quality of care, efficiency, improved health, and improved social factors. We found co-located services can improve access to care, engagement in treatment, and quality of care for disadvantaged groups. Improvements to social determinants of health and mental health and well-being outcomes were reported. Findings were inconsistent when considering the impact of co-location on efficiency. We conclude that co-located services in primary care have the potential to improve identification of people most in need and improve their access to high quality health care and social support. Policy makers and practitioners should maximize the use of primary care estates to support disadvantaged groups and communities.

To demonstrate the application of the Theoretical Domains Framework (TDF) and behaviour change theory to identify behaviour change techniques for a complex intervention targeting dementia care by general practice nurses (GPNs).

GPNs have an important role in dementia care but require support to translate evidence-based recommendations into routine practice. Theory-informed implementation strategies may help facilitate this change.

The target behaviour was derived from a Delphi study identifying national dementia care recommendations relevant to GPNs. Barriers to operationalizing the target behaviour were identified from previous research and then coded independently by two authors using the TDF. Identified domains were then mapped to behaviour change techniques using the Theory and Techniques Tool.

The specified behaviour was: ‘the general practice nurse will use language that is accurate, respectful, inclusive, empowering and non-stigmatizing when communicating with people living with dementia within each patient encounter in general practice’. Seven TDF domains were identified, including ‘knowledge’, ‘skills’ and ‘social influences’, mapping to 22 behaviour change techniques, including ‘instruction on how to perform the behaviour’ and ‘social support’. This theory-informed approach identifies practical techniques for developing interventions to improve GPN communication with people living with dementia and provides a method that could be applied to other dementia care behaviours in general practice.

Workshops with Primary Health Care (PHC) practitioners aimed to (1) identify and prioritise key features to include in a child health behaviour screening tool, and (2) understand prioritised supports needed to implement screening in PHC.

PHC is a key setting for monitoring and promoting child health behaviours including dietary intake, physical activity, sedentary behaviour and sleep. Screening tools to monitor children’s health behaviours in PHC are needed.

South Australian practitioners were recruited to participate in virtual workshops. The four-step Nominal Group Technique method was followed including individual brainstorming, round robin, group discussion, and voting. Collaborative recording of participant ideas and discussions, including workshop transcripts and live notes, enabled collection of qualitative quotes. Quantitative voting data were analysed to determine the relative importance of ideas.

Nine workshops were facilitated with two practitioner groups: 1) General Practice and Allied Health (n = 21) and 2) Child and Family Health (n = 8) . Ten practitioner-generated features of a screening tool and 10 supports to facilitate implementation of a screening tool were identified. Top ranked features included ‘Clear results and next steps’ and ‘Question design and response format’. ‘Practitioner training’ and ‘Practitioner resources’ were key supports for implementation. Consistent findings across practitioner groups demonstrate tool features and implementation strategies that are likely to be widely accepted. Unique findings demonstrate context specific tool features and implementation strategies. This study provides important insight to guide the development of an acceptable child health behaviour screening tool to facilitate a supportive prevention environment in PHC.

The COVID-19 pandemic significantly impacted primary care, including childhood infection management. Public health measures reduced respiratory infections, raising concerns about an ‘immunity debt’ in children. General practitioners (GPs) faced fewer in-person consultations, evolving diagnostic routines, and changing parental expectations. While hospital data are available, effects in general practice are less studied.

A cross-sectional online survey was conducted among Dutch GPs with experience before and after the pandemic. The 35-item questionnaire addressed infection patterns, management, parental behaviour, and communication.

Of 166 GPs, 32% noted changes in infection management and 44% observed altered seasonal trends. While consultation rates remained stable, diagnostic testing and antibiotic use increased. GPs reported longer consultations and rising parental demands, especially among those with lower health literacy or migrant backgrounds.

GPs reported key shifts in managing childhood infections. Strengthening communication and further qualitative research may enhance care and equity.

The aim of this study was to identify factors that enhanced staff wellbeing in an integrated UK maternity service.

Staff wellbeing affects the experience of patients, quality and safety of services, and staff retention. Global healthcare staff shortages mean we need to enable staff to thrive and remain in professional practice. High levels of stress, depression, burnout, attrition and staff shortages have been reported in maternity services. It is, therefore, critical to find ways to support the wellbeing of existing staff.

Appreciative Inquiry interviews (n = 39) and group discussions (n = 4) were conducted with a cross-section of midwifery, medical and maternity support staff, working in community teams, the inpatient and midwife-led unit. Interviews explored best experiences, values and what made a difference to wellbeing. Data was co-analysed thematically by the research team, participants and midwifery staff.

Despite workload and staffing pressures midwives, doctors, students and maternity support workers were highly motivated and passionate about their work. Five staff wellbeing themes were identified: Everything we need to do our work practically and psychologically; Meaning – in our work and relationships; Opportunities to learn and grow; Finding our niche; Agency – able to take care of ourselves. This study also revealed the important contribution that kindness, collegiality, feedback and psychological safety, made to staff wellbeing including professional confidence. Our findings suggest that every healthcare provider can make a difference to their colleagues wellbeing, contribute to the safety of the service and staff retention. An outline of practical recommendations for improving staff wellbeing is provided.

This study aims to evaluate the feasibility and educational impact of utilizing SHCs as primary care training sites in undergraduate medical education, with the goal of enhancing clinical competencies in young adult healthcare.

Family Medicine (FM) is essential for integrating community-based health services into medical education. In Turkey, final-year medical students complete a one-month rotation at Family Health Centers (FHCs). However, young adults often utilize Student Health Centers (SHCs) on university campuses, resulting in a gap in students’ experience with this age group. Addressing this, our programme initiated the inclusion of SHCs in the FM internship rotation for the 2024–2025 academic year.

A mixed-methodology study was conducted in two phases. A retrospective analysis was performed on medical records of patients aged 18–25 who attended the SHC over a one-month period. A prospective 9-item online survey assessed the educational impact on final-year medical students following their FM internship, which included the SHC rotation. Descriptive and qualitative statistical analyses were performed to summarize the survey and clinical data.

A total of 1228 patients were seen at the SHC, mirroring FHC trends. All 87 interns surveyed rated the FM programme initiative positively, with 94.1% highly satisfied and 85.9% reporting improved primary care skills. Qualitative feedback highlighted the value of practical experience and called for longer rotations.

Integrating SHC rotations into undergraduate medical education is both feasible and beneficial, providing relevant primary care experience for medical students and enhancing training in the care of young adult populations.

This study aimed to determine the effect of a single-session music intervention on pain intensity, state anxiety, and vital signs in cancer patients receiving palliative care.

While music therapy is recognized as a non-pharmacological complementary tool, its simultaneous effect on both physiological and psychological parameters requires robust methodological evaluation within specific palliative care settings.

A cluster quasi-experimental pre-test/post-test control group design was conducted across two palliative care centres. The sample comprised 32 patients (Intervention: 16, Control: 16). To prevent treatment contamination, allocation was systematically performed at the room level rather than the individual level. The intervention group received a 30-minute session of instrumental Turkish classical music (Hicaz and Buselik maqams) via headphones, while the control group rested in bed. Data were collected using a Patient Description Form, Visual Analog Scale (VAS), State–Trait Anxiety Inventory (STAI), and a Physiological Parameter Monitoring Form. Linear Mixed Models (LMM) analyzed group × time interactions to account for clustering effects and baseline socio-demographic imbalances.

Analysis revealed significant group × time interactions Post-intervention, the intervention group showed statistically significant reduction in pain intensity and state anxiety scores compared to the control group (p < 0.05). Vital signs (pulse rate, respiratory rate, and blood pressure) demonstrated significant stabilization, alongside a significant increase in oxygen saturation (SpO2) in the intervention group. A 30-minute maqam-based instrumental music session shows potential as a stabilizing, non-pharmacological adjunct for acute symptom management in palliative cancer patients. Due to the small sample size and cluster-allocation, findings provide preliminary evidence.

It was aimed to determine the competencies of Family Medicine residency students regarding the treatment planning of diseases coded with diagnosis-treatment in the ‘National Core Education Programme’ (NCC) in Turkey. We aimed to identify areas where residents feel less competent, which can inform curriculum improvements to better address gaps in treatment planning skills for core diseases.

The study was conducted with Family Medicine residency students from one medical school selected from each geographical region of Turkey. Students were asked to assess themselves at the time of graduation from medical school and currently during their residency training, in terms of ‘appropriate drug selection’, ‘prescribing’, ‘non-drug treatment planning’ and ‘processing treatment management and giving information’ competencies for 59 diseases in the NCC.

The rate of Family Medicine residency students who felt competent in treatment planning/management when they graduated from medical school was very low; although this rate increased to a certain extent with residency training, it could not reach an acceptable rate. Despite partial improvements after graduation, the results suggest potential gaps in achieving the desired competency levels, even after 1–3 year of residency training. The residency students’ competency perceptions ranged from 10–30% to 60–80% across different diseases.

It is important to review and reconstruct the six-year medical education and Family Medicine residency training programs, based on the framework drawn by NCC, focusing on rational treatment planning/management to reconceptualize treatment planning/management and decision-making.

To review the current diagnosis and treatment of hypertension (HTN) and explore alternative care management options.

HTN is underdiagnosed and poorly managed in the UK. With an increasing emphasis on teamwork in primary care (PC), what is the evidence base supporting the partial or complete management of HTN by practice nurses (PNs)?

Using the PRISMA-Scr checklist as a framework, six database searches (BNI, CINAHL, Embase, Emcare, Medline, and PubMed) were conducted using Boolean Operators between December 2023 and February 2024, employing four search structures to find literature on independent or collaborative HTN management by PNs. Qualitative and quantitative research studies, reports, and articles were all considered.

HTN is a significant risk factor for mortality and morbidity. Despite clear national guidelines on the diagnosis and management, many patients affected by this condition remain undiagnosed, with the majority of those diagnosed inadequately treated. PC is struggling to manage the workload due to an ageing population and reduced general practitioner (GP) numbers. The development of new roles to support GPs in their work is underway, but current roles remain vague and without nationally agreed remits or working practices. PNs currently manage most chronic non-communicable diseases, such as diabetes, asthma, and chronic obstructive pulmonary disease; however, HTN is not typically part of their remit. There is strong quantitative and qualitative evidence supporting PNs’ involvement in HTN management as care coordinators. Such a move could improve patient outcomes and release GP time, but institutional barriers need to be addressed.

To translate, culturally adapt, and validate the Capability Cards into Spanish for use with adults living with multimorbidity in community health settings.

Adults with multimorbidity face complex self-management challenges arising from multiple conditions, clinical demands, and everyday priorities. Despite this complexity, tools to support meaningful dialogue and reflection on what individuals are able to do and be in daily life are scarce. Capability Cards support structured conversations on capabilities, well-being, and life goals, fostering empowerment, reflection, and shared decision-making. Cultural adaptation to the Spanish context is essential to ensure relevance and usability in community-based care.

A methodological validation study was conducted in Lleida (Spain) following four phases: literature review to inform translation and cultural adaptation, development of instruments to assess content validity and usability, evaluation by expert and community health professional panels, and assessment with the target population. Participants included 12 experts, 19 community health professionals from nursing, physiotherapy, nutrition, and psychology, and 25 adults aged 62–81 years with multimorbidity. Content validity was evaluated using the Content Validity Index (CVI), and usability was assessed with the System Usability Scale (SUS).

High content validity was observed across all groups, with CVI scores above the recommended threshold (experts: 0.88; professionals: 0.96; target population: 0.98). The SUS indicated excellent usability. The Spanish version of the Capability Cards demonstrated strong content validity, cultural appropriateness, and usability, supporting its suitability as a tool for facilitating structured, person-centred conversations, with potential to promote empowerment and participatory care in community primary health care for adults with multimorbidity.

This study aimed to assess self-care practices for puerperal sepsis prevention and their determinants among postpartum women in Halaba Town, Central Ethiopia.

Self-care is the ability to maintain health, prevent disease, and manage illness with or without the support of healthcare personnel. Current evidence indicates a high burden of puerperal sepsis in East Africa, including Ethiopia. However, evidence on self-care practices for the prevention of puerperal sepsis and their determinants in the study setting remains limited.

A community-based cross-sectional study was conducted among postpartum women in Halaba Town from February 1 to March 30, 2025. Data were collected through face-to-face, interviewer-administered questionnaires. Bivariable and multivariable logistic regression analyses were performed to identify determinants of self-care practices; statistical significance was set at a p-value of less than 0.05.

In the present study, 413 study participants were interviewed, resulting in a response rate of 98.3%. The prevalence of good self-care practice was 43.8% (95% CI: 39.1%–48.5%). Women’s occupation (adjusted odds ratio (AOR) = 2.01; 95% CI: 1.23–3.57), educational attainment (AOR = 2.30; 95% CI: 1.46–7.93), antenatal care (ANC) contact (AOR = 2.73; 95% CI: 1.65–4.71), and women’s knowledge (AOR = 3.30; 95% CI: 2.32–10.42) were determinants of self-care practices for puerperal sepsis prevention.

The findings revealed that more than half of postpartum women had poor self-care practices for the prevention of puerperal sepsis. Hence, strengthening ANC contact, targeting women with low educational status and unemployed women, and improving women’s knowledge may help to enhance awareness and prevention of puerperal sepsis.

Out-of-hours primary care (OOH-PC) has been introduced in many health systems to reduce non-urgent emergency department (ED) use. While prior studies suggest potential efficiency gains, economic evaluations rarely stratify outcomes by patient risk, limiting policy relevance. This study assesses the cost-effectiveness of diverting low-risk patients from ED to OOH-PC.

Compare direct medical costs, time spent at the facility, and hospitalization probability across risk and care setting subgroups from a societal perspective.

We analysed data from a cluster-randomized trial conducted in Belgium that examined a nurse-led triage system. Under the study trial’s extended Manchester Triage System (eMTS) protocol, patients eligible for primary care were assigned to OOH-PC and are referred to in our study as low-risk, while those assigned to the ED are defined as high-risk. To complement previous work, we stratified costs and effects by risk group. Mixed-effects regression models estimated costs, time at the facility, and hospitalization, with bootstrap confidence intervals. We also calculated the incremental net monetary benefit (INMB).

Treating low-risk patients at the OOH-PC instead of at the ED reduced costs by €24 (€14–€39) per patient, shortened the time spent at the facility by 69 (52–94) minutes. From a societal perspective, the average INMB was €49.5 per low-risk patient. Aggregately, we estimated that the 37 intervention weekends in 2019 led to an average saving of €14,136 in direct medical costs and cumulative time savings of 28 days.

Diverting low-risk patients from the ED to OOH-PC resulted in cost- and time-savings for low-risk patients at the study site. These findings highlight the potential to improve out-of-hours healthcare delivery to maximize benefits for patients and healthcare systems, although confirmation in other healthcare settings is required before wider implementation.