General Practice and Primary Care - Research Publications

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    Histopathologic indicators of breast cancer biology: insights from population mammographic screening
    Webster, LR ; Bilous, AM ; Willis, L ; Byth, K ; Burgemeister, FC ; Salisbury, ELC ; Clarke, CL ; Balleine, RL (NATURE PUBLISHING GROUP, 2005-04-25)
    Histopathologic features of breast cancer such as tumour size, grade and axillary lymph node (LN) status variably reflect tumour biology and time. Recent evidence suggests that the biological character of breast cancer is established at an early stage and has a major impact on clinical course. The aim of this study was to distinguish the impact of biology on breast cancer histopathology by comparing features of breast cancers diagnosed following population mammographic screening with prevalent vs incident detection and screening interval. Central histopathology review data from 1147 cases of ductal in situ and/or invasive breast cancer were examined. Size, grade and LN status of invasive cancers were positively correlated (P < 0.001). Prevalent invasive cancers were larger (P < 0.001) and more likely to be LN positive (P = 0.02) than incident cases, but grade was not associated with screening episode (P = 0.7). Screening interval for incident cancers was positively associated with invasive cancer size (P = 0.05) and LN status (P = 0.002) but not grade (P = 0.1). Together, these data indicate that biology and time both impact on size and LN status of invasive breast cancer, but grade reflects biology alone. In view of the clinical importance of breast cancer biology, grade as its most direct indicator assumes particular significance.
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    Active listening: more than just paying attention.
    Robertson, K ( 2005-12)
    Communication skills courses are an essential component of undergraduate and postgraduate training and effective communication skills are actively promoted by medical defence organisations as a means of decreasing litigation. This article discusses active listening, a difficult discipline for anyone to practise, and examines why this is particularly so for doctors. It draws together themes from key literature in the field of communication skills, and examines how these theories apply in general practice.
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    Reflection in professional practice and education.
    Robertson, K ( 2005-09)
    Reflection is a crucial process in the transforming of experience into knowledge, skills and attitudes. As such it is at the core of both learning and continually evolving professional practice. This article draws on literature from adult learning and medical education fields to present a theoretical framework for reflection and practical techniques for its application in general practice. It is directed toward the training of medical students and registrars on clinical rotations, but also for the established general practitioner.