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International Primary Care Association

Clinical Focus Volume 5 N3

Listening and Learning seems to be the order of the day. Before this issue hits your floor mat the government’s, “Listening Exercise”, on the NHS reforms will have been completed and the policy enunciated by Andrew Lansley, and at inception agreed and signed off with Lib/Dem approval, will be dead or marginally watered down for appeasement. If the former I suspect Mr Lansley will have to be politically sacrificed.


Attention deficit hyperactivity disorder (ADHD) comprises a triad of:
• Hyperactivity
• Impulsivity
• Inattention

These behaviours are inconsistent with the child’s developmental/chronological age, and are present in multiple settings, over a period of time (>6 months), causing functional impairment. Multidisciplinary management, including behavioural and pharmacological interventions, improves outcome.


Anorexia nervosa (AN) can be a challenging illness for a primary care team to detect and manage in the community. Early diagnosis and effective treatment of patients with AN has been shown to improve prognosis. General practitioners can play a vital role in diagnosis and providing medical support for AN patients.


This article summarizes idiopathic headaches in childhood, differentiating the clinical characteristics from those of intracranial hypertension. There is a discussion on migraine treatment, the importance of environmental influences and the less well recognized risk posed by analgesic overuse leading to chronic refractory headaches.


Sexually acquired oncogenic Human Papillomavirus (HPV) types are important co-factors in the development of anogenital tract malignancies. HPV vaccines are a major primary prevention strategy against cervical cancer, other HPV-associated malignancies, cervical dysplasia and genital warts. Improving vaccination uptake is key to the future success of the HPV vaccination programme, and could potentially be achieved by involving GPs, sexual health services and providers in its delivery.

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