The prevalence of complex health and social needs in primary care patients is growing. Furthermore, recent research suggests that the impact of psychosocial distress on the significantly poorer health outcomes in this population may have been underestimated. The potential of social work in primary care settings has been extensively discussed in both health and social work literature and there is evidence that social work interventions in other settings are particularly effective in addressing psychosocial needs. However, the evidence base for specific improved health outcomes related to primary care social work is minimal. This review aimed to identify and synthesise the available evidence on the health benefits of social work interventions in primary care settings. Nine electronic databases were searched from 1990 to 2015 and seven primary research studies were retrieved. Due to the heterogeneity of studies, a narrative synthesis was conducted. Although there is no definitive evidence for effectiveness, results suggest a promising role for primary care social work interventions in improving health outcomes. These include subjective health measures and self‐management of long‐term conditions, reducing psychosocial morbidity and barriers to treatment and health maintenance. Although few rigorous study designs were found, the contextual detail and clinical settings of studies provide evidence of the practice applicability of social work intervention. Emerging policy on the integration of health and social care may provide an opportunity to develop this model of care.

BackgroundFormation of GP clusters began in Scotland in April 2016 as part of a new Scottish GP contract. They aim to improve the care quality for local populations (intrinsic role) and the integration of health and social care (extrinsic role).AimTo compare predicted challenges of cluster implementation in 2016 with reported challenges in 2021.Design & settingQualitative study of senior national stakeholders in primary care in Scotland.MethodQualitative analysis of semi-structured interviews with 12 senior primary care national stakeholders in 2016 (n= 6) and 2021 (n= 6).ResultsPredicted challenges in 2016 included balancing intrinsic and extrinsic roles, providing sufficient support, maintaining motivation and direction, and avoiding variation between clusters. Progress of clusters in 2021 was perceived as suboptimal and was reported to vary significantly across the country, reflecting differences in local infrastructure. Practical facilitation (data, administrative support, training, project improvement support, and funded time) and strategic guidance from the Scottish Government was felt to be lacking. GP engagement with clusters was felt to be hindered by the significant time and workforce pressures facing primary care. These barriers were considered as collectively contributing to cluster lead ‘burnout’ and loss of momentum, exacerbated by inadequate opportunities for shared learning between clusters across Scotland. Such barriers preceded, but were perpetuated by, the impact of the COVID-19 pandemic.ConclusionApart from the COVID-19 pandemic, many of the challenges reported by stakeholders in 2021 were predicted in 2016. Accelerating progress in cluster working will require renewed investment and support applied consistently across the country.

The present communication is by no means a complete description of the cranial nerves of Cryptobranchus, b u t is merely a somewhat cursory sketch of the distribution of most of the more important rami. It was the hope of the writer to have completed before this time a study of the brain and cranial nerves of this amphibian, working out the nerve components from serial sections, but the difficulty in obtaining embryonic material for sectioning has so delayed the work that it has been thought best to present a brief preliminary account based almost entirely upon dissections of adult animals.Recent researches on cranial nerve components render it possible to determine, even by dissection, some points of importance in nerve homologies, though, of course, reconstruction from sections will be necessary to ascertain the more intimate relations of the components.In general, no attempt has been made in the present paper to trace the relations between nerve-roots and the ultimate rami. So far as possible the writer has endeavored to indicate homologies with other amphibians, basing the comparisons mainly upon recent investigations on Rana, Amblystoma and Salamandra.Neivus olfactoyius. -This nerve is somewhat peculiar in Cryptobranchus from the fact that it divides into numerous branches before leaving the cranial cavity. Within the cranium these branches extend cephalad in two large bundles on each side, giving each olfactory nerve the appearance of being double.

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