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Sample records for australian general practice

  1. Patient Experience of Australian General Practices.

    Science.gov (United States)

    Narayanan, Ajit; Greco, Michael

    2016-03-01

    The number of data-based research articles focusing on patient sociodemographic profiling and experience with healthcare practices is still relatively small. One of the reasons for this relative lack of research is that categorizing patients into different demographic groups can lead to significant reductions in sample numbers for homogeneous subgroups. The aim of this article is to identify problems and issues when dealing with big data that contains information at two levels: patient experience of their general practice, and scores received by practices. The Practice Accreditation and Improvement Survey (PAIS) consisting of 27 five-point Likert items and 11 sociodemographic questions is a Royal Australian College of General Practitioners (RACGP)-endorsed instrument for seeking patient views as part of the accreditation of Australian general practices. The data were collected during the 3-year period May 2011-July 2014, during which time PAIS was completed for 3734 individual general practices throughout Australia involving 312,334 anonymous patients. This represents over 60% of practices in Australia, and ∼75% of practices that undergo voluntary accreditation. The sampling method for each general practice was convenience sampling. The results of our analysis show how sociodemographic profiles of Australian patients can affect their ratings of practices and also how the location of the practice (State/Territory, remote access area) can affect patient experience. These preliminary findings can act as an initial set of results against which future studies in patient experience trends can be developed and measured in Australia. Also, the methods used in this article provide a methodological framework for future patient experience researchers to use when dealing with data that contain information at two levels, such as the patient and practice. Finally, the outcomes demonstrate that different subgroups can experience healthcare provision differently, especially

  2. Nutrition and general practice: an Australian perspective.

    Science.gov (United States)

    Helman, A

    1997-06-01

    Australia has a government-subsidized, private medical system in which general practitioners (GPs) form the core component of primary care. There are approximately 20,000 active GPs and 80% of the population consults a GP each year. A new vocational register of GPs has been set up that requires training in general practice, followed by formal continuing education. I briefly review sources of information about Australian GPs' practices and knowledge of and attitudes toward nutrition. About 15-17% of GPs say they have a special interest in nutrition (20% of female GPs and 13% of male GPs). The main conditions for which advice is given are heart disease, hyperlipidemia, obesity, and diabetes. The extent of nutrition counseling by GPs is considerably less than might be expected from the strength of their statements about the importance of nutrition and long-term health. Obstacles to nutrition counseling are lack of time, lack of confidence, and inadequate nutrition knowledge, the last documented by objective testing. GPs express interest in learning more about nutrition (which may be partly driven by consumer pressure) but there is still little coherent teaching on the subject, specifically tailored for GPs. When asked their preferences for nutrition education, GPs tend to prefer educational material (such as diet charts) to give to patients. PMID:9174498

  3. Nutrition Knowledge, Attitudes, and Confidence of Australian General Practice Registrars

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    Caryl A. Nowson

    2015-01-01

    Full Text Available Nutrition knowledge, attitudes, and confidence were assessed in General Practice Registrars (GPRs throughout Australia. Of approximately 6,000 GPRs invited to complete a nutrition survey, 93 respondents (2% completed the online survey, with 89 (20 males, 69 females providing demographic and educational information. Fifty-one percent had graduated from medical school within the last two years. From a list of 11 dietary strategies to reduce cardiovascular risk, respondents selected weight loss (84%, reducing saturated fats (90%, a maximum of two alcoholic drinks/day (82%, and increasing vegetables (83% as “highly appropriate” strategies, with only 51% indicating that salt reduction was “highly appropriate.” Two-thirds of registrars felt “moderately” (51% or “very” confident (16% providing nutrition advice. Most of them (84% recalled receiving information during training, but only 34% recalled having to demonstrate nutritional knowledge. The results indicate that this group of Australian GPRs understood most of the key dietary recommendations for reducing cardiovascular risk but lacked consensus regarding the recommendation to reduce salt intake and expressed mixed levels of confidence in providing nutritional advice. Appropriate nutrition education before and after graduation is recommended for GPRs to ensure the development of skills and confidence to support patients to make healthy dietary choices and help prevent chronic diseases.

  4. Satisfaction and comfort with nursing in Australian general practice.

    Science.gov (United States)

    2015-01-01

    The practice nursing workforce has grown exponentially in recent years. Whilst evidence has shown the important contributions of nurses to general practice service delivery, the consumer perspective of nursing in general practice has received limited attention. Given that acceptability of nurses is influenced by patient satisfaction which can in turn improve both treatment adherence and clinical outcomes, this is an important area for investigation. The primary aim of this study was to evaluate consumer satisfaction with chronic disease management by nurses in general practice (NiGP) and comfort with the tasks undertaken by nurses in general practice. Consumers receiving chronic disease services from nurses in general practice participating in a larger study were recruited to complete a survey. The survey comprised of demographic information, and items related to satisfaction with the nurse encounter (SPN-9) and consumer comfort with nurse roles in general practice (CPN-18). Eighty-one consumers participated in the study. Cronbach's alpha values of the SPN-9 and the CPN-18 were 0.95 and 0.97 respectively. SPN-9 results demonstrated high levels of satisfaction with PN consultations. Bivariate analysis did not show any significant differences within the consumer group relating to satisfaction. However, those who presented for diabetes-related reasons were more likely to report high comfort levels with the nurse encounter compare to those who presented to general practice for other chronic disease conditions (38% versus 14%, p = 0.016). The results of this study demonstrate that consumers are generally satisfied with nursing consultations in general practice related to chronic disease. However, further research evaluating consumer confidence, comfort and satisfaction with nursing care is needed to ensure that nursing services meet consumer needs. PMID:26281408

  5. Australian and overseas models of general practice training.

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    Hays, Richard B; Morgan, Simon

    2011-06-01

    General practice training in Australia continues to evolve. It is now the responsibility of an independent organisation, is delivered by regional training providers, and comprises a structured training program. Overseas, general practice varies in its importance to health care systems, and training models differ considerably. In some cases training is mandatory, in others voluntary, but the aim is always similar--to improve the quality of care delivered to the large majority of populations that access health care through primary care. We review the current status of vocational general practice training in Australia, compare it with selected training programs in international contexts, and describe how the local model is well placed to address future challenges. Challenges include changes in population demographics, increasing comorbidity, increasing costs of technology-based health care, increasing globalisation of health, and workforce shortages. Although general practice training in Australia is strong, it can improve further by learning from other training programs to meet these challengers. PMID:21644855

  6. The new Australian after-hours general practice incentive payment mechanism: equity for rural general practice?

    Science.gov (United States)

    Neil, Amanda L; Nelson, Mark; Palmer, Andrew J

    2016-07-01

    In July 2015, a national scheme for after-hours incentive funding for general practices was re-introduced in Australia, 2-years after funding was transferred to regional primary health care organisations (Medicare Locals). The re-introduction was recommended in a 2014 review of after-hours primary care reflecting the "overwhelming desire" among general practice. Given the centrality of after-hours care provision in rural and remote practices identified in the review, we compare and contrast the current and historical after-hours incentive funding mechanisms focussing on fairness towards rural general practices. While there are similarities between the current and historical mechanisms, significant differences exist. The comparison is not straightforward. The major consistency is utilisation of practice standardised whole patient equivalents (SWPE) as the basis of funding, inherently favouring large urban general practices. This bias is expected to increase given a shift in focus from practices with no option but to provide 24/7 care to any practice providing 24/7 care; and an associated increased funding per SWPE. Differences primarily pertain to classification processes, in which the realities of rural service provision and recognition of regional support mechanisms are given minimal consideration. Rapid introduction of the new general practice after-hours incentive funding mechanism has led to inconsistencies and has exacerbated inherent biases, particularly inequity towards rural providers. Impact on morale and service provision in non-urban areas should be monitored. PMID:27237945

  7. Ordering chest X-rays in Australian general practice.

    Science.gov (United States)

    Gordon, Julie; Miller, Graeme; Pan, Ying

    2015-08-01

    Data from the BEACH program between 2012–14 were used to examine general practice encounters where chest X-rays were ordered. This included the most common problems associated with chest X-ray ordering and patient characteristics. Changes in ordering between 2004–05 and 2013–14 were also investigated. The rate of chest X-ray ordering between 2004–05 and 2013–14 decreased significantly. In 2012–14, chest X-rays were most often ordered in the management of acute bronchitis/bronchiolitis, cough and pneumonia. Pleurisy/pleural effusion had the highest likelihood of resulting in a chest X-ray order, followed by shortness of breath/dyspnoea and pneumonia. PMID:26510138

  8. Falls Prevention within the Australian General Practice Data Model: Methodology, Information Model, and Terminology Issues

    OpenAIRE

    Liaw, Siaw-Teng; Sulaiman, Nabil; Pearce, Christopher; Sims, Jane; Hill, Keith; Grain, Heather; Tse, Justin; Ng, Choon-Kiat

    2003-01-01

    The iterative development of the Falls Risk Assessment and Management System (FRAMS) drew upon research evidence and early consumer and clinician input through focus groups, interviews, direct observations, and an online questionnaire. Clinical vignettes were used to validate the clinical model and program logic, input, and output. The information model was developed within the Australian General Practice Data Model (GPDM) framework. The online FRAMS implementation used available Internet (TC...

  9. A survey of resilience, burnout, and tolerance of uncertainty in Australian general practice registrars

    OpenAIRE

    Cooke Georga PE; Doust Jenny A; Steele Michael C

    2013-01-01

    Abstract Background Burnout and intolerance of uncertainty have been linked to low job satisfaction and lower quality patient care. While resilience is related to these concepts, no study has examined these three concepts in a cohort of doctors. The objective of this study was to measure resilience, burnout, compassion satisfaction, personal meaning in patient care and intolerance of uncertainty in Australian general practice (GP) registrars. Methods We conducted a paper-based cross-sectional...

  10. The evolution of nursing in Australian general practice: a comparative analysis of workforce surveys ten years on

    OpenAIRE

    Halcomb, Elizabeth J; Salamonson, Yenna; Davidson, Patricia M; Kaur, Rajneesh; Young, Samantha AM

    2014-01-01

    Background Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the current demographic and employment characteristics of Australian nurses working in general practice and explore trends in their role over time. Methods In the nascence of the exp...

  11. Direct observation of the nutrition care practices of Australian general practitioners

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    Ball LE

    2014-06-01

    Full Text Available INTRODUCTION: Nutrition care refers to nutrition-related advice or counselling provided by health professionals in an attempt to improve the nutrition behaviour of patients. AIM: The aim of this study was to describe the practices of a sample of Australian general practitioners (GPs when providing nutrition care to adult patients. METHODS: Eighteen GPs (13 male, 5 female were observed by fourth-year medical students during their general practice rotation. Each GP was observed for five consultations that included nutrition care, totalling 90 observed consultations. In each consultation, students completed a 31-item nutrition care checklist of nutrition care practices that could feasibly occur in a standard consultation. Each practice was marked with either a ‘yes’ (completed, ‘no’ (did not complete or ‘completed by practice nurse prior to or after the consultation’. RESULTS: Twenty-eight nutrition care practices were observed at least once. The most frequently observed practices were measuring and discussing blood pressure (76.7%; n=69, followed by general questions about current diet (74.4%; n=67. Approximately half of the consultations included a statement of a nutrition-related problem (52.2%; n=47, and the provision of nutrition advice that focused on a nutrient (45.6%; n=41 or food group (52.2%; n=47. Consultations with male GPs, as well as GPs with more than 25 years of experience, were associated with an increased number of nutrition care practices per consultation. DISCUSSION: The GPs performed nutrition care practices in varying frequencies. Further research is required to identify the most effective GP nutrition care practices to improve the nutrition behaviour of patients.

  12. Practice nurses experiences of mentoring undergraduate nursing students in Australian general practice.

    Science.gov (United States)

    Halcomb, Elizabeth J; Peters, Kath; McInnes, Susan

    2012-07-01

    Internationally, the delivery of health services has shifted from secondary to primary care, necessitating an exponential growth of the nursing workforce and expansion of the nursing role in general practice. This growth, and the subsequent need to develop this workforce, has created a need to expose undergraduate nurses to general practice nursing as a viable career option. Concurrently, universities are struggling to find sufficient clinical places for their undergraduate students to gain clinical experience. It is logical, therefore, to increase the number of undergraduate nursing student placements in general practice. Through qualitative research methods, this paper seeks to explore the experiences of practice nurses mentoring undergraduate students on clinical placements within the general practice setting. Findings are presented in the following three themes: (1) Promoting Practice Nursing: We really need to get students in, (2) Mentoring future co-workers: Patience and reassurance, and (3) Reciprocity in learning: It's a bit of a two way street, which show the benefits of such placements. Clinical placements in general practice settings can be mutually beneficial in terms of providing quality teaching and learning experiences for students. Conversely, the experience provides an impetus for practice nurses to maintain currency of their clinical skills and knowledge through mentoring student nurses. PMID:21908081

  13. Consultations conducted in languages other than English in Australian general practice.

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    Bayram, Clare; Ryan, Rowena; Harrison, Christopher; Gardiner, Joanne; Bailes, Marion Jean; Obeyesekere, Nayantara; Miller, Graeme; Britt, Helena

    2016-01-01

    This study sought to determine the need for, and use of, professional interpreters in general practice. This is a sub-study of the Bettering the Evaluation and Care of Health (BEACH) program - a continuous, national, cross-sectional survey of Australian general practitioner (GP) activity. Data were provided by 206 randomly sampled GPs between December 2013 and March 2014. Of 6074 patients sampled, there were 986 (16.2%; 95% confidence interval [CI]: 13.2-19.3) who reported speaking a language other than English (LOTE) at home. Five per cent of all GP consultations involved communicating in a LOTE. Of these, 1% involved professional interpreters, 82.3% were conducted by multilingual GPs who spoke the patient's language, and 17.7% involved a family member or friend. GPs thought a professional interpreter would/may have improved the quality of 27.8% of these consultations. Our study suggests that GPs see the opportunity to improve the quality of LOTE consultations by using professional interpreters to replace family member/friend interpreters. PMID:27051980

  14. A survey of resilience, burnout, and tolerance of uncertainty in Australian general practice registrars

    Directory of Open Access Journals (Sweden)

    Cooke Georga PE

    2013-01-01

    Full Text Available Abstract Background Burnout and intolerance of uncertainty have been linked to low job satisfaction and lower quality patient care. While resilience is related to these concepts, no study has examined these three concepts in a cohort of doctors. The objective of this study was to measure resilience, burnout, compassion satisfaction, personal meaning in patient care and intolerance of uncertainty in Australian general practice (GP registrars. Methods We conducted a paper-based cross-sectional survey of GP registrars in Australia from June to July 2010, recruited from a newsletter item or registrar education events. Survey measures included the Resilience Scale-14, a single-item scale for burnout, Professional Quality of Life (ProQOL scale, Personal Meaning in Patient Care scale, Intolerance of Uncertainty-12 scale, and Physician Response to Uncertainty scale. Results 128 GP registrars responded (response rate 90%. Fourteen percent of registrars were found to be at risk of burnout using the single-item scale for burnout, but none met the criteria for burnout using the ProQOL scale. Secondary traumatic stress, general intolerance of uncertainty, anxiety due to clinical uncertainty and reluctance to disclose uncertainty to patients were associated with being at higher risk of burnout, but sex, age, practice location, training duration, years since graduation, and reluctance to disclose uncertainty to physicians were not. Only ten percent of registrars had high resilience scores. Resilience was positively associated with compassion satisfaction and personal meaning in patient care. Resilience was negatively associated with burnout, secondary traumatic stress, inhibitory anxiety, general intolerance to uncertainty, concern about bad outcomes and reluctance to disclose uncertainty to patients. Conclusions GP registrars in this survey showed a lower level of burnout than in other recent surveys of the broader junior doctor population in both Australia

  15. Feasibility of implementing routine nutritional screening for older adults in Australian general practices: a mixed-methods study

    OpenAIRE

    Hamirudin, Aliza Haslinda; Charlton, Karen; Walton, Karen; Bonney, Andrew; Potter, Jan; Milosavljevic, Marianna; Hodgkins, Adam; Albert, George; Ghosh, Abhijeet; Dalley, Andrew

    2014-01-01

    Background Nutrition screening in older adults is not routinely performed in Australian primary care settings. Low awareness of the extent of malnutrition in this patient group, lack of training and time constraints are major barriers that practice staff face. This study aimed to demonstrate the feasibility of including a validated nutrition screening tool and accompanying nutrition resource kit for use with older patients attending general practice. Secondary aims were to assess nutrition-re...

  16. Falls prevention within the Australian general practice data model: methodology, information model, and terminology issues.

    Science.gov (United States)

    Liaw, Siaw-Teng; Sulaiman, Nabil; Pearce, Christopher; Sims, Jane; Hill, Keith; Grain, Heather; Tse, Justin; Ng, Choon-Kiat

    2003-01-01

    The iterative development of the Falls Risk Assessment and Management System (FRAMS) drew upon research evidence and early consumer and clinician input through focus groups, interviews, direct observations, and an online questionnaire. Clinical vignettes were used to validate the clinical model and program logic, input, and output. The information model was developed within the Australian General Practice Data Model (GPDM) framework. The online FRAMS implementation used available Internet (TCP/IP), messaging (HL7, XML), knowledge representation (Arden Syntax), and classification (ICD10-AM, ICPC2) standards. Although it could accommodate most of the falls prevention information elements, the GPDM required extension for prevention and prescribing risk management. Existing classifications could not classify all falls prevention concepts. The lack of explicit rules for terminology and data definitions allowed multiple concept representations across the terminology-architecture interface. Patients were more enthusiastic than clinicians. A usable standards-based online-distributed decision support system for falls prevention can be implemented within the GPDM, but a comprehensive terminology is required. The conceptual interface between terminology and architecture requires standardization, preferably within a reference information model. Developments in electronic decision support must be guided by evidence-based clinical and information models and knowledge ontologies. The safety and quality of knowledge-based decision support systems must be monitored. Further examination of falls and other clinical domains within the GPDM is needed. PMID:12807809

  17. What are the perceived learning needs of Australian general practice registrars for quality prescribing?

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    Aslani Parisa

    2010-12-01

    Full Text Available Abstract Background Little is known about the perceived learning needs of Australian general practice (GP registrars in relation to the quality use of medicines (QUM or the difficulties experienced when learning to prescribe. This study aimed to address this gap. Methods GP registrars' perceived learning needs were investigated through an online national survey, interviews and focus groups. Medical educators' perceptions were canvassed in semi-structured interviews in order to gain a broader perspective of the registrars' needs. Qualitative data analysis was informed by a systematic framework method involving a number of stages. Survey data were analysed descriptively. Results The two most commonly attended QUM educational activities took place in the workplace and through regional training providers. Outside of these structured educational activities, registrars learned to prescribe mainly through social and situated means. Difficulties encountered by GP registrars included the transition from hospital prescribing to prescribing in the GP context, judging how well they were prescribing and identifying appropriate and efficient sources of information at the point of care. Conclusions GP registrars learn to prescribe primarily and opportunistically in the workplace. Despite many resources being expended on the provision of guidelines, decision-support systems and training, GP registrars expressed difficulties related to QUM. Ways of easing the transition into GP and of managing the information 'overload' related to medicines (and prescribing in an evidence-guided, efficient and timely manner are needed. GP registrars should be provided with explicit feedback about the process and outcomes of prescribing decisions, including the use of audits, in order to improve their ability to judge their own prescribing.

  18. Following the funding trail: Financing, nurses and teamwork in Australian general practice

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    Porritt Julie

    2011-02-01

    Full Text Available Abstract Background Across the globe the emphasis on roles and responsibilities of primary care teams is under scrutiny. This paper begins with a review of general practice financing in Australia, and how nurses are currently funded. We then examine the influence on funding structures on the role of the nurse. We set out three dilemmas for policy-makers in this area: lack of an evidence base for incentives, possible untoward impacts on interdisciplinary functioning, and the substitution/enhancement debate. Methods This three year, multimethod study undertook rapid appraisal of 25 general practices and year-long studies in seven practices where a change was introduced to the role of the nurse. Data collected included interviews with nurses (n = 36, doctors (n = 24, and managers (n = 22, structured observation of the practice nurse (51 hours of observation, and detailed case studies of the change process in the seven year-long studies. Results Despite specific fee-for-service funding being available, only 6% of nurse activities generated such a fee. Yet the influence of the funding was to focus nurse activity on areas that they perceived were peripheral to their roles within the practice. Conclusions Interprofessional relationships and organisational climate in general practices are highly influential in terms of nursing role and the ability of practices to respond to and utilise funding mechanisms. These factors need to be considered, and the development of optimal teamwork supported in the design and implementation of further initiatives that financially support nursing in general practice.

  19. A cross-sectional study assessing the self-reported weight loss strategies used by adult Australian general practice patients

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    Yoong Sze

    2012-05-01

    Full Text Available Abstract Background Obesity is a significant public health concern. General practitioners (GPs see a large percentage of the population and are well placed to provide weight management advice. There has been little examination of the types of weight loss strategies used in Australian general practice patients. This cross-sectional study aimed to describe the proportion of normal weight, overweight and obese general practice patients who report trying to lose weight in the past 12 months, the types of weight loss strategies and diets used as well as the proportion consulting their GP prior to trying to lose weight. Methods Adult patients completed a touchscreen computer survey while waiting for their appointment. Responses from 1335 patients in twelve Australian practices are reported. Results A larger proportion of obese patients had tried to lose weight in the past 12 months (73% compared to those who were overweight (55% and normal weight (33%. The most commonly used strategy used was changing diet and increasing exercise in all BMI categories. Less than 10% used strategies such as prescription medication, over the counter supplements and consulted a weight loss specialist. Low calorie and low fat diets were the most frequently reported diets used to lose weight in those who were normal weight, overweight and obese. Overall, the proportion seeking GP advice was low, with 12% of normal weight, 15% of overweight and 43% of obese patients consulting their GP prior to trying to lose weight. Conclusions A large proportion of overweight or obese patients have tried to lose weight and utilized strategies such as changing diet and increasing exercise. Most attempts however were unassisted, with low rates of consultation with GPs and weight loss specialists. Ways to assist overweight and obese general practice patients with their weight loss attempts need to be identified.

  20. Following the funding trail: financing, nurses and teamwork in Australian general practice.

    OpenAIRE

    2011-01-01

    BACKGROUND: Across the globe the emphasis on roles and responsibilities of primary care teams is under scrutiny. This paper begins with a review of general practice financing in Australia, and how nurses are currently funded. We then examine the influence on funding structures on the role of the nurse. We set out three dilemmas for policy-makers in this area: lack of an evidence base for incentives, possible untoward impacts on interdisciplinary functioning, and the substitution/enhancement d...

  1. Satisfaction with referral relationships between general practice and allied health professionals in Australian primary health care.

    Science.gov (United States)

    Chan, Bibiana; Proudfoot, Judy; Zwar, Nick; Davies, Gawaine Powell; Harris, Mark F

    2011-01-01

    Chronic diseases require a multidisciplinary approach to provide patients with optimal care in general practice. This often involves general practitioners (GPs) referring their patients to allied health professionals (AHPs). The Team-link study explored the impact of an intervention to enhance working relationships between GPs and AHPs in general practice regarding the management of two chronic diseases: diabetes and ischaemic heart disease (IHD) or hypertension. The Measure of Multidisciplinary Linkages (MoML) questionnaire was developed to assess professional interactions and satisfaction with various aspects of the multidisciplinary relationship. Questionnaires were completed at baseline and 6 months by GPs (n=29) participating in the Team-link project and by AHPs (n=39) who had a current working relationship with these GPs. The Chronic Care Team Profile (CCTP) and Clinical Linkages Questionnaire (CLQ) were also completed by GPs. There were significant changes from baseline to 6 months after the intervention measures for individual items and overall MoML scores for GPs, especially items assessing 'contact', 'shared care' and 'satisfaction with communication'. The comparable item in the CLQ, 'Shared Care', also showed significant improvement. However, there were no statistically significant correlations between the change in overall 'Referral Satisfaction' scores in the GP MoML and the CLQ. The CCTP also improved and was a weak negative correlation between the GP MoML and two of the subscores of this instrument. There were no changes in AHP measure. This study demonstrates that the instrument is sensitive to differences between providers and conditions and is sensitive to change over time following an intervention. There were few associations with the other measures suggesting that the MoML might assess other aspects of teamwork involving practitioners who are not collocated or in the same organisation. PMID:21896261

  2. Weigh Forward: a clinical audit of weight management in Australian general practice.

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    Hemmes, R A; Adam, N; Dixon, J B

    2016-06-01

    Weigh Forward was a prospective clinical audit, aimed to assess the use and efficacy of 12-week weight management program in general practice. Twenty-eight practitioners participated in the audit, with a total of 258 patients observed. Of these, 147 (57%) were retained to 24 weeks. Practices were asked to implement a structured 12-week weight loss program, and encouraged to utilize relevant weight management guidelines as necessary. Patients were followed up regularly, and comprehensively assessed at baseline, 12 and 24 weeks. Evaluations were made of patient weight loss, practitioner willingness to utilize available weight loss interventions, practitioner set weight loss goals and the appropriateness of such goals. Overall, the 57% of completing patients lost an average of 6.1% ± 0.5% body weight, with 27.2% losing ≥10% body weight. Practitioners were hesitant to intensify treatment, and those with comorbidities were less likely (odds ratio 1.8; 95% CI 1.4-2.4) to receive intensified treatment than those without. Practitioners also tended to set high weight loss goals, with a mean goal of 17.3% body-weight loss. The clinically significant mean weight loss demonstrates that practitioners are able to generate meaningful weight loss in primary care settings, however, could benefit from increased use of available interventions. PMID:27166135

  3. Effect of Health Literacy on Quality of Life amongst Patients with Ischaemic Heart Disease in Australian General Practice.

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    David Alejandro González-Chica

    Full Text Available Appropriate understanding of health information by patients with cardiovascular disease (CVD is fundamental for better management of risk factors and improved morbidity, which can also benefit their quality of life.To assess the relationship between health literacy and health-related quality of life (HRQoL in patients with ischaemic heart disease (IHD, and to investigate the role of sociodemographic and clinical variables as possible confounders.Cross-sectional study of patients with IHD recruited from a stratified sample of general practices in two Australian states (Queensland and South Australia between 2007 and 2009. Health literacy was measured using a validated questionnaire and classified as inadequate, marginal, or adequate. Physical and mental components of HRQoL were assessed using the Medical Outcomes Study Short Form (SF12 questionnaire. Analyses were adjusted for confounders (sociodemographic variables, clinical history of IHD, number of CVD comorbidities, and CVD risk factors using multiple linear regression.A total sample of 587 patients with IHD (mean age 72.0±8.4 years was evaluated: 76.8% males, 84.2% retired or pensioner, and 51.4% with up to secondary educational level. Health literacy showed a mean of 39.6±6.7 points, with 14.3% (95%CI 11.8-17.3 classified as inadequate. Scores of the physical component of HRQoL were 39.6 (95%CI 37.1-42.1, 42.1 (95%CI 40.8-43.3 and 44.8 (95%CI 43.3-46.2 for inadequate, marginal, and adequate health literacy, respectively (p-value for trend = 0.001. This association persisted after adjustment for confounders. Health literacy was not associated with the mental component of HRQoL (p-value = 0.482. Advanced age, lower educational level, disadvantaged socioeconomic position, and a larger number of CVD comorbidities adversely affected both, health literacy and HRQoL.Inadequate health literacy is a contributing factor to poor physical functioning in patients with IHD. Increasing health literacy

  4. Decreased management of genital warts in young women in Australian general practice post introduction of national HPV vaccination program: results from a nationally representative cross-sectional general practice study.

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    Christopher Harrison

    Full Text Available OBJECTIVES: Since the introduction of Australia's human papillomavirus vaccination program, the management rate of genital warts in sexual health clinics and private hospitals has decreased in women of vaccine-eligible age. However, most genital warts in Australia are managed in general practice. This study examines whether a similar decrease occurred in Australian general practice after the introduction of the program. METHODS: Analysis of a nationally representative cross-sectional database of Australian general practice activity (1,175,879 patient encounters with 11,780 general practitioners. Genital warts management rates were estimated for the periods before and after introduction of the program (Pre-program, July 2002-June 2006; Post-program, July 2008-June 2012. Control conditions included genital herpes and gardnerella/bacterial vaginosis in female patients and genital herpes and urethritis in male patients. Trends in management rates by year, pre-vaccine (July 2000-June 2007 and post-vaccine (July 2007-June 2012 were also calculated. RESULTS: Management rate of genital warts among women potentially covered by program (aged 15-27 years decreased by 61% from 4.33 per 1,000 encounters in the Pre-program period to 1.67 in the Post-program period. Trend analysis of the post-vaccine period showed, among women of vaccine eligible age, a significant year-on-year reduction in the rate of genital warts management (p<0.0001 and a significant increase in the management rate of control conditions per year (p<0.0001. For all other age-sex groups there was no significant change in the management rate of genital warts between the Pre- and Post-program periods. CONCLUSION: The large decrease in general practice management of genital warts in women of vaccine-eligible age highlights the success of the program in the wider community.

  5. Diabetic Retinopathy Screening and Monitoring of Early Stage Disease in Australian General Practice: Tackling Preventable Blindness within a Chronic Care Model

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    Lisa Crossland

    2016-01-01

    Full Text Available Introduction. Diabetic retinopathy (DR is the leading cause of preventable blindness in Australia. Up to 50% of people with proliferative DR who do not receive timely treatment will become legally blind within five years. Innovative and accessible screening, involving a variety of primary care providers, will become increasingly important if patients with diabetes are to receive optimal eye care. Method. An open controlled trial design was used. Five intervention practices in urban, regional, and rural Australia partnered with ophthalmologists via telehealth undertook DR screening and monitoring of type 2 diabetes patients and were compared with control practices undertaking usual care 2011–2014. Results. Recorded screening rates were 100% across intervention practices, compared with 22–53% in control practices. 31/577 (5% of patients in the control practices were diagnosed with mild-moderate DR, of whom 9 (29% had appropriate follow-up recorded. This was compared with 39/447 (9% of patients in the intervention group, of whom 37 (95% had appropriate follow-up recorded. Discussion and Conclusion. General practice-based DR screening via Annual Cycle of Care arrangements is effective across differing practice locations. It offers improved recording of screening outcomes for Australians with type 2 diabetes and better follow-up of those with screen abnormalities.

  6. Perceptions of primary care staff on a regional data quality intervention in Australian general practice: a qualitative study

    OpenAIRE

    Ghosh, Abhijeet; McCarthy, Sandra; Halcomb, Elizabeth

    2016-01-01

    Background Technological advances in clinical data capturing and storage systems have led to recent attempts at disease surveillance and region specific population health planning through regularly collected primary care administrative clinical data. However the accuracy and comprehensiveness of primary care health records remain questionable. Methods We aimed to explore the perceptions and experiences of general practice staff in maintaining accurate patient health data within clinical softw...

  7. Guidelines for computer security in general practice

    OpenAIRE

    Peter Schattner; Catherine Pleteshner; Heinz Bhend; Johan Brouns

    2007-01-01

    Background As general practice becomes increasingly computerised, data security becomes increasingly important for both patient health and the efficient operation of the practice. Objective To develop guidelines for computer security in general practice based on a literature review, an analysis of available information on current practice and a series of key stakeholder interviews. While the guideline was produced in the context of Australian general practice, we have developed a template ...

  8. Australian nurses in general practice, enabling the provision of cervical screening and well women’s health care services: a qualitative study

    Directory of Open Access Journals (Sweden)

    Mills Jane

    2012-11-01

    Full Text Available Abstract Background The role of Australian general practice nurses (PNs has developed exponentially since the introduction of service based funding in 2005. In particular, their role has expanded to include cervical screening and well women’s health care services provided under the supervision of a general practitioner (GP. While previous research identifies barriers to the provision of these services, this study sought to investigate enablers for nurse led care in this area. Methods A number of grounded theory methods including constantly comparing data, concurrent data collection and analysis and theoretical sampling are utilised in this qualitative, exploratory study. A purposive sample of PNs who completed the required program of education in order to provide cervical screening and well women’s health care services was recruited to the study. Data is presented in categories, however a limitation of the study is that a fully integrated grounded theory was unable to be produced due to sampling constraints. Results Four enablers for the implementation of a change in the PN role to include cervical screening and well women’s health checks are identified in this study. These enablers are: GPs being willing to relinquish the role of cervical screener and well women’s health service provider; PNs being willing to expand their role to include cervical screening and well women’s health services; clients preferring a female practice nurse to meet their cervical screening and well women’s health needs; and the presence of a culture that fosters interprofessional teamwork. Seven strategies for successfully implementing change from the perspective of PNs are also constructed from the data. This study additionally highlights the lack of feedback on smear quality provided to PNs cervical screeners and well women’s health service providers. Conclusions The influence of consumers on the landscape of primary care service delivery in Australia is

  9. Decolonising Australian Psychology: Discourses, Strategies, and Practice

    Directory of Open Access Journals (Sweden)

    Pat Dudgeon

    2015-08-01

    Full Text Available Colonisation in Australia has had a devastating and lasting impact on the wellbeing of Aboriginal and Torres Strait Islander peoples in Australia (herein referred to as Indigenous Australians. This paper discusses the role of psychology in Australia and the negative impact that certain disciplinary theories and practices have had on Indigenous Australians. The impact has been further exacerbated by the failure of mainstream policy makers and mental health practitioners to recognise the key, distinctive cultural and social determinants that contribute to Aboriginal health and wellbeing. There is a growing response by Aboriginal psychologists, critical social theorists, and their allies to decolonise psychological theory and practice to redress this situation. This paper outlines key decolonising strategies that have been effective in interrupting those aspects of psychology that are inimical to Aboriginal wellbeing.

  10. Inequality in provider continuity for children by Australian general practitioners

    Directory of Open Access Journals (Sweden)

    Reynolds Graham

    2011-09-01

    Full Text Available Abstract Background There is little published on provider continuity in Australian general practice and none on its effect on inequality of care for children. Method Questionnaire administered to parents of the ACT Kindergarten Health Screen asking the name of their child's usual GP and practice address between 2001 and 2008. Results Parents of 30,789 children named 433 GPs and 141 practices. In each year, an average of 77% of parents could name both the GP and the practice, an average of 11% of parents could name only the practice, and an average of 12% of parents could name neither. In each year, 25% of parents could not name a usual GP for children of Aboriginal or Torres Straight Islander descent, or children born outside of Australia, compared to 10% of all other children (p = Conclusions Many GPs (39% were reported to provide continuity of care for in the ACT region and some GPs (20% displayed transient care. Indigenous children or children born outside of Australia had less equity of access to a nominated GP than all other children. Such inequity might disappear if voluntary registration of children was adopted in Australian general practice.

  11. Care for chronic illness in Australian general practice – focus groups of chronic disease self-help groups over 10 years: implications for chronic care systems reforms

    Directory of Open Access Journals (Sweden)

    Martin Carmel M

    2009-01-01

    Full Text Available Abstract Background Chronic disease is a major global challenge. However, chronic illness and its care, when intruding into everyday life, has received less attention in Asia Pacific countries, including Australia, who are in the process of transitioning to chronic disease orientated health systems. Aim The study aims to examine experiences of chronic illness before and after the introduction of Australian Medicare incentives for longer consultations and structured health assessments in general practice. Methods Self-help groups around the conditions of diabetes, epilepsy, asthma and cancer identified key informants to participate in 4 disease specific focus groups. Audio taped transcripts of the focus groups were coded using grounded theory methodology. Key themes and lesser themes identified using a process of saturation until the study questions on needs and experiences of care were addressed. Thematic comparisons were made across the 2002/3 and 1992/3 focus groups. Findings At times of chronic illness, there was need to find and then ensure access to 'the right GP'. The 'right GP or specialist' committed to an in-depth relationship of trust, personal rapport and understanding together with clinical and therapeutic competence. The 'right GP', the main specialist, the community nurse and the pharmacist were key providers, whose success depended on interprofessional communication. The need to trust and rely on care providers was balanced by the need for self-efficacy 'to be in control of disease and treatment' and 'to be your own case manager'. Changes in Medicare appeared to have little penetration into everyday perceptions of chronic illness burden or time and quality of GP care. Inequity of health system support for different disease groupings emerged. Diabetes, asthma and certain cancers, like breast cancer, had greater support, despite common experiences of disease burden, and a need for research and support programs. Conclusion Core

  12. General practice 'going places'.

    Science.gov (United States)

    Hughes, C

    1992-05-01

    This paper, which was presented at the Annual General Meeting of the Royal Australian College of General Practitioners in September 1991, outlines possible roles for the general practitioner in the public health system. Four fundamental steps need to be taken: affirmative action by health boards to include GPs in all activities; representation of the RACGP on health boards; adequate remuneration; and part time employment of GPs in all health care delivery service units. PMID:1520131

  13. Practice related factors that may impact on postpartum care for mothers and infants in Australian general practice: a cross-sectional survey

    OpenAIRE

    Brodribb, Wendy E; Mitchell, Benjamin L; van Driel, Mieke L

    2016-01-01

    Background While there is a significant focus on the health and well-being of women during pregnancy, labour and birth, much less emphasis is placed on the care of postpartum women and their infants in primary care following the birth. Some studies have investigated the role of GPs in postpartum care, and others examined facilitators and barriers to mothers accessing care. However there is little information available to investigate the effect of practice related factors on access to care of ...

  14. Microbiological quality control practices at Australian Radioisotopes

    International Nuclear Information System (INIS)

    As a domestic manufacturer of therapeutic substances, Australian Radioisotopes (ARI) must adhere to guidelines set out by the Commonwealth Department of Health in the Code of Good Manufacturing Practices for Therapeutic Goods 1983 (GMP). The GMP gives guidelines for staff training, building requirements, sanitation, documentation and quality control practices. These guidelines form the basis for regular audits performed by officers of the National Biological Standards Laboratories. At Lucas Heights, ARI has combined the principles of the GMP with the overriding precautions introduced for environmental and staff safety and protection. Its policy is to maintain a high level of quality assurance for product identity, purity and sterility and apyrogenicity during all stages of product manufacture

  15. Optimizing Stroke Prevention in Patients With Atrial Fibrillation: A Cluster-Randomized Controlled Trial of a Computerized Antithrombotic Risk Assessment Tool in Australian General Practice, 2012–2013

    Science.gov (United States)

    Magin, Parker J.; Hilmer, Sarah N.; Krass, Ines

    2016-01-01

    Introduction Clinicians have expressed a need for tools to assist in selecting treatments for stroke prevention in patients with atrial fibrillation. The objective of this study was to evaluate the impact of a computerized antithrombotic risk assessment tool (CARAT) on general practitioners’ prescribing of antithrombotics for patients with atrial fibrillation. Methods A prospective, cluster-randomized controlled trial was conducted in 4 regions (in rural and urban settings) of general practice in New South Wales, Australia (January 2012–June 2013). General practitioner practices were assigned to an intervention arm (CARAT) or control arm (usual care). Antithrombotic therapy prescribing was assessed before and after application of CARAT. Results Overall, the antithrombotic therapies for 393 patients were reviewed by 48 general practitioners; we found no significant baseline differences in use of antithrombotics between the control arm and intervention arm. Compared with control patients, intervention patients (n = 206) were 3.1 times more likely to be recommended warfarin therapy (over any other treatment option; P benefits of these new therapy options. PMID:27418212

  16. Care for chronic illness in Australian general practice – focus groups of chronic disease self-help groups over 10 years: implications for chronic care systems reforms

    OpenAIRE

    Martin Carmel M; Peterson Chris; Robinson Rowena; Sturmberg Joachim P

    2009-01-01

    Abstract Background Chronic disease is a major global challenge. However, chronic illness and its care, when intruding into everyday life, has received less attention in Asia Pacific countries, including Australia, who are in the process of transitioning to chronic disease orientated health systems. Aim The study aims to examine experiences of chronic illness before and after the introduction of Australian Medicare incentives for longer consultations and structured health assessments in gener...

  17. 澳大利亚全科医学教育考核评估体系及启示%InsPiration and Reference of Australian General practice Education Assessment System

    Institute of Scientific and Technical Information of China (English)

    王欣怡; 崔爽; 段丽萍

    2014-01-01

    澳大利亚全科医学教育具有成熟和健全的考核评估体系,考核体系根据参加考核评估对象的不同类别设置不同内容。澳大利亚皇家全科医生学会(RACGP)通过会员制(Fellowship)的方式对全科医生候选人(以下简称候选人)进行评估和资格认证。候选人在成为会员之前应通过学会组织的一系列评估考核。这些多元化的评估考核方式实现了全科医学教育理论与实践的统一,为全科医生在澳大利亚独立行医提供了保障。本文指出我国全科医学教育正处于起步和探索阶段,故吸收澳大利亚全科医学教育考核评估体系的先进经验,将有利于完善我国全科医学教育培养制度,规范我国全科医生的培养过程。%There is a mature and robust examination and evaluation system in Australian general practice education, which set up different contents based on different sorts of examined and evaluated objects. Rural Australian Institute of General Practitioners( RACGP)evaluates GP candidates through Fellowship and gives them certifications. Considering the situation of general practice in China which is still adolescing,this paper offers advices in order to improve the development of general prac-tice education in China by learning valuable lessons from Australia.

  18. Exposures to patients in Australian radiological practice

    Energy Technology Data Exchange (ETDEWEB)

    Paix, D. (South Australian Inst. of Tech., Adelaide)

    1983-11-01

    The findings of a 1980 Australian Radiation Laboratory study of genetic and bone-marrow doses to the population from medical, dental and chiropractic uses of ionising radiation are discussed. Attention is drawn to the large variability in patient exposure: maximum values were from five to eleven times greater than the means.

  19. Exposures to patients in Australian radiological practice

    International Nuclear Information System (INIS)

    The findings of a 1980 Australian Radiation Laboratory study of genetic and bone-marrow doses to the population from medical, dental and chiropractic uses of ionising radiation are discussed. Attention is drawn to the large variability in patient exposure: maximum values were from five to eleven times greater than the means

  20. Content of general practice.

    Science.gov (United States)

    Lim, T O

    1991-06-01

    Eight general practitioners participated in a survey of content of general practice. This is useful as an indicator or morbidity in the community as well as of workload of general practice. A total of 3164 consultations were recorded, of which 2764 (87%) were because of an illness and the rest (13%) for other reasons like medical examinations, antenatal check, family planning advice, pregnancy tests, pap smear and vaccination. The old and the young have high consultation rates for an illness, men consulted as often as women. The most common illness seen was upper respiratory tract infections, accounting for 37% of all illnesses. Other common minor illnesses were skin infections (6%), genito-urinary infections (5%), minor musculoskeletal (6%) and gastrointestinal (6%) complaints as well as minor injuries and cuts (4%). Major disorders form an unusually low proportion (18%) of all illnesses seen, in comparison with figures from United Kingdom. The common major disorders seen were hypertension, asthma, chronic rheumatic disorders and diabetes. Circulatory disorders were remarkably rare, accounting for only 1% of illnesses. Psychological disorders, both major and minor, were also rarely seen, accounting for only 1% of illnesses which is in marked contrast with figures from the United Kingdom. Factors contributing to these notable findings are discussed. PMID:1839420

  1. General practitioner participation in the second Australian National Blood Pressure Study (ANBP2).

    Science.gov (United States)

    Reid, C M; Ryan, P; Nelson, M; Beckinsale, P; McMurchie, M; Gleave, D; DeLoozef, F; Wing, L M

    2001-08-01

    1. The second Australian National Blood Pressure Study (ANBP2) is an outcome trial of the treatment of hypertension in the elderly conducted entirely in general practices across Australia. Prior to ANBP2, no study of this size and nature had been undertaken in Australian general practice and the response of General Practitioners (GPs) to becoming involved in long-term cardiovascular research was unknown. 2. Academic departments and Divisions of General Practice were approached to support the project. General Practitioners were approached by letter of invitation and contacted by a regional medical coordinator (RMC) either at a face-to-face meeting or by telephone. 3. At the close of recruitment to ANBP2, 1938 GPs from 950 practices had registered as investigators. Sixty-two Divisions of General Practice were approached to support the study in five mainland Australian states with 39 (63%) participating, although participation by state was highly variable (range: 18-100%). Thirty divisional or promotional dinner meetings were held, with 56% (368/658) of those attending registering as investigators. Of the 8098 GPs sent a letter of invitation to participate in the study, 1357 (17%) expressed interest and eventually enrolled as investigators, ranging from 8% in Queensland to 28% in New South Wales. Ninety-six per cent of GPs who had a personal face-to-face contact (696/724) with the RMC registered in the study. 4. The GP recruitment phase of ANBP2 has been successfully completed. Peer-to-peer recruitment was the most successful strategy; however, success varied between states. General Practitioner recruitment to long-term clinical trials appears to be successful with a multifactorial approach focusing on peer-to-peer recruitment. PMID:11473534

  2. Questioning behaviour in general practice: a pragmatic study.

    OpenAIRE

    Barrie, A. R.; Ward, A M

    1997-01-01

    OBJECTIVE: To study the extent to which general practitioners' questioning behaviour in routine practice is likely to encourage the adoption of evidence based medicine. DESIGN: Self recording of questions by doctors during consultations immediately followed by semistructured interview. SETTING: Urban Australian general practice. SUBJECTS: Random sample of 27 general practitioners followed over a half day of consultations. MAIN OUTCOME MEASURES: Rate of recording of clinical questions about pa...

  3. [European general practice research agenda].

    Science.gov (United States)

    Mäntyselkä, Pekka; Koskela, Tuomas

    2014-01-01

    The EGPRN (European General Practice Research Network) research agenda is a review compiling the strengths and areas of development of European general practice, based on a systematic literature survey and its versatile analysis. The research agenda is a framework paper sharpening the definition and functions of general practice as well as its significance for researchers and decisionmakers. The agenda is useful in structuring the research, evaluation of research needs, strengthening of infrastructure and strategic planning of new research. PMID:24961062

  4. Methodological practicalities in analytical generalization

    DEFF Research Database (Denmark)

    Halkier, Bente

    2011-01-01

    In this article, I argue that the existing literature on qualitative methodologies tend to discuss analytical generalization at a relatively abstract and general theoretical level. It is, however, not particularly straightforward to “translate” such abstract epistemological principles into more...... operative methodological strategies for producing analytical generalizations in research practices. Thus, the aim of the article is to contribute to the discussions among qualitatively working researchers about generalizing by way of exemplifying some of the methodological practicalities in analytical...

  5. Cultural safety and its importance for Australian midwifery practice.

    Science.gov (United States)

    Phiri, Jasten; Dietsch, Elaine; Bonner, Ann

    2010-01-01

    Cultural safety is an important concept in health care that originated in Aotearoa (New Zealand) to address Maori consumer dissatisfaction with health care. In Australia and internationally, midwives are now expected to provide culturally safe midwifery care to all women. Historically, Australia has received large numbers of immigrants from the United Kingdom, European countries and the Middle East. There have also been refugees and immigrants from South-East Asia, and most recently, from Africa. Australia continues to become more culturally diverse and yet to date no studies have explored the application of cultural safety in Australian midwifery practice. This paper explores how cultural safety has evolved from cultural awareness and cultural sensitivity. It examines the importance of cultural safety in nursing and midwifery practice. Finally, it explores the literature to determine how midwives can apply the concept of cultural safety to ensure safe and woman centred care. PMID:21046963

  6. Does patient satisfaction of general practice change over a decade?

    OpenAIRE

    Schattner Peter; Allan James; Stocks Nigel; Ramsay Emmae

    2009-01-01

    Abstract Background The Patient Participation Program (PPP) was a patient satisfaction survey endorsed by the Royal Australian College of General Practitioners and designed to assist general practitioners in continuous quality improvement (CQI). The survey was been undertaken by 3500 practices and over a million patients between 1994 and 2003. This study aimed to use pooled patient questionnaire data to investigate changes in satisfaction with primary care over time. Methods The results of 10...

  7. Cancer Investigation in General Practice

    DEFF Research Database (Denmark)

    Jensen, Jacob Reinholdt; Møller, Henrik; Thomsen, Janus Laust;

    2014-01-01

    Initiation of cancer investigations in general practice Background Close to 90% of all cancers are diagnosed because the patient presents symptoms and signs. Of these patients, 85% initiate the diagnostic pathway in general practice. Therefore, the initiation of a diagnostic pathway in general...... react on very different and vague symptoms to ensure early cancer diagnosis. To enable earlier cancer diagnosis, we need much more knowledge and a better understanding of the initiation of cancer-specific tests and investigations in general practice. Aim To investigate how, how often and on which...... background investigation for suspected cancer is initiated in general practice. Methods Participating Danish GPs will fill in an electronic questionnaire after random consultations. A total of 70,000 consultations will be included. Perspectives The results will show how often and why GPs suspect cancer, how...

  8. Rectal examination in general practice.

    OpenAIRE

    Hennigan, T W; Franks, P. J.; Hocken, D. B.; Allen-Mersh, T. G.

    1990-01-01

    OBJECTIVE--To investigate factors influencing a general practitioner's decision to do a rectal examination in patients with anorectal or urinary symptoms. DESIGN--Postal questionnaire survey. SETTING--General practices in inner London and Devon. SUBJECTS--859 General practitioners, 609 (71%) of whom returned the questionnaire. MAIN OUTCOME MEASURES--Number of rectal examinations done each month; the indication score, derived from answers to a question asking whether the respondent would do a ...

  9. Using MIQUEST in General Practice

    Directory of Open Access Journals (Sweden)

    Victoria Hammersley

    1998-11-01

    Full Text Available This paper describes ten months' experience with MIQUEST software used for the collection of data from computerised databases in General Practice. We report on the following: the MIQUEST software in use, the time costs to the practice, the completeness of confidentiality barriers and the accuracy of data collected using MIQUEST compared with similar data collected by the practice system (EMIS. There were no problems encountered with installation of MIQUEST-related software. With experience, MIQUEST was equal to the practice system for speed and ease of use. The confidentiality safeguards were found to be in accordance with the GMSC/RCGP Guidelines - patients could not be directly, or indirectly, identified from the data extracted by external searches. Inaccuracies in the data collected using MIQUEST were identified, but these were largely attributable to problems with the EMIS-written interpreter available on the practice system at the time, or with the coding schemes used by the practice. In an individual practice, MIQUEST represents an alternative data collection method to the practice-based software. For data collection from multiple general practices it should prove an invaluable tool for Health Authorities and research organisations.

  10. Facilitating the Learning of All Students: The "Professional Positive" of Inclusive Practice in Australian Primary Schools

    Science.gov (United States)

    Boyle, Christopher; Scriven, Brooke; Durning, Sara; Downes, Carissa

    2011-01-01

    This article considers the positive aspects of inclusion in Australian primary schools through a historical account of the nation's journey to adopting current policies and practices. The authors suggest that across the different states the picture is positive as there are clear attempts to make Australian schools as inclusive as possible. The…

  11. Functional neurological disorders in outpatient practice: An Australian cohort.

    Science.gov (United States)

    Ahmad, Omar; Ahmad, Kate E

    2016-06-01

    Functional disorders are defined as neurological symptoms without causative organic pathology identified. They are a diverse and often neglected group of disorders. The aim of this was to determine the incidence and outcome of functional neurological disorders in an Australian neurology practice. Over a 17month period, all patients presenting to a single outpatient neurology service were evaluated to determine the incidence and outcome of these disorders. A total of 884 patients were assessed and of these, 137 had a final diagnosis of functional neurological illness, equating to an incidence of 15% of all patients seen. Functional disorders were the third most common presentation overall. Patients with functional disorders were younger, more likely to be female and had a higher rate of current psychiatric comorbidity compared to other neurology patients. Sensory symptoms were the most common manifestation (48%) followed by limb weakness (37%) and psychogenic non-epileptic seizures (14%). Outcome information was available for 49% of patients at an average of 3months follow-up. 45% had some improvement in their symptoms, 43% had static symptoms and 12% had worsening of symptoms. This study confirms the high incidence of functional disorders in outpatient neurology practice. Early improvement was seen in a substantial proportion of patients and is influenced by duration of symptoms. PMID:26754851

  12. Teaching Australian Football in Physical Education: Constraints Theory in Practice

    Science.gov (United States)

    Pill, Shane

    2013-01-01

    This article outlines a constraints-led process of exploring, modifying, experimenting, adapting, and developing game appreciation known as Game Sense (Australian Sports Commission, 1997; den Duyn, 1996, 1997) for the teaching of Australian football. The game acts as teacher in this constraints-led process. Rather than a linear system that…

  13. Sexually transmissible diseases--knowledge and practices of general practitioners in Victoria, Australia.

    OpenAIRE

    Mulvey, G; Temple-Smith, M J; Keogh, L A

    1997-01-01

    OBJECTIVE: To examine knowledge and practices in relation to sexually transmissible diseases (STDs) of general practitioners (GPs) in Victoria, Australia. METHOD: A questionnaire was distributed to 520 Victorian GPs randomly selected from the Australian Medical Publishing Company (AMPCo) database of Australian medical practitioners. RESULTS: A response rate of 85% was obtained. While sexual health consultations were common for Victorian GPs, STD caseloads were generally low. Knowledge of clin...

  14. Differences between Irish and Australian psychiatric nurses' family-focused practice in adult mental health services

    LENUS (Irish Health Repository)

    Grant, Anne

    2016-04-01

    Psychiatric nurses\\' practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses\\' family-focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family-focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family-focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.

  15. The General Practice Research Club.

    OpenAIRE

    Jones, R.; Wilmot, J; Fry, J.

    1991-01-01

    The General Practice Research Club was established in 1969, and now has 120 members. A meeting of the club is held twice a year, at which various papers, from research ideas through to completed, published studies are presented. A survey of 40 individuals who had presented papers at meetings during the period 1984-89 showed that almost half (18) had presented papers on clinical topics. As a result of the presentation, 29 individuals had modified their research, with 11 undertaking major alter...

  16. Epilepsy care in general practice.

    LENUS (Irish Health Repository)

    Varley, J

    2009-06-01

    Epilepsy care in Ireland is shared between primary, secondary and tertiary care services with the General Practitioner (GP) managing the process. Barriers to effective epilepsy care in Irish general practice remain undocumented although sub-optimal and fragmented services are frequently anecdotally reported. This survey of Irish GPs reports on such barriers to epilepsy care and on the Information & Communication Technology (ICT) issues potentially relevant to the use of an epilepsy specific Electronic Patient Record (EPR). The response rate was 247\\/700 (35.3%). Respondents supported the concept of shared care for epilepsy 237 (96%) however they were very dissatisfied with existing neurology services, including pathways of referral 207 (84%) and access to specialist neurology advice and investigations 232 (94%). They reported that neurology services and investigations may be accessed more expeditiously by patients with private health insurance than those without 178 (72%). Consequently many patients are referred to the emergency department for assessment and treatment 180 (73%). A deficit in epilepsy care expertise among GPs was acknowledged 86 (35%). While computerisation of GP practices appears widespread 230 (93%), just over half the respondents utilise available electronic functionalities specific to chronic disease management. GP specific electronic systems infrequently link or communicate with external electronic sources 133 (54%). While the current pathways of care for epilepsy in Ireland appear fragmented and inadequate, further investigations to determine the quality and cost effectiveness of the current service are required.

  17. Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations.

    Science.gov (United States)

    Reilly, T; Crawford, G; Lobo, R; Leavy, J; Jancey, J

    2016-04-01

    Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap. PMID:27041127

  18. Using Communities of Practice to Enhance Interdisciplinary Teaching: Lessons from Four Australian Institutions

    Science.gov (United States)

    Pharo, Emma; Davison, Aidan; McGregor, Helen; Warr, Kristin; Brown, Paul

    2014-01-01

    We report on the establishment of communities of practice at four Australian institutions and evaluate their effectiveness and durability as a means of building staff and institutional capacity for interdisciplinary teaching. A community of practice approach is a potentially valuable methodology for overcoming dynamics of fragmentation, isolation…

  19. Sign Language Users' Education and Employment Levels: Keeping Pace with Changes in the General Australian Population?

    Science.gov (United States)

    Willoughby, Louisa

    2011-01-01

    This article draws on data from the 2006 Australian census to explore the education and employment outcomes of sign languages users living in Victoria, Australia, and to compare them with outcomes reported in the general population. Census data have the advantage of sampling the entire population on the one night, avoiding problems of population…

  20. The implementation of diagnostic reference levels to Australian radiology practice

    International Nuclear Information System (INIS)

    Full text: At the presen time, there is no national surveillance of the increasing ionising radiation dose to the population from diagnostic imaging procedures. As the number of procedures undertaken is increasing, it is expected that the population dose will also increase. A substantial component of that contribution is from multi-detector computed tomography (MDCT) systems. The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) estimates that the growth in MDCT scans, based on Medicare Benefits Sch due data, is increasing at approximately 9% per annum, with over 2 million DCT scans being performed in 2009. The caput effective dose (mSv) from this modality is expected to be approaching 1.2 mSv per annum. If cu nt dose-detriment models are accurate, the risk of induction of carcinogenic detriment from current MDCT scanning patterns is a significant public health issue that requires a concerted and ongoing response. For the application of ionising radiation in medicine, the International Commission on Radiological Protection recommends the conservative philosophy of Justification and Optimisation via the measurement of 'Diagnostic Reference Levels' to limit the potential overexposure of patients and decrease the overall population burden. The Australian government has commissioned ARPANSA to survey, calculate and construct representative national diagnostic reference levels for diagnostic imaging modalities that use ionising radiation. This will be achieved in close consultation with the professional organisations who represent the professionals responsible for the use of ionising radiation in diagnostic imaging.

  1. Creating Opportunities: Good Practice in Small Business Training for Australian Rural Women.

    Science.gov (United States)

    Simpson, Lyn; Daws, Leonie; Wood, Leanne

    2002-01-01

    To overcome barriers to participation in small business training faced by rural Australian women, training needs and delivery issues were identified and a good practice matrix was developed with the following components: marketing, content, delivery, support, impact, and innovation. Underlying principles included unique needs, diversity, use of…

  2. The Activation, Appropriation and Practices of Student-Equity Policy in Australian Higher Education

    Science.gov (United States)

    Peacock, David; Sellar, Sam; Lingard, Bob

    2014-01-01

    Current national reforms in Australian higher education have prioritised efforts to reduce educational disadvantage within a vernacular expression of neoliberal education policy. Student-equity policy in universities is enmeshed in a set of competitive student recruitment relations. This raises practice-based tensions as universities strive to…

  3. Policy Change and Its Effect on Australian Community-Based Natural Resource Management Practices

    Science.gov (United States)

    Cooke, Penelope R.; Hemmings, Brian C.

    2016-01-01

    The authors of this article report on a qualitative study of Australian community-based natural resource management groups known as Landcare groups. They discuss how four Landcare groups contributed to sustainability practices and how a policy change implemented in 2003 influenced the efforts of the groups to remain active in their activities.…

  4. Email consultations in general practice

    Directory of Open Access Journals (Sweden)

    Ron Neville

    2004-12-01

    Conclusions Use of an email consultation facility worked well within an urban practice, was deemed helpful by patients, and resulted in no apparent increase in GP workload. Our results suggest that there may be an unmet need amongst patients for clinical email services, and that such services may have positive outcomes for patients and practices.

  5. Practicing Teachers’ Reflections: Indigenous Australian Student Mobility and Implications for Teacher Education

    Directory of Open Access Journals (Sweden)

    Beverley Moriarty

    2016-02-01

    Full Text Available Social constructions of education historically have impacted adversely on marginalised Indigenous Australian students whose mobile lifestyles and cultural positioning challenge teachers’ social inclusion practices. This paper examines the preparation and capacity of pre-service teachers to engage with mobile Indigenous students and their communities. Evidence is drawn from practicing teachers who reflected on their experiences in working with Indigenous students and their communities since graduation and how their experiences, both pre- and post-graduation, impacted on their beliefs and practices. Individual interviews were conducted with four teachers who also participated in the first stage of the study as a group of 24 second year primary pre-service teachers at a regional Australian university. It was found that pre-service teachers representing a range of world views benefit from positive, scaffolded experiences that provide opportunities to develop practices that foster social justice and inclusion. The findings of this study have implications for providing pre-service teachers with opportunities to understand how historical factors impact on Indigenous student mobility in contemporary Australian educational settings and the development of socially inclusive pedagogical practices. Further longitudinal research to expand the evidence base around developing culturally-appropriate pedagogical practices in pre-service teachers is needed to support their transition into teaching.

  6. Supply Chain Practice, Supply Chain Performance Indicators and Competitive Advantage of Australian Beef Enterprises: A Conceptual Framework

    OpenAIRE

    Jie, Ferry; Parton, Kevin A.; Cox, Rodney J.

    2007-01-01

    This research focuses on an Australian agribusiness supply chain, the Australian Beef Supply Chain. The definition of the Australian Beef Supply Chain is the chain or sequence of all activities from the breeding property to the domestic or overseas consumers. The beef sector in Australia is undergoing rapid change because of globalisation, a highly competitive beef market (local and export), quicker production cycle and delivery times and consequently reduced inventories, a general speed-up o...

  7. Relational Coordination in Danish General Practice

    DEFF Research Database (Denmark)

    Lundstrøm, Sanne Lykke

    This PhD dissertation is a product of my PhD project carried out in collaboration between DTU Management Engineering, The Technical University of Denmark, Research Unit for General Practice at University of Southern Denmark, and Research Unit for General Practice at University of Copenhagen. The ...... the psychosocial work environment in organisations, and is seen as a powerful resources for improving organisational performance. Relational coordination and organisational social capital may oer new insight and opportunities for general practice to learn. General practice provides cost...

  8. Incorporating online teaching in an introductory pharmaceutical practice course: a study of student perceptions within an Australian University

    Directory of Open Access Journals (Sweden)

    Benino D

    2011-12-01

    Full Text Available Objectives: To examine student perceptions regarding online lectures and quizzes undertaken during a pharmaceutical practice course for first year undergraduate students enrolled in the Bachelor of Pharmacy course at an Australian University.Methods: The University uses a standard instrument to collect feedback from students regarding unit satisfaction. Data were collected for three different teaching modalities: traditional face-to-face, online and partially online. Results: Descriptive statistics support that, from a student's perspective, partial online delivery is the preferred teaching methodology for an introductory pharmaceutical practice unit. Conclusion: This study has served to highlight that while there are a few points of significant difference between traditional and online teaching and learning, a combination of the two provides a reasonable avenue for teaching exploration. This result has implications for teaching practice generally, and within the pharmacy discipline, specifically.

  9. Why and how do general practitioners teach? An exploration of the motivations and experiences of rural Australian general practitioner supervisors

    OpenAIRE

    Ingham, Gerard; Fry, Jennifer; O’Meara, Peter; Tourle, Vianne

    2015-01-01

    Background In medical education, a learner-centred approach is recommended. There is also a trend towards workplace-based learning outside of the hospital setting. In Australia, this has resulted in an increased need for General Practitioner (GP) supervisors who are receptive to using adult learning principles in their teaching. Little is known about what motivates Australian GP supervisors and how they currently teach. Methods A qualitative study involving semi-structured interviews with 20 ...

  10. Access to general practitioner services amongst underserved Australians: a microsimulation study

    Directory of Open Access Journals (Sweden)

    Schofield Deborah J

    2012-01-01

    Full Text Available Abstract Background One group often identified as having low socioeconomic status, those living in remote or rural areas, are often recognised as bearing an unequal burden of illness in society. This paper aims to examine equity of utilisation of general practitioner services in Australia. Methods Using the 2005 National Health Survey undertaken by the Australian Bureau of Statistics, a microsimulation model was developed to determine the distribution of GP services that would occur if all Australians had equal utilisation of health services relative to need. Results It was estimated that those who are unemployed would experience a 19% increase in GP services. Persons residing in regional areas would receive about 5.7 million additional GP visits per year if they had the same access to care as Australians residing in major cities. This would be a 18% increase. There would be a 20% increase for inner regional residents and a 14% increase for residents of more remote regional areas. Overall there would be a 5% increase in GP visits nationally if those in regional areas had the same access to care as those in major cities. Conclusion Parity is an insufficient goal and disadvantaged persons and underserved areas require greater access to health services than the well served metropolitan areas due to their greater poverty and poorer health status. Currently underserved Australians suffer a double disadvantage: poorer health and poorer access to health services.

  11. Analysis of dyslexia candidate genes in the Raine cohort representing the general Australian population

    OpenAIRE

    Paracchini, S; Ang, Q W; Stanley, F J; Monaco, A. P.; Pennell, C E; Whitehouse, A J O

    2011-01-01

    Several genes have been suggested as dyslexia candidates. Some of these candidate genes have been recently shown to be associated with literacy measures in sample cohorts derived from the general population. Here, we have conducted an association study in a novel sample derived from the Australian population (the Raine cohort) to further investigate the role of dyslexia candidate genes. We analysed markers, previously reported to be associated with dyslexia, located within the MRPL19/C2ORF3, ...

  12. Technical, allocative and cost efficiency in the Australian general insurance industry

    OpenAIRE

    Andrew C. Worthington; Emily V. Hurley

    2000-01-01

    Data envelopment analysis is used to calculate technical, allocative and cost efficiency indices for a sample of fifty-three Australian general insurers. The inputs used are labour, physical capital (in the form of both information technology and plant and equipment) and financial capital. The outputs are net premium revenues for housing-related insurance, transport-related insurance, indemnity-related insurance and other insurance, along with investment revenue. The results indicate that the...

  13. Case Studies of Mental Health in General practice(28)---HIV and Mood Disturbance

    Institute of Scientific and Technical Information of China (English)

    Fiona Judd; Leon Piterman; Grant Blashki; Hui Yang

    2014-01-01

    The Journal presents the Column of Case Studies of Mental Health in General Practice;with aca-demic support from Australian eXperts in general practice,psychology and psychiatry from Monash University and the University of Mel-bourne. The Columnˊs purpose is to respond to the increasing need for the development of mental health services in China. Through study and analysis of mental health cases,we hope to improve understanding of mental illnesses in Chinese primary health settings,and to build capaci-ty amongst community health professionals in managing mental illnesses and psychological problems in general practice. A patient - centred whole - person approach in general practice is the best way to maintain and improve the physical and mental health of residents. Our hope is that these case studies will lead the new wave of general practice and mental health service development both in practice and research. A num-ber of Australian eXperts from the disciplines of general practice,mental health and psychiatry will contribute to the Column. Professor Blash-ki,Professor Judd and Professor Piterman are authors of the teXt General Practice Psychiatry;the Chinese version of the book to be published in 2014. The Journal cases are helping to prepare for the translation and publication of a Chinese version of the book in China. We believe Chi-nese mental health in primary health care will reach new heights under this international cooperation.

  14. Multiple sclerosis: management in Dutch general practice.

    NARCIS (Netherlands)

    Donker, G.A.; Foets, M.; Spreeuwenberg, P.

    1996-01-01

    BACKGROUND AND OBJECTIVES: A descriptive study on 118 MS patients in general practice, to describe the family physician's role in diagnosis, treatment and follow-up of patients. METHOD: Random sample of 103 general practices (161 family physicians) throughout The Netherlands with a total list of 335

  15. Supporting General Educators' Inclusive Practices.

    Science.gov (United States)

    Coombs-Richardson, Rita; Mead, Jean

    2001-01-01

    This article describes Project Inclusion, a state-funded project at Southeastern Louisiana University, which provided financial support for general educators to take university courses to develop their knowledge and skills concerning students with disabilities. The courses emphasized collaboration techniques, curricular modifications, and behavior…

  16. Organization and change in general practice

    DEFF Research Database (Denmark)

    Andersen, John Sahl

    Organization and change in general practice Abstract for a symposium at Nordic Congress for General Practice Thursday 14 May at 15.30-17.00 General practice is under increasing pressure to assume new tasks, adopt new technologies and engage in new organizational structures. However, in a field...... of multiple actors and concerns such visions are rarely straightforward to realize. This symposium explores the significance of various organizational, cultural and regulative features of general practice in relation to proposals for change in the sector. Presentations: Thorkil Thorsen, Marius Kousgaard...... the challenge of ensuring coherent cancer treatment can be handled by a case manager or if other modes should also be considered. Lars Borgquist. A new model for General Practice in Sweden- consequences for quality of care and economics. Many Swedish county councils will introduce new models for organizing...

  17. The Australian Quality Assurance and Continuing Education Program as a model for the reaccreditation of general practitioners in the United Kingdom.

    OpenAIRE

    Salisbury, C.

    1997-01-01

    A Quality Assurance and Continuing Education Program has been developed in Australian general practice over the past nine years. This effectively integrates audit and education within a coherent strategy for quality improvement. The programme fulfils many of the same aims as current proposals for reaccreditation in the United Kingdom (UK). This report describes the operation of the programme and an analysis of the effects of the scheme. A similar quality assurance strategy is proposed for the...

  18. Estimating the Number of Organ Donors in Australian Hospitals—Implications for Monitoring Organ Donation Practices

    OpenAIRE

    Pilcher, David; Gladkis, Laura; Arcia, Byron; Bailey, Michael; Cook, David; Cass, Yael; Opdam, Helen

    2015-01-01

    Background The Australian DonateLife Audit captures information on all deaths which occur in emergency departments, intensive care units and in those recently discharged from intensive care unit. This information provides the opportunity to estimate the number of donors expected, given present consent rates and contemporary donation practices. This may then allow benchmarking of performance between hospitals and jurisdictions. Our aim was to develop a method to estimate the number of donors u...

  19. Infant Feeding Practices and Nut Allergy over Time in Australian School Entrant Children

    OpenAIRE

    Jessica Paton; Marjan Kljakovic; Karen Ciszek; Pauline Ding

    2012-01-01

    Aim. To measure the association between infant feeding practices and parent-reported nut allergy in school entrant children. Method. The Kindergarten Health Check Questionnaire was delivered to all 110 Australian Capital Territory (ACT) primary schools between 2006 and 2009. Retrospective analyses were undertaken of the data collected from the kindergarten population. Results. Of 15142 children a strong allergic reaction to peanuts and other nuts was reported in 487 (3.2%) and 307 (3.9%), chi...

  20. Australian General Practice: Where Have the GP Services Gone?

    OpenAIRE

    Ian McRae

    2006-01-01

    Background: While the number of GP services provided in Australia increased steadily from the inception of Medicare in 1984 until the mid 1990s, it declined by 6.6% from 1997-8 to 2003-4. This reflects a decline in average number of services provided per GP of 8.0%. In Australia, as in the US and Canada, there has been a change in the composition of the GP workforce in recent years, in particular an increased feminisation and aging of the GP workforce. We explore whether the decline in averag...

  1. An Australian survey of current practice regarding radiation treatment records

    International Nuclear Information System (INIS)

    Thirty one Radiation Oncology Departments were surveyed to assess the structure and content of their external photon beam treatment sheets. A master index of standard data items was compiled from previously published recommendations and the frequency of recording these items was tabulated. A wide variation in practice was observed. The data highlights the need for agreed common data recording for quality assurance, outcome analysis and participation in clinical trials. 4 tabs

  2. Gastroenteritis in sentinel general practices, the Netherlands.

    NARCIS (Netherlands)

    Wit, M.A.S. de; Koopmans, M.P.G.; Kortbeek, L.M.; Leeuwen, N.J. van; Bartelds, A.I.M.; Duynhoven, Y.T.H.P. van

    2001-01-01

    From 1996 to 1999, the incidence of gastroenteritis in general practices and the role of a broad range of pathogens in the Netherlands were studied. All patients with gastroenteritis who had visited a general practitioner were reported. All patients who had visited a general practitioner for gastroe

  3. ARCADO - Adding random case analysis to direct observation in workplace-based formative assessment of general practice registrars

    OpenAIRE

    Ingham, Gerard; Fry, Jennifer; Morgan, Simon; Ward, Bernadette

    2015-01-01

    Background Workplace-based formative assessments using consultation observation are currently conducted during the Australian general practice training program. Assessment reliability is improved by using multiple assessment methods. The aim of this study was to explore experiences of general practice medical educator assessors and registrars (trainees) when adding random case analysis to direct observation (ARCADO) during formative workplace-based assessments. Methods A sample of general pra...

  4. The social world of Australian practice nurses and the influence of medical dominance: an analysis of the literature.

    Science.gov (United States)

    Mills, Jane; Hallinan, Christine

    2009-12-01

    In Australia, the number of practice nurses is growing at a rapid rate. On the nursing landscape, this group of nurses stand out because of their relationship with the Australian Government who both fund them, and concern themselves with their continuing professional development. This paper provides a construction of the social world of Australian practice nurses, identifying stakeholders in the business of practice nursing. Literature produced by the various social world segments is analysed for the influence of medical dominance on the role, image, power and politics of practice nurses. PMID:19958402

  5. Undertreatment of urinary incontinence in general practice.

    NARCIS (Netherlands)

    Penning-van Beest, F.J.A.; Sturkenboom, M.C.; Bemelmans, B.L.H.; Herings, R.M.C.

    2005-01-01

    BACKGROUND: In the urinary incontinence guidelines that are issued by the Dutch College of General Practitioners, treatment guidelines are related to the type of incontinence. It is unknown whether treatment of urinary incontinence in general practice complies with these guidelines. OBJECTIVE: To de

  6. The care work of general practice receptionists.

    Science.gov (United States)

    Neuwelt, Pat M; Kearns, Robin A; Cairns, Isobel R

    2016-06-01

    INTRODUCTION The care work of general practice receptionists has received limited research attention, despite receptionists position at the beginning of patients' journeys in many health care systems. We examine receptionists' perceptions of their work and the opportunities and constraints they experience in caring for patients while providing administrative support to practices. METHODS Data were collected in focus group interviews with 32 receptionists from urban and rural general practices in the Auckland and Northland regions of New Zealand. We employed tools from inductive thematic analysis and Straussian grounded theory in interpreting the data. FINDINGS We found that the way receptionists identified with a caring role strongly challenged the pejorative view of them in public discourse. Receptionists provide care in two key ways: for the practice and for patients. The juggling they do between the demands of the practice and of patients creates considerable work tensions that are often invisible to other staff members. CONCLUSION Receptionists have a critical role as the first step in the patient care pathway, bridging health care system and community. For general practice to be patient-centred and improve accessibility for the most vulnerable, the care work of receptionists must be considered core. KEYWORDS Receptionists; general practice; care; New Zealand. PMID:27477554

  7. Blending work-integrated learning with distance education in an Australian radiation therapy advanced practice curriculum

    International Nuclear Information System (INIS)

    Advanced practice for radiation therapists has been a part of the international landscape for several years; however formal implementation into the Australian health care system is yet to happen. Despite this, three short course radiation therapy advanced practitioner programs have been established by an Australian tertiary institution in response to clinical service needs at several organisations. This paper describes the rationale for curriculum design and development of the program materials, the small-scale implementation of the programs at pilot sites, and the evolution of the curriculum to be available to registered radiation therapists nationally. Each program has been designed around a specific clinical role, where flexibility of delivery to busy practitioners was central to the decision to offer them via distance education. The curriculum comprises theoretical units of study which run in parallel to and underpin clinical practice units, where advanced competence in the specific area of practice is overseen by an experienced radiation oncologist mentor. Given the nature of the disparate clinical services requiring an advanced radiation therapy practitioner, the workplace learning component of the course is individually negotiated at a local level. Outcomes suggest that the flexible clinically based training underpinned by a distance education academic curriculum is able to support the development of advanced radiation therapy practitioners responsive to local service need, and ultimately may improve the patient experience

  8. Developing organisational vision in general practice.

    OpenAIRE

    al-Shehri, A; Stanley, I; Thomas, P

    1993-01-01

    Vision is a fashionable but ill defined term in management circles. Nevertheless, it embodies a significant concept related to guiding an organisation from present realities, through opportunities and hazards, to a viable future. Until recently a typical general practice could assume a stable external environment, but now it is caught up in the uncertainties stemming from the NHS reforms. For such a practice to undertake effective strategic planning it will have to develop a vision connecting...

  9. Commentary on Carter, Stephenson and Strnadova's Reported Prevalence by Australian Special Educators of Evidence-Based Instructional Practices

    Science.gov (United States)

    Dempsey, Ian

    2011-01-01

    In Volume 35, Issue 1 of the "Australasian Journal of Special Education," Carter, Stephenson and Strnadova (2011) replicated a study by Burns and Ysseldyke (2009). In Carter et al.'s study, 194 Australian special educators were asked to rate the extent to which they used eight instructional practices. These practices were applied behaviour…

  10. Disease Risk Perception and Safety Practices: A Survey of Australian Flying Fox Rehabilitators.

    Directory of Open Access Journals (Sweden)

    Cecilia A Sánchez

    2016-02-01

    Full Text Available Interactions with flying foxes pose disease transmission risks to volunteer rehabilitators (carers who treat injured, ill, and orphaned bats. In particular, Australian bat lyssavirus (ABLV can be transmitted directly from flying foxes to humans in Australia. Personal protective equipment (PPE and rabies vaccination can be used to protect against lyssavirus infection. During May and June 2014, active Australian flying fox carers participated in an online survey (SOAR: Survey Of Australian flying fox Rehabilitators designed to gather demographic data, assess perceptions of disease risk, and explore safety practices. Responses to open-ended questions were analysed thematically. A logistic regression was performed to assess whether rehabilitators' gender, use of PPE, threat perception, and years of experience predicted variation in their odds of being bitten or scratched. Eligible responses were received from 122 rehabilitators located predominantly on the eastern coast of Australia. Eighty-four percent of respondents were female. Years of experience ranged from <1 to 30 years (median 5 years. Respondents were highly educated. All rehabilitators were vaccinated against rabies and 94% received a rabies titre check at least every two years. Sixty-three percent of carers did not perceive viruses in flying foxes as a potential threat to their health, yet 74% of carers reported using PPE when handling flying foxes. Eighty-three percent of rehabilitators had received a flying fox bite or scratch at some point during their career. Carers provide an important community service by rescuing and rehabilitating flying foxes. While rehabilitators in this study have many excellent safety practices, including a 100% vaccination rate against rabies, there is room for improvement in PPE use. We recommend 1 the establishment of an Australia-wide set of guidelines for safety when caring for bats and 2 that the responsible government agencies in Australia support

  11. Transformative learning in first year Indigenous Australian studies: Posing problems, asking questions and achieving change. A Practice Report

    Directory of Open Access Journals (Sweden)

    Elizabeth Mackinlay

    2010-07-01

    Full Text Available Indigenous Australian studies necessarily addresses emotionally-difficult topics related to race, history, colonialism and our identities as Indigenous and non-Indigenous Australians. As educators in this discipline, it is important for us to find teaching and learning approaches which make space for these topics to be accessed, understood, discussed and engaged with in meaningful ways. Problem-Based Learning (PBL, because of its emphasis on dialogic learning, is a pedagogical tool used in many Indigenous Australian studies classrooms in preference to other methods. In this presentation we want to explore the potential of PBL to allow personal and emotional responses to become accessible, dialogic and discursive, so that the resulting new awareness translates into practical action and change. We will focus on a practice-based initiative which involves the implementation of PBL in a first year introductory course at The University of Queensland and provide practical guidance on the incorporation of PBL in curriculum development.

  12. Discontinuation of Preventive Drugs in General Practice

    DEFF Research Database (Denmark)

    Andersen, John Sahl; Lindberg, Laura Maria Glahder; Nixon, Michael Simon;

    the most preventive drugs are prescribed in general practice. Special considerations exist in relation to medication of elderly patients. The prevalence of polypharmacy and the subsequent increased risk of side effects and drug interactions is high. Drug-related problems represent the fifth leading...

  13. Guidelines for computer security in general practice

    Directory of Open Access Journals (Sweden)

    Peter Schattner

    2007-06-01

    Conclusions This paper maps out a process for developing computer security guidelines for general practice. The specific content will vary in different countries according to their levels of adoption of IT, and cultural, technical and other health service factors. Making these guidelines relevant to local contexts should help maximise their uptake.

  14. [Patient-safety incidents in general practice

    NARCIS (Netherlands)

    Gaal, S.; Smits, M.; Verstappen, W.H.J.M.; Giesen, P.H.J.; Wensing, M.J.P.

    2011-01-01

    OBJECTIVE: To gain insight into the frequency, severity, causes and consequences of potentially preventable patient-safety incidents in Dutch primary care. DESIGN: Retrospective medical record review study. METHOD: We screened a sample of 1000 medical records in 20 general practices and 1145 medical

  15. Aspects of stoma care in general practice

    OpenAIRE

    Rubin, Gregory

    1986-01-01

    A survey of stoma care in general practice is reported. It demonstrates a wide diversity in the patterns of care provided to ostomates, with only half of the general practitioners reporting regular follow-up by a member of the health care team. Dealing with appliance difficulties was found to be an aspect of stoma care in which a majority of general practitioners have little confidence. The district nurse and stoma nurse are considered to be the most valuable sources of back-up. It is suggest...

  16. General practitioner management of shoulder pain in comparison with rheumatologist expectation of care and best evidence: an Australian national survey.

    Directory of Open Access Journals (Sweden)

    Rachelle Buchbinder

    Full Text Available OBJECTIVES: To determine whether current care for common shoulder problems in Australian general practice is in keeping with rheumatologist expectations and the best available evidence. METHODS: We performed a mailed survey of a random sample of 3500 Australian GPs and an online survey of all 270 rheumatologists in Australia in June 2009. Each survey included four vignettes (first presentation of shoulder pain due to rotator cuff tendinopathy, acute rotator cuff tear in a 45 year-old labourer and early and later presentation of adhesive capsulitis. For each vignette, GPs were asked to indicate their management, rheumatologists were asked to indicate appropriate primary care, and we determined best available evidence from relevant Cochrane and other systematic reviews and published guidelines. RESULTS: Data were available for at least one vignette for 614/3500 (17.5% GPs and 64 (23.8% rheumatologists. For first presentation of rotator cuff tendinopathy, 69% and 82% of GPs and 50% and 56% rheumatologists would order a shoulder X-ray and ultrasound respectively (between group comparisons P = 0.004 and P<0001. Only 66% GPs and 60% rheumatologists would refer to an orthopaedic surgeon for the acute rotator cuff tear. For adhesive capsulitis, significantly more rheumatologists recommended treatments of known benefit (e.g. glucocorticoid injection (56% versus 14%, P<0.0001, short course of oral glucocorticoids (36% versus 6%, p<0.0001 and arthrographic distension of the glenohumeral joint (41% versus 19%, P<0.0001. CONCLUSIONS: There is a mismatch between the stated management of common shoulder problems encountered in primary care by GPs, rheumatologist expectations of GP care and the available evidence.

  17. Rating scales in general practice depression

    DEFF Research Database (Denmark)

    Bech, Per; Paykel, Eugene; Sireling, Lester;

    2015-01-01

    within major depressive disorder. The CID was compared to the Hamilton Depression Rating Scale (HAM-D17). METHODS: 146 patients from a previous study in general practice with the CID were investigated. The item response theory model established by Rasch was used to investigate the scalability (a scale......BACKGROUND: Our objective was to investigate to what extent the Clinical Interview for Depression (CID) used in the general practice setting covers clinically valid subscales (depression, anxiety, and apathy) which can measure outcome of antidepressant therapy as well as identifying subsyndromes......׳s psychometric adequacy) of the subscales, and principal component analysis was used to identify subsyndromes with the symptoms of major depression according to DSM-5 or ICD-10. RESULTS: Whereas the HAM-D17 was found not to have an acceptable scalability, the three brief CID subscales for depression (six items...

  18. Adherence to COPD guidelines in general practice

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Sørensen, Tina Brandt; Højmark, Torben Brunse;

    2013-01-01

    BACKGROUND: The general practitioner (GP) is often the first healthcare contact for patients with chronic obstructive pulmonary disease (COPD). AIMS: To determine whether participating in a standardised educational programme delivered in the GP's own practice is associated with adherence to COPD...... guidelines. METHODS: A nationwide register-based observational before and after study was undertaken with a control group of propensity-matched practices (follow-up period 6 months). COPD was defined as age 40+ years and at least two prescriptions for inhaled medication. The educational programme consisted...... were used to compare the rate of spirometry testing, preventive consultations, and influenza vaccinations provided to COPD patients and the rate of spirometry testing in non-COPD individuals, assumed to reflect diagnostic activity. RESULTS: Data for 102 participating GP practices were analysed...

  19. Access to complementary medicine via general practice.

    OpenAIRE

    Thomas, K.J.; Nicholl, J P; Fall, M.

    2001-01-01

    BACKGROUND: The popularity of complementary medicine continues to be asserted by the professional associations and umbrella organisations of these therapies. Within conventional medicine there are also signs that attitudes towards some of the complementary therapies are changing. AIM: To describe the scale and scope of access to complementary therapies (acupuncture, chiropractic, homoeopathy, hypnotherapy, medical herbalism, and osteopathy) via general practice in England. DESIGN OF STUDY: A ...

  20. How does depression present in general practice?

    OpenAIRE

    Lam, CLK

    1998-01-01

    This was a retrospective study of the records of Chinese patients diagnosed as having depression in a general practice clinic in Hong Kong. The records of 66 newly diagnosed patients during the period September 1, 1992 to April 30, 1994 were reviewed for their initial presenting symptoms and depressive symptoms. Ninety-four per cent of the patients with depression initially presented with somatic symptoms. The spectrum of complaints was broad with symptoms referred to various organ systems. T...

  1. Management practices in Australian healthcare: can NSW public hospitals do better?

    Science.gov (United States)

    Agarwal, Renu; Green, Roy; Agarwal, Neeru; Randhawa, Krithika

    2016-05-16

    Purpose - The purpose of this paper is to investigate the determinants of best management practices in an Australian state-run healthcare system, namely New South Wales (NSW), and studies the impact of a range of hospital factors in driving best management practices as a means of enhancing healthcare delivery. Design/methodology/approach - This study adapts a unique survey instrument globally tested to quantify the multi-dimensional nature of hospital management practices in 42 acute care public hospitals of NSW. The authors then analysed the role of hospital-specific characteristics in driving best management practices, namely hospital size (measured by the number of hospital beds, employees and doctors), level of skill and education, degree of hospital manager autonomy and organisational hierarchy. Findings - The findings of this study show the areas of strength and potential areas of improvement in NSW hospitals. The authors find a positive association between the adoption of better management practices and hospital size (measured by the number of hospital beds and employees), level of skills and education, degree of hospital manager autonomy and organisational hierarchy. However, hospital size as measured by the number of doctors did not have a statistically significant relationship. Practical implications - This paper is of interest to both hospital administrators, clinical doctors and healthcare policy-makers who want to improve and develop strategies for better management in the healthcare sector. Originality/value - This study provides an internationally comparable robust measure of management capability in public hospitals, and contributes to the evidence-base of management practices and performance in hospitals. PMID:27119390

  2. Australian and South African perspectives on the implementation of flexible work practices (Fwp: an exploratory study

    Directory of Open Access Journals (Sweden)

    Aletta Odendaal

    2002-10-01

    Full Text Available The purpose of this study was to identify examples of good and innovative practices of Flexible Work Practices to benchmark against and then to use the information to develop strategies of implementation that will assist South African organisations to emulate their success. One hundred-and-twenty (120 individuals, representing different stakeholder groups were requested to complete a questionnaire, based on an Australian study. Comparative findings of both countries strongly confirmed variables that are positively associated with the adoption and successful implementation of Flexible Work Practices (FWP. Opsomming Die doel van hierdie studie was om voorbeelde van goeie en innoverende gebruike van Buigsame Werkspraktyke te identifiseer ten einde daarteen te kan vergelyk, en dan om hierdie inligting te gebruik ten einde implementeringstrategieë te ontwikkel wat Suid Afrikaanse maatskappye kan gebruik om sukses na te volg. Honderd en twintig (120 individue, wat verskillende belangegroepe verteenwoordig, is genader om ‘n vraelys, gebaseer op ‘n Australiese studie, te voltooi. Vergelykende bevindinge van beide lande bevestig veranderlikes wat positief geassosieer word met die aanvaarding en suksesvolle implementering van Buigsame Werkspraktyke (BWP.

  3. Implications of Harold Shipman for general practice.

    Science.gov (United States)

    Baker, R

    2004-06-01

    Harold Shipman was an English general practitioner who murdered at least 215 of his patients between 1974 and 1998. A public inquiry is underway, but general practitioners and all doctors also need to consider the implications for their profession. The aim of this paper is to stimulate debate. Issues identified as important to consider include: trust between doctors; attitudes towards failing systems such as cremation certification; acceptance of the duty of accountability; ensuring patients can have reasonable confidence in their doctors; commitment to preventing such a case occurring again; and relationships with patients. It is argued that restricting debate to methods to detect doctors who murder would limit the opportunity to improve medical practice and would constitute a failure to fulfil the duty owed by doctors to Shipman's victims and their families. PMID:15192157

  4. Clinical Activity in General Practice and Cancer

    DEFF Research Database (Denmark)

    Hjertholm, Peter

    2015-01-01

    BACKGROUND AND AIMS Cancer is a common, serious disease and early diagnosis is a cornerstone in the effort to improve the outcome from cancer disease. The general practitioner (GP) plays a crucial role in achieving this goal. Little is known about GPs’ suspicion of cancer and the activities the GPs...... institute in relation to such suspicion. Knowledge is also sparse on any effects of different diagnostic activities in general practice. The overall aims of this thesis were therefore: -to describe how often Danish GPs suspected cancer or other serious diseases and how they acted on the suspicion......, and to analyse how a suspicion influenced the demand for health care services and predicted a future diagnosis of serious disease - to investigate whether variation in GPs’ diagnostic activity influences cancer patients’ prognosis in relation to prostate-specific antigen (PSA) testing and prostate cancer...

  5. Disease Risk Perception and Safety Practices: A Survey of Australian Flying Fox Rehabilitators

    OpenAIRE

    Sánchez, Cecilia A.; Baker, Michelle L

    2016-01-01

    Interactions with flying foxes pose disease transmission risks to volunteer rehabilitators (carers) who treat injured, ill, and orphaned bats. In particular, Australian bat lyssavirus (ABLV) can be transmitted directly from flying foxes to humans in Australia. Personal protective equipment (PPE) and rabies vaccination can be used to protect against lyssavirus infection. During May and June 2014, active Australian flying fox carers participated in an online survey (SOAR: Survey Of Australian f...

  6. European General Practice Research Workshop: profiles of somatizing patients in general practice (2).

    OpenAIRE

    Collijn, D.H.; Verhaak, P.; Wijkel, D.; van der Feltz-Cornelis, C. M.; Huyse, F.J.

    1994-01-01

    OBJECTIVE: The purpose of the study was to assess the feasibility of a psychiatric consultation intervention for somatizing patients in the family practice setting in terms of 1) patient compliance, 2) patient satisfaction, and 3) compliance and satisfaction of general practitioners (GPs). METHOD: In a period of nine months, forty-six patients were selected for psychiatric consultation in six solo family practices in a semi-urban area in the Netherlands. The consultation included an interview...

  7. Globalization and Classroom Practice: Insights on Learning about the World in Swedish and Australian Schools

    Directory of Open Access Journals (Sweden)

    Ruth Reynolds

    2013-08-01

    Full Text Available Globalization and global education implies changes to practices at the classroom level to adapt to new imperatives associated with technology use and awareness, and environmental sustainability. It also implies much more. It implies that teachers apply their classroom pedagogy to take account of students’ new found global understandings of which they, and the school community, is largely unaware. This article addresses and discuses three key consequences of globalization for classrooms worldwide; an increased diversity of experience of the students within the classroom, an increased competitiveness of educational outcomes between national states and subsequently some standardisation of curriculum across nations to enable this, and an increased emphasis on teaching skills and values associated with intercultural understanding. Young children’s map knowledge and their resultant, and associated, interpretations of the world from a comparative study a from Swedish and Australian primary classrooms is used as examples of some of these implications of the impact of ‘global culture’ and ‘global issues’ on current and future classroom practice.

  8. Examining the Beliefs and Practices of Four Effective Australian Primary Science Teachers

    Science.gov (United States)

    Fitzgerald, Angela; Dawson, Vaille; Hackling, Mark

    2013-06-01

    With trends across many countries still indicating the decline of student interest in school science and diminishing numbers of students studying science beyond the compulsory years, it seems that the field remains in crisis. To address these unfortunate trends, there needs to be a greater emphasis on science education research that highlights the good news stories. For example, what are science teachers actually doing in their classrooms to increase student interest and understanding in science? This article focuses on the science teaching beliefs and practices of four Western Australian primary school teachers. The teachers were nominated by a professional colleague as effective practitioners. The study involved gathering information from classroom observations and teacher interviews to provide background information to assist in developing understandings of these teachers and their science teaching. This article reports on the initial findings drawn from Deanne A, Kate B, Lisa C and Rebecca D. Their practices were organised into the following six categories: classroom environment; conceptual knowledge and procedural skills; teaching strategies and approaches; student-specific considerations; teacher-specific considerations; and context-specific considerations. In examining the components contributing to these categories, it was evident that the teachers' beliefs, as well as the contextual factors inherent in each classroom environment, influenced how and why they teach science in the ways they do.

  9. Organising a physiotherapy service in general practice.

    Science.gov (United States)

    Waters, W H; Udy, S C; Lunn, J E

    1975-08-01

    This paper describes three years' experience of running a domiciliary physiotherapy service based on general practice and financed by limited voluntary funds.The need arose from the remoteness of, and lack of, open access to, hospital physiotherapy. This was particularly so for elderly patients who were often frail and mentally confused. In addition there were obvious advantages in properly instructing relatives in management and treatment, especially since many of the patients and their relatives expressed a desire for home treatment.There was also a desire on the part of the general practitioners, nurses, and ancillary workers to develop further the teamwork in the health services of the four villages involved. Details of the constitution of the voluntary service and its financial arrangements are given.The results of the service and the nature of its work are described. There were no difficulties experienced in selecting the correct patients for treatment and the type of equipment required was almost all normally available through the health authority nursing service. There was no great need for expensive or heavy equipment and no transport problems arose.It was found that one hour of physiotherapist's time per 1,000 patients per week was adequate to cover all patients requiring short-term intensive therapy and to allow a small amount of palliative therapy in addition, although this had not been the original intention of the service.The physiotherapist averaged about 40 hours work per month and under these conditions the travelling and costs averaged 1.54 miles and 83 pence per visit. With self-determined hours of work and flexible timing, these conditions proved ideal for a married physiotherapist with the responsibility of a young family. Expansion of the hours of work in this particular area would have led to wasteful visits devoted to palliative and placebo therapy; and extension of the service beyond the area defined, would have increased travelling time at

  10. Exploring Self-Efficacy in Australian General Practitioners Managing Patient Obesity: A Qualitative Survey Study

    Science.gov (United States)

    Ashman, Freya; Sturgiss, Elizabeth; Haesler, Emily

    2016-01-01

    Background. Obesity is a leading cause of morbidity and mortality in the Australian community, and general practitioners (GPs) are commonly approached by patients for assistance in losing weight. Previous studies have shown that GPs have low self-efficacy and low outcome expectation when it comes to managing overweight and obese patients, which affects their willingness to initiate and continue with weight counselling. This qualitative survey study aimed to explore the factors influencing confidence and behaviour in obesity management in GPs. Method. Twelve GPs recruited to deliver a pilot of an obesity management program participated in semistructured interviews, and interpretive analysis underpinned by social cognitive theory was performed on the transcripts. Results. Analysis identified five main themes: (1) perceived knowledge and skills, (2) structure to management approach, (3) the GP-patient relationship, (4) acknowledged barriers to weight loss and lifestyle change, and (5) prior experience and outcome expectation. Conclusions. GPs are likely to welcome tools which provide a more structured approach to obesity management. Shifting away from weight and BMI as sole yardsticks for success or failure and emphasising positive lifestyle changes for their own sake may improve GP self-efficacy and allow for a more authentic GP-patient interaction.

  11. Improving infection control in general practice.

    Science.gov (United States)

    Farrow, S C; Zeuner, D; Hall, C

    1999-03-01

    Infection control measures in the health care setting should protect patients and staff from cross-infection. The prevention of harm is an essential part of good medical practice and failure might result in professional misconduct proceedings by the General Medical Council (GMC) and prosecution under the Health and Safety at Work legislation, as well as civil liability. For a health authority, overall responsibility for public health includes arrangements for the control of communicable diseases and infection in hospital and the community (NHS Management Executive, 1993), a function usually led by the Consultant in Communicable Disease Control (CCDC). This paper describes one district's collaborative approach between public health and GPs to assess and improve local infection control standards. PMID:10327810

  12. Antibiotic Prescription in Danish General Practice

    DEFF Research Database (Denmark)

    Sydenham, Rikke Vognbjerg; Plejdrup Hansen, Malene; Pedersen, Line Bjørnskov;

    2016-01-01

    explore how the GPs prescription behaviour is influenced by selected factors. Antibiotics are essential when treating potentially lethal infections. An increasing development of resistant bacteria is considered one of the primary threats to public health. The majority of antibiotics (90%) are prescribed...... selected factors (microbiological diagnostics, point-of-care tests, patients’ expectations) in the management of infectious diseases. 3. Results This PhD project is scheduled to be carried out in 2016-2019. The hypotheses and anticipated perspectives will be discussed at the conference. 4. Conclusions The...... project will contribute to existing knowledge with information on the diagnostic approaches to infections in general practice. The results will create a base for targeted interventions aiming to optimize diagnostic approaches to infectious diseases benefitting the individual patient and society as a whole....

  13. Non-Standard Assessment Practices in the Evaluation of Communication in Australian Aboriginal Children

    Science.gov (United States)

    Gould, Judith

    2008-01-01

    Australian Aboriginal children typically receive communication assessment services from Standard Australian English (SAE) speaking non-Aboriginal speech-language pathologists (SLPs). Educational assessments, including intelligence testing, are also primarily conducted by non-Aboriginal educational professionals. While the current paper will show…

  14. General dentist orthodontic practice in foreign legal systems

    OpenAIRE

    Ivan Toshio Maruo; Armando Saga; Maria da Glória Colucci; Orlando Tanaka; Hiroshi Maruo

    2012-01-01

    OBJECTIVE: General dentist orthodontic practice is a controversial issue and this paper aims to analyze it comparing foreign laws to Brazilian Legal System. METHODS: Regulations and scientific texts concerning orthodontic practice by general dentists, in Portuguese or English language, were sought. RESULTS AND CONCLUSION: Portugal clearly forbids general dentist orthodontic practice; United States of America do not clearly forbid general dentist orthodontic practice, but do regulate and promo...

  15. Undergraduate teaching in the community: can general practice deliver?

    OpenAIRE

    Wilson, A; Fraser, R; McKinley, R K; Preston-Whyte, E.; Wynn, A.

    1996-01-01

    BACKGROUND: All UK medical schools are revising their curricula following the General Medical Council recommendations to increase general practice involvement in undergraduate education. However, workload in general practice has increased in recent years, raising questions about its ability to maintain, let alone extend, its educational activities. AIM: The aim of this study was examine whether recent changes in general practice have affected delivery of practice-based undergraduate education...

  16. Incorporating online teaching in an introductory pharmaceutical practice course: a study of student perceptions within an Australian University

    OpenAIRE

    Benino D; Girardi A; Czarniak P

    2011-01-01

    Objectives: To examine student perceptions regarding online lectures and quizzes undertaken during a pharmaceutical practice course for first year undergraduate students enrolled in the Bachelor of Pharmacy course at an Australian University.Methods: The University uses a standard instrument to collect feedback from students regarding unit satisfaction. Data were collected for three different teaching modalities: traditional face-to-face, online and partially online. Results: Descriptive stat...

  17. Measuring the health impact of human rights violations related to Australian asylum policies and practices: A mixed methods study

    OpenAIRE

    Mulholland Kim; Allotey Pascale; Johnston Vanessa; Markovic Milica

    2009-01-01

    Abstract Background Human rights violations have adverse consequences for health. However, to date, there remains little empirical evidence documenting this association, beyond the obvious physical and psychological effects of torture. The primary aim of this study was to investigate whether Australian asylum policies and practices, which arguably violate human rights, are associated with adverse health outcomes. Methods We designed a mixed methods study to address the study aim. A cross-sect...

  18. Violence in general practice: a gendered risk?

    Science.gov (United States)

    Elston, Mary Ann; Gabe, Jonathan

    2016-03-01

    This article focuses on the extent to which violence against family doctors in England is experienced in gendered terms. It draws on data from two studies: a postal survey of 1,300 general practitioners (GPs) (62% response rate) and in-depth interviews with 26 doctors who have been assaulted or threatened; and 13 focus groups with primary care teams and 19 in-depth interviews with GPs who had expressed an interest in the topic of violence against doctors. Most GPs, regardless of gender, reported receiving verbal abuse over the last two years, often interpreted as a consequence of declining deference to professionals, while actual physical assaults and threats were much rarer and more likely to be reported by men. Overall, women GPs were much more likely to express concern about violence and to take personal precautions, although younger male GPs working in inner-city practices also had high levels of concern. The study shows how some aspects of family doctors' work has been organised on gendered lines and how these contribute to the differences in experience of violence. We suggest that the increasing proportion of women among family doctors may have implications for these, often tacit, organisational routines. PMID:26498299

  19. Integrating a pharmacist into the general practice environment: opinions of pharmacist’s, general practitioner’s, health care consumer’s, and practice manager’s

    Directory of Open Access Journals (Sweden)

    Freeman Christopher

    2012-08-01

    Full Text Available Abstract Background Pharmacists are viewed as highly trained yet underutilised and there is growing support to extend the role of the pharmacist within the primary health care sector. The integration of a pharmacist into a general practice medical centre is not a new concept however is a novel approach in Australia and evidence supporting this role is currently limited. This study aimed to describe the opinions of local stakeholders in South-East Queensland on the integration of a pharmacist into the Australian general practice environment. Methods A sample of general practitioners, health care consumers, pharmacists and practice managers in South-East Queensland were invited to participate in focus groups or semi-structured interviews. Seeding questions common to all sessions were used to facilitate discussion. Sessions were audio recorded and transcribed verbatim. Leximancer software was used to qualitatively analyse responses. Results A total of 58 participants took part in five focus groups and eighteen semi-structured interviews. Concepts relating to six themes based on the seeding questions were identified. These included positively viewed roles such as medication reviews and prescribing, negatively viewed roles such as dispensing and diagnosing, barriers to pharmacist integration such as medical culture and remuneration, facilitators to pharmacist integration such as remuneration and training, benefits of integration such as access to the patient’s medical file, and potential funding models. Conclusions These findings and future research may aid the development of a new model of integrated primary health care services involving pharmacist practitioners.

  20. Near patient testing in general practice: a review.

    OpenAIRE

    Hilton, S

    1990-01-01

    Until recently, technological advances in general practice have generally been thought of as the applications of microcomputers in practice organization and record keeping. Advances in miniaturization and versatility of diagnostic technology will have a similarly large impact on the way general practitioners practice medicine in the next decade. This article reviews some of the newer tests that are already available to general practitioners, particularly in diagnostic biochemistry and microbi...

  1. Life Satisfaction of Young Australians: Relationships between Further Education, Training and Employment and General and Career Satisfaction. Longitudinal Surveys of Australian Youth Research Report 43

    Science.gov (United States)

    Hillman, Kylie; McMillan, Julie

    2005-01-01

    Prepared by the Australian Council for Educational Research (ACER) under an agreement with the Australian Government Department of Education, Science and Training (DEST), this report has three broad aims: (1) To describe the relationship between life satisfaction and participation in a range of post-school education, training and labour market…

  2. Preventive evidence into practice (PEP study: implementation of guidelines to prevent primary vascular disease in general practice protocol for a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Harris Mark F

    2013-01-01

    Full Text Available Abstract Background There are significant gaps in the implementation and uptake of evidence-based guideline recommendations for cardiovascular disease (CVD and diabetes in Australian general practice. This study protocol describes the methodology for a cluster randomised trial to evaluate the effectiveness of a model that aims to improve the implementation of these guidelines in Australian general practice developed by a collaboration between researchers, non-government organisations, and the profession. Methods We hypothesise that the intervention will alter the behaviour of clinicians and patients resulting in improvements of recording of lifestyle and physiological risk factors (by 20% and increased adherence to guideline recommendations for: the management of CVD and diabetes risk factors (by 20%; and lifestyle and physiological risk factors of patients at risk (by 5%. Thirty-two general practices will be randomised in a 1:1 allocation to receive either the intervention or continue with usual care, after stratification by state. The intervention will be delivered through: small group education; audit of patient records to determine preventive care; and practice facilitation visits adapted to the needs of the practices. Outcome data will be extracted from electronic medical records and patient questionnaires, and qualitative evaluation from provider and patient interviews. Discussion We plan to disseminate study findings widely and directly inform implementation strategies by governments, professional bodies, and non-government organisations including the partner organisations.

  3. Primary health care and general practice--a comparison between Australia and Malaysia.

    Science.gov (United States)

    Ee-Ming Khoo; Kidd, Michael Richard

    2002-01-01

    The Australian and Malaysian systems of general practice were examined and compared. The issues of similarity and difference identified are discussed in this paper. Quality clinical practice and the importance of compulsory vocational training prior to entry into general practice and continuing professional development is one important area. A move towards preventive health care and chronic disease management was observed in both countries. Practice incentive programmes to support such initiatives as improved rates of immunisation and cervical smear testing and the implementation of information technology and information management systems need careful implementation. The Medicare system used in Australia may not be appropriate for general practitioners in Malaysia and, if used, a pharmaceutical benefit scheme would also need to be established. In both countries the corporatisation of medical practice is causing concern for the medical profession. Rural and aboriginal health issues remain important in both countries. Graduate medical student entry is an attractive option but workforce requirements mean that medical education will need individual tailoring for each country. Incorporating nurses into primary health care may provide benefits such as cost savings. The integration model of community centres in Malaysia involving doctors, nurses and allied health professionals, such as physiotherapists, in a single location deserves further examination. PMID:12862408

  4. Engaging Musical Practices: A Sourcebook for Middle School General Music

    Science.gov (United States)

    Burton, Suzanne L., Ed.

    2012-01-01

    Middle school general music may be a student's last encounter with school music. A practical book with accessible pedagogical resources on middle school general music is needed for methods courses and music practitioners' use. The book "Engaging Musical Practices: A Sourcebook for Middle School General Music" presents numerous ways to engage…

  5. Audit of abdominal pain in general practice

    OpenAIRE

    Edwards, M.W.; Forman, W.M.; Walton, J.

    1985-01-01

    An audit of 150 consecutive cases of abdominal pain presenting to an urban teaching practice between October 1983 and May 1984 was performed. The median duration of pain prior to presentation was two days. Females predominated in all age groups.

  6. Practical pediatric chest radiology for general radiologists

    International Nuclear Information System (INIS)

    This paper reviews practical problems in the radiologic study of infants and children, provides helpful hints for daily practice, and brings the application of newer imaging modalities up to date for specific clinical problems. The discussion attends to normal variants, diagnostic pitfalls, and iatrogenic problems. The authors cover three major areas: (1) Emphysema in infants and children, including bilateral, unilateral, and localized emphysema. (2) The borderlands of the lungs, including evaluation of diaphragmatic abnormalities, mediastinal and pleural lesions, and air leak phenomena, (3) Newborn chest radiology, with an emphasis on differential diagnosis, natural history of disease processes, and therapeutic complications

  7. Clinical audit of health promotion of vitamin D in one general practice

    Directory of Open Access Journals (Sweden)

    Kljakovic Marjan

    2012-04-01

    Full Text Available Abstract Background The clinical audit of vitamin D health promotion in one Australian general practice was undertaken by measuring health service use and serum 25-hydroxyvitamin D levels in 995 patients aged 45 to 49 years. Findings Over 3 years, 486 (51% patients had a Medicare funded Health Assessment. More women (54% were assessed than men (46% p = 0.010. Mean 25-OHD was higher for men (70.0 nmol/l than women (60.3 nmol/l p Among 266 patients who had a 25-OHD test, 68 (26% had normal levels 80+ nmol/l, 109 (41% were borderline 51-79 nmol/l, and 89 (33% were low Conclusions Health promotion information about vitamin D was provided to 50% of a targeted group of patients over a one-year period. Provision of this information had no effect on the uptake rates of an invitation to attend for a general health assessment.

  8. Quality, Identity and Practice in Offshore University Programmes: Issues in the Internationalization of Australian Higher Education

    Science.gov (United States)

    Chapman, Anne; Pyvis, David

    2006-01-01

    This paper reports the findings of qualitative case studies aimed at exploring student experiences of offshore programmes delivered in Singapore, Hong Kong and Malaysia by Australian universities. The paper draws on a cross-case analysis of the studies to develop propositions about student experience and identity formation in the context of…

  9. Measuring the health impact of human rights violations related to Australian asylum policies and practices: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Mulholland Kim

    2009-02-01

    Full Text Available Abstract Background Human rights violations have adverse consequences for health. However, to date, there remains little empirical evidence documenting this association, beyond the obvious physical and psychological effects of torture. The primary aim of this study was to investigate whether Australian asylum policies and practices, which arguably violate human rights, are associated with adverse health outcomes. Methods We designed a mixed methods study to address the study aim. A cross-sectional survey was conducted with 71 Iraqi Temporary Protection Visa (TPV refugees and 60 Iraqi Permanent Humanitarian Visa (PHV refugees, residing in Melbourne, Australia. Prior to a recent policy amendment, TPV refugees were only given temporary residency status and had restricted access to a range of government funded benefits and services that permanent refugees are automatically entitled to. The quantitative results were triangulated with semi-structured interviews with TPV refugees and service providers. The main outcome measures were self-reported physical and psychological health. Standardised self-report instruments, validated in an Arabic population, were used to measure health and wellbeing outcomes. Results Forty-six percent of TPV refugees compared with 25% of PHV refugees reported symptoms consistent with a diagnosis of clinical depression (p = 0.003. After controlling for the effects of age, gender and marital status, TPV status made a statistically significant contribution to psychological distress (B = 0.5, 95% CI 0.3 to 0.71, p ≤ 0.001 amongst Iraqi refugees. Qualitative data revealed that TPV refugees generally felt socially isolated and lacking in control over their life circumstances, because of their experiences in detention and on a temporary visa. This sense of powerlessness and, for some, an implicit awareness they were being denied basic human rights, culminated in a strong sense of injustice. Conclusion Government asylum policies

  10. Subacronial shoulder complaints in physiotherapy an general practice.

    NARCIS (Netherlands)

    Kooijman, M.; Swinkels, I.; Veenhof, C.

    2011-01-01

    Purpose: The aim of this study is to describe the patient population and the process of care in patients with subacromial shoulder complaints both in physiotherapy and in general practice. Relevance: Shoulder complaints are common in the daily practice of a general practitioner (GP) and physiotherap

  11. Urinary incontinence management in women: audit in general practice.

    NARCIS (Netherlands)

    Gerrits, M.; Avery, A.J.; Lagro-Janssen, A.L.M.

    2008-01-01

    OBJECTIVES: In several Western European countries guidelines regarding urinary incontinence (UI) management in general practice have been drawn up. The aim of this study was to evaluate guideline adherence with feedback in general practice in order to improve UI management. METHODS: First, a retrosp

  12. Urinary incontinence management in women: audit in general practice

    NARCIS (Netherlands)

    Gerrits, M.; Avery, A.J.; Lagro-Janssen, A.L.M.

    2008-01-01

    Objectives In several Western European countries guidelines regarding urinary incontinence (UI) management in general practice have been drawn up. The aim of this study was to evaluate guideline adherence with feedback in general practice in order to improve UI management. Methods First, a retrospec

  13. Improvisational Practices in Elementary General Music Classrooms

    Science.gov (United States)

    Gruenhagen, Lisa M.; Whitcomb, Rachel

    2014-01-01

    Despite historic and ongoing support for the inclusion of improvisation in the elementary general music curriculum, music educators consistently report challenges with implementation of improvisational activities in their classes. This study was designed to examine (a) the extent to which improvisational activities were occurring in the…

  14. Translation of tobacco policy into practice in disadvantaged and marginalized subpopulations: a study of challenges and opportunities in remote Australian Indigenous communities

    Directory of Open Access Journals (Sweden)

    Robertson Jan A

    2012-07-01

    Full Text Available Abstract Background In Australia generally, smoking prevalence more than halved after 1980 and recently commenced to decline among Australia's disadvantaged Indigenous peoples. However, in some remote Indigenous Australian communities in the Northern Territory (NT, extremely high rates of up to 83% have not changed over the past 25 years. The World Health Organisation has called for public health and political leadership to address a global tobacco epidemic. For Indigenous Australians, unprecedented policies aim to overcome disadvantage and close the 'health gap' with reducing tobacco use the top priority. This study identifies challenges and opportunities to implementing these important new tobacco initiatives in remote Indigenous communities. Methods: With little empirical evidence available, we interviewed 82 key stakeholders across the NT representing operational- and management-level service providers, local Indigenous and non-Indigenous participants to identify challenges and opportunities for translating new policies into successful tobacco interventions. Data were analysed using qualitative approaches to identify emergent themes. Results The 20 emergent themes were classified using counts of occasions each theme occurred in the transcribed data as challenge or opportunity. The 'smoke-free policies' theme occurred most frequently as opportunity but infrequently as challenge while 'health workforce capacity' occurred most frequently as challenge but less frequently as opportunity, suggesting that policy implementation is constrained by lack of a skilled workforce. 'Smoking cessation support' occurred frequently as opportunity but also frequently as challenge suggesting that support for individuals requires additional input and attention. Conclusions These results from interviews with local and operational-level participants indicate that current tobacco policies in Australia targeting Indigenous smoking are sound and comprehensive

  15. Learning a novel technique to identify possible melanomas: are Australian general practitioners better than their U.K. colleagues?

    Directory of Open Access Journals (Sweden)

    Watson Tony

    2009-04-01

    Full Text Available Abstract Background Spectrophotometric intracutaneous analysis (SIAscopy™ is a multispectral imaging technique that is used to identify 'suspicious' (i.e. potentially malignant pigmented skin lesions for further investigation. The MoleMate™ system is a hand-held scanner that captures SIAscopy™ images that are then classified by the clinician using a computerized diagnostic algorithm designed for the primary health care setting. The objectives of this study were to test the effectiveness of a computer program designed to train health care workers to identify the diagnostic features of SIAscopy™ images and compare the results of a group of Australian and a group of English general practitioners (GPs. Methods Thirty GPs recruited from the Perth (Western Australia metropolitan area completed the training program at a workshop held in March 2008. The accuracy and speed of their pre- and post-test scores were then compared with those of a group of 18 GPs (including 10 GP registrars who completed a similar program at two workshops held in Cambridge (U.K. in March and April, 2007. Results The median test score of the Australian GPs improved from 79.5% to 86.5% (median increase 5.5%; p Conclusion Most of the SIAscopy™ features can be learnt to a reasonable degree of accuracy with this brief computer training program. Although the Australian GPs scored higher in the pre-test, both groups had similar levels of accuracy and speed in interpreting the SIAscopy™ features after completing the program. Scores were not affected by previous dermoscopy experience or dermatology training, which suggests that the MoleMate™ system is relatively easy to learn.

  16. Characteristics of general practices involved in undergraduate medical teaching.

    OpenAIRE

    Gray, R W; Carter, Y H; Hull, S A; Sheldon, M.G.; Ball, C

    2001-01-01

    BACKGROUND: The movement of medical education into the community has accelerated the development of a new model of general practice in which core clinical services are complemented by educational and research activities involving the whole primary care team. AIM: To compare quality indicators, workload characteristics, and health authority income of general practices involved in undergraduate medical education in east London with those of other practices in the area and national figures where...

  17. Delegation to nurses in general practice

    OpenAIRE

    Bowling, Ann

    1981-01-01

    A random sample of general practitioners and their nursing staff was interviewed to examine the extent to which the doctors delegated medical tasks to the nurses and to analyse attitudes towards delegation. A significant minority of both doctors and nurses were reluctant to have minor clinical tasks delegated and a majority did not think that nurses should carry out delegated diagnostic procedures. Doctors and nurses who had completed their training since 1960 were more likely to favour deleg...

  18. Early detection of COPD in general practice

    OpenAIRE

    Ulrik, Charlotte Suppli; Løkke, Anders; Dahl, Ronald; Dollerup, Jens; Hansen, Gert; Cording, Patrick Hagge; Andersen, Klaus Kaae

    2011-01-01

    Background and aim Early detection enables the possibility for interventions to reduce the future burden of COPD. The Danish National Board of Health recommends that individuals >35 years with tobacco/occupational exposure, and at least 1 respiratory symptom should be offered a spirometry to facilitate early detection of COPD. The aim, therefore, was to provide evidence for the feasibility and impact of doing spirometry in this target population. Methods Participating general practitioners (G...

  19. Computerisation of general practice in the Republic of Croatia: experience gained in general practice use

    Directory of Open Access Journals (Sweden)

    Biserka Bergman-Markovi_

    2007-09-01

    Full Text Available Well-organised medical records are the prerequisite for achieving a high level of performance in primary healthcare settings. Recording balanced structured and coded data as well as free text can improve both quality and organisation of work in the office. It provides a more substantiated support of financial transactions and accountancy, allows better communication with other facilities and institutions, and is a source of valuable scientific research material. This article is the result of an individual experience gained in general practice use of various programs/ systems employed within the family medicine frame, and the frame of evaluation of available and commonly- exploited program solutions. The use of various programs allows for systematic adjustments as to the increasingly complex requirements imposed on electronic medical records (EMRs. The experience of a general practitioner, presented in this paper, confirms the assumption that an adequate program to be employed with EMRs should be developed, provided that family medicine practitioners, that is, the final users, have been involved in each and every stage of its development, adjustment, implementation and evaluation.

  20. The quality of COPD care in general practice

    DEFF Research Database (Denmark)

    Rasmussen, F.V.; Borgeskov, H.; Dollerup, J.; Jensen, M.S.; Roslind, K.; Nielsen, L.M.; Lange, Peter

    2008-01-01

    We investigated whether the quality of management of COPD in general practice could be improved by the participation of general practitioners and their staff in a COPD-specific educational programme. One-hundred and fifty-four doctors participated in the study, and 2549 patient record forms were...... programme can improve the quality of COPD care in general practice Udgivelsesdato: 2008/8/25...

  1. Shoulder disorders in general practice: prognostic indicators of outcome.

    OpenAIRE

    Windt, van der, D.A.W.M.; Koes, B.W.; Boeke, A J P; Deville, W.L.J.M.; De, Jong; Bouter, L.M.

    1996-01-01

    BACKGROUND: Shoulder pain is common in primary health care. Nevertheless, information on the outcome of shoulder disorders is scarce, especially for patients encountered in general practice. AIM: To study the course of shoulder disorders in general practice and to determine prognostic indicators of outcome. METHOD: For this prospective follow-up study, 11 Dutch general practitioners recruited 349 patients with new episodes of shoulder pain. The participants filled out a questionnaire at prese...

  2. Non-surgical treatment of hallux valgus: a current practice survey of Australian podiatrists

    OpenAIRE

    Hurn, Sheree E; Vicenzino, Bill T; Smith, Michelle D

    2016-01-01

    Background Patients with hallux valgus (HV) frequently present to podiatrists for non-surgical management, with a wide range of concerns including pain, footwear difficulty and quality of life impacts. There is little research evidence guiding podiatrists’ clinical decisions surrounding non-surgical management of HV. Thus practitioners rely largely upon clinical experience and expert opinion. This survey was conducted to determine whether a consensus exists among Australian podiatrists regard...

  3. Indigenous vegetation burning practices and their impact on the climate of the northern Australian monsoon region

    Directory of Open Access Journals (Sweden)

    K.-H. Wyrwoll

    2013-08-01

    Full Text Available Here we pose the question: was there a downturn in summer monsoon precipitation over northern Australia due to Aboriginal vegetation practices over prehistoric time scales? In answering this question we consider the results from a global climate model incorporating ocean, land, ice, atmosphere and vegetation interactions, reducing the total vegetation cover over northern Australia by 20% to simulate the effects of burning. The results suggest that burning forests and woodlands in the monsoon region of Australia led to a shift in the regional climate, with a delayed monsoon onset and reduced precipitation in the months preceding the "full" monsoon. We place these results in a global context, drawing on model results from five other monsoon regions, and note that although the precipitation response is highly varied, there is a general but region specific climate response to reduced vegetation cover in all cases. Our findings lead us to conclude that large-scale vegetation modification over millennial time-scales due to indigenous burning practices, would have had significant impacts on regional climates. With this conclusion comes the need to recognise that the Anthropocene saw the impact of humans on regional-scale climates and hydrologies at much earlier times than generally recognized.

  4. Indigenous vegetation burning practices and their impact on the climate of the northern Australian monsoon region

    Science.gov (United States)

    Wyrwoll, K.-H.; McRobie, F. H.; Notaro, M.; Chen, G.

    2013-08-01

    Here we pose the question: was there a downturn in summer monsoon precipitation over northern Australia due to Aboriginal vegetation practices over prehistoric time scales? In answering this question we consider the results from a global climate model incorporating ocean, land, ice, atmosphere and vegetation interactions, reducing the total vegetation cover over northern Australia by 20% to simulate the effects of burning. The results suggest that burning forests and woodlands in the monsoon region of Australia led to a shift in the regional climate, with a delayed monsoon onset and reduced precipitation in the months preceding the "full" monsoon. We place these results in a global context, drawing on model results from five other monsoon regions, and note that although the precipitation response is highly varied, there is a general but region specific climate response to reduced vegetation cover in all cases. Our findings lead us to conclude that large-scale vegetation modification over millennial time-scales due to indigenous burning practices, would have had significant impacts on regional climates. With this conclusion comes the need to recognise that the Anthropocene saw the impact of humans on regional-scale climates and hydrologies at much earlier times than generally recognized.

  5. General practice and primary health care in Denmark

    DEFF Research Database (Denmark)

    Møller Pedersen, Kjeld; Andersen, John Sahl; Søndergård, Jens

    2012-01-01

    challenges. Practice units are fairly small: close to 2 GPs per unit plus nurses and secretaries. The units are fully computerized, that is, with computer-based patient records and submission of prescriptions digitally to pharmacies etc. Over the past few years a decrease in solo practices has been seen and......General practice is the corner stone of Danish primary health care. General practitioners (GPs) are similar to family physicians in the United States. On average, all Danes have 6.9 contacts per year with their GP (in-person, telephone, or E-mail consultation). General practice is characterized by...... postgraduate education. The contract is (re)negotiated every 2 years. General practice is embedded in a universal tax-funded health care system in which GP and hospital services are free at the point of use. The current system has evolved over the past century and has shown an ability to adapt flexibly to new...

  6. Prevalence of alcohol problems in general practice

    DEFF Research Database (Denmark)

    Rambaldi, A; Todisco, N; Gluud, C;

    1996-01-01

    The Michigan Alcoholism Screening Test (MAST) and the response to a question about heavy alcohol consumption were used to assess the prevalence of alcohol problems in consecutive patients (77 males and 46 females) consulting a general practitioner in an urban area in the South of Italy...... (Castellammare di Stabia). Alcohol problems, which were defined by a cut-off score of 5 on the MAST and/or by heavy alcohol consumption (corresponding to at least 60 g of ethanol daily for males and 36 g of ethanol daily for females for at least 2 years), were identified in 54 patients [43.9%; 95% confidence...... screening question in order to detect alcohol problems and give advice regarding reduction of alcohol consumption....

  7. 19 CFR 177.1 - General ruling practice and definitions.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false General ruling practice and definitions. 177.1 Section 177.1 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) ADMINISTRATIVE RULINGS General Ruling Procedure § 177.1 General...

  8. General Practice in the United Kingdom – A training evolution

    Directory of Open Access Journals (Sweden)

    Patrick Hutt

    2014-01-01

    Full Text Available This article will outline the current state of training for UK General Practice, specifying some of the steps that must be taken in order to qualify, the challenges that trainees often face, and the career opportunities that may await them once completed. A historical perspective will be used to demonstrate the extent to which General Practice has evolved during the last sixty years. A few of the examples and explanations used in this article are by necessity simplistic, designed to highlight key areas of UK general practice in a bid to encourage readers to explore further if they wish to do so.

  9. High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands.

    OpenAIRE

    Grol Richard; Akkermans Reinier; van Doremalen Jan; Elwyn Glyn; Künzi Beat; van den Hombergh Pieter; Wensing Michel

    2009-01-01

    Abstract Background The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. Methods Secondary analysis of data from 239 general practices, collected in practice visits between 2003 to 2006 in the Netherlands using a comprehensive set of measures of practice management. Data were collected by a practice...

  10. General practice ethnicity data: evaluation of a tool

    Directory of Open Access Journals (Sweden)

    Neuwelt P

    2014-03-01

    Full Text Available INTRODUCTION: There is evidence that the collection of ethnicity data in New Zealand primary care is variable and that data recording in practices does not always align with the procedures outlined in the Ethnicity Data Protocols for the Health and Disability Sector. In 2010, The Ministry of Health funded the development of a tool to audit the collection of ethnicity data in primary care. The aim of this study was to pilot the Ethnicity Data Audit Tool (EAT in general practice. The goal was to evaluate the tool and identify recommendations for its improvement. METHODS: Eight general practices in the Waitemata District Health Board region participated in the EAT pilot. Feedback about the pilot process was gathered by questionnaires and interviews, to gain an understanding of practices’ experiences in using the tool. Questionnaire and interview data were analysed using a simple analytical framework and a general inductive method. FINDINGS: General practice receptionists, practice managers and general practitioners participated in the pilot. Participants found the pilot process challenging but enlightening. The majority felt that the EAT was a useful quality improvement tool for handling patient ethnicity data. Larger practices were the most positive about the tool. CONCLUSION: The findings suggest that, with minor improvements to the toolkit, the EAT has the potential to lead to significant improvements in the quality of ethnicity data collection and recording in New Zealand general practices. Other system-level factors also need to be addressed.

  11. Structuring diabetes care in general practices: many improvements, remaining challenges.

    LENUS (Irish Health Repository)

    Jennings, S

    2009-08-07

    BACKGROUND: For people with type 2 diabetes to enjoy improved longevity and quality of life, care needs to be organised in a systematic way. AIM: To test if processes and intermediate outcomes for patients with type 2 diabetes changed with the move to structured care in general practice shared with secondary care. METHODS: An audit of process and intermediate outcomes for patients with type 2 diabetes before and after the change to structured care in 10 Dublin general practices shared with secondary care four years on. RESULTS: Structured diabetes care in general practice has led to more dedicated clinics improved processes of care and increased access to multidisciplinary expertise. Improvement in blood pressure control, the use of aspirin and the use of lipid lowering agents indicate a significant decrease in absolute risk of vascular events for this population. CONCLUSIONS: Structured care in general practice improves intermediate outcomes for people with type 2 diabetes. Further improvements need to be made to reach international targets.

  12. Doctoring gay men: Exploring the contribution of General Practice

    OpenAIRE

    Keogh, Peter; Weatherburn, Peter; Henderson, Laurie; Reid, David; Dodds, Catherine; Hickson, Ford

    2004-01-01

    Primary care is the first point of contact with the NHS for many people. It includes services provided outside hospitals by general practitioners, practice nurses, community nurses, health visitors, dentists, opticians, pharmacists etc. This report is concerned mainly with gay and bisexual men’s experiences of, and interactions with General Practice (GP) surgeries. Two concerns prompted this research. First, research which continually indicates that men are less likely to access primary ca...

  13. Promoting mental health and preventing mental illness in general practice

    OpenAIRE

    Thomas, S.; Jenkins, R; Burch, T.; Nasir, L.C.; Fisher, B; Giotaki, G.; Gnani, S; Hertel, L; Marks, M.; Mathers, N.; Millington-Sanders, C.; D. Morris; Ruprah-Shah, B.; Stange, K.; Thomas, P

    2016-01-01

    This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity. files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert ‘Think Tank’ convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHIC...

  14. Moneymed: a game to develop management skills in general practice

    OpenAIRE

    Essex, B.; Jackson, R. N.

    1981-01-01

    A game has been developed to train people in the financial and administrative skills needed for effective general practice management. These skills cover a wide range of legal, economic, administrative and personnel problems encountered in general practice. Thirty-four trainees and six trainers showed a highly significant improvement in knowledge and problem-solving skills after playing the game. The format and design of the game allow the problem type, complexity and solution to vary and to ...

  15. A survey of statistics in three UK general practice journal

    Directory of Open Access Journals (Sweden)

    Campbell Michael J

    2004-12-01

    Full Text Available Abstract Background Many medical specialities have reviewed the statistical content of their journals. To our knowledge this has not been done in general practice. Given the main role of a general practitioner as a diagnostician we thought it would be of interest to see whether the statistical methods reported reflect the diagnostic process. Methods Hand search of three UK journals of general practice namely the British Medical Journal (general practice section, British Journal of General Practice and Family Practice over a one-year period (1 January to 31 December 2000. Results A wide variety of statistical techniques were used. The most common methods included t-tests and Chi-squared tests. There were few articles reporting likelihood ratios and other useful diagnostic methods. There was evidence that the journals with the more thorough statistical review process reported a more complex and wider variety of statistical techniques. Conclusions The BMJ had a wider range and greater diversity of statistical methods than the other two journals. However, in all three journals there was a dearth of papers reflecting the diagnostic process. Across all three journals there were relatively few papers describing randomised controlled trials thus recognising the difficulty of implementing this design in general practice.

  16. The Role of Collaborative Learning on Training and Development Practices within the Australian Men's Shed Movement: A Study of Five Men's Sheds

    Science.gov (United States)

    Cavanagh, Jillian; Southcombe, Amie; Bartram, Tim

    2014-01-01

    This study examines the role and impact of collaborative learning on training and development practices in Australian Men's Sheds. We use a case study approach, underpinned by Peters and Armstrong's theoretical framework of collaborative learning in adult education, to investigate five Men's Sheds. Semi-structured interviews were…

  17. Australian Chinese Parents' Language Attitudes and Practices Relating to Their Children's Bilingual Development Prior to School

    Science.gov (United States)

    Hu, Jiangbo; Torr, Jane; Whiteman, Peter

    2014-01-01

    This article reports on a deep investigation of five Australian Chinese families regarding their preschool-aged children's bilingual experiences and development. Each family was visited 3 to 5 times by the first author. The mothers were interviewed about their attitudes toward their child's bilingualism and their practices to promote it.…

  18. Exploratory study of general practitioners' orientations to general practice and responses to change.

    OpenAIRE

    Petchey, R

    1994-01-01

    BACKGROUND. Research into general practitioners' responses to the changes in the health service has focused on the quantifiable dimensions of workload, stress, job satisfaction and mental health. AIM. This study set out to investigate general practitioners' practice orientations and responses to change. METHOD. The study was undertaken in 1992. 'Young principals' who had attended MSD Foundation regional courses were invited by letter to reflect on recent change in general practice and to give...

  19. The quality of COPD care in general practice in Denmark

    DEFF Research Database (Denmark)

    Lange, Peter; Rasmussen, Finn Vejlø; Borgeskov, Hanne;

    2007-01-01

    We studied the quality of care for COPD patients in a large sample of general practices in Denmark. We focussed on whether participation by general practitioners (GPs) in an educational programme could enhance the use of spirometry in the diagnosis and staging of the disease and improve adherence...

  20. The organization of cervical screening in general practice

    OpenAIRE

    Havelock, Christine; Edwards, Robert; Cuzick, Jack; Chamberlain, Jocelyn

    1988-01-01

    Well organized cervical screening in general practice can have considerable clinical and financial rewards. Yet in a randomized survey of general practitioners in the United Kingdom only 43% operated a system for cervical screening which allows previously untested women to be identified and invited for testing.

  1. Positive experiences with a specialist as facilitator in general practice

    DEFF Research Database (Denmark)

    Kousgaard, Marius Brostrøm; Thorsen, Thorkil

    2012-01-01

    The use of facilitators for quality improvement in general practice has accelerated during the past decade. As general practitioners (GPs) or pharmacists have typically been used as facilitators, there is a lack of knowledge of how other professionals function as facilitators. This article explores...

  2. The role of general practice in postgraduate basic training

    DEFF Research Database (Denmark)

    Kjaer, Niels Kristian; Kodal, Troels; Qvesel, Dorte

    2010-01-01

    understanding of the health care system but also strengthens the ability to collaborate with general practitioners upon entering another specialty. It also develops important medical and communicative competences. The training in general practice is considered beneficial for the development of professional...

  3. Theory and interpretation in qualitative studies from general practice

    DEFF Research Database (Denmark)

    Malterud, Kirsti

    2016-01-01

    of the interpretative paradigm. Associations between paradigms, philosophies, methodologies and methods are examined and different strategies for theoretical commitment presented. Finally, I discuss the impact of theory for interpretation and the development of general practice knowledge.  Main...... theoretical commitment in qualitative analysis are presented, emphasizing substantive theories to sharpen the interpretative focus. Such approaches are clearly within reach for a general practice researcher contributing to clinical practice by doing more than summarizing what the participants talked about......Objective: In this article, I want to promote theoretical awareness and commitment among qualitative researchers in general practice and suggest adequate and feasible theoretical approaches.  Approach: I discuss different theoretical aspects of qualitative research and present the basic foundations...

  4. Quality of stroke prevention in general practice: relationship with practice organization

    NARCIS (Netherlands)

    J.S. de Koning (Johan); N.S. Klazinga (Niek); P.J. Koudstaal (Peter Jan); A. Prins (Ad); G.J.J.M. Borsboom (Gerard); J.P. Mackenbach (Johan)

    2005-01-01

    textabstractOBJECTIVE: To investigate the relationship between elements of practice organization related to stroke prevention in general practice, and suboptimal preventive care preceding the occurrence of stroke. DESIGN: This study was conducted among 69 Dutch general practitioners in the Rotterda

  5. Provision of mental health care in general practice in Italy.

    OpenAIRE

    Tansella, M; Bellantuono, C

    1991-01-01

    The main features of the psychiatric system and of the general practice system in Italy since the psychiatric reform and the introduction of a national health service are briefly described. Research conducted in Italy confirms that a large proportion of patients seen by general practitioners have psychological disorders and that only some of those patients whose psychological problems are identified by general practitioners are referred to specialist psychiatric care. Thus, the need to identi...

  6. General practitioners and clinical practice guidelines: a reexamination.

    Science.gov (United States)

    Clerc, Isabelle; Ventelou, Bruno; Guerville, Marc-André; Paraponaris, Alain; Verger, Pierre

    2011-08-01

    General practitioners' (GPs') use of clinical practice guidelines (CPGs) may be influenced by various contextual and attitudinal factors. This study examines general attitudes toward CPGs to establish profiles according to these attitudes and to determine if these profiles are associated with awareness and with use of CPGs in daily practice. The authors conducted a cross-sectional telephone survey of 1,759 French GPs and measured (a) their general attitudes toward CPGs and (b) their awareness and use in daily practice of CPGs for six specific health problems. A bivariate probit model was used with sample selection to analyze the links between GPs' general attitudes and CPG awareness/use. The authors found three GP profiles according to their opinions toward CPGs and a positive association between these profiles and CPG awareness but not use. It is important to build awareness of CPGs before GPs develop negative attitudes toward them. PMID:21536601

  7. Challenges of providing HIV care in general practice.

    Science.gov (United States)

    Newman, Christy E; de Wit, John B F; Crooks, Levinia; Reynolds, Robert H; Canavan, Peter G; Kidd, Michael R

    2015-01-01

    As the management of HIV changes and demand for HIV health services in primary care settings increases, new approaches to engaging the general practice workforce with HIV medicine are required. This paper reports on qualitative research conducted with 47 clinicians who provide HIV care in general practice settings around Australia, including accredited HIV s100 prescribers as well as other GPs and general practice nurses. Balanced numbers of men and women took part; less than one-quarter were based outside of urban metropolitan settings. The most significant workforce challenges that participants said they faced in providing HIV care in general practice were keeping up with knowledge, navigating low caseload and regional issues, balancing quality care with cost factors, and addressing the persistent social stigma associated with HIV. Strategic responses developed by participants to address these challenges included thinking more creatively about business and caseload planning, pursuing opportunities to share care with specialist clinicians, and challenging prejudiced attitudes amongst patients and colleagues. Understanding and supporting the needs of the general practice workforce in both high and low HIV caseload settings will be essential in ensuring Australia has the capacity to respond to emerging priorities in HIV prevention and care. PMID:24581265

  8. Quit in General Practice: a cluster randomised trial of enhanced in-practice support for smoking cessation

    Directory of Open Access Journals (Sweden)

    Zwar Nicholas

    2010-08-01

    , flexible support from the PN in partnership with the GP and the Quitline could become the preferred model for providing smoking cessation advice in Australian general practice. Trial Registration ACTRN12609001040257

  9. Conversant or clueless? Chlamydia-related knowledge and practice of general practitioners in Western Australia

    Directory of Open Access Journals (Sweden)

    Bastian Lisa

    2008-02-01

    Full Text Available Abstract Background A survey of Western Australia's general practitioners' (GPs' knowledge and practices relating to genital chlamydia infection was conducted in mid-2005, prior to a multi-media campaign which encouraged 15–24 year olds to seek chlamydia testing through their general practitioner (GP. The survey aimed to raise GPs' awareness of chlamydia in preparation for the campaign and to establish a baseline measure of their chlamydia-related knowledge and practices. Methods All 2038 GPs registered on the Australian Medical Publishing Company's database as practising in Western Australia were sent a survey which covered clinical features of chlamydia, investigations, treatment and public health issues; 576 (29% responded. Results Most GPs were aware of chlamydia being common in the 20–24 year old age group, but less than half were aware that it is common in 15–19 year olds. GPs missed many opportunities for chlamydia testing in patients likely to be at risk of STIs, largely because they thought the patient would be embarrassed. It is of concern that public health responsibilities in relation to chlamydia, ie notification and contact tracing, were not undertaken by all GPs. Conclusion Australia is currently piloting chlamydia screening. For this to be successful, GPs will need to maintain current knowledge and clinical suspicion about chlamydia, and be comfortable in asking and receiving information about sexual behaviours. Only then will GPs have a significant impact on curbing Australia's ever-increasing rates of chlamydia.

  10. Social environment and frequent attendance in Danish general practice

    DEFF Research Database (Denmark)

    Vedsted, Peter; Olesen, Frede

    2005-01-01

    of 1423 (73.7%) frequent attenders and 1103 (74.9%) infrequent attenders responded. Male frequent attendance was associated, with statistical significance, with living alone and being without work or on a disability pension. Among women, lack of professional education or being without work tended to......BACKGROUND: A lack of social support is associated with increased morbidity and mortality and a decreased effect of prevention. Frequent attenders to primary care are characterised by poorer social conditions than other patients in general practice, but we do not know whether this is due to social...... inequalities in health or whether social factors in themselves determine the use of general practice. AIM: To examine if social factors are associated with frequent attendance in general practice after adjusting for physical and psychological health variables. DESIGN OF STUDY: Population-based cross...

  11. Comparison of medical care in prison and in general practice.

    OpenAIRE

    Martin, E.

    1984-01-01

    The medical care of prisoners "declaring sick" to the medical officer and hospital officers in Bedford Prison was surveyed and compared with the medical care given to the medical officer's patients in general practice. The consultation rate of prisoners was higher than that of patients in the practice. Part of this increase was because household remedies were not available to prisoners except through the prison medical service and part may also have been due to the stresses of life in prison....

  12. Video-assisted feedback in general practice internships using German general practitioner's guidelines

    OpenAIRE

    Bolter, R.; Freund, T; Ledig, T.; Boll, B; Szecsenyi, J; Roos, M.

    2012-01-01

    Introduction: The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the possibility to spend one quarter of the internship, in the last year of their academic studies, in a practice of family medicine. The demonstrated teaching method aims at giving feedback to the student based...

  13. Practical Rehabilitation and Physical Therapy for the General Equine Practitioner.

    Science.gov (United States)

    Kaneps, Andris J

    2016-04-01

    Physical treatment and rehabilitation play major roles in recovery and maintenance of the equine athlete, and many therapeutic measures are accessible by the veterinarian in general practice. An accurate diagnosis of the condition undergoing treatment is a requirement, and measurable parameters obtained at diagnosis allows for quantification of treatment outcomes. Therapeutic modalities accessible to the general practicing veterinarian are reviewed. Mechanisms of action, indications, and treatment protocols of thermal therapy, therapeutic ultrasound, extracorporeal shock wave, and laser are discussed. Manipulative therapies, including stretching and use of core strengthening exercises and equipment, are outlined. PMID:26898959

  14. Implementation of an Arranged Preventive Consultation in Danish General Practice

    DEFF Research Database (Denmark)

    Junge, Anne Gram; Kirkegaard, Pia; Thomsen, Janus Laust

    /nurses, but must be accompanied with a basic belief in the effect of preventive consultations in general practice. The better payment of the 0106-service is used to spend more time per consultation and it makes the GPs/nurses feel rewarded for the preventive work they perform. The consultation frames a social......Background: In 2006 an arranged preventive consultation (0106-service) was implemented in Danish general practice. The purpose of the consultation is an attempt to improve the systematic prevention of the main chronic lifestyle diseases. Aim: This study examines the GP's experiences with the...

  15. Primary non-adherence to prescribed medication in general practice

    DEFF Research Database (Denmark)

    Linnet, Kristján; Halldórsson, Matthías; Thengilsdóttir, Gudrún;

    2013-01-01

    Primary non-adherence refers to the patient not redeeming a prescribed medication at some point during drug therapy. Research has mainly focused on secondary non-adherence. Prior to this study, the overall rate of primary non-adherence in general practice in Iceland was not known.......Primary non-adherence refers to the patient not redeeming a prescribed medication at some point during drug therapy. Research has mainly focused on secondary non-adherence. Prior to this study, the overall rate of primary non-adherence in general practice in Iceland was not known....

  16. Business to Consumer E-Services: Australian Accounting Practices and their Web Sites

    OpenAIRE

    Stephen Burgess; John Breen; Regina Quiazon

    2009-01-01

    This article reports on a study involving analysis of the Web sites of 100 accounting practices located in Melbourne, Australia, and subsequent interviews with twenty practices. This article focuses on identifying the level of e-services that they employ. In this regard, Angehrn’s virtual dimensions of Web site spaces were used to classify the various service delivery strategies adopted by the different practices. The results suggest that information technology plays a critical role in the ...

  17. Discourse analysis in general practice: a sociolinguistic approach.

    Science.gov (United States)

    Nessa, J; Malterud, K

    1990-06-01

    It is a simple but important fact that as general practitioners we talk to our patients. The quality of the conversation is of vital importance for the outcome of the consultation. The purpose of this article is to discuss a methodological tool borrowed from sociolinguistics--discourse analysis. To assess the suitability of this method for analysis of general practice consultations, the authors have performed a discourse analysis of one single consultation. Our experiences are presented here. PMID:2369986

  18. The role of counsellors in general practice. A qualitative study.

    OpenAIRE

    Sibbald, B.; Addington-Hall, J; Brenneman, D; Obe, P. F.

    1996-01-01

    Counselling services in general practice are now widespread but little is known about their nature or role. We therefore carried out in-depth telephone interviews with a representative sample of 72 general practitioners and 60 of their counsellors who had participated in a previous national survey of counselling services in England and Wales. Our aim was to gain greater insight into the functioning of these services in order to determine the most appropriate focus for future research and deve...

  19. Prevention in practice: what Wessex general practitioners are doing.

    OpenAIRE

    Catford, J C; Nutbeam, D

    1984-01-01

    A random sample of 214 general practitioners in the Wessex region was invited to complete a postal questionnaire about the practice of preventive medicine and 90% replied. This inquired into their attitude and behaviour towards smoking and accident prevention, promoting exercise, and controlling obesity and hypertension. The results were generally encouraging. Most recognised their key role in health promotion and health education and their shared responsibility with other professionals. Many...

  20. Psychological aspects of acute low back pain in general practice

    OpenAIRE

    Gilchrist, Iain C.

    1983-01-01

    A prospective controlled study of acute low back pain in general practice was carried out. The presence of psychiatric illness was measured by use of the general health questionnaire (GHQ), by clinical assessment, and personality factors by use of the Eysenck personality inventory (EPI). It was found that overall the amount of psychiatric illness did not differ between patients with back pain and their controls at the time of presentation, although there was a higher prevalence of previous ps...

  1. The general practice formulary — its role in rational therapeutics

    OpenAIRE

    Green, Philip E.

    1985-01-01

    This paper describes a project in which a voluntary preferred prescribing list (general practice formulary), analogous to those already in use in some hospitals, was created, implemented and monitored. Cooperation between a pharmacist with knowledge of drug information, access to specialist advice and back-up in the form of evaluated information from drug information centres and a group of five general practitioners and their trainees was necessary.

  2. A Practical Orthography for Kuuk Thaayorre. Australian Review of Applied Linguistics, Vol. l, No. 2.

    Science.gov (United States)

    Hall, Allen

    A practical orthography is presented for Kuuk Thaayorre, which is spoken by over 300 Aborigines in Australia. The phonemes in Thaayorre and the way they are symbolized in normal writing practice are presented. Frequent occurrence of six conventional digraphs for some Thaayorre consonants has given rise to complementary orthography as an initial…

  3. Australian Middle Eastern parents' perceptions and practices of children's weight-related behaviours: Talking with Parents' Study.

    Science.gov (United States)

    Hardy, Louise L; Hector, Debra; Saleh, Shay; King, Lesley

    2016-09-01

    The home environment is associated with obesity-related behaviours among children, and research in Australia has shown that some of these behaviours are more prevalent among children from particular cultural backgrounds including Middle Eastern. This study presents findings from face-to-face, semi-structured interviews conducted in April 2013 with a convenience sample of Middle Eastern parents of primary school-age children at an Islamic private school in Sydney, Australia. The interviews explored parental perceptions and practices regarding state government health messages addressing children's eating, physical activity and screen time. The purpose of the study was to investigate whether the content of these generic public health messages is relevant and acceptable to Middle Eastern parents of young children, and to identify any enablers and barriers to adopting these healthy practices at home. Thematic analysis identified predominant themes. In total, 21 interviews were conducted (reference children: 12 boys/9 girls, aged 5-12 years). The content of current health messages regarding children's weight-related behaviours was familiar to respondents, and accepted as relevant for guiding their parenting practices. Parents perceived that they typically encouraged healthy behaviours, although they also reported making regular exemptions, in response to various circumstances. Overall, the perceptions and reported practices of the parents were consistent with other studies with Australian parents. There were no apparent culturally specific barriers or enablers to children's weight-related behaviours. There is however scope for health promoters to provide more precise information on health recommendations, health risks and benefits, and to provide more specific ideas for ways in which parents can act on these health messages within the home and family environment, to encourage and support healthy behaviours in their children. PMID:25929280

  4. Video-assisted feedback in general practice internships using German general practitioner's guidelines

    NARCIS (Netherlands)

    Bolter, R.; Freund, T.; Ledig, T.; Boll, B.; Szecsenyi, J.; Roos, M.

    2012-01-01

    Introduction: The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the possibilit

  5. A joint course for general practitioner and practice nurse trainers.

    OpenAIRE

    Bolden, K. J.; Lewis, A P

    1990-01-01

    An experimental multidisciplinary course for prospective general practitioner and practice nurse trainers is described. Factual knowledge and attitudes were measured before and after the course and some of the changes measured emphasized the importance of multidisciplinary training. The ideas generated by the group of nurse trainers in terms of their future professional development were identified.

  6. Sustainability economics: General versus specific, and conceptual versus practical

    OpenAIRE

    Baumgärtner, Stefan; Quaas, Martin

    2010-01-01

    We clarify the definition and interpretation of “sustainability economics” (Baumgärtner and Quaas 2010) in response to recent comments by van den Bergh (2010), Bartelmus (2010) and others. For that sake, we distinguish between general and specific definitions of sustainability and sustainability economics, as well as between conceptual and practical approaches.

  7. Management of bibliographic information by Dutch researchers in general practice

    NARCIS (Netherlands)

    Verhoeven, AAH; Jong, BMD

    1997-01-01

    Background. As a result of changes in information technology and the rapid growth of publications methods of searching the literature have changed. Systematic searching of the growing literature has become very important. It is not known whether researchers in general practice search systematically,

  8. General practice: a secondment from emergency medicine--so what!

    OpenAIRE

    Nicol, M. F.; McLauchlan, C A

    1998-01-01

    The Joint Committee for Higher Medical Training has issued a core curriculum for training in accident and emergency medicine. This article highlights some of the knowledge, skills, and attitudes one may usefully gain from a period of 6-12 months in general practice and how this can be integrated and adapted to a career in emergency medicine.

  9. Digital Competence: general problems and experimental practices concerning highschools

    OpenAIRE

    Roberto Gris

    2015-01-01

    In the current social context Information and Communication Technologies (ICT) are more and more present and pervasive and the European institutions enter the Digital Competence in the Key Competences for Lifelong Learning. In this focus we are deepened the general problems of Digital Competence and competence-based education and to describe experimental practices concerning highschools.

  10. Organisational development in general practice: lessons from practice and professional development plans (PPDPs)

    OpenAIRE

    Hocking Paul; Elwyn Glyn

    2000-01-01

    Abstract Background Improving the quality and effectiveness of clinical practice is becoming a key task within all health services. Primary medical care, as organised in the UK is composed of clinicians who work in independent partnerships (general practices) that collaborate with other health care professionals. Although many practices have successfully introduced innovations, there are no organisational development structures in place that support the evolution of primary medical care towar...

  11. Osteoarthritis of the hip and/or knee in Dutch general practice and physiotherapy practice.

    NARCIS (Netherlands)

    Barten, D.J.; Swinkels, I.C.; Dorsman, S.A.; Veenhof, C.

    2012-01-01

    Purpose: To describe demographic characteristics and the treatment process of patients with hip osteoarthritis (OA) or knee OA treated in Dutch general practice (GP) and/or physiotherapy practice. Additionally, to investigate whether there are differences in characteristics between referred and non-

  12. Open-access ultrasound referrals from general practice.

    LENUS (Irish Health Repository)

    Hughes, P

    2015-03-01

    Direct access referral for radiological investigations from General Practice (GP) provides an indispensable diagnostic tool and avoids the inherently long waiting time that referral through a hospital based specialty would entail. Improving access to hospital based radiology services is one of Health Information and Quality Authority\\'s key recommendations in its report on patient referrals from general practice. This study aimed to review all GP referrals for ultrasound investigations to a tertiary referral teaching hospital over a seven month period with respect to their demographics, waiting times and diagnostic outcomes. 1,090 ultrasounds originating in general practice were carried out during the study period. Positive findings were recorded in 332 (30.46%) examinations. The median waiting time from receipt of referral to the diagnostic investigation was 56 days (range 16 - 91 years). 71 (6.5%) patients had follow-up imaging investigations while recommendation for hospital based specialty referral was made in 35 cases (3.2%). Significant findings included abdominal aortic aneurysms, metastatic disease and lymphoma. Direct access to ultrasound for general practitioners allows the referring physician to make an informed decision with regard to the need for specialist referral. We believe these findings help support the case for national direct access to diagnostic ultrasound for general practitioners.

  13. Poor Knowledge and Practices Related to Iodine Nutrition during Pregnancy and Lactation in Australian Women: Pre- and Post-Iodine Fortification

    Directory of Open Access Journals (Sweden)

    Fiona Houweling

    2012-09-01

    Full Text Available A before-after review was undertaken to assess whether knowledge and practices related to iodine nutrition, supplementation and fortification has improved in Australian women since the introduction of mandatory iodine fortification in 2009. Surveys of pregnant (n = 139 and non-pregnant (n = 75 women in 2007–2008 are compared with surveys of pregnant (n = 147 and lactating women (n = 60 one to two years post-fortification in a regional area of New South Wales, Australia. A self-administered questionnaire was completed and dietary intake of iodine was assessed using a validated food frequency questionnaire. A generally poor knowledge about the role and sources of iodine in the diet remained after fortification. Post-fortification, iodine-containing supplements were being taken by 60% (up from 20% pre-fortification and 45% of pregnant and lactating women, respectively. Dairy foods were the highest contributors to dietary iodine intake (57%–62%. A low intake of fish and seafood resulted in this food group contributing only 3%–8% of total intake. A low level of public awareness regarding the role of iodine in health supports the need for public health strategies in addition to fortification, such as an accompanying consumer education campaign, increased uptake of supplementation, and on-going monitoring.

  14. Poor knowledge and practices related to iodine nutrition during pregnancy and lactation in Australian women: pre- and post-iodine fortification.

    Science.gov (United States)

    Charlton, Karen; Yeatman, Heather; Lucas, Catherine; Axford, Samantha; Gemming, Luke; Houweling, Fiona; Goodfellow, Alison; Ma, Gary

    2012-09-01

    A before-after review was undertaken to assess whether knowledge and practices related to iodine nutrition, supplementation and fortification has improved in Australian women since the introduction of mandatory iodine fortification in 2009. Surveys of pregnant (n = 139) and non-pregnant (n = 75) women in 2007-2008 are compared with surveys of pregnant (n = 147) and lactating women (n = 60) one to two years post-fortification in a regional area of New South Wales, Australia. A self-administered questionnaire was completed and dietary intake of iodine was assessed using a validated food frequency questionnaire. A generally poor knowledge about the role and sources of iodine in the diet remained after fortification. Post-fortification, iodine-containing supplements were being taken by 60% (up from 20% pre-fortification) and 45% of pregnant and lactating women, respectively. Dairy foods were the highest contributors to dietary iodine intake (57%-62%). A low intake of fish and seafood resulted in this food group contributing only 3%-8% of total intake. A low level of public awareness regarding the role of iodine in health supports the need for public health strategies in addition to fortification, such as an accompanying consumer education campaign, increased uptake of supplementation, and on-going monitoring. PMID:23112919

  15. Australian intern pharmacists’ perceived preparedness for practice, and their expectations and experiences of the internship year and future career intentions

    Directory of Open Access Journals (Sweden)

    Mak VSL

    2013-11-01

    Full Text Available Vivienne SL Mak,1,2 Geoff March,2 Alice Clark,2 Andrew L Gilbert21Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia; 2Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, AustraliaBackground: A key objective of Australia's health care reform is a skilled, flexible, and well-trained workforce. To meet these requirements, the training of health professionals, including pharmacists, needs to be focused on patient care processes, and students must develop competencies in the delivery of patient care. Pharmacy graduates need to be well prepared for new and alternative career pathways through their education and training, to be a part of the future workforce. This study explores Australian intern pharmacists' perceived preparedness for practice, the match between their expectations and experience to meet the requirements of health professionals in Australia's health care reforms, and their future career intentions.Methods: Two questionnaires were sent by post to all 136 intern pharmacists in South Australia; one was sent early in their internship and the second follow-up questionnaire was sent near the completion of their internship.Results: Pharmacy graduates felt prepared for patient care, medicines information, and primary health care roles. A mismatch between expectations and actual experiences was found. By the end of the internship, 45% agree/strongly agree that they wanted to do something else other than being a practicing pharmacist.Conclusion: The current internship model no longer meets the needs and expectations of knowledgeable and skilled pharmacy graduates. An alternative internship model, which considers the expectations of graduates, is required.Keywords: intern pharmacist, preparedness, expectations, experiences, internship, future career

  16. Reducing suicidal thoughts in the Australian general population through web-based self-help: study protocol for a randomized controlled trial

    OpenAIRE

    van Spijker, Bregje AJ; Calear, Alison L; Batterham, Philip J; Mackinnon, Andrew J.; Gosling, John A; Kerkhof, Ad JFM; Solomon, Daniela; Christensen, Helen

    2015-01-01

    Background Suicidal thoughts are common in the general population, causing significant disability. However, a substantial number of people struggling with suicidality do not access appropriate services. Online self-help may help overcome barriers to help-seeking. This study aims to examine the effectiveness of an online self-help program targeted at reducing suicidal thoughts compared with an attention-matched control condition in the Australian adult population. This trial is based on a Dutc...

  17. General practice and primary health care in Denmark

    DEFF Research Database (Denmark)

    Møller Pedersen, Kjeld; Andersen, John Sahl; Søndergaard, Jens

    2012-01-01

    postgraduate education. The contract is (re)negotiated every 2 years. General practice is embedded in a universal tax-funded health care system in which GP and hospital services are free at the point of use. The current system has evolved over the past century and has shown an ability to adapt flexibly to new...... is expected to accelerate, in part because of the GP age structure, with many GPs retiring and new GPs not wanting to practice alone. This latter workforce trend is pointing toward a new model with employed GPs, particularly in rural areas....

  18. Diffusion of new drugs in Danish general practice

    DEFF Research Database (Denmark)

    Steffensen, Flemming Hald; Sørensen, Henrik Toft; Olesen, Frede

    1999-01-01

    prescribers. The shape and slope of the diffusion curve were highly drug dependent. There was poor agreement of the three adopter categories (early, intermediate and late prescribers) between the five drugs (kappa < 0.35), but being a late prescriber was the most consistent condition. Late prescribing of......OBJECTIVES: There is a large variation in implementing research findings in clinical practice. We examined whether the concept of early or late adopters is universal for the diffusion of all new drugs, and whether it is associated with non-scientific factors in general practice. METHODS: We...

  19. Poor Knowledge and Practices Related to Iodine Nutrition during Pregnancy and Lactation in Australian Women: Pre- and Post-Iodine Fortification

    OpenAIRE

    Fiona Houweling; Gary Ma; Alison Goodfellow; Luke Gemming; Samantha Axford; Catherine Lucas; Heather Yeatman; Karen Charlton

    2012-01-01

    A before-after review was undertaken to assess whether knowledge and practices related to iodine nutrition, supplementation and fortification has improved in Australian women since the introduction of mandatory iodine fortification in 2009. Surveys of pregnant (n = 139) and non-pregnant (n = 75) women in 2007–2008 are compared with surveys of pregnant (n = 147) and lactating women (n = 60) one to two years post-fortification in a regional area of New South Wales, Australia. A self-administere...

  20. On the Borders: Adjusting to Academic, Social and Cultural Practices at an Australian University

    Science.gov (United States)

    Buchanan, John; Ljungdahl, Lesley; Maher, Damian

    2015-01-01

    Adjustment to university is challenging for students as they navigate a path through new academic, social and cultural practices. Some may feel on the borders, marginalised by their background. Issues such as adjustment to university life, independence, performance expectations, establishing friendships, technological competence, cultural capital,…

  1. Family Literacy Practices and Home Literacy Resources: An Australian Pilot Study

    Science.gov (United States)

    Grieshaber, Susan; Shield, Paul; Luke, Allan; Macdonald, Shelly

    2012-01-01

    The combined impact of social class, cultural background and experience upon early literacy achievement in the first year of schooling is among the most durable questions in educational research. Links have been established between social class and achievement but literacy involves complex social and cognitive practices that are not necessarily…

  2. Simulation to Practice: Developing Nursing Skills in Mental Health--An Australian Perspective

    Science.gov (United States)

    Edward, Karen-leigh; Hercelinskyj, Julie; Warelow, Philip; Munro, Ian

    2007-01-01

    A variety of developments in nursing education in Australia including some innovative and exciting models, educational enterprises between education and industry, and evidence of developing strengths in research and professional alliances on a national level have been discussed recently. This paper presents Simulation to Practice as an example of…

  3. Being good neighbours : Current practices, barriers, and opportunities for community engagement in Australian plantation forestry

    NARCIS (Netherlands)

    Gordon, Melissa; Schirmer, Jacki; Lockwood, Michael; Vanclay, Frank; Hanson, Dallas

    2013-01-01

    Although community engagement (CE) is widely recognised as an essential element of sustainable management, few studies have evaluated CE at an industry-wide scale, i.e. in terms of the specific CE needs and best practice methods needed when addressing engagement issues that apply across more than on

  4. Integrating relationship- and research-based approaches in Australian health promotion practice.

    Science.gov (United States)

    Klinner, Christiane; Carter, Stacy M; Rychetnik, Lucie; Li, Vincy; Daley, Michelle; Zask, Avigdor; Lloyd, Beverly

    2015-12-01

    We examine the perspectives of health promotion practitioners on their approaches to determining health promotion practice, in particular on the role of research and relationships in this process. Using Grounded Theory methods, we analysed 58 semi-structured interviews with 54 health promotion practitioners in New South Wales, Australia. Practitioners differentiated between relationship-based and research-based approaches as two sources of knowledge to guide health promotion practice. We identify several tensions in seeking to combine these approaches in practice and describe the strategies that participants adopted to manage these tensions. The strategies included working in an evidence-informed rather than evidence-based way, creating new evidence about relationship-based processes and outcomes, adopting 'relationship-based' research and evaluation methods, making research and evaluation useful for communities, building research and evaluation skills and improving collaboration between research and evaluation and programme implementation staff. We conclude by highlighting three systemic factors which could further support the integration of research-based and relationship-based health promotion practices: (i) expanding conceptions of health promotion evidence, (ii) developing 'relationship-based' research methods that enable practitioners to measure complex social processes and outcomes and to facilitate community participation and benefit, and (iii) developing organizational capacity. PMID:24800758

  5. Operator priming and generalization of practice in adults' simple arithmetic.

    Science.gov (United States)

    Chen, Yalin; Campbell, Jamie I D

    2016-04-01

    There is a renewed debate about whether educated adults solve simple addition problems (e.g., 2 + 3) by direct fact retrieval or by fast, automatic counting-based procedures. Recent research testing adults' simple addition and multiplication showed that a 150-ms preview of the operator (+ or ×) facilitated addition, but not multiplication, suggesting that a general addition procedure was primed by the + sign. In Experiment 1 (n = 36), we applied this operator-priming paradigm to rule-based problems (0 + N = N, 1 × N = N, 0 × N = 0) and 1 + N problems with N ranging from 0 to 9. For the rule-based problems, we found both operator-preview facilitation and generalization of practice (e.g., practicing 0 + 3 sped up unpracticed 0 + 8), the latter being a signature of procedure use; however, we also found operator-preview facilitation for 1 + N in the absence of generalization, which implies the 1 + N problems were solved by fact retrieval but nonetheless were facilitated by an operator preview. Thus, the operator preview effect does not discriminate procedure use from fact retrieval. Experiment 2 (n = 36) investigated whether a population with advanced mathematical training-engineering and computer science students-would show generalization of practice for nonrule-based simple addition problems (e.g., 1 + 4, 4 + 7). The 0 + N problems again presented generalization, whereas no nonzero problem type did; but all nonzero problems sped up when the identical problems were retested, as predicted by item-specific fact retrieval. The results pose a strong challenge to the generality of the proposal that skilled adults' simple addition is based on fast procedural algorithms, and instead support a fact-retrieval model of fast addition performance. (PsycINFO Database Record PMID:26461035

  6. Open Access to General Practice Was Associated with Burnout among General Practitioners.

    Science.gov (United States)

    Vedsted, Peter; Sokolowski, Ineta; Olesen, Frede

    2013-01-01

    Walk-in open access in general practice may influence the general practitioner's (GP's) work, but very little research has been done on the consequences. In this study from Danish general practice, we compare the prevalence of burnout between GPs with a walk-in open access and those without. In a questionnaire study (2004), we approached all 458 active GPs in the county of Aarhus, Denmark, and 376 (82.8%) GPs returned the questionnaire. Walk-in open access was defined as at least 30 minutes every weekday where patients could attend practice without an appointment. Burnout was measured by the Maslach Burnout Inventory. Analyses using logistic regression were adjusted for gender, age, marital status, job satisfaction, minutes per consultation, practice organisation, working hours, number of listed patients per GP, number of contacts per GP, continuing medical education- (CME-) activities, and clusters of GPs. In all, 8% of GPs had open access and the prevalence of burnout was 24%. GPs with walk-in open access were more likely to suffer from burnout. Having open access was associated with a 3-fold increased likelihood of burnout (OR = 3.1 (95% CI: 1.1-8.8, P = 0.035)). Although the design cannot establish causality, it is recommended to closely monitor possible negative consequences of open access in general practice. PMID:23401770

  7. Traumatic and Non-traumatic Knee Complaints in General Practice

    OpenAIRE

    Kastelein, Marlous

    2013-01-01

    textabstractGeneral practitioners (GPs) are frequently consulted by patients with various types of knee complaints. The incidence of these knee complaints presented in Dutch general practice is about 13.7 per 1000 registered patients per year with a prevalence of 19.0 per 1000 patients per year. About 80% of these knee complaints are of non-­‐traumatic origin. The most common non-­‐traumatic diagnosis varies with age; adolescents and young adults suffer mostly from patellofemoral pain syndrom...

  8. Hesitative introduction of E-mail consultations in general practice.

    OpenAIRE

    Verheij, R.; Ton, C.; Tates, K.

    2008-01-01

    Introduction: The Dutch Council for Public Health and Health Care reported in 2005 that 70% of internet users would want to have the opportunity to consult their own general practitioner by e-mail [1]. Since January 1, 2006, general practitioners in the Netherlands are reimbursed 4.50 euro for e-mail consultations, on the condition that it does not concern a new health problem and that it substitutes for a normal practice consultation. In this presentation we will investigate how many doctors...

  9. The uses and implications of standards in general practice consultations

    DEFF Research Database (Denmark)

    Lippert, Maria Laura; Reventlow, Susanne; Kousgaard, Marius Brostrøm

    2016-01-01

    Quality standards play an increasingly important role in primary care through their inscription in various technologies for improving professional practice. While ‘hard’ biomedical standards have been the most common and debated, current quality development initiatives increasingly seek to include...... standards for the ‘softer’ aspects of care. This article explores the consequences of both kinds of quality standards for chronic care consultations. The article presents findings from an explorative qualitative field study in Danish general practice where a standardized technology for quality development...... disease consultations. However, at the same time, adherence to those standards was observed to narrow the focus of doctor–patient dialogues and to divert general practitioners’ attention from patients’ personal concerns. Similar consequences of quality standards have previously been framed as...

  10. General practice--a post-modern specialty?

    Science.gov (United States)

    Mathers, N; Rowland, S

    1997-01-01

    The 'modern' view of the world is based on the premise that we can discover the essential truth of the world using scientific method. The assumption is made that knowledge so acquired has been 'uncontaminated' by the mind of the investigator. Post-modern theory, however, is concerned with the process of knowing and how our minds are part of the process, i.e. our perceptions of reality and the relationships between different concepts are important influences on our ways of knowing. The values of post-modern theory are those of uncertainty, many different voices and experiences of reality and multifaceted descriptions of truth. These values are closer to our experience of general practice than the 'modern' values of scientific rationalism and should be reflected in a new curriculum for general practice. PMID:9167325

  11. The cost-effectiveness of point of care testing in a general practice setting: results from a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Briggs Nancy E

    2010-06-01

    Full Text Available Abstract Background While point of care testing (PoCT for general practitioners is becoming increasingly popular, few studies have investigated whether it represents value for money. This study aims to assess the relative cost-effectiveness of PoCT in general practice (GP compared to usual testing practice through a pathology laboratory. Methods A cost-effectiveness analysis based on a randomized controlled trial with 4,968 patients followed up for 18 months and fifty-three general practices in urban, rural and remote locations across three states in Australia. The incremental costs and health outcomes associated with a clinical strategy of PoCT for INR, HbA1c, lipids, and ACR were compared to those from pathology laboratory testing. Costs were expressed in year 2006 Australian dollars. Non-parametric bootstrapping was used to generate 95% confidence intervals. Results The point estimate of the total direct costs per patient to the health care sector for PoCT was less for ACR than for pathology laboratory testing, but greater for INR, HbA1c and Lipids, although none of these differences was statistically significant. PoCT led to significant cost savings to patients and their families. When uncertainty around the point estimates was taken into account, the incremental cost-effectiveness ratio (ICER for PoCT was found to be unfavourable for INR, but somewhat favourable for ACR, while substantial uncertainty still surrounds PoCT for HbA1c and Lipids. Conclusions The decision whether to fund PoCT will depend on the price society is willing to pay for achievement of the non-standard intermediate outcome indicator. Trial registration Australian New Zealand Clinical Trial Registry ACTRN12605000272695

  12. Endoscopic studies of dyspepsia in a general practice.

    OpenAIRE

    Gear, M. W.; Barnes, R. J.

    1980-01-01

    In an urban general practice serving 7800 patients, all patients presenting over five and a half years with dyspepsia lasting more than two weeks were investigated by fibreoptic endoscopy and cholecystography, and many by barium meal. Of the 393 patients with dyspepsia, 346 completed the investigation: 180 had specific disease of the oesophagus, stomach, duodenum, or gall bladder, including six with carcinoma. Al further 67 had mucosal disease, and only 99 patients had no abnormality. After t...

  13. Impact of an audiology clinic in one general practice.

    OpenAIRE

    Khunti, K; Carr, M

    1997-01-01

    There is a large demand for the provision of hearing aids. However, there are lengthy delays involved between referral and fitment of National Health Service (NHS) hearing aids. This report shows that a general practice based audiology clinic can lead to an increase in the number of patients referred and fitted with a hearing aid. The introduction of the clinic also led to reduced waiting times for patients to be fitted with hearing aids.

  14. Communicating fatigue in general practice and the role of gender

    OpenAIRE

    Meeuwesen, L.; Bensing, J.; Brink-Muinen, A. van den

    2002-01-01

    From the viewpoint of quality of care, doctor-patient communication has become more and more important. Gender is an important factor in communication. Besides, cultural norms and values are likely to influence doctor-patient communication as well. This study examined (1) whether or not communication patterns of gender-dyads in general practice consultations differ across and between Western-European countries, and (2) if so, whether these differences continue to exist when controlling for pa...

  15. General practice registrars as teachers: a questionnaire-based evaluation

    OpenAIRE

    Williams, Bronwen; Amiel, Cressida

    2012-01-01

    Objectives To determine how many General Practice (GP) Registrars in the London Deanery taught medical students during their final year of training. For those who did teach, to evaluate their experiences and for those who did not, to identify perceived barriers to teaching. Design Cross sectional survey of GP Registrars in the London Deanery completing their training in August 2010. Setting Online survey of GP Registrars sent after completion of training via the London Deanery GP Vocational T...

  16. Screening for type 2 diabetes in general practice

    OpenAIRE

    Janssen, P. G. H.

    2008-01-01

    The presented studies were conducted within the framework of the international ADDITION study (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care), a randomised controlled trial in 3,057 screen-detected type 2 diabetic patients. The aim of ADDITION is to evaluate whether screening for type 2 diabetes in general practice is feasible and subsequent intensified, multifactorial treatment beneficial. Intensified treatment consisted of pharmacolo...

  17. Globalization and classroom practice: insights on learning about the world in Swedish and Australian schools

    OpenAIRE

    Ruth Reynolds; Monika Vinterek

    2013-01-01

    Globalization and global education implies changes to practices at the classroom level to adapt to new imperatives associated with technology use and awareness, and environmental sustainability. It also implies much more. It implies that teachers apply their classroom pedagogy to take account of students’ new found global understandings of which they, and the school community, is largely unaware. This article addresses and discuses three key consequences of globalization for classrooms worldw...

  18. The results of an Australian and New Zealand Survey on the current practice of chest immobilisation during radiation therapy

    International Nuclear Information System (INIS)

    To determine how widely chest immobilisation and 3D planning are currently being used, a survey was sent to each Chief Radiation Therapist of Australia (31) and New Zealand (6) in 2001. Questions were focused to radiation therapy practice when planning and treating patients with lung cancer with curative intent. There was a high response rate of 86 per cent (32/37) from the Radiation Oncology Departments of Australia (26/31) and New Zealand (6/6). 87.5 per cent (28/32) of departments use chest immobilisation (Australia, 22/26; New Zealand, 6/6) and of these, 82.1 per cent (23/28) use a 3D planning system. Furthermore, 78.6 per cent (22/28) practice conformal therapy. There are three main devices for chest immobilisation that are routinely used in Australia and one in New Zealand. The devices comprise: a) Personally contoured chest immobilisation (6/22) such as Vac Fix(Registered Trade Mark). This was the only device used in New Zealand. b) Adjustable chest immobilisation (7/22), consisting of movable shoulder and hand support such as Wing Board (Med-Tec(Registered Trade Mark)) or a device created in the department. c) A device comprised of (a) and (b), utilising the personalised contoured device and adjustable hand and shoulder supports (9/22). The results also showed that 65.6% (21/32) of users of chest immobilisation and no immobilisation reported satisfaction with the devices utilised in their department. Chest immobilisation was routinely used in 90.5% (19/21) of these departments. Copyright (2003) Australian Institute of Radiography

  19. [The practice guideline 'Anemia' from the Dutch College of General Practitioners; a response from the perspective of general practice medicine].

    Science.gov (United States)

    van den Bosch, W J

    2003-10-01

    The practice guideline 'Anaemia' from the Dutch College of General Practitioners will certainly be a support for the Dutch general practitioner. The inclusion of an algorithm to make a more precise diagnosis is an experiment that needs to be evaluated in the near future. However, many general practitioners will regard it as too complex for use in daily practice and specialists will find it to be of limited use, as it does not cover all cases. Consultation between the general practitioner and the specialist will give the best answer in complicated cases. Patients who complain about tiredness or dizziness will expect their general practitioner to take a blood sample for a haemoglobin test. The general practitioner will consider the risk of false-positive test results in interpreting the patient's haemoglobin level. A few concrete remarks: the guideline does not mention that vegetarianism and a low meat intake can increase the risk of vitamin B12 deficiency, and iron suppletion is advised in premenopausal women with profuse vaginal blood loss, whereas there are several treatable disorders that may cause menorrhagia. PMID:14574775

  20. General practice training and virtual communities of practice - a review of the literature

    Directory of Open Access Journals (Sweden)

    Barnett Stephen

    2012-08-01

    Full Text Available Abstract Background Good General Practice is essential for an effective health system. Good General Practice training is essential to sustain the workforce, however training for General Practice can be hampered by a number of pressures, including professional, structural and social isolation. General Practice trainees may be under more pressure than fully registered General Practitioners, and yet isolation can lead doctors to reduce hours and move away from rural practice. Virtual communities of practice (VCoPs in business have been shown to be effective in improving knowledge sharing, thus reducing professional and structural isolation. This literature review will critically examine the current evidence relevant to virtual communities of practice in General Practice training, identify evidence-based principles that might guide their construction and suggest further avenues for research. Methods Major online databases Scopus, Psychlit and Pubmed were searched for the terms “Community of Practice” (CoP AND (Online OR Virtual OR Electronic AND (health OR healthcare OR medicine OR “Allied Health”. Only peer-reviewed journal articles in English were selected. A total of 76 articles were identified, with 23 meeting the inclusion criteria. There were no studies on CoP or VCoP in General Practice training. The review was structured using a framework of six themes for establishing communities of practice, derived from a key study from the business literature. This framework has been used to analyse the literature to determine whether similar themes are present in the health literature and to identify evidence in support of virtual communities of practice for General Practice training. Results The framework developed by Probst is mirrored in the health literature, albeit with some variations. In particular the roles of facilitator or moderator and leader whilst overlapping, are different. VCoPs are usually collaborations between stakeholders

  1. Do quality indicators for general practice teaching practices predict good outcomes for students?

    Science.gov (United States)

    Bartlett, Maggie; Potts, Jessica; McKinley, Bob

    2016-07-01

    Keele medical students spend 113 days in general practices over our five-year programme. We collect practice data thought to indicate good quality teaching. We explored the relationships between these data and two outcomes for students; Objective Structured Clinical Examination (OSCE) scores and feedback regarding the placements. Though both are surrogate markers of good teaching, they are widely used. We collated practice and outcome data for one academic year. Two separate statistical analyses were carried out: (1) to determine how much of the variation seen in the OSCE scores was due to the effect of the practice and how much to the individual student. (2) to identify practice characteristics with a relationship to student feedback scores. (1) OSCE performance: 268 students in 90 practices: six quality indicators independently influenced the OSCE score, though without linear relationships and not to statistical significance. (2) Student satisfaction: 144 students in 69 practices: student feedback scores are not influenced by practice characteristics. The relationships between the quality indicators we collect for practices and outcomes for students are not clear. It may be that neither the quality indicators nor the outcome measures are reliable enough to inform decisions about practices' suitability for teaching. PMID:27117344

  2. Treatment of heart failure in Dutch general practice

    Directory of Open Access Journals (Sweden)

    van den Bosch Wil JHM

    2006-07-01

    Full Text Available Abstract Background To study the relation between the prescription rates of selected cardiovascular drugs (ACE-inhibitors and Angiotensin receptor blockers, beta-blockers, diuretics, and combinations, sociodemographic factors (age, gender and socioeconomic class and concomitant diseases (hypertension, coronary heart disease, cerebrovascular accident, heart valve disease, atrial fibrillation, diabetes mellitus and asthma/COPD among patients with heart failure cared for in general practice. Methods Data from the second Dutch National Survey in General Practice, conducted mainly in 2001. In this study the data of 96 practices with a registered patient population of 374.000 were used. Data included diagnosis made during one year by general practitioners, derived from the electronic medical records, prescriptions for medication and sociodemographic characteristics collected via a postal questionnary (response 76% Results A diagnosis of HF was found with 2771 patients (7.1 in 1000. Their mean age was 77.7 years, 68% was 75 years or older, 55% of the patients were women. Overall prescription rates for RAAS-I, beta-blockers and diuretics were 50%, 32%, 86%, respectively, whereas a combination of these three drugs was prescribed in 18%. Variations in prescription rates were mainly related to age and concomitant diseases. Conclusion Prescription is not influenced by gender, to a small degree influenced by socioeconomic status and to a large degree by age and concomitant diseases.

  3. Spirometry in general practice: the performance of practice assistants scored by lung function technicians.

    OpenAIRE

    Otter, J.J. den; Knitel, M; Akkermans, R P; C P van Schayck; Folgering, H.T.M.; van Weel, C

    1997-01-01

    Recently, spirometers have become available for use within general practice as an alternative to peak flow meters. This study investigates whether practice assistants, after comprehensive training, can effectively carry out spirometry with patients suffering from asthma and other chronic obstructive pulmonary diseases. A scoring system, consisting of 20 items, was devised to determine the effectiveness of the assistants' instructions and to assess the patient's subsequent use of the spiromete...

  4. Gastro-oesophageal reflux disease (GORD) in Australian general practice patients.

    Science.gov (United States)

    Miller, Graeme; Wong, Carmen; Pollack, Allan

    2015-10-01

    Gastro-oesophageal reflux disease (GORD) imposes a high level of societal and financial burden on the community. Recently, concern has been expressed regarding the number of prescriptions for proton pump inhibitors (PPIs), mostly for GORD, in Australia. This study investigated changes in the management of GORD since 2006–08. This was a secondary analysis of data from the Bettering the Evaluation and Care of Health (BEACH) program. There was an increase of about 15% in the management rate of GORD between 2006–08 and 2012–14. Medication rates were high, with 95 prescriptions per 100 GORD problems managed, of which 83% were for PPIs. Most patients with GORD are on long-term PPI therapy, usually at full dosage. Trials of cessation or dosage reduction may be appropriate in many patients. PMID:26484482

  5. The Case for Family-Friendly Work Practices in the Australian Construction Industry

    Directory of Open Access Journals (Sweden)

    Valerie Francis

    2012-11-01

    Full Text Available Although significant changes at the social, demographic, technological and workforce levelshave transformed the relationship between family and work, these changes have notbeen reflected in the employment practices of many construction companies. Many of thejob and organisational factors found to be negatively associated with family functioning arepertinent to construction professionals. Staff are expected to work long hours in demandingroles and this, combined with job insecurity and frequent relocation, means that familylife and individual well-being can be compromised. A growing body of research has foundthat the implementation of family-friendly work policies and practices can lead to greaterproductivity, lower attrition rates and higher morale in the workplace. In addition providinga work environment that is supportive of workers' family roles can help to alleviate workrelatedmental health problems.This paper outlines the changing demographic trends and societal attitudes that are makingindividuals and organisations question current work cultures and structures. Optionsfor making the construction industry a more family-friendly work environment are considered.All professionals, regardless of their age, gender and family responsibilities, canbenefit from these initiatives. The paper concludes by discussing the implications of theseissues for construction companies and future research work.

  6. Best practice guidelines for the operation of a donor human milk bank in an Australian NICU.

    Science.gov (United States)

    Hartmann, B T; Pang, W W; Keil, A D; Hartmann, P E; Simmer, K

    2007-10-01

    Until the establishment of the PREM Bank (Perron Rotary Express Milk Bank) donor human milk banking had not occurred in Australia for the past 20 years. In re-establishing donor human milk banking in Australia, the focus of the PREM Bank has been to develop a formal and consistent approach to safety and quality in processing during the operation of the human milk bank. There is currently no existing legislation in Australia that specifically regulates the operation of donor human milk banks. For this reason the PREM Bank has utilised existing and internationally recognised management practices for managing hazards during food production. These tools (specifically HACCP) have been used to guide the development of Standard Operating Procedures and Good Manufacturing Practice for the screening of donors and processing of donor human milk. Donor screening procedures are consistent with those recommended by other human milk banks operating internationally, and also consistent with the requirements for blood and tissue donation in Australia. Controlled documentation and record keep requirements have also been developed that allow complete traceability from individual donation to individual feed dispensed to recipient and maintain a record of all processing and storage conditions. These operational requirements have been developed to reduce any risk associated with feeding pasteurised donor human milk to hospitalised preterm or ill infants to acceptable levels. PMID:17913402

  7. Transformation of the Australian Public Sector and Environmental Accounting Practices: the Case of Water in 2001

    Directory of Open Access Journals (Sweden)

    David Moore

    2008-03-01

    Full Text Available This paper analyses a case study undertaken in 2001 of a Victorian public sector water utility to examine theimplications of public sector ‘modernisation’ reforms of the 1980s and 1990s for the adoption ofenvironmental accounting (EA procedures within the Victorian water industry. Legislative reforms haveresulted in the allocation of overhead costs for the purpose of segmented reporting and to measure the ‘fullcost’ of departments. This was consistent with the “managerialist”, “marketization” and “strategic” phases ofpublic sector ‘modernisation’ reforms, but did not measure the full economic (environmental cost. Theapplication of full cost recovery for the purpose of efficiency was further evidence of the impact of publicsector modernisation reforms but did not extend to the recovery of externalities. Private environmental costswere traced and integrated into direct cost categories, consistent with the philosophy of managerialism. Costswere measured for the purposes of promoting the contracting out of selected services and functions. Therewas limited adoption of environmental accounting practices, due to the absence of environmental accountingmeasurement guidelines. Staff interviewed recognized the importance of environmental issues, but were yetto appreciate the benefits of adopting EA practices. Subsequent to the case study, the Victorian governmentintroduced legislation that required water authorities to make provisions for environmental contributions, astep towards accounting for environmental externalities. This was the beginning of the “sustainability” phaseof public sector ‘modernisation’ reforms.

  8. Chinese hotel general managers' perspectives on energy-saving practices

    Science.gov (United States)

    Zhu, Yidan

    As hotels' concern about sustainability and budget-control is growing steadily, energy-saving issues have become one of the important management concerns hospitality industry face. By executing proper energy-saving practices, previous scholars believed that hotel operation costs can decrease dramatically. Moreover, they believed that conducting energy-saving practices may eventually help the hotel to gain other benefits such as an improved reputation and stronger competitive advantage. The energy-saving issue also has become a critical management problem for the hotel industry in China. Previous research has not investigated energy-saving in China's hotel segment. To achieve a better understanding of the importance of energy-saving, this document attempts to present some insights into China's energy-saving practices in the tourist accommodations sector. Results of the study show the Chinese general managers' attitudes toward energy-saving issues and the differences among the diverse hotel managers who responded to the study. Study results indicate that in China, most of the hotels' energy bills decrease due to the implementation of energy-saving equipments. General managers of hotels in operation for a shorter period of time are typically responsible for making decisions about energy-saving issues; older hotels are used to choosing corporate level concerning to this issue. Larger Chinese hotels generally have official energy-saving usage training sessions for employees, but smaller Chinese hotels sometimes overlook the importance of employee training. The study also found that for the Chinese hospitality industry, energy-saving practices related to electricity are the most efficient and common way to save energy, but older hotels also should pay attention to other ways of saving energy such as water conservation or heating/cooling system.

  9. Ten “Big Bangs” in Theory and Practice that Have Made a Difference to Australian Policing in the Last Three Decades

    Directory of Open Access Journals (Sweden)

    Rick Sarre

    2016-05-01

    Full Text Available This paper discusses what could be considered the top ten innovations that have occurred in policing in the last thirty years. The intent is to focus attention on how practice could be further inspired by additional innovation. The innovations are discussed here as “Big Bangs” as a way of drawing attention to the significant impact they have had on policing, in the same way that the cosmological Big Bang was an important watershed event in the universe’s existence. These ten policing innovations ushered in, it is argued, a new mindset, pattern or trend, and they affected Australian policing profoundly; although many had their roots in other settings long before Australian policy-makers implemented them.

  10. The Influence of Forums and Multilevel Governance on the Climate Adaptation Practices of Australian Organizations

    Directory of Open Access Journals (Sweden)

    Lorraine E. Bates

    2013-12-01

    Full Text Available To date, there are few regulations and policies relating to climate change in Australia. Uncertainty about the timing, structure, and potential impact of proposed legislation such as a national carbon abatement scheme, is leading to planning delays across the country. To assist with these policy uncertainties, organizations can embed themselves in multilevel governance frameworks that inform, structure, and facilitate strategic development, planning, and action. As part of these networks, organizational representatives also engage in formal and informal forums, a type of interorganizational relationship, which can include industry task forces, policy development committees, interagency groups, and specific climate change committees. Forums constitute an additional level of governance that influences decision making. The patterns of relationships within these multilevel governance frameworks are examined in this paper, with a focus on the forum level of organizational cooperation. Specifically, we investigate the type of forums operating and their role in supporting organizational responses to climate change. A series of interviews and focus groups were conducted in two study areas, the Swan Canning region of Western Australia and the Hunter / Central Coast region of New South Wales. The results indicate that organizations participate in a diverse range of forums. Further, forums appear to play a key role in the everyday business of organizations by enhancing their ability to plan and address a range of issues, including those associated with climate change. In addition the research highlights some of the barriers and drivers for the development and implementation of climate adaptation practices that emerge from forum discussions. For example, a lack of government guidance in interpreting climate change policy was described as a barrier yet access to the knowledge and expertise of participants was highlighted as a potential driver. The paper

  11. Medical engagement and organizational characteristics in general practice

    DEFF Research Database (Denmark)

    Ahnfeldt-Mollerup, Peder; dePont Christensen, René; Halling, Anders;

    2016-01-01

    BACKGROUND: Medical engagement is a mutual concept of the active and positive contribution of doctors to maintaining and enhancing the performance of their health care organization, which itself recognizes this commitment in supporting and encouraging high quality care. A Medical Engagement Scale...... (MES) was developed by Applied Research Ltd (2008) on the basis of emerging evidence that medical engagement is critical for implementing radical improvements. OBJECTIVES: To study the importance of medical engagement in general practice and to analyse patterns of association with individual and...... results were analysed in conjunction with the GP register data. RESULTS: Statistically adjusted analyses revealed that the GPs' medical engagement varied substantially. GPs working in collaboration with colleagues were more engaged than GPs from single-handed practices, older GPs were less engaged than...

  12. The future of bereavement care in British general practice.

    Science.gov (United States)

    Woof, W R

    1997-06-01

    This paper discusses the future of bereavement care in British general practice by providing an insight into existing practice and then speculating on influences that may shape developments. There have been calls for the specialty to build on this traditional role and expand its bereavement service. Specific suggestions for the content of such a service are summarised. This emphasis reflects the increasing awareness in bereavement by other health organisations. This image of an expanding service needs to be contextualised within a primary care system that is feeling more pressurised due to increasing workload. This will continue to inhibit extensive service development. In addition it is important for the profession to consider the appropriateness of this activity. This complex debate has received little attention and research is required to inform and provide the necessary direction. PMID:9233164

  13. Knowledge Management Practice in Two Australian Architecture-Engineering-Construction (AEC Companies

    Directory of Open Access Journals (Sweden)

    Patrick Zou

    2012-11-01

    Full Text Available Knowledge management (KM could be described as a management system that supports the creation, sharing and retrieving of valued information, expertise and insight within and across communities of people and related organizations using information and communication technologies and hence it is a combination of the effective application of information technlogy and management of human resources. KM is becoming a core competitive factor in construction operations. This paper presents the results of two case studies of KM practices in large AEC (architecture, engineering and construction companies through desk-top study and semi-structured interviews. The results indicate that implementing KM in AEC companies leads to competitive advantages and improved decision-making, problem solving and business performance. The results also indicateed that while technology plays an important role, top management commitment, total employee involvement, performance assessment and the culture of knowledge-learning and sharing must be considered when implementing KM. Therefore it is suggested that the implementation of KM should incorporate the company's vision, work processes, technology and culture, to improve the ability of knowledge creating, capturing, sharing, retrieving and ultimately, to improve the company's competitive advantage, decision making, problem solving and innovation.

  14. Economic impact of homeopathic practice in general medicine in France

    OpenAIRE

    Colas, Aurélie; Danno, Karine; Tabar, Cynthia; Ehreth, Jenifer; Duru, Gérard

    2015-01-01

    Health authorities are constantly searching for new ways to stabilise health expenditures. To explore this issue, we compared the costs generated by different types of medical practice in French general medicine: i.e. conventional (CM-GP), homeopathic (Ho-GP), or mixed (Mx-GP). Data from a previous cross-sectional study, EPI3 La-Ser, were used. Three types of cost were analysed: (i) consultation cost (ii) prescription cost and (iii) total cost (consultation + prescription). Each was evaluated...

  15. Clostridium difficile in general practice and community health.

    OpenAIRE

    Riley, T V; Wymer, V.; Bamford, V. W.; Bowman, R. A.

    1986-01-01

    The isolation rate for Clostridium difficile in diarrhoeal stools was investigated in patients from general practice and community health centres over a 14-month period. C. difficile or its cytotoxin was detected in specimens from 89 (4.7%) of 1882 patients studied and accounted for 30.3% of all enteropathogenic micro-organisms isolated. Overall C. difficile was second only to Giardia lamblia in frequency. Recovery rates in the different groups of patients surveyed varied from 3.6 to 27.5%. T...

  16. Placebo controlled trial of nicotine chewing gum in general practice.

    OpenAIRE

    Jamrozik, K; Fowler, G; Vessey, M; Wald, N

    1984-01-01

    Of 2110 adult cigarette smokers originally recruited to a study of the effect of antismoking advice in general practice, 429 who reported at follow up after one year that they had tried unsuccessfully to stop smoking were offered "a special antismoking chewing gum," either nicotine gum or a placebo gum, in a double blind study. Of 200 who were willing to try the gum, 101 were randomly allocated to the nicotine gum and 99 to the placebo gum. They were followed up at six months by an unannounce...

  17. Determinants of frequent attendance in Danish general practice

    DEFF Research Database (Denmark)

    Jørgensen, Jeanette Therming; Andersen, John Sahl; Tjønneland, Anne;

    2016-01-01

    BACKGROUND: Previous studies addressing determinants of frequent attendance have mainly focused on socio-demographic, psychosocial and medical factors, and few had data on lifestyle and gender-specific factors. This study aims to describe determinants of general practice frequent attendance in...... Danish adult population, by examining lifestyle, socio-demographic, medical and gender-specific factors. METHOD: For 54,849 participants of the Danish Diet, Cancer and Health cohort (50-65 year old) we obtained data on visits to general practitioner (GP) from the Danish National Health Service Register...... at cohort baseline (1993-97), when information on medical conditions and lifestyle, socio-demographic and gender-specific factors was collected by questionnaire. Logistic regression was used to identify determinants of frequent attendance, defined as top 10 % GP users at the year of recruitment into...

  18. Risk Reduction Technologies in General Practice and Social Work

    Directory of Open Access Journals (Sweden)

    Devin Rexvid

    2012-12-01

    Full Text Available General practitioners (GPs and social workers (SWs are professions whose professional autonomy and discretion have changed in the so-called risk and audit society. The aim of this article is to compare GPs’ and SWs’ responses to Evidence-Based and Organizational Risk Reduction Technologies (ERRT and ORRT. It is based on a content analysis of 54 peer-reviewed empirical articles. The results show that both professions held ambivalent positions towards ERRT. The response towards ORRT differed in that GPs were sceptical whilst SWs took a more pragmatic view. Furthermore the results suggest that SWs might experience professional benefits by adopting an adherent approach to the increased dissemination of risk reduction technologies (RRT. GPs, however, did not seem to experience such benefits. Keywords: Profession, risk, social worker, general practitioner, risk reduction technologies, evidence-based practice/medicine 

  19. High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands

    Directory of Open Access Journals (Sweden)

    Grol Richard

    2009-07-01

    Full Text Available Abstract Background The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. Methods Secondary analysis of data from 239 general practices, collected in practice visits between 2003 to 2006 in the Netherlands using a comprehensive set of measures of practice management. Data were collected by a practice visitor, a trained non-physician observer using patients questionnaires, doctors and staff. For this study we selected five measures of practice performance as outcomes and six measures of GP workload and job stress as predictors. A total of 79 indicators were used out of the 303 available indicators. Random coefficient regression models were applied to examine associations. Results and discussion Workload and job stress are associated with practice performance. Workload: Working more hours as a GP was associated with more positive patient experiences of accessibility and availability (b = 0.16. After list size adjustment, practices with more GP-time per patient scored higher on GP care (b = 0.45. When GPs provided more than 20 hours per week per 1000 patients, patients scored over 80% on the Europep questionnaire for quality of GP care. Job stress: High GP job stress was associated with lower accessibility and availability (b = 0.21 and insufficient practice management (b = 0.25. Higher GP commitment and more satisfaction with the job was associated with more prevention and disease management (b = 0.35. Conclusion Providing more time in the practice, and more time per patient and experiencing less job stress are all associated with perceptions by patients of better care and better practice performance. Workload and job stress should be assessed by using list size adjusted data in order to realise better quality of care. Organisational development using

  20. The management of otitis externa in UK general practice.

    Science.gov (United States)

    Pabla, L; Jindal, M; Latif, K

    2012-03-01

    Acute otitis externa is common and provides a heavy workload for general practitioners. We aim to determine the first-line treatment used by general practitioners in the management of otitis externa and subsequent second-line treatment in a hospital ENT clinic. In addition, this study aims to ascertain whether local and national guidelines are being followed appropriately. A prospective observational study on the management of otitis externa in consecutive patients referred to an ENT emergency clinic was undertaken. Data were collected and analysed on symptoms, initial management by general practitioners, findings and treatment in the ENT clinic. A total of 106 patients were studied. The mean duration of symptoms before presentation to clinic was 13 days; 42% of patients received no treatment by their GP prior to referral to the ENT emergency clinic. Only 14% of patients received topical antibiotics alone, whilst 44% received oral antibiotics, either alone or in conjunction with topical antibiotics by their GP. Of the 106 patients, 86% received topical antibiotics in the ENT emergency clinic and oral antibiotics were reserved for those presenting with complicated acute otitis externa. Topical antibiotics are associated with a decrease in disease persistence, whilst oral antibiotics are associated with an increase. However, general practitioners are prescribing oral antibiotics more often than required. There are few regional guidelines and no explicit national guidelines on the management of acute otitis externa for GPs to refer to. We suggest the implementation of national guidelines to aid clinical practice. PMID:21761191

  1. Clinical usefulness of teleradiology in general dental practice

    International Nuclear Information System (INIS)

    This study was performed to investigate the clinical usefulness of teleradiology in general dental practice. Two hundred and seventy five cases were submitted for inquiry to the case presentation board of the website of The Korean Academy of Oral and Maxillofacial Radiology for a 5 year periods. The diagnosis results of those cases were analyzed according to the disease classification, the correlation with the patient's chief complaint, the necessity of additional examinations or treatments, the image modalities, and the number of dentists inquiring. Differential diagnoses of normal anatomic structures were the most frequently submitted cases, covering 15.6% of all cases. Among 275 cases, 164 cases required no additional treatments or examinations. Panoramic radiographs were the most frequently submitted images, accounting for 248 inquiries. The 275 cases were submitted by 96 dentists. Fifty-two dentists wrote one inquiry, and 44 inquired 2 or more times. The average inquiry number of the latter group was 5.0 cases. A teleradiology system in general dental practice could be helpful in the differential diagnosis of common lesions and reduce unnecessary costs.

  2. Clinical usefulness of teleradiology in general dental practice

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Woo [Dept. of Oral and Maxillofacial Radiology, Dankook University College of Dentistry, Cheonan (Korea, Republic of)

    2013-06-15

    This study was performed to investigate the clinical usefulness of teleradiology in general dental practice. Two hundred and seventy five cases were submitted for inquiry to the case presentation board of the website of The Korean Academy of Oral and Maxillofacial Radiology for a 5 year periods. The diagnosis results of those cases were analyzed according to the disease classification, the correlation with the patient's chief complaint, the necessity of additional examinations or treatments, the image modalities, and the number of dentists inquiring. Differential diagnoses of normal anatomic structures were the most frequently submitted cases, covering 15.6% of all cases. Among 275 cases, 164 cases required no additional treatments or examinations. Panoramic radiographs were the most frequently submitted images, accounting for 248 inquiries. The 275 cases were submitted by 96 dentists. Fifty-two dentists wrote one inquiry, and 44 inquired 2 or more times. The average inquiry number of the latter group was 5.0 cases. A teleradiology system in general dental practice could be helpful in the differential diagnosis of common lesions and reduce unnecessary costs.

  3. Training medical students in general practice: a qualitative study among general practitioner trainers in Sri Lanka

    OpenAIRE

    Ramanayake, R. P. J. C.; de Silva, A. H. W.; Perera, D. P.; Sumanasekera, R. D. N.; Athukorala, L. A. C. L.; Fernando, K. A. T.

    2015-01-01

    Introduction: Worldwide Family Medicine has gained an important place in the undergraduate medical curriculum over the last few decades and general practices have become training centers for students. Exposure to patients early in the disease process, out patient management of common problems, follow up of chronic diseases and psychosocial aspects of health and disease are educational advantages of community based training but such training could have varying impact on patients, students and ...

  4. IMPLEmenting a clinical practice guideline for acute low back pain evidence-based manageMENT in general practice (IMPLEMENT: Cluster randomised controlled trial study protocol

    Directory of Open Access Journals (Sweden)

    Francis Jill

    2008-02-01

    Full Text Available Abstract Background Evidence generated from reliable research is not frequently implemented into clinical practice. Evidence-based clinical practice guidelines are a potential vehicle to achieve this. A recent systematic review of implementation strategies of guideline dissemination concluded that there was a lack of evidence regarding effective strategies to promote the uptake of guidelines. Recommendations from this review, and other studies, have suggested the use of interventions that are theoretically based because these may be more effective than those that are not. An evidence-based clinical practice guideline for the management of acute low back pain was recently developed in Australia. This provides an opportunity to develop and test a theory-based implementation intervention for a condition which is common, has a high burden, and for which there is an evidence-practice gap in the primary care setting. Aim This study aims to test the effectiveness of a theory-based intervention for implementing a clinical practice guideline for acute low back pain in general practice in Victoria, Australia. Specifically, our primary objectives are to establish if the intervention is effective in reducing the percentage of patients who are referred for a plain x-ray, and improving mean level of disability for patients three months post-consultation. Methods/Design This study protocol describes the details of a cluster randomised controlled trial. Ninety-two general practices (clusters, which include at least one consenting general practitioner, will be randomised to an intervention or control arm using restricted randomisation. Patients aged 18 years or older who visit a participating practitioner for acute non-specific low back pain of less than three months duration will be eligible for inclusion. An average of twenty-five patients per general practice will be recruited, providing a total of 2,300 patient participants. General practitioners in the

  5. Psychiatric morbidity and referral in general practice-a survey of general practitioners in bangalore city.

    Science.gov (United States)

    Gautam, S; Kapur, R L; Shamasundar, C

    1980-07-01

    60 General practitioners having M.B., B.S. qualification from all age group practicing in Bangalore city's centrally located locality were personally visited and a specially designed proforma was administered to find out whether they come across Psychiatric patients in their general practice, if yes what percentage of their practice ? Whether they referred any cases for Psychiatric consultation, what factors determined their decision to refer a case to the psychiatrist.9% General practitioners reportedly were seeing Psychiatric cases, on an average 10% of total patients seen by GP's were suffering from Psychiatric illness. 85% GP's had referred cases for Psychiatric consultation and factors which determined GP's decision to refer a case were : Request from patient to see a Specialist, patient was excited and unmanageable, pressure from relatives of patients serious impirsonment of patients' working capacity, patient finds it more acceptable to be told by a Specialist that he has nervous trouble, lack of emotional support from family of patient. Less commonly given reasons inlcuded inability to diagnose a case, for confirmation of diagnosis and treatment, for detailed examination and investigation, for better managment, resistant casses and lack of time to deal with Psychiatric problems. These findings have been discussed and their implications in planning further services have been highlighted. PMID:22058484

  6. Influences on the variation in prevalence of type 2 diabetes between general practices: practice, patient or socioeconomic factors?

    OpenAIRE

    Whitford, David L; Griffin, Simon J; Prevost, A. Toby

    2003-01-01

    BACKGROUND: The prevalence of type 2 diabetes is known to vary between countries, districts and general practices. The influence of early detection and screening on the variation of prevalence between general practices has not previously been investigated. AIM: To test the hypothesis that the prevalence of type 2 diabetes is associated with awareness of and screening for diabetes within general practices and to explore other factors that may explain the variation in prevalence between practic...

  7. Setting goal and implementation intentions in consultations between practice nurses and patients with overweight or obesity in general practice

    NARCIS (Netherlands)

    Dillen, S.M. van; Noordman, J.; Dulmen, S. van; Hiddink, G.J.

    2015-01-01

    OBJECTIVE: Patients with overweight or obesity increasingly attend general practice, which is an ideal setting for weight-loss counselling. The present study is the first to investigate the quality of weight-loss counselling provided by practice nurses in general practice to patients with overweight

  8. Setting goal and implementation intentions in consultations between practice nurses and patients with overweight or obesity in general practice.

    NARCIS (Netherlands)

    Dillen, S.M.E. van; Noordman, J.; Dulmen, S. van; Hiddink, G.J.

    2015-01-01

    Objective: Patients with overweight or obesity increasingly attend general practice, which is an ideal setting for weight-loss counselling. The present study is the first to investigate the quality of weight-loss counselling provided by practice nurses in general practice to patients with overweight

  9. Setting goal and implementation intentions in consultations between practice nurses and patients with overweight or obesity in general practice

    NARCIS (Netherlands)

    Dillen, van S.; Noordman, J.; Dulmen, van S.; Hiddink, G.J.

    2015-01-01

    Objective Patients with overweight or obesity increasingly attend general practice, which is an ideal setting for weight-loss counselling. The present study is the first to investigate the quality of weight-loss counselling provided by practice nurses in general practice to patients with overweight

  10. Do Australian Adolescent Female Fake Tan (Sunless Tan) Users Practice Better Sun-Protection Behaviours than Non-Users?

    Science.gov (United States)

    Williams, Melinda; Jones, Sandra C.; Caputi, Peter; Iverson, Don

    2012-01-01

    Objective: To determine differences in sun-protection behaviours, and incidence of sunburn, between Australian adolescent female fake tan users and non-users. Design: Cross sectional survey. Method: 398 adolescent females aged 12 to 18 years participated in a survey at public venues, schools, and online. The main outcome measures were…

  11. Best Practice? Advice Provided to Teachers about the Use of Brain Gym[R] in Australian Schools

    Science.gov (United States)

    Stephenson, Jennifer

    2009-01-01

    Perceptual motor programs continue to be used in Australian schools despite evidence showing they do not influence academic learning. Brain Gym[R] is one perceptual motor program that is used in schools in Australia and overseas. There is little evidence to support the claims made about the benefits of Brain Gym[R]; its theoretical underpinning…

  12. Practices in communicating technical issues to the general public

    International Nuclear Information System (INIS)

    The conclusions and recommendations of this session can be summarized this way. - Basic goal for the regulator is to protect the public and communication is a must to fully achieve this goal. - Regulator should become the prime source of information to the public and the media, regulator should base its actions upon values of competence, independence, transparency and stringency. - Set up of a Information and Communication Policy will help for consistency and efficiency. Policy will include setting goals, strategies, organisational aspects, procedures, and tools. Practices should be developed in accordance with local culture. - Challenges will consider transparency, public involvement and consultation with the stakeholders. - Practices will include in general: - Interactions with the media like press releases, news conferences, media workshops. Printed materials from plant periodical status reports, to periodical and annual reports and specific reports. Audio-visual materials. Use of radio and TV. Web site and electronic mail. - Method chosen depends on the targeted audience and the relevance of the topic. - Messages should be clearly understandable. Do not dehumanize the message by making it technically unintelligible. - Two excellent examples presented. How local culture and social characteristics were taken into account in designing and implementing plans is key for success. - Municipalities are to be considered as front line stakeholders. - Communicators role is relevant to meet regulatory needs. Good collaboration between communicators and technical staff produces benefits for the nuclear regulator and the public. (authors)

  13. Sampling in forests for radionuclide analysis. General and practical guidance

    Energy Technology Data Exchange (ETDEWEB)

    Aro, Lasse (Finnish Forest Research Inst. (METLA) (Finland)); Plamboeck, Agneta H. (Swedish Defence Research Agency (FOI) (Sweden)); Rantavaara, Aino; Vetikko, Virve (Radiation and Nuclear Safety Authority (STUK) (Finland)); Straalberg, Elisabeth (Inst. Energy Technology (IFE) (Norway))

    2009-01-15

    The NKS project FOREST was established to prepare a guide for sampling in forest ecosystems for radionuclide analysis. The aim of this guide is to improve the reliability of datasets generated in future studies by promoting the use of consistent, recommended practices, thorough documentation of field sampling regimes and robust preparation of samples from the forest ecosystem. The guide covers general aims of sampling, the description of major compartments of the forest ecosystem and outlines key factors to consider when planning sampling campaigns for radioecological field studies in forests. Recommended and known sampling methods for various sample types are also compiled and presented. The guide focuses on sampling practices that are applicable in various types of boreal forests, robust descriptions of sampling sites, and documentation of the origin and details of individual samples. The guide is intended for scientists, students, forestry experts and technicians who appreciate the need to use sound sampling procedures in forest radioecological projects. The guide will hopefully encourage readers to participate in field studies and sampling campaigns, using robust techniques, thereby fostering competence in sampling. (au)

  14. Service-mix in general dental practice in Australia.

    Science.gov (United States)

    Spencer, A J; Lewis, J M

    1989-02-01

    An understanding of the current service-mix in private general practice in Australia and the factors that may influence its distribution is important in the anticipation of the future practice of dentistry. The present study aimed to describe service-mix, to investigate the association of service-mix with characteristics of presenting patients, and to identify and discuss a number of factors which may be influencing change in service-mix. Service-mix was dominated by restorative, diagnostic and preventive services and a limited number of services accounted for most service provision or dentist time. Both the broad areas of service and more frequently provided services were related to age of presenting patients. Service-mix appears to be changing over time. Changing needs and expectations of patients and philosophies and technologies available to dentists are among factors that push or pull service-mix in new directions. However, changing service-mix and practitioner variation require considerably more exploration. PMID:2495788

  15. Sampling in forests for radionuclide analysis. General and practical guidance

    International Nuclear Information System (INIS)

    The NKS project FOREST was established to prepare a guide for sampling in forest ecosystems for radionuclide analysis. The aim of this guide is to improve the reliability of datasets generated in future studies by promoting the use of consistent, recommended practices, thorough documentation of field sampling regimes and robust preparation of samples from the forest ecosystem. The guide covers general aims of sampling, the description of major compartments of the forest ecosystem and outlines key factors to consider when planning sampling campaigns for radioecological field studies in forests. Recommended and known sampling methods for various sample types are also compiled and presented. The guide focuses on sampling practices that are applicable in various types of boreal forests, robust descriptions of sampling sites, and documentation of the origin and details of individual samples. The guide is intended for scientists, students, forestry experts and technicians who appreciate the need to use sound sampling procedures in forest radioecological projects. The guide will hopefully encourage readers to participate in field studies and sampling campaigns, using robust techniques, thereby fostering competence in sampling. (au)

  16. An Australian hospital-based student training ward delivering safe, client-centred care while developing students' interprofessional practice capabilities.

    Science.gov (United States)

    Brewer, Margo L; Stewart-Wynne, Edward G

    2013-11-01

    Royal Perth Hospital, in partnership with Curtin University, established the first interprofessional student training ward in Australia, based on best practice from Europe. Evaluation of the student and client experience was undertaken. Feedback from all stakeholders was obtained regularly as a key element of the quality improvement process. An interprofessional practice program was established with six beds within a general medical ward. This provided the setting for 2- to 3-week clinical placements for students from medicine, nursing, physiotherapy, occupational therapy, social work, pharmacy, dietetics and medical imaging. Following an initial trial, the training ward began with 79 students completing a placement. An interprofessional capability framework focused on the delivery of high quality client care and effective teamwork underpins this learning experience. Quantitative outcome data showed not only an improvement in students' attitudes towards interprofessional collaboration but also acquisition of a high level of interprofessional practice capabilities. Qualitative outcome data from students and clients was overwhelmingly positive. Suggestions for improvement were identified. This innovative learning environment facilitated the development of the students' knowledge, skills and attitudes required for interprofessional, client centred collaborative practice. Staff reported a high level of compliance with clinical safety and quality. PMID:24299579

  17. Economic costs of chemotherapy-induced febrile neutropenia among patients with non-Hodgkin’s lymphoma in European and Australian clinical practice

    Directory of Open Access Journals (Sweden)

    Weycker Derek

    2012-08-01

    Full Text Available Abstract Background Economic implications of chemotherapy-induced febrile neutropenia (FN in European and Australian clinical practice are largely unknown. Methods Data were obtained from a European (97% and Australian (3% observational study of patients with non-Hodgkin’s lymphoma (NHL receiving CHOP (±rituximab chemotherapy. For each patient, each cycle of chemotherapy within the course, and each occurrence of FN within cycles, was identified. Patients developing FN in a given cycle (“FN patients”, starting with the first, were matched to those who did not develop FN in that cycle (“comparison patients”, irrespective of subsequent FN events. FN-related healthcare costs (£2010 were tallied for the initial FN event as well as follow-on care and FN events in subsequent cycles. Results Mean total cost was £5776 (95%CI £4928-£6713 higher for FN patients (n = 295 versus comparison patients, comprising £4051 (£3633-£4485 for the initial event and a difference of £1725 (£978-£2498 in subsequent cycles. Among FN patients requiring inpatient care (76% of all FN patients, mean total cost was higher by £7259 (£6327-£8205, comprising £5281 (£4810-£5774 for the initial hospitalization and a difference of £1978 (£1262-£2801 in subsequent cycles. Conclusions Cost of chemotherapy-induced FN among NHL patients in European and Australian clinical practice is substantial; a sizable percentage is attributable to follow-on care and subsequent FN events.

  18. The relationship between census-derived socio-economic variables and general practice consultation rates in three town centre practices.

    OpenAIRE

    Carlisle, R; Johnstone, S.

    1998-01-01

    BACKGROUND: The relationship between socio-economic factors and consultation rates is important in determining resource allocation to general practices. AIM: To determine the relationship between general practice surgery consultation rates and census-derived socio-economic variables for patients receiving the same primary and secondary care. METHOD: A retrospective analysis was taken of computerized records in three general practices in Mansfield, North Nottinghamshire, with 29,142 patients s...

  19. Managing patient demand: a qualitative study of appointment making in general practice.

    OpenAIRE

    Gallagher, M; Pearson, P; Drinkwater, C; Guy, J

    2001-01-01

    BACKGROUND: Managing patients' requests for appointments is an important general practice activity. No previous research has systematically observed how patients and receptionists negotiate appointments. AIM: To observe appointment making and investigate patients' and professionals' experiences of appointment negotiations. DESIGN OF STUDY: A qualitative study using participant observation. SETTING: Three general practices on Tyneside; a single-handed practice, a practice comprising three doct...

  20. Assessment of general education teachers' Tier 1 classroom practices: contemporary science, practice, and policy.

    Science.gov (United States)

    Reddy, Linda A; Fabiano, Gregory A; Jimerson, Shane R

    2013-12-01

    Progress monitoring is a type of formative assessment. Most work on progress monitoring in elementary school settings has been focused on students. However, teachers also can benefit from frequent evaluations. Research addressing teacher progress monitoring is critically important given the recent national focus on teacher evaluation and effectiveness. This special topic section of School Psychology Quarterly is the first to showcase the current research on measuring Tier 1 instructional and behavioral management practices used by prekindergarten and elementary school teachers in general education settings. The three studies included in the special section describe the development and validation efforts of several teacher observational and self-report measures of instruction and/or behavioral management. These studies provide evidence for the utility of such assessments for documenting the use of classroom practices, and these assessment results may be leveraged in innovative coaching models to promote best practice. These articles also offer insight and ideas for the next generation of teacher practice assessment for the field. Finally, the special topic is capped by a commentary synthesizing the current work and offers "big ideas" for future measurement development, policy, and professional development initiatives. PMID:24341924

  1. Prescribing Data in General Practice Demonstration (PDGPD project - a cluster randomised controlled trial of a quality improvement intervention to achieve better prescribing for chronic heart failure and hypertension

    Directory of Open Access Journals (Sweden)

    Williamson Margaret

    2012-08-01

    Full Text Available Abstract Background Research literature consistently documents that scientifically based therapeutic recommendations are not always followed in the hospital or in the primary care setting. Currently, there is evidence that some general practitioners in Australia are not prescribing appropriately for patients diagnosed with 1 hypertension (HT and 2 chronic heart failure (CHF. The objectives of this study were to improve general practitioner’s drug treatment management of these patients through feedback on their own prescribing and small group discussions with peers and a trained group facilitator. The impact evaluation includes quantitative assessment of prescribing changes at 6, 9, 12 and 18 months after the intervention. Methods A pragmatic multi site cluster RCT began recruiting practices in October 2009 to evaluate the effects of a multi-faceted quality improvement (QI intervention on prescribing practice among Australian general practitioners (GP in relation to patients with CHF and HT. General practices were recruited nationally through General Practice Networks across Australia. Participating practices were randomly allocated to one of three groups: two groups received the QI intervention (the prescribing indicator feedback reports and small group discussion with each group undertaking the clinical topics (CHF and HT in reverse order to the other. The third group was waitlisted to receive the intervention 6 months later and acted as a “control” for the other two groups. De-identified data on practice, doctor and patient characteristics and their treatment for CHF and HT are extracted at six-monthly intervals before and after the intervention. Post-test comparisons will be conducted between the intervention and control arms using intention to treat analysis and models that account for clustering of practices in a Network and clustering of patients within practices and GPs. Discussion This paper describes the study protocol for a

  2. Learner discipline: An Australian perspective

    OpenAIRE

    STEWART, D.

    2004-01-01

    Australian schools by and large are safe schools. Nonetheless discipline problems do exist – including bullying behaviour. For this kind of problem schools should have management policies in place. As traditional behaviour-management practices – including corporal punishment – are largely prohibited in Australian schools, contemporary practices centre on management through supportive school programmes, including appropriate curricula and school-support structures. This article supports the be...

  3. Organisational development in general practice: lessons from practice and professional development plans (PPDPs

    Directory of Open Access Journals (Sweden)

    Hocking Paul

    2000-12-01

    Full Text Available Abstract Background Improving the quality and effectiveness of clinical practice is becoming a key task within all health services. Primary medical care, as organised in the UK is composed of clinicians who work in independent partnerships (general practices that collaborate with other health care professionals. Although many practices have successfully introduced innovations, there are no organisational development structures in place that support the evolution of primary medical care towards integrated care processes. Providing incentives for attendance at passive educational events and promoting 'teamwork' without first identifying organisational priorities are interventions that have proved to be ineffective at changing clinical processes. A practice and professional development plan feasibility study was evaluated in Wales and provided the experiential basis for a summary of the lessons learnt on how best to guide organisational development systems for primary medical care. Results Practice and professional development plans are hybrids produced by the combination of ideas from management (the applied behavioural science of organisational development and education (self-directed adult learning theories and, in conceptual terms, address the lack of effectiveness of passive educational strategies by making interventions relevant to identified system wide needs. In the intervention, each practice participated in a series of multidisciplinary workshops (minimum 4 where the process outcome was the production of a practice development plan and a set of personal portfolios, and the final outcome was a realised organisational change. It was apparent during the project that organisational admission to a process of developmental planning needed to be a stepwise process, where initial interest can lead to a fuller understanding, which subsequently develops into motivation and ownership, sufficient to complete the exercise. The advantages of

  4. Expanding access to rheumatology care: the rheumatology general practice toolbox.

    LENUS (Irish Health Repository)

    Conway, R

    2015-02-01

    Management guidelines for many rheumatic diseases are published in specialty rheumatology literature but rarely in general medical journals. Musculoskeletal disorders comprise 14% of all consultations in primary care. Formal post-graduate training in rheumatology is limited or absent for many primary care practitioners. Primary care practitioners can be trained to effectively treat complex diseases and have expressed a preference for interactive educational courses. The Rheumatology General Practice (GP) Toolbox is an intensive one day course designed to offer up to date information to primary care practitioners on the latest diagnostic and treatment guidelines for seven common rheumatic diseases. The course structure involves a short lecture on each topic and workshops on arthrocentesis, joint injection and DXA interpretation. Participants evaluated their knowledge and educational experience before, during and after the course. Thirty-two primary care practitioners attended, who had a median of 13 (IQR 6.5, 20) years experience in their specialty. The median number of educational symposia attended in the previous 5 years was 10 (IQR-5, 22.5), with a median of 0 (IQR 0, 1) in rheumatology. All respondents agreed that the course format was appropriate. Numerical improvements were demonstrated in participant\\'s confidence in diagnosing and managing all seven common rheumatologic conditions, with statistically significant improvements (p < 0.05) in 11 of the 14 aspects assessed. The Rheumatology Toolbox is an effective educational method for disseminating current knowledge in rheumatology to primary care physicians and improved participant\\'s self-assessed competence in diagnosis and management of common rheumatic diseases.

  5. The identification of the general practice registrar needing assistance

    Directory of Open Access Journals (Sweden)

    Gladman G

    2011-06-01

    Full Text Available BackgroundDoctors undertaking vocational training in general practicein Australia may require assistance, in addition to thenormal training offered as part of their training programme.Issues requiring assistance may go undetected for a periodof time. Delay in the identification of issues leads to delay inthe provision of the assistance. The aim of this study is todetermine the most common reasons registrars requireextra assistance, and how these issues are identified. Thefindings of this study will provide direction for 21 regionallybased training providers (RTPs to develop improved toolsto ensure earlier detection of registrars requiring assistance.MethodThis study is based on qualitative research methods, usingsemi-structured interviews with senior medical educationstaff of four regional general practice training providers inVictoria, Australia.ResultsIssues identified included language and cultural issues,applied knowledge and skills, attitude and professionalism,and health and family issues.The principal method that training providers identifiedissues was via the GP supervisor. This was predominantly byinformal communication, rather than formal evaluationsheets. Other methods included the external clinicalteaching visit and other training formative assessments.These more formalised procedures were more likely toidentify issues later than desired. They were also used as away of clarifying suspected problems. The selection processwas not felt to be helpful, and the examinations providedinformation too late.ConclusionAn increased awareness of the potential issues leading to aregistrar to require assistance enables identification andsubsequent action to occur in a more timely and moreuseful fashion. Informal communication between practicesand training programme staff should be encouraged toenable these issues to be dealt with early in training.

  6. Virtual visits in a general medicine practice: a pilot study.

    Science.gov (United States)

    Dixon, Ronald F; Stahl, James E

    2008-08-01

    The purpose of this pilot study is to investigate the feasibility, effectiveness, and acceptability of a patient-physician real-time encounter using videoconferencing technology (a virtual visit) compared to a face-to-face office visit in the general medical setting. The three broad aims of the study are (1) to compare the physician's ability to make diagnoses in both settings, (2) to compare the physician's ability to provide therapy in both settings, and (3) to examine both patient and physician satisfaction with both modalities. Thirty patients were recruited from a single practice to participate in the study. Patients were first interviewed and examined in the virtual setting, and then in the face-to-face setting. Both patients and physician were surveyed after each visit type with regard to quality of the history, quality of the examination, and satisfaction with the experience. The data were analyzed using two-tailed t-tests and analysis of variance. Patients significantly preferred the in-person visit (4.7 of 5), but were very satisfied with the virtual visit as well (4.1 of 5) (p virtual visit modality (2.3 versus 4.9 for the face-to-face visit, p virtual visit a potentially useful alternative to the traditional visit for many medical conditions. This may have significant implications for the general medical care environment. Patients may benefit from reduced opportunity costs associated with physician visits and clinicians may benefit from decrease overhead costs. Further research is ongoing to investigate the generalizability of these findings. PMID:18729750

  7. Australian Aboriginal Astronomy: Overview

    CERN Document Server

    Norris, Ray P

    2013-01-01

    The traditional cultures of Aboriginal Australians include a significant astronomical component, perpetuated through oral tradition, ceremony, and art. This astronomical component includes a deep understanding of the motion of objects in the sky, and this knowledge was used for practical purposes, such as constructing calendars. There is also evidence that traditional Aboriginal Australians made careful records and measurements of cyclical phenomena, paid careful attention to unexpected phenomena such as eclipses and meteorite impacts, and could determine the cardinal points to an accuracy of a few degrees.

  8. Influence of population and general practice characteristics on prescribing of minor tranquilisers in primary care

    Directory of Open Access Journals (Sweden)

    Wagner AC

    2010-09-01

    Full Text Available Prevalence of generalised anxiety disorders is widespread in Great Britain. Previous small-scale research has shown variations in minor tranquiliser prescribing, identifying several potential predictors of prescribing volume. Objective: This study aimed to investigate the relationship between general practice minor tranquiliser prescribing rates and practice population and general practice characteristics for all general practices in England.Methods: Multiple regression analysis of minor tranquiliser prescribing volumes during 2004/2005 for 8,291 English general practices with general practice and population variables obtained from the General Medical Services (GMS statistics, Quality and Outcomes Framework (QOF, 2001 Census and 2004 Index of Multiple Deprivation (IMD. Results: The highest rates of minor tranquiliser prescribing were in areas with the greatest local deprivation while general practices situated in areas with larger proportions of residents of black ethnic origin had lower rates of prescribing. Other predictors of increased prescribing were general practices with older general practitioners and general practices with older registered practice populations.Conclusion: Our findings show that there is wide variation of minor tranquilisers prescribing across England which has implications regarding access to treatment and inequity of service provision. Future research should determine the barriers to equitable prescribing amongst general practices serving larger populations of black ethnic origin.

  9. The practical usefulness of dermoscopy in general dermatology.

    Science.gov (United States)

    Errichetti, E; Stinco, G

    2015-10-01

    Beside to traditional use, dermoscopy is more and more used in the assessment of other "general" dermatologic conditions, namely scalp and hair disorders (trichoscopy), nails abnormalities (onychoscopy), skin infections and infestations (entomodermoscopy), and cutaneous inflammatory diseases (inflammoscopy). Among the list of new applications of dermoscopy, the study of inflammatory dermatoses is probably the most promising topic in terms of development and usefulness, considering the large number of such disorders and the frequent problems in their differential diagnosis which the dermatologist encounters in own daily clinical practice. In this paper, we report selected relatively common clinical differential diagnosis issues concerning inflammatory dermatoses (and some clinically related noninflammatory conditions), analysing them by a dermoscopic point of view in order to assist their noninvasive resolution according to the available literature data and our personal experience, including papulosquamous dermatoses (guttate psoriasis, pityriasis lichenoides chronica, pityriasis rosea, lichen planus, lymphomatoid papulosis, classic pityriasis rubra pilaris, papulosquamous sarcoidosis, disseminated forms of porokeratosis and papulosquamous chronic GVHD), dermatoses presenting with erythematous-desquamative patches/plaques (plaque psoriasis, eczematous dermatitis, pityriasis rosea, mycosis fungoides, subacute cutaneous lupus erythematosus), palmar psoriasis vs. chronic hand eczema, scalp psoriasis vs. seborrheic dermatitis, erythematous-desquamative disorders typically involving the elbows (psoriasis vulgaris, circumscribed juvenile pityriasis rubra pilaris, dermatomyositis/Gottron's sign), itchy papulonodular dermatoses (hypertrophic lichen planus, prurigo nodularis, nodular scabies and acquired perforating dermatosis), common facial inflammatory skin diseases (rosacea, seborrheic dermatitis and demodicidosis), lichen sclerosus vs. morphea, urticaria vs. urticarial

  10. Specialist treatment versus self-help for bulimia nervosa: a randomised controlled trial in general practice.

    OpenAIRE

    Durand, Mary Alison; King, Michael

    2003-01-01

    BACKGROUND: Little is known about general practice management of patients with eating disorders. AIM: To compare the effectiveness of a general practice-based, self-help approach to the treatment of bulimia nervosa with that of specialist outpatient treatment. DESIGN OF STUDY: A prospective, parallel group, randomised controlled trial. SETTING: General practices and specialist eating disorder clinics in London. METHOD: Patients were recruited from general practitioner (GP) referrals to specia...

  11. Distribution of mental health professionals working on site in English and Welsh general practices.

    OpenAIRE

    Kendrick, T.; Sibbald, B; Addington-Hall, J.; Brenneman, D; Freeling, P.

    1993-01-01

    OBJECTIVE--To describe the nature and distribution of mental health professionals working on site in general practices. DESIGN--Postal questionnaire and telephone interview survey. SETTING--English and Welsh general practices. SUBJECTS--1880 general practitioners, of whom 1542 (82%) responded. MAIN OUTCOME MEASURES--Prevalence, types, and distribution of mental health professionals working on site among general practices. Factors predicting the presence of mental health professionals on site....

  12. Relational Coordination and Organisational Social Capital Association with Characteristics of General Practice

    DEFF Research Database (Denmark)

    Lundstrøm, Sanne Lykke; Edwards, Kasper; Bøllingtoft Knudsen, Thomas;

    2014-01-01

    Background. Relational coordination (RC) and organisational social capital (OSC) aremeasures of novel aspects of an organisation’s performance, which have not previously been analysed together, in general practice. Objectives.The aim of this studywas to analyse the associations between RC and OSC......, and characteristics of general practice. Methods. Questionnaire survey study comprising 2074 practices in Denmark. Results. General practitioners (GPs) rated both RC and OSC in their general practice higher than their secretaries and nurses. The practice form was statistically significantly associated...

  13. Practices, patients and (imperfect data - feasibility of a randomised controlled clinical drug trial in German general practices

    Directory of Open Access Journals (Sweden)

    Hummers-Pradier Eva

    2011-04-01

    Full Text Available Abstract Background Randomised controlled clinical (drug trials supply high quality evidence for therapeutic strategies in primary care. Until now, experience with drug trials in German general practice has been sparse. In 2007/2008, the authors conducted an investigator-initiated, non-commercial, double-blind, randomised controlled pilot trial (HWI-01 to assess the clinical equivalence of ibuprofen and ciprofloxacin in the treatment of uncomplicated urinary tract infection (UTI. Here, we report the feasibility of this trial in German general practices and the implementation of Good Clinical Practice (GCP standards as defined by the International Conference on Harmonisation (ICH in mainly inexperienced general practices. Methods This report is based on the experience of the HWI-01 study conducted in 29 German general practices. Feasibility was defined by 1 successful practice recruitment, 2 sufficient patient recruitment, 3 complete and accurate data collection and 4 appropriate protection of patient safety. Results The final practice recruitment rate was 18%. In these practices, 79 of 195 screened UTI patients were enrolled. Recruitment differed strongly between practices (range 0-12, mean 2.8 patients per practice and was below the recruitment goal of approximately 100 patients. As anticipated, practice nurses became the key figures in the screening und recruitment of patients. Clinical trial demands, in particular for completing symptom questionnaires, documentation of source data and reporting of adverse events, did not agree well with GPs' documentation habits and required support from study nurses. In many cases, GPs and practice staff seemed to be overwhelmed by the amount of information and regulations. No sudden unexpected serious adverse reactions (SUSARs were observed during the trial. Conclusions To enable drug trials in general practice, it is necessary to adapt the setup of clinical research infrastructure to the needs of GPs and

  14. General Education: Concept and Practice. ASHE Annual Meeting 1981 Paper.

    Science.gov (United States)

    Flexner, Hans; Berrettini, Robert

    The perceptions of faculty and administrators regarding the following issues were assessed: the distinction between general and liberal education; the supporting philosophical or conceptual bases of general education; its societal goals and intellectual orientation; the place within general education of interdisciplinarity; and the role of general…

  15. Economic impact of homeopathic practice in general medicine in France.

    Science.gov (United States)

    Colas, Aurélie; Danno, Karine; Tabar, Cynthia; Ehreth, Jenifer; Duru, Gérard

    2015-12-01

    Health authorities are constantly searching for new ways to stabilise health expenditures. To explore this issue, we compared the costs generated by different types of medical practice in French general medicine: i.e. conventional (CM-GP), homeopathic (Ho-GP), or mixed (Mx-GP).Data from a previous cross-sectional study, EPI3 La-Ser, were used. Three types of cost were analysed: (i) consultation cost (ii) prescription cost and (iii) total cost (consultation + prescription). Each was evaluated as: (i) the cost to Social Security (ii) the remaining cost (to the patient and/or supplementary health insurance); and (iii) health expenditure (combination of the two costs).With regard to Social Security, treatment by Ho-GPs was less costly (42.00 vs 65.25 for CM-GPs, 35 % less). Medical prescriptions were two-times more expensive for CM-GPs patients (48.68 vs 25.62 ). For the supplementary health insurance and/or patient out-of-pocket costs, treatment by CM-GPs was less expensive due to the lower consultation costs (6.19 vs 11.20 for Ho-GPs) whereas the prescription cost was comparable between the Ho-GPs and the CM-GPs patients (15.87 vs 15.24 respectively) . The health expenditure cost was 20 % less for patients consulting Ho-GPs compared to CM-GPs (68.93 vs 86.63 , respectively). The lower cost of medical prescriptions for Ho-GPs patients compared to CM-GPs patients (41.67 vs 63.72 ) was offset by the higher consultation costs (27.08 vs 22.68 respectively). Ho-GPs prescribed fewer psychotropic drugs, antibiotics and non-steroidal anti-inflammatory drugs.In conclusions management of patients by homeopathic GPs may be less expensive from a global perspective and may represent an important interest to public health. PMID:26152791

  16. 澳大利亚国际教育产业化实践经验剖析%Analysis of the Practical Experience of Australian International Education Industrialization

    Institute of Scientific and Technical Information of China (English)

    朱萍; 熊峰

    2015-01-01

    澳大利亚其高质量的教育水平、严格的教学质量保障、政府的政策支持、潜在的就业机会等因素受到国际学生的欢迎.本文剖析了澳大利亚国际教育的现状、发展历程、教育政策和实践经验,以期对我国发展国际教育带来启示.%With high education quality, strict teaching quality assurance, government policies support and potential employ-ment opportunities, Australia attracts more and more international students. Through the analysis of the key facts, development history, education policies and practice experience of Australian international education, the article tries to bring enlightenment to China's international education.

  17. Influences on final year medical students’ attitudes to general practice as a career

    Directory of Open Access Journals (Sweden)

    Parker JE

    2014-03-01

    Full Text Available INTRODUCTION: General practice is under-represented in student career choices. This study aimed to identify and explore factors that influence the attitudes of final year medical students to general practice as a career. METHODS: This qualitative study used semi-structured interviews of focus groups of final year undergraduate medical students at the University of Otago, Christchurch, New Zealand. Thematic analysis and grounded theory were used to interpret the data. FINDINGS: General practitioners (GPs play a key role in influencing medical students’ attitudes to general practice as a career. Students identified their general practice placement during medical school training and personal contact with their own GP as principal factors. The media portrayal of general practice and the attitudes of friends and family were also influential. Students were positively influenced when they were made to feel part of the team, involved with consultations, allowed to carry out practical procedures under supervision, and witnessed what they perceived as good medical practice during clinical placements. Positive experiences often occurred later in training, when students felt more confident of their clinical abilities. While students reported occasional negative comments about general practice by some hospital doctors, these had a lesser role in influencing their perceptions of general practice compared with their own experiences, both as students and patients. CONCLUSION: GPs have a strong influence, positively and negatively, on the attitudes of medical students to general practice as a career. Effective influences include being made to feel welcome, involved, valued, and given legitimate roles during clinical placements.

  18. Assessing the work of medical audit advisory groups in promoting audit in general practice.

    OpenAIRE

    Baker, R; Hearnshaw, H; Cooper, A.; Cheater, F; Robertson, N

    1995-01-01

    Objectives--To determine the role of medical audit advisory groups in audit activities in general practice. Design--Postal questionnaire survey. Subjects--All 104 advisory groups in England and Wales in 1994. Main measures--Monitoring audit: the methods used to classify audits, the methods used by the advisory group to collect data on audits from general practices, the proportion of practices undertaking audit. Directing and coordinating audits: topics and number of practices participating in...

  19. General parenting, smoking-specific parenting practices and adolescent smoking in Hong Kong

    OpenAIRE

    Wang, Yun; 王芸

    2014-01-01

    Introduction Though the associations of general parenting styles and smoking-specific parenting practices with adolescent smoking have received much attention in recent years, important questions remain. Most general parenting studies focused on Caucasian parents but much less in the literature is known about Chinese parents. As for smoking-specific parenting practices in the household, anti-smoking practices have been the focus, with pro-smoking practices seldom being studied. The ob...

  20. Controlled trial of pharmacist intervention in general practice: the effect on prescribing costs.

    OpenAIRE

    Rodgers, S.; Avery, A J; Meechan, D; Briant, S; Geraghty, M.; Doran, K; Whynes, D K

    1999-01-01

    BACKGROUND: It has been suggested that the employment of pharmacists in general practice might moderate the growth in prescribing costs. However, empirical evidence for this proposition has been lacking. We report the results of a controlled trial of pharmacist intervention in United Kingdom general practice. AIM: To determine whether intervention practices made savings relative to controls. METHOD: An evaluation of an initiative set up by Doncaster Health Authority. Eight practices agreed to...

  1. Suicide ideation, plans, and attempts among general practice patients with chronic health conditions in Puerto Rico

    OpenAIRE

    Vera, Mildred; Reyes-Rabanillo, María L; Huertas, Sarah; Juarbe, Deborah; Pérez-Pedrogo, Coralee; Huertas, Aracelis; Peña, Marisol

    2011-01-01

    Background: Little is known about suicidal ideation among general practice patients in Puerto Rico. In this study we examined the rates, severity, and correlates of suicidal ideation, plans, and attempts among general practice patients with chronic illnesses. This is important in targeting appropriate interventions and management approaches to minimize and prevent suicide. Methods: We screened patients with chronic physical conditions at general practices. Suicidal ideation was assessed with ...

  2. Management of Overweight during Childhood: A Focus Group Study on Health Professionals’ Experiences in General Practice

    OpenAIRE

    Lone Marie Larsen; Loni Ledderer; Dorte Ejg Jarbøl

    2015-01-01

    Background. Because of the increasing prevalence of overweight and obesity in childhood in the Western world, focus on the management in general practice has also increased. Objective. To explore the experiences of general practitioners (GPs) and practice nurses participating in a randomised controlled trial (RCT) comparing two management programmes in general practice for children who are overweight or obese. Methods. Three focus groups with GPs and nurses participating in the RCT. Transcrib...

  3. Internet services for communicating with the general practice: barely noticed and used by patients

    OpenAIRE

    Huygens, M.W.J.; VERMEULEN, J; Friele, R.; Schayck, O.C.P. van; Jong, J.D. de; de Witte, L.P.

    2015-01-01

    Background: The Netherlands is one of the frontrunners of eHealth in Europe. Many general practices offer Internet services, which can be used by patients to communicate with their general practice. In promoting and implementing such services, it is important to gain insight into patients’ actual use and intention toward using. Objective: The objective of the study is to investigate the actual use and intention toward using Internet services to communicate with the general practice by the gen...

  4. Algorithm linking patients and general practices in Denmark using the Danish National Health Service Register

    OpenAIRE

    Kjaersgaard,Maiken; Vedsted, Peter; Parner, Erik; Bech,Bodil; Vestergaard, Mogens; Flarup,Kaare; Fenger-Grøn,Morten

    2016-01-01

    Maiken Ina Siegismund Kjaersgaard,1 Peter Vedsted,2 Erik Thorlund Parner,1 Bodil Hammer Bech,3 Mogens Vestergaard,2,4 Kaare Rud Flarup,2 Morten Fenger-Grøn,2 1Section for Biostatistics, 2Research Unit for General Practice, 3Section for Epidemiology, 4Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark Background: The patient list system in Denmark assigns virtually all residents to a general practice. Nevertheless, historical inform...

  5. Accuracy of perception of severity of asthma: patients treated in general practice.

    OpenAIRE

    Kendrick, A. H.; Higgs, C M; Whitfield, M. J.; Laszlo, G

    1993-01-01

    OBJECTIVE--To determine the frequency of poor perception of severity of asthma in general practice. DESIGN--Asthmatic patients recorded their perceived severity of asthma, with a visual analogue score, and a coded measurement of their peak expiratory flow up to four times daily for 14 consecutive days. SETTINGS--11 general practices in and around Bristol. SUBJECTS--255 asthmatic patients (139 men and 116 women) aged 17-76 who were recruited by random selection from the general practices' dise...

  6. The 'heartsink' patient revisited. The Welsh Philosophy And General Practice discussion Group.

    OpenAIRE

    Butler, C C; Evans, M

    1999-01-01

    The term 'heartsink patient' is now part of the vocabulary of general practice. But what and where is the heartsink? How should the phenomenon be studied? What are the implications of differing interpretations for general practice? The heartsink patient presents personal, social, and soteriological (pertaining to salvation) problems in physical terms. This poses a fundamental challenge to the philosophical foundations of general practice. Emphasizing a biomedical role justifies questioning th...

  7. Feasibility study of hernia surgery in a general practice setting

    OpenAIRE

    Dhumale, Raj

    2004-01-01

    Background: In the early 1990s, waiting times for some surgical procedures and opinions for such routine problems as groin hernia repair were unacceptably long. General practitioners with a special interest (GPwSIs) in general surgery may improve this, but little evidence exists as to whether such service developments may improve efficiency and effectiveness of care.

  8. General educational disciplines practice-oriented training in intermediate vocational education

    OpenAIRE

    Liya G. Skorobogatova

    2011-01-01

    The article concerns crucial issues of practice-oriented training in Russia's intermediate vocational education, designates directions of general educational disciplines study in intermediate vocational education.

  9. Urinary tract infections in general practice patients: diagnostic tests versus bacteriological culture.

    NARCIS (Netherlands)

    Nys, S.; Merode, T. van; Bartelds, A.I.M.; Stobberingh, E.E.

    2006-01-01

    Objectives: Urinary tract infections (UTIs) are common bacterial infections encountered in general practice. For the optimal treatment the general practitioner (GP) should rely on the results of diagnostic tests and recent antimicrobial susceptibility of uropathogens. Patients and methods: In total

  10. PBL. Linguistics Collage Rubric (practical sessions) - 31710 General Linguistics I

    OpenAIRE

    Muñoz Baell, Irma María

    2012-01-01

    Project Based Learning (PBL). Creating your own Linguistics Collage. Linguistics Collage Rubric (Four-point review) – Weeks 13-15 (In-class work) - Academic year 2011-2012 (ECTS credits: 6 (150 hours)). See the Planned Weekly Schedule (Practical sessions).

  11. Special features of general practice (primary care) and ethical implications.

    OpenAIRE

    Fry, J

    1980-01-01

    In all systems of health care there are certain essential levels of care and service. These take the form of self-care within the family unit; primary professional care by general medical nursing or social practitioners within a local neighbourhood; general specialist care in a district and super-specialist care in a region. Each of these has its own special roles and responsibilities and each is considered in this paper.

  12. WestREN: a description of an Irish academic general practice research network

    Directory of Open Access Journals (Sweden)

    Glynn Liam G

    2010-10-01

    Full Text Available Abstract Background Primary care research networks have been established internationally since the 1960s to enable diverse practitioners to engage in and develop research and education and implement research evidence. The newly established Western Research and Education Network (WestREN is one such network consisting of a collaboration between the Discipline of General Practice at NUI Galway and 71 West of Ireland general practices. In September 2009 all member practices were issued with a questionnaire with two objectives: to describe the structure and characteristics of the member practices and to compare the results to the national profile of Irish general practice. Methods A postal survey was used followed by one written and one email reminder. Results A response rate of 73% (52/71 was achieved after two reminders. Half of practices were in a rural location, one quarter located in an urban setting and another quarter in a mixed location. Ninety-four per cent of general practitioners practice from purpose-built or adapted premises with under 6% of practices being attached to the general practitioner's residence. Over 96% of general practitioners use appointment systems with 58% using appointment only. All practices surveyed were computerised, with 80% describing their practices as 'fully computerised'. Almost 60% of general practitioners are coding chronic diagnoses with 20% coding individual consultations. Twenty-five per cent of general practitioners were single-handed with the majority of practices having at least two general practitioners, and a mean number of general practitioners of 2.4. Ninety-two per cent of practices employed a practice nurse with 30% employing more than one nurse. Compared to the national profile, WestREN practices appear somewhat larger, and more likely to be purpose-built and in rural areas. National trends apparent between 1982 and 1992, such as increasing computerisation and practice nurse availability, appear

  13. Continuing education for general practice. 1. Experience, competence and the media of self-directed learning for established general practitioners.

    OpenAIRE

    Stanley, I; al-Shehri, A; Thomas, P

    1993-01-01

    The arrangements under which continuing education for general practice is provided and attendance by general practitioners is rewarded have now been in operation for three years. More recently, reaccreditation has emerged as a significant issue for the profession. For these reasons it appears timely to review the whole basis of ongoing learning by established general practitioners. In this the first of two papers, learning by established professionals is considered in relation to the educatio...

  14. Standard practice for liquid penetrant examination for general industry

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2009-01-01

    1.1 This practice covers procedures for penetrant examination of materials. Penetrant testing is a nondestructive testing method for detecting discontinuities that are open to the surface such as cracks, seams, laps, cold shuts, shrinkage, laminations, through leaks, or lack of fusion and is applicable to in-process, final, and maintenance testing. It can be effectively used in the examination of nonporous, metallic materials, ferrous and nonferrous metals, and of nonmetallic materials such as nonporous glazed or fully densified ceramics, as well as certain nonporous plastics, and glass. 1.2 This practice also provides a reference: 1.2.1 By which a liquid penetrant examination process recommended or required by individual organizations can be reviewed to ascertain its applicability and completeness. 1.2.2 For use in the preparation of process specifications and procedures dealing with the liquid penetrant testing of parts and materials. Agreement by the customer requesting penetrant inspection is strongly rec...

  15. Patient exposure in general dental practice in the Netherlands

    International Nuclear Information System (INIS)

    To estimate the population risk due to dental radiography an investigation was started among 1200 dental practitioners. A questionnaire was set up to inventory commonly applied indications of X-ray examinations, the number of examinations and the organizational actions taken by the dentists to limit radiation doses to the patients. Information was gathered on the type of X-ray machines, the use of aiming devices, protective measurements for patients and dental staff, developing procedures and the type of films. A number of practical tests was applied to obtain a quantitative impression of patient doses in accordance with special circumstances. For the practical tests films and lithium fluoride TLD-100 chips (Harshaw) were used to determine the beam diameter, the exposure of the X-ray machine and the scatter at a set distance of the middle of the beam, developing circumstances as well as entrance and exist skin doses measured on the skin of a patient. The results of 544 dental practices will be discussed. Finally an estimation of the possible extent of reduction in patient exposure in the Netherlands will be made

  16. Management of gout in a South Auckland general practice

    Directory of Open Access Journals (Sweden)

    Reaves E

    2014-03-01

    Full Text Available BACKGROUND AND CONTEXT: In New Zealand, the highest prevalence of gout is in Maori and Pacific people. Counties Manukau District Health Board (CMDHB has the highest Maori and Pacific population of any New Zealand District Health Board. A CMDHB study found that a high proportion of patients with gout were also at increased risk of cardiovascular disease. ASSESSMENT OF PROBLEMS: The primary objective was to examine whether the control of gout had changed over time at one clinic. The secondary objective was to assess the management of cardiovascular risk factors in patients with gout at that clinic. RESULTS: The mean serum uric acid level of patients with gout in the practice had risen in comparison with a similar audit carried out in March 2009. This indicates that the control of gout for patients at the practice has worsened over time. Many patients had not had an annual serum uric acid test. STRATEGIES FOR IMPROVEMENT: A repeat uric acid level was scheduled for all patients with gout in the practice, with follow-up appointments to be arranged if the result was abnormal. LESSONS: Gout is often suboptimally managed. Serum uric acid levels may only be tested when a patient presents with an acute attack of gout. Consideration should be given to a minimum of annual serum uric acid levels. Appropriate management of modifiable cardiovascular risk factors in this particular cohort is important and should be a particular focus of care.

  17. A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse-general practitioner teams: Study Protocol

    Directory of Open Access Journals (Sweden)

    Bunker Jeremy M

    2012-09-01

    quality of life measures, smoking and immunisation status, medications, inhaler technique, and lung function. Outcomes will be assessed by project officers blinded to patients’ randomization groups. Discussion This study will use proven case-finding methods to identify patients with undiagnosed COPD in general practice, where improved care has the potential for substantial benefit in health and healthcare utilization. The study provides the capacity to trial a new model of team-based assessment and management of newly diagnosed COPD in Australian primary care. Trial registration ACTRN12610000592044

  18. 全科医学中的心理健康病案研究(十五)——一位老人的抑郁(第二部分)%Case Studies of Mental Health in General Practice(15)--Depression in An Old Person(Part Two)

    Institute of Scientific and Technical Information of China (English)

    Fiona Judd; Grant Blashki; Leon Piterman; 杨辉

    2013-01-01

    The Journal presents the Column of Case Studies of Mental Health in General Practice; with academic support from Australian experts in general practice, psychology and psychiatry from Monash University and the U-niversity of Melbourne. The Column's purpose is to respond to the increasing needs of mental health services in China. Through study and analysis of mental health cases, we hope to improve understanding of mental illnesses in Chinese primary health settings , and to build capacity of community health professional in managing of mental illnesses in general practice. Patient - centred and whole - person approach in general practice is the best way to maintain and improve the physical and mental health of residents. Our hope is that these case studies will lead new wave of general practice and mental health development both in practice and academic research. A number of Australian experts from the disciplines of general practice, mental health and psychiatry will contribute to the Column. You will find A/Professor Blashki, Professor Judd and Professor Piterman are authors of General Practice Psychiatry. The Journal cases are helping to prepare for the translation and publication of a Chinese version of the book in China. We believe Chinese mental health in primary health care will step up to a new level under this international cooperation.

  19. Australian Extinctions

    Science.gov (United States)

    Science Teacher, 2005

    2005-01-01

    Massive extinctions of animals and the arrival of the first humans in ancient Australia--which occurred 45,000 to 55,000 years ago--may be linked. Researchers at the Carnegie Institution, University of Colorado, Australian National University, and Bates College believe that massive fires set by the first humans may have altered the ecosystem of…

  20. Increasing the general level of academic capacity in general practice: introducing mandatory research training for general practitioner trainees through a participatory research process

    DEFF Research Database (Denmark)

    Tulinius, Anne-Charlotte; Nielsen, Anni Brit Sternhagen; Hansen, Lars Jørgen;

    2012-01-01

    production in academia. CONCLUSION: It is possible to support the development of general academic capacity in general practice using participatory design in collaboration with GP academics and clinicians, building bridges between academia and clinical work, as well as within academia between research......BACKGROUND: To obtain good quality evidence-based clinical work there needs to be a culture of critical appraisal, and strong bridges between the clinical and the academic worlds in general practice. AIM: The aim was to educate the general practitioner (GP) trainees to obtain critical appraisal...

  1. Patients with shoulder syndromes in general and physiotherapy practice: an observational study.

    NARCIS (Netherlands)

    Kooijman, M.; Swinkels, I.; Dijk, C. van; Bakker, D. de; Veenhof, C.

    2013-01-01

    Background: Shoulder complaints are commonly seen in general practice and physiotherapy practice. The only complaints for which general practitioners (GPs) refer more patients to the physiotherapist are back and neck pain. However, a substantial group have persistent symptoms. The first goal of this

  2. Transferable and non-transferable drug resistance in enteric bacteria from hospital and from general practice

    DEFF Research Database (Denmark)

    Møller, JK; Bak, AL; Bülow, P;

    1976-01-01

    strains from general practice. Multiple resistance was common especially in strains from hospital. R factors was found in 23% of the 317 drug-resistant strains from hospital and in 11% of the 46 drug-resistant strains from general practice. Resistance to streptomycin, sulphonamide and tetracycline either...

  3. Internet services for communicating with the general practice: barely noticed and used by patients

    NARCIS (Netherlands)

    Huygens, M.W.J.; Vermeulen, J.; Friele, R.; Schayck, O.C.P. van; Jong, J.D. de; Witte, L.P. de

    2015-01-01

    Background: The Netherlands is one of the frontrunners of eHealth in Europe. Many general practices offer Internet services, which can be used by patients to communicate with their general practice. In promoting and implementing such services, it is important to gain insight into patients’ actual us

  4. Epidemiology of respiratory tract infections in Dutch general practice: a historical analysis.

    NARCIS (Netherlands)

    Schellevis, F.G.; Donker, G.

    2007-01-01

    Aims: To describe time trends in the incidence of respiratory tract infections in general practice in the Netherlands and its relation to sex and age. Design and Methods: Data will be presented from several morbidity surveys conducted in general practices in the Netherlands: the Intermittent Morbidi

  5. General principles of advertising practices and consumer protection

    OpenAIRE

    Slánská, Martina

    2008-01-01

    Diploma thesis provides an overview of legal and ethical regulation of advertising, defines the basic concepts in advertising, summarizes the functions and objectives of advertising and characterized various forms of advertising by the communication media. Through the questionnaire survey detects and analyzes the general attitudes towards advertising as specific views on ethically problematic advertisements.

  6. Communicating fatigue in general practice and the role of gender

    NARCIS (Netherlands)

    Meeuwesen, L.; Bensing, J.; Brink-Muinen, A. van den

    2002-01-01

    The aim of this study has been to obtain more insight into the health condition of fatigued patients, their expectations when visiting the general practitioner (GP), the way they communicate, and possible gender differences. Data consisted of 579 patient questionnaires and 440 video-observations of

  7. New drugs in general practice: prescribing patterns and external influences

    NARCIS (Netherlands)

    Florentinus, S.R.

    2006-01-01

    In this thesis several studies are presented with the objective to detect and elucidate the patterns by which new drugs are prescribed by general practitioners (GPs). Furthermore, we studied the influences of medical specialists and community pharmacists as important factors on the GP's decision to

  8. Chinese Rebalancing and Australian Exports

    OpenAIRE

    Gerard Kelly

    2014-01-01

    The Chinese authorities plan to gradually rebalance the composition of Chinese economic growth from investment towards household consumption. This article uses the World Input-Output Database (WIOD) to give a general sense of how this rebalancing might affect Australian exports and economic activity. Dollar for dollar, Chinese investment appears to absorb more than twice as much Australian value-added output as Chinese household consumption. This largely reflects the significant role of resou...

  9. A counsellor in general practice: a one-year survey

    OpenAIRE

    Martin, Edwin; Mitchell, Hazel

    1983-01-01

    A counsellor was included within the professional staff of a practice of 11,000 patients cared for by five partners. A review of her work over a 12-month period is described. Eighty-seven patients were counselled in 197 sessions. Thirty-five per cent of first appointments and 22 per cent of subsequent appointments were not kept. The problems dealt with most frequently were anxiety and stress, marital troubles and abortion. Patients perceived the service as giving relief by allowing them to ta...

  10. [The practice guideline 'Pregnancy and puerperium' (first revision) from the Dutch College of General Practitioners; a response from the perspective of general practice medicine].

    Science.gov (United States)

    Giesen, P H; Slagter-Roukema, T M

    2004-01-10

    The first revision of the Dutch College of General Practitioners' practice guideline about pregnancy and puerperium does not significantly differ from the first edition. The guideline is extensive, is well-worth reading and supports daily practice. There is a greater emphasis on the importance of cooperation and differentiation in primary care (midwifes and general practitioners). During the last decade many general practitioners stopped doing home deliveries and have therefore lost their experience in obstetric care and pathology. The guideline describes the general practitioner's tasks as a preconception counsellor, a professional expert on illnesses during pregnancy and after the delivery, and as the doctor of the newborn baby. It will hopefully stimulate a revived interest of and involvement in pregnancy and post-partum care among general practitioners. PMID:14753124

  11. Gender Differences in Practice Style: A Dutch Study of General Practitioners

    OpenAIRE

    Bensing, J.; Brink-Muinen, A. van den; Bakker, D.

    1993-01-01

    The differences between female and male general practitioners (GPs) were studied regarding three different factors: 1) Do female GPs see more female patients than their male colleagues in the same practice?; 2) Are female GPs confronted with different types of health problems from their male colleagues?; and 3) Do female GPs provide different services to their patients? Data from the Dutch National Study on Morbidity and Interventions in General Practice were used. All practices in this study...

  12. Do clinical guidelines improve general practice management and referral of infertile couples?

    OpenAIRE

    Emslie, C.; Grimshaw, J; Templeton, A.

    1993-01-01

    OBJECTIVE--To evaluate guidelines for general practice management and referral of infertile couples. Guidelines were implemented with a disease specific reminder at the time of consultation (the guidelines were embedded within a structured infertility management sheet for each couple). DESIGN--Pragmatic randomised controlled trial. Participating practices were randomised to a group that received the guidelines and a control group. SETTING--82 general practices in Grampian region. SUBJECTS--10...

  13. Factors predicting team climate, and its relationship with quality of care in general practice

    OpenAIRE

    Eccles Martin P; Goh Teik T; Steen Nick

    2009-01-01

    Abstract Background Quality of care in general practice may be affected by the team climate perceived by its health and non-health professionals. Better team working is thought to lead to higher effectiveness and quality of care. However, there is limited evidence available on what affects team functioning and its relationship with quality of care in general practice. This study aimed to explore individual and practice factors that were associated with team climate, and to explore the relatio...

  14. Evaluation of a pharmacist-led intervention to reduce prescribing costs in general practice

    OpenAIRE

    Rodgers, Sarah

    2005-01-01

    Introduction and aim It has been suggested that the employment of pharmacists in general practice might moderate the growth in prescribing costs. However, empirical evidence for this proposition has been lacking. The aim of this study was to evaluate a controlled trial of pharmacist-led intervention in general practice to determine whether intervention practices made savings relative to controls and if so, exactly how these savings were made and whether quality of prescribing was maintain...

  15. Risk Reduction Technologies in General Practice and Social Work

    OpenAIRE

    Devin Rexvid; Björn Blom; Lars Evertsson; Annika Forssén

    2012-01-01

    General practitioners (GPs) and social workers (SWs) are professions whose professional autonomy and discretion have changed in the so-called risk and audit society. The aim of this article is to compare GPs’ and SWs’ responses to Evidence-Based and Organizational Risk Reduction Technologies (ERRT and ORRT). It is based on a content analysis of 54 peer-reviewed empirical articles. The results show that both professions held ambivalent positions towards ERRT. The response towards ORRT differed...

  16. Risk reduction technologies in general practice and social work

    OpenAIRE

    Rexvid, Devin; Blom, Björn; Evertsson, Lars; Forssén, Annika

    2012-01-01

    General practitioners (GPs) and social workers (SWs) are professions whose professional autonomy and discretion have changed in the so-called risk and audit society. The aim of this article is to compare GPs’ and SWs’ responses to Evidence-Based and Organizational Risk Reduction Technologies (ERRT and ORRT). It is based on a content analysis of 54 peer-reviewed empirical articles. The results show that both professions held ambivalent positions towards ERRT. The response towards ORRT differed...

  17. Welfare to work: the role of general practice.

    OpenAIRE

    Ford, F M; Ford, J; Dowrick, C.

    2000-01-01

    This paper considers the potential effects of the government's Welfare to Work policy on general practitioner (GP) working patterns, and aims to explore the relationship between unemployment, ill health, and GP sickness certification. Social security and employment policy initiatives are discussed in relation to the literature on the relationship between unemployment and ill health, sociological and psychological perspectives on work and unemployment, medicalisation of unemployment, adjudicat...

  18. Upper gastrointestinal endoscopy — a view from general practice

    OpenAIRE

    Jones, Roger

    1986-01-01

    An open-access upper gastrointestinal endoscopy service for general practitioners is described. Between July 1981 and May 1985, 391 endoscopies were performed on 354 patients. In contrast to the results of other studies, demand for endoscopy and the pick-up rate for major lesions has remained steady, and the number of requests for barium meals has fallen by almost a quarter. Major lesions — cancer, gastric and duodenal ulcers and severe oesophagitis — were found in 33% of patients. Oesophagit...

  19. LFI: A Practical and General Library-Level Fault Injector

    OpenAIRE

    MARINESCU Paul; Candea, George

    2009-01-01

    Fault injection, a critical aspect of testing robust systems, is often overlooked in the development of general-purpose software. We believe this is due to the absence of easy-to-use tools and to the extensive manual labor required to perform fault injection tests. This paper introduces LFI (Library Fault Injector), a tool that automates the preparation of fault scenarios and their injection at the boundary between shared libraries and applications. LFI extends prior work by automatically pro...

  20. A modified framework for rural general practice: the importance of recruitment and retention.

    Science.gov (United States)

    Humphreys, J S; Rolley, F

    1998-04-01

    Whilst definitions of what constitutes general practice vary according to purpose, the pivotal role of general practitioners as key providers of health and medical services is acknowledged. Recent concerns to address both what general practitioners and their patients want and get from general practice stem from a recognized need to include stakeholder concerns about the adequacy of general practice alongside workforce issues such as recruitment and retention. Nowhere is this need so crucial as in rural areas where the range of health services is limited and major inequities exist in the availability of general practitioners. An extended framework for evaluating what general practitioners and their patients expect and receive from general practice, with particular reference to rural general practice in Australia is presented. Three inter-related dimensions of recruitment, retention and a whole patient/whole family approach to health care are suggested as underpinning this framework. The significance of each dimension to ensuring the provision of quality general practice care in rural communities, and the links between them, are outlined in the proposed framework. PMID:9579746

  1. Open Access to General Practice Was Associated with Burnout among General Practitioners

    DEFF Research Database (Denmark)

    Vedsted, Peter; Sokolowski, Ineta; Olesen, Frede

    2013-01-01

    Burnout Inventory. Analyses using logistic regression were adjusted for gender, age, marital status, job satisfaction, minutes per consultation, practice organisation, working hours, number of listed patients per GP, number of contacts per GP, continuing medical education- (CME-) activities, and clusters...

  2. The Objective structured clinical examination for general practice: design, validity and reliability

    OpenAIRE

    Thomson, Donald M.

    1987-01-01

    This paper describes and analyses an experimental clinical examination for general practice. Differences in the results obtained by fourth year students, fifth year students and trainee general practitioners highlight some of the dilemmas of medical education. It is concluded that examinations which include clinical tests can increase the credibility of general practice examinations, can be reliably applied to small groups of candidates and therefore have considerable potential for formative ...

  3. Patient satisfaction surveys as a market research tool for general practices.

    OpenAIRE

    Khayat, K.; Salter, B.

    1994-01-01

    BACKGROUND. Recent policy developments, embracing the notions of consumer choice, quality of care, and increased general practitioner control over practice budgets have resulted in a new competitive environment in primary care. General practitioners must now be more aware of how their patients feel about the services they receive, and patient satisfaction surveys can be an effective tool for general practices. AIM. A survey was undertaken to investigate the use of a patient satisfaction surve...

  4. Long-term outcome of patients with neurotic illness in general practice.

    OpenAIRE

    Lloyd, K. R.; Jenkins, R; Mann, A.

    1996-01-01

    OBJECTIVE--To determine the 11 year outcome of neurotic disorder in general practice. DESIGN--Cohort study over 11 years. SETTING--Two general practices in Warwickshire England. SUBJECTS--100 patients selected to be representative of those identified nationally by general practitioners as having neurotic disorders. MAIN OUTCOME MEASURES--Mortality, morbidity, and use of health services. RESULTS--At 11 years 87 subjects were traced. The 11 year standardised mortality ratio was 173 (95% confide...

  5. The epidemiology of suicide and attempted suicide in Dutch general practice 1983-2003.

    OpenAIRE

    Schellevis François G; Kerkhof Ad JFM; Bartelds Aad IM; Marquet Richard L; van der Zee Jouke

    2005-01-01

    Abstract Background Many patients attempting or committing suicide consult their general practitioner (GP) in the preceding period, indicating that GPs might play an important role in prevention. The aim of the present study was to analyse the epidemiology of suicidal behaviour in Dutch General Practice in order to find possible clues for prevention. Method Description of trends in suicide and suicide attempts occurring from 1983–2003 in the Dutch General Practice Sentinel Network, representi...

  6. Effect of mailed reminders on the response rate in surveys among patients in general practice

    DEFF Research Database (Denmark)

    Wensing, M; Mainz, Jan; Kramme, O; Jung, H P; Ribacke, M

    1999-01-01

    Randomized trials were performed in Denmark and The Netherlands to determine the effect of mailed reminders on the response rate in surveys among patients in general practice. In both countries, general practitioners handed out questionnaires to 200 adult patients who came to visit them. An......) but not in Denmark (87% versus 81%, respectively). Mailed reminders can improve the response rate in surveys related to a general practice, but they are not effective in all situations....

  7. What Should General Practice Trainees Learn about Atopic Eczema?

    Directory of Open Access Journals (Sweden)

    Deepani Munidasa

    2015-02-01

    Full Text Available Effective atopic eczema (AE control not only improves quality of life but may also prevent the atopic march. The Royal College of General Practitioners’ (RCGP curriculum does not currently provide specific learning outcomes on AE management. We aimed to gain consensus on learning outcomes to inform curriculum development. A modified Delphi method was used with questionnaires distributed to gather the views of a range of health care professionals (HCPs including general practitioners (GPs, dermatologists, dermatology nurses and parents of children with AE attending a dedicated paediatric dermatology clinic. Ninety-one questionnaires were distributed to 61 HCPs and 30 parents; 81 were returned. All agreed that learning should focus on the common clinical features, complications and management of AE and the need to appreciate its psychosocial impact. Areas of divergence included knowledge of alternative therapies. Parents felt GPs should better understand how to identify, manage and refer severe AD and recognized the value of the specialist eczema nurse. Dermatologists and parents highlighted inconsistencies in advice regarding topical steroids. This study identifies important areas for inclusion as learning outcomes on AE management in the RCGP curriculum and highlights the importance of patients and parents as a valuable resource in the development of medical education.

  8. Jump detection in generalized error-in-variables regression with an application to Australian health tax policies

    OpenAIRE

    Kang, Yicheng; Gong, Xiaodong; Gao, Jiti; Qiu, Peihua

    2015-01-01

    Without measurement errors in predictors, discontinuity of a nonparametric regression function at unknown locations could be estimated using a number of existing approaches. However, it becomes a challenging problem when the predictors contain measurement errors. In this paper, an error-in-variables jump point estimator is suggested for a nonparametric generalized error-in-variables regression model. A major feature of our method is that it does not impose any parametric distribution on the m...

  9. When General Skills Are Not Enough: The Influence of Recent Shifts in Australian Skilled Migration Policy on Migrant Employment Outcomes

    OpenAIRE

    Justin van de Ven; Sarah Voitchovsky; Hielke Buddelmeyer

    2014-01-01

    Although many countries are now using skilled migration to offset declining fertility and increased longevity, there is thin empirical evidence concerning the effects of alternative approaches to managing the skilled migrant intake. This study focusses on the effects on migrant labour market outcomes of Australia’s recent shift from a points-based “supply driven” model that favoured independent General Skilled Migrants, to a “hybrid model” that balances supply driven migration against Employe...

  10. The estimation of patients' views on organizational aspects of a general dental practice by general dental practitioners: a survey study

    OpenAIRE

    Truin Gert-Jan; Bronkhorst Ewald M; Wensing Michel; Sonneveld Rutger E; Brands Wolter G

    2011-01-01

    Abstract Background Considering the changes in dental healthcare, such as the increasing assertiveness of patients, the introduction of new dental professionals, and regulated competition, it becomes more important that general dental practitioners (GDPs) take patients' views into account. The aim of the study was to compare patients' views on organizational aspects of general dental practices with those of GDPs and with GDPs' estimation of patients' views. Methods In a survey study, patients...

  11. Controlling Non-Point Source Pollution in Australian Agricultural Systems

    Institute of Scientific and Technical Information of China (English)

    C. GOURLEY; A. RIDLEY

    2005-01-01

    The Australian farming sector is continuing to intensify, particularly within 300 km of the east and southern coastlines.In the future there will be fewer and larger farms, which will use more fertilizer, support more stock, grow more monoculture crops, and utilise more marginal soils. This is likely to increase the major environmental impacts of soil degradation, salt,nutrient and sediment contamination of waterways, and greenhouse gas emissions. Australian national water policy continues to focus on land, stream and groundwater salinity issues, although there is now a greater recognition of the importance of nitrogen and phosphorus losses from agriculture. The general philosophy of policy for dealing with nonpoint source pollution has been towards a voluntary rather than regulatory approach, with state and national governments supporting a range of programs to encourage sustainable agricultural practices. A catchment (watershed) based approach,through the use of integrated catchment management plans, is the primary way that non-point source pollution is addressed at the farm and local level. At an industry level, cotton, grains, meat, sugarcane and dairy amongst others, as well as the Australian fertilizer industry, have responded to non-point source issues by investing in research and development, and developing codes of practice aimed at abating these environmental impacts. Understanding the economic, social, political and cultural contexts of farming as well as the environmental impacts of agriculture are very important in determining the appropriateness of policy responses for Australian farming systems.

  12. [Meticulous handling of electronic patient records in general practice].

    Science.gov (United States)

    Lamberts, H; van Boven, C

    2000-10-21

    A 41-year-old woman visited her general practitioner because she wished to receive her medical records and those of her two children. She had decided to move pending divorce and wanted to transfer her medical information to another physician. The information was handed to her on a floppy disk. The next day her husband came and demanded that his own information be deleted from the records. Many Dutch physicians have electronic patient records, which will replace paper records presently. Patients may decide to have their medical information selectively transferred to another physician. This may interfere with adequate information of the treating physician. Electronic episode-related patient records may facilitate transfer of information and will have an important role in regulating physician-patient contact according to the Wet Bescherming Persoonsgegevens (Act on the protection of personal data), the Wet op de Geneeskundige Behandelingsovereenkomst (Act on agreement concerning medical treatment), and the Wet op de Beroepen in de Individuele Gezondheidszorg (Individual health care professionals act). Patients' rights to control the transfer of their information must be ensured. PMID:11072504

  13. An expanded prescribing role for pharmacists - an Australian perspective

    OpenAIRE

    Kreshnik Hoti; Jeffery Hughes; Bruce Sunderland

    2011-01-01

    Expanded pharmacist prescribing is a new professional practice area for pharmacists. Currently, Australian pharmacists’ prescribing role is limited to over-the-counter medications. This review aims to identify Australian studies involving the area of expanded pharmacist prescribing. Australian studies exploring the issues of pharmacist prescribing were identified and considered in the context of its implementation internationally. Australian studies have mainly focused on the attitudes of com...

  14. Problems in Communications with Patients in General Surgery Outpatient Practice

    Science.gov (United States)

    Yilmaz, Tonguc Utku; Gumus, Enes; Salman, Bulent

    2015-01-01

    Objective: Communication between the patient and physician is central to medical care. However communication skills in Turkey haven’t been gained so much concern. This situation effect the national quality of health care. Here, we tried to perform some basic communication skills and to find the problems with the possible solution suggestions. Materials and Methods: The study was conducted for a month in general surgery outpatient department located in the slum part of Ankara with low socio-economic population. Basic communication skills were performed. The age, sex, education levels of the patients were obtained. Total symptom expression and interview time were recorded. Previous medical histories were asked. Interruptions including telephone, door knocking were noted. The questions of the patients at the end of the interview classified as hospital setting, nutrition and treatment. Results: Total 410 interviews were analysed. Mean symptom expression and interview times were 22.9 sec and 7.05 min, respectively. Educated patients, males and young patients expressed symptoms longer than the others (p<0.05). There were 174 interruptions in which total interview time signifantly increased than the non interrupted ones (p<0.05). Final questions about hospital setting were signifantly higher in illiterate patients than the educated ones (p<0.05). Awareness of medical history is higher in educated and young patients. Conclusion: Basic communications skills can be performed whether in rural regions. Much more concern should be given to the education of communication skills. The obstacles in communication in medicine are low education levels, and unorganised health system. PMID:26644767

  15. COPD exacerbations in general practice: variability in oral prednisolone courses

    Directory of Open Access Journals (Sweden)

    de Vries Marianne

    2012-01-01

    Full Text Available Abstract Background The use of oral corticosteroids as treatment of COPD exacerbations in primary care is well established and evidence-based. However, the most appropriate dosage regimen has not been determined and remains controversial. Corticosteroid therapy is associated with a number of undesirable side effects, including hyperglycaemias, so differences in prescribing might be relevant. This study examines the differences between GPs in dosage and duration of prednisolone treatment in patients with a COPD exacerbation. It also investigates the number of general practitioners (GPs who adjust their treatment according to the presence of diabetic co-morbidity. Methods Cross-sectional study among 219 GPs and 25 GPs in training, located in the Northern part of the Netherlands. Results The response rate was 69%. Nearly every GP prescribed a continuous dose of prednisolone 30 mg per day. Among GPs there were substantial differences in treatment duration. GPs prescribed courses of five, seven, ten, or fourteen days. A course of seven days was most common. The duration of treatment depended on exacerbation and disease severity. A course of five days was especially prescribed in case of a less severe exacerbation. In a more severe exacerbation duration of seven to fourteen days was more common. Hardly any GP adjusted treatment to the presence of diabetic co-morbidity. Conclusion Under normal conditions GPs prescribe prednisolone quite uniformly, within the range of the current Dutch guidelines. There is insufficient guidance regarding how to adjust corticosteroid treatment to exacerbation severity, disease severity and the presence of diabetic co-morbidity. Under these circumstances, there is a substantial variation in treatment duration.

  16. The practice characterization model: the importance of organizational life cycles and targeted interventions in general medical practice.

    Science.gov (United States)

    Atkins, E M; Duffy, M C; Bain, D J

    2001-01-01

    In response to a climate of constant change and increasing demand for services, general practice in the UK has undergone significant modification over the last 10 years. It has become a multi-disciplinary organisation encouraged by funding bodies to plan for service delivery using a more structured team based approach. In Tayside in 1996, practices were charged with producing formal Practice Development Plans (PDPs) which would focus on priority areas aligned with the Health Boards own strategic plan--those were teamwork, information management and technology, and clinical service delivery. The University of Dundee's Department of General Practice successfully applied for funding to develop ways of facilitating practices so that they could a) identify their own development priorities, and b) plan and implement action and learning to see these priorities through. Using action research methodology, the project attempted to create a climate for change, provide support and training to see the changes implemented, and ensure commitment to the changes from all members of the practice team. The Facilitator adopted a flexible style varying her role between expert, guide and support. Analysis of progress made by different practices, coupled with the Facilitator's in depth knowledge of them, suggested the importance of certain key aspects of practice organisation and culture. A practice characterisation model identified practices which were stable, currently coping, proactive and ready to face the challenge of change as best placed to engage in a full scale development programme. Other profiles suggested a range of alternative interventions as more likely to be acceptable and productive. PMID:11499046

  17. Reducing the risk of heart disease among Indian Australians: knowledge, attitudes, and beliefs regarding food practices – a focus group study

    Directory of Open Access Journals (Sweden)

    Ritin Fernandez

    2015-06-01

    Full Text Available Background: Australia has a growing number of Asian Indian immigrants. Unfortunately, this population has an increased risk for coronary heart disease (CHD. Dietary adherence is an important strategy in reducing risk for CHD. This study aimed to gain greater understanding of the knowledge, attitudes and beliefs relating to food practices in Asian Indian Australians. Methods: Two focus groups with six participants in each were recruited using a convenience sampling technique. Verbatim transcriptions were made and thematic content analysis undertaken. Results: Four main themes that emerged from the data included: migration as a pervasive factor for diet and health; importance of food in maintaining the social fabric; knowledge and understanding of health and diet; and elements of effective interventions. Discussion: Diet is a complex constructed factor in how people express themselves individually, in families and communities. There are many interconnected factors influencing diet choice that goes beyond culture and religion to include migration and acculturation. Conclusions: Food and associated behaviors are an important aspect of the social fabric. Entrenched and inherent knowledge, attitudes, beliefs and traditions frame individuals’ point of reference around food and recommendations for an optimal diet.

  18. Regenerating the Australian Landscape of Professional VET Practice: Practitioner-Driven Changes to Teaching and Learning. Research Overview

    Science.gov (United States)

    Figgis, Jane

    2009-01-01

    Donald Schon once famously pictured professional practice as a high, hard ground overlooking a swamp. The high ground is the place of theory and, one might add, of policy. The swampy lowland is where vocational education and training (VET) practitioners meet the learners. It is where the skills, knowledge, and attitudes they wish to see instilled…

  19. Mentoring Reflective Practice in Pre-Service Teachers: A Reconstruction through the Voices of Australian Science Teachers

    Science.gov (United States)

    de Ville, Paul A.

    2010-01-01

    This paper explores the formative basis of the professional reflective practice of in-service science teachers through their reconstruction of their pre-service interaction with lecturing staff. It reports through the voice of graduates of the Bachelor of Science/Bachelor of Teaching double degree program of Avondale College, NSW who are currently…

  20. General educational disciplines practice-oriented training in intermediate vocational education

    Directory of Open Access Journals (Sweden)

    Liya G. Skorobogatova

    2011-01-01

    Full Text Available The article concerns crucial issues of practice-oriented training in Russia's intermediate vocational education, designates directions of general educational disciplines study in intermediate vocational education.

  1. Shortages in general practice despite feminisation of medicine: a seeming paradox? A cohort study.

    NARCIS (Netherlands)

    Maiorova, T.; Stevens, F.; Zee, J. van der; Boode, B.; Scherpbier, A.

    2008-01-01

    Background: Female medical students often prefer primary care specialties, while male students appear to be attracted to hospital specialties. Notwithstanding the steady feminisation of medicine, in many countries there are still difficulties in recruiting trainees for general practice. This seeming

  2. Australian intern pharmacists’ perceived preparedness for practice, and their expectations and experiences of the internship year and future career intentions

    OpenAIRE

    Mak VSL; March G; Clark A; Gilbert AL

    2013-01-01

    Vivienne SL Mak,1,2 Geoff March,2 Alice Clark,2 Andrew L Gilbert21Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia; 2Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, AustraliaBackground: A key objective of Australia's health care reform is a skilled, flexible, and well-trained workforce. To meet these...

  3. An Australian Example of Translating Psychological Research into Practice and Policy: Where We are and Where We Need to Go

    OpenAIRE

    Werner-Seidler, Aliza; Perry, Yael; Christensen, Helen

    2016-01-01

    Research findings from psychological science have identified interventions that will benefit human health. However, these findings are not often incorporated into practice-based settings or used to inform policy, in part, due to methodological and contextual limitations. A strategic approach is required if we are to find a way to facilitate the translation of these findings into areas that will offer genuine impact on health. There is an overwhelming focus on conducting more clinical trials, ...

  4. Partnership effects in general practice: identification of clustering using intra-class correlation coefficients.

    OpenAIRE

    Ashworth, Mark; Armstrong, David

    2003-01-01

    Although most United Kingdom general practitioners (GPs) work together in a shared professional arrangement termed 'partnership', little is known about the nature of such partnerships. We report the results of a survey of 61 general practice partners in 15 group practices and their attitudes to prescribing and managerial issues related to participation in a commissioning group. Intra-class correlation coefficients (ICCs) were used to explore how these individually held attitudes clustered wit...

  5. MR imaging in patients with knee injury: an observational study in general practice

    OpenAIRE

    Boks, Simone

    2007-01-01

    textabstractKnee trauma is often seen in general practice. The availability of magnetic resonance (MR) imaging has improved the diagnostic possibilities after knee trauma. Nevertheless, little is known about the findings on MR imaging after knee trauma in general practice. Especially, there is little known about bone bruise (a finding seen on MR imaging, but not on conventional radiographs). In this thesis the available knowledge on the natural course of posttraumatic knee lesions and bone br...

  6. Benchmarking the burden of 100 diseases: results of a nationwide representative survey within general practices

    OpenAIRE

    Grimaldi-Bensouda, Lamiae; Begaud, Bernard; Lert, France; Rouillon, Frederic; Massol, Jacques; Guillemot, Didier; Avouac, Bernard; Duru, Gerard; Magnier, Anne-Marie; Rossignol, Michel; Abenhaim, Lucien; ,

    2011-01-01

    Objective To assess the burden of diseases and quality of life (QOL) of patients for a large variety of diseases within general practice. Design In a representative nationwide cross-sectional study, a total of 825 general practitioners (GPs) were randomly selected from across France. Independent investigators recruited 8559 patients attending the GPs' practices. Data on QOL (12-Item Short Form questionnaire) and other individual characteristics were documented by the independent investigators...

  7. Access to complementary medicine in general practice: survey in one UK health authority.

    OpenAIRE

    Wearn, A M; Greenfield, S M

    1998-01-01

    Complementary therapy (CT) has become increasingly popular with the general public and interest from the health professions has been rising. There has been no study focusing on the pattern of availability of CT within urban and inner-city general practice. We aimed to describe the prevalence and pattern of access to complementary therapy in this setting, identifying the characteristics of practices offering CT and the perceived barriers to service provision. We sent a postal questionnaire to ...

  8. Risk factors for late-life insomnia in a representative general practice sample.

    OpenAIRE

    Morgan, K.; Clarke, D

    1997-01-01

    BACKGROUND: Insomnia is widely reported and widely treated in general practice, yet relatively little research has focused on the natural history of the condition in primary care settings. As a result, there is at present little information to enable clinicians to assess insomnia risk, or anticipate outcomes in older general practice populations. AIM: To estimate, using 8-year longitudinal data, the risk of insomnia onset associated with selected health and lifestyle factors. METHOD: Survivor...

  9. Train the Trainer for general practice trainer - a report of the pilot within the programme Verbundweiterbildungplus

    OpenAIRE

    Steinhäuser, Jost; Ledig, Thomas; Szecsenyi, Joachim; Eicher, Christiane; Engeser, Peter; Roos, Marco; Bungartz, Jessica; Joos, Stefanie

    2012-01-01

    [english] Background: Since 2008 the Verbundweiterbildung programme of the Competence Centre General Practice Baden-Wuerttemberg offers continual improvement with regards to content and structure of general practice training. The programme uses the didactical concept of the CanMEDs competencies, which were developed in Canada, as a postgraduate medical training framework. Train the trainer (TTT)-programmes are an additional important element of these contentual optimisations of postgraduate t...

  10. Effectiveness and cost of different strategies for information feedback in general practice.

    OpenAIRE

    Szczepura, A; Wilmot, J; Davies, C; Fletcher, J

    1994-01-01

    AIM. The aim of this study was to determine the effectiveness and relative cost of three forms of information feedback to general practices--graphical, graphical plus a visit by a medical facilitator and tabular. METHOD. Routinely collected, centrally-held data were used where possible, analysed at practice level. Some non-routine practice data in the form of risk factor recording in medical notes, for example weight, smoking status, alcohol consumption and blood pressure, were also provided ...

  11. The Influence of Advanced General Dentistry Training on Practice Patterns of Iowa Dental Graduates.

    Science.gov (United States)

    Bolden, Aljernon J.; And Others

    1992-01-01

    A study compared the practice patterns of 41 dentists with graduate training in general dentistry with those of 41 dentists without such training, in terms of number and types of procedures performed, patient characteristics, professional and community activities, and practice characteristics. Some differences were found, particularly in patient…

  12. Interactive proof-of-concept dashboard to explore patient follow-up in general practice

    OpenAIRE

    De Croon, Robin; Klerkx, Joris; Duval, Erik

    2015-01-01

    This paper reports on our proof-of-concept interactive visualization dashboard to support general practitioners (GPs) explore patient follow-up in their practice. The dashboard enables GPs to create visual queries in order to filter patients. Using the dashboard, GPs themselves can verify their practice with official quality indicators.

  13. Food parenting practices and child dietary behavior. Prospective relations and the moderating role of general parenting

    NARCIS (Netherlands)

    Sleddens, E.F.C.; Kremers, S.P.J.; Stafleu, A.; Dagnelie, P.C.; Vries, N.K. de; Thijs, C.

    2014-01-01

    Research on parenting practices has focused on individual behaviors while largely failing to consider the context of their use, i.e., general parenting. We examined the extent to which food parenting practices predict children's dietary behavior (classified as unhealthy: snacking, sugar-sweetened be

  14. Relational Coordination and Organisational Social Capital Association with Characteristics of General Practice

    Directory of Open Access Journals (Sweden)

    Sanne Lykke Lundstrøm

    2014-01-01

    Full Text Available Background. Relational coordination (RC and organisational social capital (OSC are measures of novel aspects of an organisation’s performance, which have not previously been analysed together, in general practice. Objectives. The aim of this study was to analyse the associations between RC and OSC, and characteristics of general practice. Methods. Questionnaire survey study comprising 2074 practices in Denmark. Results. General practitioners (GPs rated both RC and OSC in their general practice higher than their secretaries and nurses. The practice form was statistically significantly associated with high RC and OSC. RC was positively associated with the number of patients listed with a practice per staff, where staff is defined as all members of a practice including both owners and employees. Conclusion. The study showed that RC and OSC were significantly associated with type of profession and practice type. RC was also found to be significantly positively associated with number of patients per staff. However, the low response rate must be taken into consideration when interpreting the self-reported results of this study.

  15. "Empathy" and "Sympathy" in Action: Attending to Patients' Troubles in Finnish Homeopathic and General Practice Consultations

    Science.gov (United States)

    Ruusuvuori, Johanna

    2005-01-01

    This paper analyzes "empathy" and "sympathy" as situated practices, sequential processes that are coconstructed by the participants in the situation. The data consists of 228 sequences of patients' descriptions of their problematic experiences and professionals' responses to them in videorecorded general practice and homeopathic consultations. One…

  16. Relational coordination and organisational social capital association with characteristics of general practice.

    Science.gov (United States)

    Lundstrøm, Sanne Lykke; Edwards, Kasper; Knudsen, Thomas Bøllingtoft; Larsen, Pia Veldt; Reventlow, Susanne; Søndergaard, Jens

    2014-01-01

    Background. Relational coordination (RC) and organisational social capital (OSC) are measures of novel aspects of an organisation's performance, which have not previously been analysed together, in general practice. Objectives. The aim of this study was to analyse the associations between RC and OSC, and characteristics of general practice. Methods. Questionnaire survey study comprising 2074 practices in Denmark. Results. General practitioners (GPs) rated both RC and OSC in their general practice higher than their secretaries and nurses. The practice form was statistically significantly associated with high RC and OSC. RC was positively associated with the number of patients listed with a practice per staff, where staff is defined as all members of a practice including both owners and employees. Conclusion. The study showed that RC and OSC were significantly associated with type of profession and practice type. RC was also found to be significantly positively associated with number of patients per staff. However, the low response rate must be taken into consideration when interpreting the self-reported results of this study. PMID:25045537

  17. The estimation of patients' views on organizational aspects of a general dental practice by general dental practitioners: a survey study

    Directory of Open Access Journals (Sweden)

    Truin Gert-Jan

    2011-10-01

    Full Text Available Abstract Background Considering the changes in dental healthcare, such as the increasing assertiveness of patients, the introduction of new dental professionals, and regulated competition, it becomes more important that general dental practitioners (GDPs take patients' views into account. The aim of the study was to compare patients' views on organizational aspects of general dental practices with those of GDPs and with GDPs' estimation of patients' views. Methods In a survey study, patients and GDPs provided their views on organizational aspects of a general dental practice. In a second, separate survey, GDPs were invited to estimate patients' views on 22 organizational aspects of a general dental practice. Results For 4 of the 22 aspects, patients and GDPs had the same views, and GDPs estimated patients' views reasonably well: 'Dutch-speaking GDP', 'guarantee on treatment', 'treatment by the same GDP', and 'reminder of routine oral examination'. For 2 aspects ('quality assessment' and 'accessibility for disabled patients' patients and GDPs had the same standards, although the GDPs underestimated the patients' standards. Patients had higher standards than GDPs for 7 aspects and lower standards than GDPs for 8 aspects. Conclusion On most aspects GDPs and patient have different views, except for social desirable aspects. Given the increasing assertiveness of patients, it is startling the GDP's estimated only half of the patients' views correctly. The findings of the study can assist GDPs in adapting their organizational services to better meet the preferences of their patients and to improve the communication towards patients.

  18. A proposal for enhancement of research capacities in Croatian general practice

    Directory of Open Access Journals (Sweden)

    Davorka Vrdoljak

    2013-05-01

    Full Text Available Research in family medicine contributes to the increase of knowledge, and its practical application improves the work of family physicians. Although research in family medicine in the Republic of Croatia has a long tradition, no sustainable research network exists as yet. Enhancing such a network is essential to efficaciously conduct research that is specific and important for family practice. This article describes the experiences of other countries and offers a proposal for a conceptual model for the development of a permanent research network in family medicine through three key elements: recognition of research as an indicator of quality of care that is specifically funded, introducing a continuing cycle of education for family physicians/researchers in the field of scientific research and building the capacity of academic family medicine and the success of their applications for domestic and international projects and funding sources. Conclusion. The application of the conceptual model from Australian primary health care research, adjusted to our circumstances, could further enhance research capacity building in Croatian family medicine.

  19. Promoting chlamydia screening with posters and leaflets in general practice - a qualitative study

    Directory of Open Access Journals (Sweden)

    Ford-Young William

    2009-10-01

    Full Text Available Abstract Background General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP, have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Methods Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Results Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. Conclusion The NCSP

  20. Relational coordination is associated with productivity in general practice: a survey and register based study

    DEFF Research Database (Denmark)

    Lundstrøm, Sanne Lykke; Edwards, Kasper; Reventlow, Susanne;

    2014-01-01

    In this paper we investigate the association between relational coordination among the practice team in general practice and number of consultations performed in a general practice per staff, i.e. a proxy of productivity. We measured relational coordination using the Relational Coordination Survey...... and combined the results with register data. We found that relational coordination was statistically significant associated with number of consultation per staff per year. We later divided consultations in to three types: Face-to-face, Email and phone consultations. We found a statistically...... significant associating between relational coordination and with number of face-to-face consultation per staff per year....

  1. Representations of the Japanese in Contemporary Australian Literature and Film

    OpenAIRE

    Erika Smith

    2008-01-01

    The objective of this article is to investigate general contemporary Australian perceptions of the Japanese. I will do this by exploring how Australian contemporary literature (2006- 2007) and Australian contemporary film (1997-2007) depicts Japanese characters. By analysing the representation of the Japanese characters in these areas I will attempt to gather a broad understanding of how Australians represent, perceive and identify the Japanese today.

  2. The epidemiology of suicide and attempted suicide in Dutch general practice 1983-2003.

    NARCIS (Netherlands)

    Marquet, R.L.; Bartelds, A.I.M.; Kerkhof, A.J.F.M.; Schellevis, F.G.; Zee, J. van der

    2005-01-01

    BACKGROUND: Many patients attempting or committing suicide consult their general practitioner (GP) in the preceding period, indicating that GPs might play an important role in prevention. The aim of the present study was to analyse the epidemiology of suicidal behaviour in Dutch general practice in

  3. Personnel planning in general practices: development and testing of a skill mix analysis method.

    NARCIS (Netherlands)

    Eitzen-Strassel, J. von; Vrijhoef, H.J.M.; Derckx, E.W.C.C.; Bakker, D.H. de

    2014-01-01

    Background: General practitioners (GPs) have to match patients’ demands with the mix of their practice staff’s competencies. However, apart from some general principles, there is little guidance on recruiting new staff. The purpose of this study was to develop and test a method which would allow GPs

  4. Getting back into the emergency department: diversifying general practice while relieving emergency medicine workforce shortages.

    Science.gov (United States)

    Willcock, Simon M

    2008-07-21

    New medical graduates expect to work in an environment that allows scope for flexibility and change across a career in medicine. Recruitment to general practice is adversely affected by its perceived limited scope of practice. Training in procedural and hospital skills is not difficult to access for general practice trainees, but complex and inconsistent credentialling criteria and protectionist attitudes among some specialist colleges mean that many skilled general practitioners are unable to utilise the full range of their skills in clinical practice. The discipline of emergency medicine is also experiencing difficulty in recruiting trainees. The employment of skilled GPs in emergency departments (including metropolitan departments) could improve vocational satisfaction for GPs and emergency physicians, and possibly also improve patient outcomes and flow through the emergency department. PMID:18637784

  5. Effect of Health Literacy on Quality of Life amongst Patients with Ischaemic Heart Disease in Australian General Practice

    OpenAIRE

    David Alejandro González-Chica; Zandile Mnisi; Jodie Avery; Katherine Duszynski; Jenny Doust; Philip Tideman; Andrew Murphy; Jacquii Burgess; Justin Beilby; Nigel Stocks

    2016-01-01

    Background Appropriate understanding of health information by patients with cardiovascular disease (CVD) is fundamental for better management of risk factors and improved morbidity, which can also benefit their quality of life. Objectives To assess the relationship between health literacy and health-related quality of life (HRQoL) in patients with ischaemic heart disease (IHD), and to investigate the role of sociodemographic and clinical variables as possible confounders. Methods Cross-sectio...

  6. Australian Research Council

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    @@ Introduction The Australian Research Council(ARC) is the Australian Government's main agency for allocating research funding to academics and researchers in Australian universities.Its mission is to deliver policy and programs that advance Australian research and innovation globally and benefit the community.

  7. Variation in examination and treatment offers to patients with allergic diseases in general practice

    DEFF Research Database (Denmark)

    Hansen, Dorte Gilså; Jarbøl, Dorte Ejg; Munck, Anders Peter

    2010-01-01

    general practice to patients with allergic diseases, and to evaluate guideline compliance with respect to anaphylaxis emergency treatment kits. DESIGN: A questionnaire-based survey among general practitioners (GPs) about examination and treatment procedures offered in the surgery to patients with allergic...... recommendations for preparedness for anaphylactic shock in connection with allergy vaccine therapy were not fully implemented. CONCLUSION: General practice is substantially involved in the examination and treatment of patients with allergic diseases. There is room for further involvement of staff members and...

  8. Integrating a pharmacist into the general practice environment: opinions of pharmacist’s, general practitioner’s, health care consumer’s, and practice manager’s

    OpenAIRE

    Freeman Christopher; Cottrell W; Kyle Greg; Williams Ian; Nissen Lisa

    2012-01-01

    Abstract Background Pharmacists are viewed as highly trained yet underutilised and there is growing support to extend the role of the pharmacist within the primary health care sector. The integration of a pharmacist into a general practice medical centre is not a new concept however is a novel approach in Australia and evidence supporting this role is currently limited. This study aimed to describe the opinions of local stakeholders in South-East Queensland on the integration of a pharmacist ...

  9. General practice-based clinical trials in Germany - a problem analysis

    Directory of Open Access Journals (Sweden)

    Hummers-Pradier Eva

    2012-11-01

    Full Text Available Abstract Background In Germany, clinical trials and comparative effectiveness studies in primary care are still very rare, while their usefulness has been recognised in many other countries. A network of researchers from German academic general practice has explored the reasons for this discrepancy. Methods Based on a comprehensive literature review and expert group discussions, problem analyses as well as structural and procedural prerequisites for a better implementation of clinical trials in German primary care are presented. Results In Germany, basic biomedical science and technology is more reputed than clinical or health services research. Clinical trials are funded by industry or a single national programme, which is highly competitive, specialist-dominated, exclusive of pilot studies, and usually favours innovation rather than comparative effectiveness studies. Academic general practice is still not fully implemented, and existing departments are small. Most general practitioners (GPs work in a market-based, competitive setting of small private practices, with a high case load. They have no protected time or funding for research, and mostly no research training or experience. Good Clinical Practice (GCP training is compulsory for participation in clinical trials. The group defined three work packages to be addressed regarding clinical trials in German general practice: (1 problem analysis, and definition of (2 structural prerequisites and (3 procedural prerequisites. Structural prerequisites comprise specific support facilities for general practice-based research networks that could provide practices with a point of contact. Procedural prerequisites consist, for example, of a summary of specific relevant key measures, for example on a web platform. The platform should contain standard operating procedures (SOPs, templates, checklists and other supporting materials for researchers. Conclusion All in all, our problem analyses revealed that

  10. Sleep problems in general practice: a national survey of assessment and treatment routines of general practitioners in Norway.

    Science.gov (United States)

    Sivertsen, Børge; Nordhus, Inger H; Bjorvatn, Bjørn; Pallesen, Ståle

    2010-03-01

    The aim of the current national survey of all general practitioners (GPs) practising in Norway was to explore assessment, treatment practice and perceived efficacy of treatment of sleep problems in general practice. A short questionnaire, including self-report measures of the frequency and routines of treatment and assessment of sleep problems, was sent to all 4049 GPs in Norway, of whom 1465 (36.7%) provided valid responses. The prevalence of sleep problems among patients in general practice was estimated to be 11.2%, of which almost two-thirds were believed to be caused by a medical condition. Anamnestic information and blood tests were the most common assessment of sleep problems, whereas GPs rarely referred patients to all-night polysomnographic recording. Sleep hygiene advices were the most commonly used treatment strategy, whereas hypnotics were believed to have the best short-term efficacy. Antidepressives were considered to be the best option for long-term management of sleep problems. About one-third of the patients were prescribed benzodiazepines or 'Z-drugs' for more than 6 months. This study demonstrates that sleep problems are recognized by GPs, but despite evidence that non-pharmacological treatment is superior in the long-term management of insomnia, the current study shows that hypnotics are still considered by GPs to be the most successful treatment. PMID:19732316

  11. Can we import quality tools? a feasibility study of European practice assessment in a country with less organised general practice

    Directory of Open Access Journals (Sweden)

    Pestiaux Dominique

    2009-10-01

    Full Text Available Abstract Background Quality is on the agenda of European general practice (GP. European researchers have, in collaboration, developed tools to assess quality of GPs. In this feasibility study, we tested the European Practice Assessment (EPA in a one-off project in Belgium, where general practice has a low level of GP organisation. Methods A framework for feasibility analysis included describing the recruiting of participants, a brief telephone study survey among non-responders, organisational and logistic problems. Using field notes and focus groups, we studied the participants' opinions. Results In this study, only 36 of 1000 invited practices agreed to participate. Co-ordination, administrative work, practice visits and organisational problems required several days per practice. The researchers further encountered technical problems, for instance when entering the data and uploading to the web-based server. In subsequent qualitative analysis using two focus groups, most participant GPs expressed a positive feeling after the EPA procedure. In the short period of follow-up, only a few GPs reported improvements after the visit. The participant GPs suggested that follow-up and coaching would probably facilitate the implementation of changes. Conclusion This feasibility study shows that prior interest in EPA is low in the GP community. We encountered a number of logistic and organisational problems. It proved attractive to participants, but it can be augmented by coaching of participants in more than a one-off project to identify and achieve targets for quality improvement. In the absence of commitment of the government, a network of universities and one scientific organisation will offer EPA as a service to training practices.

  12. Patients' reasons for not presenting emotional problems in general practice consultations.

    OpenAIRE

    Cape, J; McCulloch, Y

    1999-01-01

    BACKGROUND: Patients commonly do not mention emotional problems in consultations, and this is a factor in general practitioners' (GPs') difficulty in identifying psychological morbidity. AIM: To investigate patients' self-reported reasons for not disclosing psychological problems in consultations with GPs. METHOD: From nine general practices, a sample of patients with high General Health Questionnaire scores, who planned to present only somatic symptoms to the GP, were interviewed after their...

  13. Australian Aboriginal Astronomy - An Overview

    Science.gov (United States)

    Norris, Ray P.; Hamacher, Duane W.

    The traditional cultures of Aboriginal Australians include a significant astronomical component, perpetuated through oral tradition, ceremony, and art. This astronomical component includes a deep understanding of the motion of objects in the sky, and this knowledge was used for practical purposes such as constructing calendars. There is also evidence that traditional Aboriginal Australians made careful records and measurements of cyclical phenomena, paid careful attention to unexpected phenomena such as eclipses and meteorite impacts, and could determine the cardinal points to an accuracy of a few degrees.

  14. Do general practitioners adhere to the guideline on infectious conjunctivitis? Results of the Second Dutch National Survey of General Practice

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2007-09-01

    Full Text Available Abstract Background In 1996 the guideline 'The Red Eye' was first published by the Dutch College of General Practitioners. The extent to which general practitioners adhere to this guideline is unclear. Recently, data on the management of infectious conjunctivitis by general practitioners became available from the Second Dutch National Survey of General Practice. We measured the age-specific incidence of infectious conjunctivitis, described its management by Dutch general practitioners, and then compared these findings with the recommendations made in the guideline. Methods In 2001, over a 12-month period, data from all patient contacts with 195 general practitioners were taken from electronic medical records. Registration was episode-oriented; all consultations dealing with the same health problem were grouped into disease episodes. Data concerning all episodes of infectious conjunctivitis (ICPC-code F70 and sub codes were analysed. Results Over one year, 5,213 new and recurrent episodes of infectious conjunctivitis were presented to general practitioners from a population of N = 375,899, resulting in an overall incidence rate of 13.9 per 1000 person-years, varying from more than 80/1000 py in children up to one-year old, to less than 12/1000 py in children over the age of 4. Topical ophthalmic ointments were prescribed in 87% of the episodes, of which 80% was antibiotic treatment. Fusidic acid gel was most frequently prescribed (69%. In most episodes general practitioners did not adhere to the guideline. Conclusion In 2001, the management of infectious conjunctivitis by Dutch general practitioners was not in accordance with the recommendations of the consensus-based guideline published five years previously, despite its wide distribution. In 2006 this guideline was revised. Its successful implementation requires more than distribution alone. Probably the most effective way to achieve this is by following a model for systemic implementation.

  15. Prevention of healthcare-associated infections in general practice: Current practice and drivers for change in a French study

    OpenAIRE

    Gignon, M; S Farcy; Schmit, J. L.; Ganry, O.

    2012-01-01

    Purpose: The fight against Healthcare-associated infections is a public health priority and a major challenge for the safety and quality of care. The objective was to assess hygiene in general practitioners′ (GPs′) office and identify barriers to and drivers for better practice. Materials and Methods: We performed a cross-sectional study in which a questionnaire was sent to a randomly selected, representative sample of 800 GPs. We used a self-administered questionnaire. The first part assesse...

  16. Ad hoc supervision of general practice registrars as a 'community of practice': analysis, interpretation and re-presentation.

    Science.gov (United States)

    Clement, T; Brown, J; Morrison, J; Nestel, D

    2016-05-01

    General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also provide an opportunity for learning and teaching. Wenger's (Communities of practice: learning, meaning, and identity. Cambridge University Press, New York, 1998) social theory of learning ('communities of practice') guided a secondary analysis of audio-recordings of ad hoc encounters. Data from one encounter is re-presented as an extended sequence to maintain congruence with the theoretical perspective and enhance vicariousness. An interpretive commentary communicates key features of Wenger's theory and highlights the researchers' interpretations. We argue that one encounter can reveal universal understandings of clinical supervision and that the process of naturalistic generalisation allows readers to transfer others' experiences to their own contexts. The paper raises significant analytic, interpretive, and representational issues. We highlight that report writing is an important, but infrequently discussed, part of research design. We discuss the challenges of supporting the learning and teaching that arises from adopting a socio-cultural lens and argue that such a perspective importantly captures the complex range of issues that work-based practitioners have to grapple with. This offers a challenge to how we research and seek to influence work-based learning and teaching in health care settings. PMID:26384813

  17. Reducing general practice trainees' antibiotic prescribing for respiratory tract infections: an evaluation of a combined face-to-face workshop and online educational intervention.

    Science.gov (United States)

    Magin, Parker J; Morgan, Simon; Tapley, Amanda; Davis, Joshua S; McArthur, Lawrie; Henderson, Kim M; Mulquiney, Katie J; Dallas, Anthea; Davey, Andrew R; Scott, John; van Driel, Mieke L

    2016-03-01

    Over-prescription of antibiotics for non-pneumonia respiratory tract infections (RTIs) is a major concern in general practice. Australian general practice registrars (trainees) have inappropriately high rates of prescription of antibiotics for RTIs. The 'apprenticeship' educational model and the trainee-trainer relationship are drivers of this inappropriate prescribing. We aimed to reduce registrars' non-pneumonia RTI antibiotic prescribing via an educational intervention (a 90-min face-to-face workshop supported by online modules), complemented by delivery of the same intervention, separately, to their trainers. We conducted a pre- and post-intervention comparison of the registrars' intention to prescribe antibiotics for common RTIs using McNemar's test. We similarly tested changes in supervisors' intended prescribing. Prescribing intentions were elicited by responses to six written clinical vignettes (upper respiratory tract infection, otitis media, sore throat and three acute bronchitis vignettes). We found that, for registrars, there were statistically significant reductions in antibiotic prescribing for the sore throat (24.0% absolute reduction), otitis media (17.5% absolute reduction) and two of the three acute bronchitis (12.0% and 18.0% absolute reduction) vignettes. There were significant reductions in supervisors' antibiotic prescribing intentions for the same four vignettes. We conclude that our intervention produced a significant change in registrars' intention to prescribe antibiotics for non-pneumonia RTIs. PMID:27005837

  18. Diagnosing dementia in Dutch general practice: a qualitative study of GPs’ practices and views

    Science.gov (United States)

    Prins, Agnes; Hemke, Feia; Pols, Jeannette; van Charante, Eric P Moll

    2016-01-01

    Background GPs play an important role in recognising the symptoms of dementia; however, little is known about how they perceive their actual and future role in diagnosing dementia. Aim To explore Dutch GPs’ perceptions of their current position in diagnosing dementia, their reasons for referral to secondary care, and views on the future diagnostic role of GPs. Design and setting A qualitative study among Dutch GPs. Method Eighteen GPs participated in a semi-structured interview that ranged from 20 to 60 minutes. Interviews were transcribed verbatim and thematic analysis was performed. Results GPs reported that their role in the diagnostic phase of identifying people with suspected dementia is limited to recognising cognitive problems and deciding whether a patient needs to be referred for further investigation, or whether care could be organised without specialist diagnosis. GPs indicated that they were likely to refer patients if patients/caregivers or dementia case managers requested it, or if they thought it could have consequences for treatment. Typically, GPs do not see the need for referral when their patients are very old and declining slowly. GPs would welcome a more prominent role in diagnosing dementia in their own practice. Conclusion Diagnosing dementia involves a complex balance between patient and carer preferences, the consequences for treatment and care, and the burden of referral. Dutch GPs favour a stronger involvement in diagnosing dementia provided that both resources and diagnostic algorithms are improved. PMID:27114209

  19. The importance of gender of patients and general practitioners in relation to treatment practices for overweight

    DEFF Research Database (Denmark)

    Rohde, Jeanett Friis; Hessner, Marie Vik; Lous, Jørgen; Müller, Pia; Hølund, Ulla; Heitmann, Berit Lilienthal

    2014-01-01

    BACKGROUND: Several studies suggest that men and women are treated differently for similar disease including diabetes and cardiovascular disease. Differences in attitudes and treatment practices towards men and women with obesity are not well recognized. OBJECTIVE: To investigate the attitudes and...... treatment practices among Danish general practitioners (GPs), in relation to treatment of overweight, while taking gender of both the patients and practitioners into account. DESIGN: Questionnaire inventory covertly examining attitudes and practices among Danish general practitioners towards treatment of...... overweight. All 3.637 general practitioners from the Danish Medical Association register were invited to participate in the survey. In total 1.136 participated. RESULTS: The GPs found weight loss to be more important for overweight male than overweight female patients. They also treated complications to...

  20. Beyond the specific child. What is 'a child's case' in general practice?

    DEFF Research Database (Denmark)

    Hølge-Hazelton, Bibi; Tulinius, C.

    2010-01-01

    BACKGROUND: Too many abused and neglected children are being overlooked by GPs and other professionals who are in contact with the families. Some suggestions for a definition of 'a child in need' have been given, but the functionality of these definitions has not been tested in general practice...... the wellbeing of the family or the child. CONCLUSION: Based on this analysis, one suggestion as to why some abused and neglected children are overlooked in general practice is that GPs often have to navigate in difficult indirect consultations, where there is a high risk of losing the overview Udgivelsesdato....... AIM: To describe the problems presented by GPs as cases with children in need during supervision, and from here to suggest an empirically-based definition of a child in need in general practice. DESIGN OF STUDY: A mixed-method evaluation design was used. SETTING: Twenty-one GPs, in Denmark...

  1. The Risk of Fracture in Patients With Multiple Sclerosis: The UK General Practice Research Database

    DEFF Research Database (Denmark)

    Bazelier, M. T.; van Staa, T.; Uitdehaag, B. M. J.;

    2011-01-01

    conducted a population-based cohort study using data from the UK General Practice Research Database linked to the National Hospital Registry (1997-2008). Incident MS patients (n = 5565) were matched 1:6 by year of birth, sex, and practice with patients without MS (controls). Cox proportional-hazards models...... may be indicated in patients with MS, especially those prescribed GCs or antidepressants. (C) 2011 American Society for Bone and Mineral Research....

  2. Prevalence of eating disorders in three Cambridge general practices: hidden and conspicuous morbidity.

    OpenAIRE

    Whitehouse, A. M.; Cooper, P. J.; Vize, C V; Hill, C.; L. Vogel

    1992-01-01

    The aims of this study were to investigate the prevalence of anorexia nervosa, bulimia nervosa and partial syndromes in women general practice attenders to establish the relative proportions of 'conspicuous' and 'hidden' morbidity. A consecutive series of 540 women patients aged 16-35 years attending their family doctor were screened using a specially devised questionnaire, the weight and dietary practices survey. A total of 115 patients were selected for further assessment and of these 101 p...

  3. Routine general practice care for panic disorder within the lifestyle approach to managing panic study

    OpenAIRE

    Lambert, Rodney A.

    2012-01-01

    Routine general practice (GP) care is rarely comprehensively described in clinical trials. This paper examines routine GP care within the lifestyle approach to managing panic (LAMP) study. The aim of this paper is to describe/discuss routine GP care for panic disorder (PD) patients within both study arms in the LAMP study. An unblinded pragmatic randomised controlled trial in 15 East of England GP practices (2 primary care trusts). Participants met Diagnostic and Statistical Manual of Mental ...

  4. Cooperation of nurses and students of the field General nurse during practical education

    OpenAIRE

    BĚHANOVÁ, Kateřina

    2016-01-01

    Still higher demands have been placed on the job of a general nurse recently. This is why secondary education started to seem insufficient and completion of higher vocational or university education has become necessary for future nurses. To be adequately prepared for their jobs the future graduates of the Nursing course have to obtain adequate practical experience during the practical education. Mutual cooperation between nurses and students is necessary in this context. Lack of such coopera...

  5. The Importance of Gender of Patients and General Practitioners in Relation to Treatment Practices for Overweight

    OpenAIRE

    Rohde, Jeanett Friis; Hessner, Marie Vik; Lous, Jørgen; Müller, Pia; Hølund, Ulla; Heitmann, Berit Lilienthal

    2014-01-01

    Background Several studies suggest that men and women are treated differently for similar disease including diabetes and cardiovascular disease. Differences in attitudes and treatment practices towards men and women with obesity are not well recognized. Objective To investigate the attitudes and treatment practices among Danish general practitioners (GPs), in relation to treatment of overweight, while taking gender of both the patients and practitioners into account. Design Questionnaire inve...

  6. Strategies for Washing Australian Coals

    Energy Technology Data Exchange (ETDEWEB)

    Mackinnon, W.L.A.; Swanson, A.R. [Downer EDI Engineering Projects Pty. Ltd. QCC, East Maitland, NSW (Australia)

    2010-07-01

    This article represents a distillation of QCC's experience over the last 20 years in developing coal-washing circuits to optimize coal recoveries for a wide range of Australian coals. The article will look at typical washabilities and product types to capture the general washing requirements. The major processing equipment will be reviewed as to their typical usage in the Australian context. From this background the processing circuits and strategies commonly used will be discussed for the relevant coal types, including hard coking coal, semi-hard coking coal, PCI, export thermal, and domestic thermal coal from the major producing regions in NSW and Queensland.

  7. Australian uranium and the election

    International Nuclear Information System (INIS)

    The international and national complexities of the situation in Australia over the question of mining of the country's large and rich uranium deposits are explored with especial reference to the pending general election. The present position is ironical since access to low cost uranium would give a welcome boost to the nuclear industry which is enthusiastically supported by the Australian prime minister and his colleagues yet the Australian government is unable to promote mining as rapidly as it would like because of the international commitments it has made to provide a justification for its policy. (U.K.)

  8. Motivations for the Adoption of Chronic Disease Information Systems in General Practice

    Directory of Open Access Journals (Sweden)

    Daniel Carbone

    2014-09-01

    Full Text Available The purpose of this paper is to highlight the key motivational factors that lead to the successful implementation of Chronic Diseases Information Systems (CDISs in twenty eight general practices in a case study of a large general practice division network in Australia. The literature identified three major areas of CDIS motivation: patient care gap motivator, internal motivators and external motivators. Patient care emerged as the most important motivation for adopting CDIS, followed by risk management and financial incentives. However, the study also determined that the motivational forces are inter-related and suggests that the decision to adopt CDIS should consider a number of these identified factors.

  9. Workforce trends in general practice in the UK: results from a longitudinal study of doctors' careers

    OpenAIRE

    Jones, Lorelei; Fisher, Tania

    2006-01-01

    The career paths of 544 UK medical school graduates were followed for 10 years. Although general practice was not attractive to graduates initially, it became popular in subsequent years, mainly because it was seen as offering a superior quality of life. Once in general practice both men and women chose to work reduced hours and/or in non-principal posts. The findings suggest the need to look more closely at the nature of these trends and the implications for patient care and service provision.

  10. The Australian experiment: how primary health care organizations supported the evolution of a primary health care system.

    Science.gov (United States)

    Nicholson, Caroline; Jackson, Claire L; Marley, John E; Wells, Robert

    2012-03-01

    Primary health care in Australia has undergone 2 decades of change. Starting with a vision for a national health strategy with general practice at its core, Australia established local meso-level primary health care organizations--Divisions of General Practice--moving from focus on individual practitioners to a professional collective local voice. The article identifies how these meso-level organizations have helped the Australian primary health care system evolve by supporting the roll-out of initiatives including national practice accreditation, a focus on quality improvement, expansion of multidisciplinary teams into general practice, regional integration, information technology adoption, and improved access to care. Nevertheless, there are still challenges to ensuring equitable access and the supply and distribution of a primary care workforce, addressing the increasing rates of chronic disease and obesity, and overcoming the fragmentation of funding and accountability in the Australian system. PMID:22403246

  11. Benefits of ICT adoption and use in regional general medical practices: a pilot study.

    Science.gov (United States)

    MacGregor, Rob; Hyland, Peter; Harvei, Charles; Lee, Boon-Chye; Dalley, Andrew; Ramu, Sangeetha

    2006-01-01

    This paper presents a pilot study of benefits derived from information and communications technology(ICT) adoption and use in medical practices in regional Australia. The study involved 122 regional medical practitioners. The results show that like the more general small business sector, the perception of certain benefits is associated with the size of the practice (in terms of employee levels) and/or the gender of the respondent practitioner. The data also showed that the level of skill of certain software used within the practice was significantly associated with the level of perceived benefit derived from ICT adoption and use. PMID:18195425

  12. Review of existing issues, ethics and practices in general medical research and in radiation protection research

    International Nuclear Information System (INIS)

    A literature review was carried out in relation to general medical research and radiation protection research. A large number of documents were found concerning the subject of ethics in general medical research. For radiation protection research, the number of documents and the information available is very limited. A review of practices in 13 European countries concerning general medical research and radiation protection research was carried out by sending a questionnaire to each country. It was found that all countries reviewed were well regulated for general medical research. For research that involves ionising radiation, the UK and Ireland are by far the most regulated countries. For other countries, there does not seem to be much information available. From the literature review and the review of practices, a number of existing ethical issues were identified and exposed, and a number of conclusions were drawn. (authors)

  13. The Australian Movement against Uranium Mining: Its Rationale and Evolution

    Directory of Open Access Journals (Sweden)

    Marty Branagan

    2014-09-01

    The paper then describes how the movement evolved between the Roxby and Jabiluka blockades, with changes to the movement’s philosophy, strategy, tactics and internal dynamics. This analysis includes a comparison between two anti-nuclear bike rides, one a year after the 1984 Roxby blockade and involving some of the same activists, and another at the time of the Jabiluka blockade. This author was present at all these events, and provides an emic (insider perspective within a longitudinal participant-observation methodology. Although this perspective obviously has a subjective element, the paper fills a gap in that there is little written history of these blockades (particularly Roxby and more generally of Australian resistance to uranium mining, let alone the aspects of nonviolence and movement evolution. It is an introductory history of these campaigns, examining the direct action components, the practicalities of nonviolent campaigning, and the evolution of Australian anti-uranium activism.

  14. Feasibility and acceptance of electronic quality of life assessment in general practice: an implementation study

    Directory of Open Access Journals (Sweden)

    Kochen Michael M

    2009-06-01

    Full Text Available Abstract Background Patients' health related quality of life (HRQoL has rarely been systematically monitored in general practice. Electronic tools and practice training might facilitate the routine application of HRQoL questionnaires. Thorough piloting of innovative procedures is strongly recommended before the conduction of large-scale studies. Therefore, we aimed to assess i the feasibility and acceptance of HRQoL assessment using tablet computers in general practice, ii the perceived practical utility of HRQoL results and iii to identify possible barriers hindering wider application of this approach. Methods Two HRQoL questionnaires (St. George's Respiratory Questionnaire SGRQ and EORTC QLQ-C30 were electronically presented on portable tablet computers. Wireless network (WLAN integration into practice computer systems of 14 German general practices with varying infrastructure allowed automatic data exchange and the generation of a printout or a PDF file. General practitioners (GPs and practice assistants were trained in a 1-hour course, after which they could invite patients with chronic diseases to fill in the electronic questionnaire during their waiting time. We surveyed patients, practice assistants and GPs regarding their acceptance of this tool in semi-structured telephone interviews. The number of assessments, HRQoL results and interview responses were analysed using quantitative and qualitative methods. Results Over the course of 1 year, 523 patients filled in the electronic questionnaires (1–5 times; 664 total assessments. On average, results showed specific HRQoL impairments, e.g. with respect to fatigue, pain and sleep disturbances. The number of electronic assessments varied substantially between practices. A total of 280 patients, 27 practice assistants and 17 GPs participated in the telephone interviews. Almost all GPs (16/17 = 94%; 95% CI = 73–99%, most practice assistants (19/27 = 70%; 95% CI = 50–86% and the majority of

  15. The evaluation of stress management strategies in general practice: an evidence-led approach.

    OpenAIRE

    Sims, J

    1997-01-01

    Recent surveys have highlighted sources of stress for UK general practitioners (GPs). Interventions to reduce stress in general practice have been introduced at both an individual and an organizational level, but there is little published evidence of their effectiveness. This paper systematically reviews the literature and reports that the research evidence from stress management programmes employed with other workforces is equivocal. Results so far suggest that relaxation and cognitive behav...

  16. General Reflections on how to Practice and Train for Action Research

    OpenAIRE

    Fricke, Werner

    2006-01-01

    "There is much uncertainty about action research (AR) in the academic social science debate; that’s why critical comments on AR are often uninformed. One of the main reasons for these deficits is the lack of training opportunities at universities. The following article is general in style, though based on broad action research experience. It is not my intention to present the great variety of AR concepts and practices or my experiences in detail, but to draw some general ...

  17. Prevention of cardiovascular diseases, diabetes mellitus and chronic kidney diseases in general practice.

    OpenAIRE

    van Nielen, M; Assendelft, P.; Drenthen, T; Hombergh, P. van den; Dis, I. van; Schellevis, F.

    2009-01-01

    Purpose: To study the attitudes and working methods of general practitioners (GPs) in primary prevention of cardiovascular diseases, diabetes mellitus and chronic kidney diseases. Methods: A questionnaire with questions about primary prevention of cardiovascular diseases, diabetes mellitus and chronic kidney diseases in general practice was sent to a representative sample of 1100 Dutch GPs. The data were analyzed using frequency tables, chi-square and ANOVA. Results: 330 GPs completed and ret...

  18. Remuneration and organization in general practice: Three essays on doctors' preferences

    OpenAIRE

    Holte, Jon Helgheim

    2015-01-01

    Paper I and II of this thesis are not available in Munin. Paper I: The impact of pecuniary and non-pecuniary incentives for attracting young doctors to rural general practice. Holte, J. H., Kjaer, T., Abelsen, B. & Olsen, J. A. Available in Social Science & Medicine, 128 (2015) 1-9Paper II: Modelling nonlinearities and reference-dependence in general practitioners’ income preferences. Holte, J. H., Sivey, P., Abelsen, B. & Olsen, J. Available in Health Economics (2015)

  19. What do patients bring up in consultations? An observational study in general practice

    OpenAIRE

    2015-01-01

    Objective. The main aim of the study was to investigate how many and what kind of problems patients present in consultations with their general practitioner (GP). A secondary aim was to explore patients’ views on what is important in consultations. Design. Cross-sectional study including observation of unselected consultations with recording on a pre-designed scheme, and a brief questionnaire filled in by patients. Setting. Four general practices in Oslo, Norway. Subjects. A total of 201 pati...

  20. Benzodiazepine prescribing behaviour and attitudes: a survey among general practitioners practicing in northern Thailand

    OpenAIRE

    Critchley Julia; Garner Paul; Srisurapanont Manit; Wongpakaran Nahathai

    2005-01-01

    Abstract Background Over-prescribing of benzodiazepines appears common in many countries, a better understanding of prescribing practices and attitudes may help develop strategies to reduce prescribing. This study aimed to evaluate benzodiazepine prescribing behaviour and attitudes in general practitioners practising in Chiang Mai and Lampoon, Thailand. Methods Questionnaire survey of general practitioners in community hospitals, to estimate: i) use of benzodiazepines for anxiety/insomnia, pa...

  1. Managing back pain in general practice--is osteopathy the new paradigm?

    OpenAIRE

    Williams, N.

    1997-01-01

    Back pain is a common problem in general practice, and is of enormous economic importance. A recent report urges general practitioners (GPs) to refer early for manual therapies, such as osteopathy. The key concept to understanding osteopathic principles is somatic dysfunction. This is a disorder of function, rather than pathology, of the musculoskeletal and related systems. Its characteristic features are asymmetry of anatomical landmarks, asymmetry of joint movement, tissue texture changes, ...

  2. The menopause and hormone replacement therapy: views of women in general practice receiving hormone replacement therapy.

    OpenAIRE

    Roberts, P J

    1991-01-01

    Women's views on the menopause and hormone replacement therapy were explored using a questionnaire given to women attending one general practice who were having hormone replacement therapy under the supervision of their doctor. Sixty four women (67%) responded. Although only 5% of women had requested hormone replacement therapy from their general practitioner the majority of women indicated that they had been helped by hormone replacement therapy. Eight per cent of women were using hormone re...

  3. Prevention of healthcare-associated infections in general practice: Current practice and drivers for change in a French study

    Directory of Open Access Journals (Sweden)

    M Gignon

    2012-01-01

    Full Text Available Purpose: The fight against Healthcare-associated infections is a public health priority and a major challenge for the safety and quality of care. The objective was to assess hygiene in general practitioners′ (GPs′ office and identify barriers to and drivers for better practice. Materials and Methods: We performed a cross-sectional study in which a questionnaire was sent to a randomly selected, representative sample of 800 GPs. We used a self-administered questionnaire. The first part assessed current practice and the second part focused on barriers and motivating factors for better practice. We performed a descriptive statistical analysis of the responses to closed questions and a qualitative analysis of the responses to open-ended questions. Results: Only a third of the GPs were aware of the current guidelines. Disposable equipment was used by 31% of the GPs. For the remainder, only 38% complied with the recommended procedures for sterilisation or disinfection. Seventy-two percent of the GPs washed their hands between consultations in the office. A significant minority of physicians disregarded the guidelines by never wearing gloves to perform sutures (11%, treat wounds (10%, fit intrauterine devices (18% or perform injections (18%. The main barriers to good practice were the high cost of modifications and lack of time/space. Two third of the GPs did not intend to change their practices. The drivers for change were pressure from patients (4.8 on a scale of 1 to 7, inspection by the health authorities (4.8 and the fear of legal action (4.4. Conclusions: Our results show that there are significant differences between current practice and laid-down professional guidelines. Policies for improvement of hygiene must take into account barriers and motivating factors.

  4. Organizational values in general practice and public involvement: case studies in an urban district.

    Science.gov (United States)

    Brown, I

    2001-05-01

    A multiple case study design was used to explore dimensions of organizational values in general practice with respect to developing public involvement. The study was undertaken in an urban district in England with data collected through in-depth individual and focus group interviews with service providers and service users. Four general practice organizations were randomly selected for study after sorting all in the district according to their record of developing involvement activities. The case studies provide evidence of how organizational values can differ markedly in general practice in relation to ideas of public involvement, with consequences for the quantity and quality of activities for involving local people and service users. The differences manifest themselves in the beliefs and attitudes of service providers about the purpose of the organization and the types of relationships that are appropriate with service users and local people. Service users appear to be very perceptive to the underlying ethos and purpose to their practice organization and this affects their responsiveness to initiatives for their involvement. The dimensions of the different values found in the study appear to be essentially the same as a number of established empirical findings of variations in values in general practice: an orientation to a narrow medical role and to general practice as a business are associated with a low valuation of involvement; an orientation to teamwork and to a broader social role appear more congruent with the development of involvement. Power is a critical issue in this setting with evidence in the study of the dominance of the medical practitioners in establishing organizational values and the nature of public involvement activities. PMID:11560732

  5. Recruitment methods in Alzheimer's disease research: general practice versus population based screening by mail

    Directory of Open Access Journals (Sweden)

    Halvorsen Dag S

    2010-04-01

    Full Text Available Abstract Background In Alzheimer's disease (AD research patients are usually recruited from clinical practice, memory clinics or nursing homes. Lack of standardised inclusion and diagnostic criteria is a major concern in current AD studies. The aim of the study was to explore whether patient characteristics differ between study samples recruited from general practice and from a population based screening by mail within the same geographic areas in rural Northern Norway. Methods An interventional study in nine municipalities with 70000 inhabitants was designed. Patients were recruited from general practice or by population based screening of cognitive function by mail. We sent a questionnaire to 11807 individuals ≥ 65 years of age of whom 3767 responded. Among these, 438 individuals whose answers raised a suspicion of cognitive impairment were invited to an extended cognitive and clinical examination. Descriptive statistics, chi-square, independent sample t-test and analyses of covariance adjusted for possible confounders were used. Results The final study samples included 100 patients recruited by screening and 87 from general practice. Screening through mail recruited younger and more self-reliant male patients with a higher MMSE sum score, whereas older women with more severe cognitive impairment were recruited from general practice. Adjustment for age did not alter the statistically significant differences of cognitive function, self-reliance and gender distribution between patients recruited by screening and from general practice. Conclusions Different recruitment procedures of individuals with cognitive impairment provided study samples with different demographic characteristics. Initial cognitive screening by mail, preceding extended cognitive testing and clinical examination may be a suitable recruitment strategy in studies of early stage AD. Clinical Registration ClinicalTrial.gov Identifier: NCT00443014

  6. BOOMERANG - the Australian light source

    International Nuclear Information System (INIS)

    A proposal has been prepared for the installation in Australia of a national high performance synchrotron light facility called Boomerang. The Boomerang proposal had its origin in the establishment of the Australian Synchrotron Research Program (ASRP) which was one of the seven Major National Research Facilities announced by the Federal Government in December 1995. The ASRP provides the opportunity and funding for Australian researchers to access international synchrotron facilities, specifically two consortia at the Advanced Photon Source (APS) at the Argonne National Laboratory, USA and continued interaction with the Photon Factory at the KEK Laboratory in Japan. The ASRP was the successor to the Australian National Beamline Facility project (ANBF) which began in 1991 following the ASTEC inquiry titled 'Small Country - Big Science'. The Federal Government also provided funding for a Feasibility Study to determine the value of establishing an Australian-based synchrotron radiation facility. The Feasibility Study was completed in August 1998 and endorsed by the institutional members of the ASRP and the research community in general. The study concluded that, on the data available in Australia, there was a strong case for the installation of an Australian-based facility. The study considered several options for an Australian-based facility and recommended that these options and the data supporting the general conclusions receive further investigation. A mission was arranged to a select group of overseas laboratories to explore these questions in detail. The review team included a mix of scientific and industrial experience and also represented the interests of the ASRP and an Industrial Synchrotron Consortium based in Victoria. Based on the conclusions of the overseas mission and incorporating the advice of all international specialists in the design and use of synchrotron facilities consulted during the mission, the most cost-effective option was an extended

  7. Developing a general practice library: a collaborative project between a GP and librarian.

    Science.gov (United States)

    Pearson, D; Rossall, H

    2001-12-01

    The authors report on a self-completed questionnaire study from a North Yorkshire based general practice regarding the information needs of its clinicians. The work was carried out with a particular focus on the practice library, and the findings identified that a new approach to maintaining and developing the library was needed. The literature regarding the information needs of primary care clinicians and the role of practice libraries is considered, and compared to those of the clinicians at the practice. Discussion follows on how a collaborative project was set up between the practice and a librarian based at the local NHS Trust library in order to improve the existing practice library. Difficulties encountered and issues unique to the project are explored, including training implications presented by the implementation of electronic resources. Marketing activities implemented are discussed, how the library will operate in its new capacity, and how ongoing support and maintenance of the library will be carried out. It is concluded that although scepticism still exists regarding librarian involvement in practice libraries, collaboration between clinicians and librarians is an effective approach to the successful development and maintenance of a practice library, and recommendations are therefore made for similar collaborative work. PMID:11791859

  8. Transient Ischaemic Attack (TIA Knowledge in General Practice: a cross-sectional study of Western Adelaide general practitioners

    Directory of Open Access Journals (Sweden)

    Leung Elaine

    2012-06-01

    Full Text Available Abstract Background With evidence to support early assessment and management of TIAs, the role of the general practitioner (GP needs to be considered in developing a TIA service in Western Adelaide. We thus aimed to determine GP knowledge of TIA assessment and management and identify perceived barriers, in order to tailor subsequent GP education and engage primary care in the co-ordinated care of TIA patients. Findings A self-administered questionnaire was mailed to all GPs (n = 202 in the Adelaide Western General Practice Network. Response frequencies were calculated for all variables, and associations examined by univariate analysis. 32 GPs responded. All respondents correctly identified early risk of stroke following a TIA. Difficulty accessing neurological expertise was identified as a barrier (40.6 %, as was a lack of GP knowledge (18.8 %. Areas for improvement included access to neurologists (36.7 %, relevant guidelines and education (43.3 %. Conclusions Diagnosis of TIA is difficult and this study highlights the need for further education and practical guidelines for GPs. With this training, GPs could be better equipped to assess and manage TIAs effectively in the community in consultation with stroke physicians.

  9. From the Billabong to the Mainstream? A Teachers' Guide to Australian Training & Literacy Policy Developments 1974-1998. Research into Practice Series Number 6.

    Science.gov (United States)

    Kell, Peter

    This document traces Australian training and literacy policy developments from 1974 to 1998. The document begins with a brief discussion of the global political, educational, social, and economic trends that have affected Australia's training and literacy policies. Discussed next are major events of the four policy "epochs" in Australia's…

  10. Best Practice in Aboriginal and Torres Strait Islander Education. Proceedings of the Conference (Canberra, Australian Capital Territory, Australia, November 17-18, 1993).

    Science.gov (United States)

    Australian National Languages and Literacy Inst., Deakin.

    Papers from the conference on the education of Australian Aborigines and Torres Strait Islanders include: "English Language and Numeracy Program for Aboriginal Students" (Alison Jarred); "The Aboriginal Identity Course: A Midstream Evaluation" (Simon Vaughan); "Making the Curriculum Your Own: The Senior Girls at Lajamanu School Read Glenyse Ward's…

  11. Implementing evidence-based medicine in general practice: a focus group based study

    Directory of Open Access Journals (Sweden)

    Aertgeerts Bert

    2005-09-01

    Full Text Available Abstract Background Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore the barriers of Flemish GPs (General Practitioners to the implementation of EBM in routine clinical work and to identify possible strategies for integrating EBM in daily work. Methods We used a qualitative research strategy to gather and analyse data. We organised focus groups between September 2002 and April 2003. The focus group data were analysed using a combined strategy of 'between-case' analysis and 'grounded theory approach'. Thirty-one general practitioners participated in four focus groups. Purposeful sampling was used to recruit participants. Results A basic classification model documents the influencing factors and actors on a micro-, meso- as well as macro-level. Patients, colleagues, competences, logistics and time were identified on the micro-level (the GPs' individual practice, commercial and consumer organisations on the meso-level (institutions, organisations and health care policy, media and specific characteristics of evidence on the macro-level (policy level and international scientific community. Existing barriers and possible strategies to overcome these barriers were described. Conclusion In order to implement EBM in routine general practice, an integrated approach on different levels needs to be developed.

  12. Randomized controlled trial of the effect of medical audit on AIDS prevention in general practice

    DEFF Research Database (Denmark)

    Sandbæk, Annelli

    1999-01-01

    OBJECTIVE: We aimed to evaluate the effect of a medical audit on AIDS prevention in general practice. METHODS: We conducted a prospective randomized controlled study performed as 'lagged intervention'. At the time of comparison, the intervention group had completed 6 months of audit including...

  13. "Cascades, Torrents & Drowning" in Information: Seeking Help in the Contemporary General Practitioner Practice in the UK

    Science.gov (United States)

    Holley, Debbie; Santos, Patricia; Cook, John; Kerr, Micky

    2016-01-01

    This paper responds to the Alpine Rendez-Vous "crisis" in technology-enhanced learning. It takes a contested area of policy as well as a rapid change in the National Health Service, and documents the responses to "information overload" by a group of general practitioners practices in the North of England. Located between the…

  14. Multimorbidity and blood pressure control in 37 651 hypertensive patients from Danish general practice

    DEFF Research Database (Denmark)

    Paulsen, Maja Skov; Andersen, Morten; Thomsen, Janus L;

    2013-01-01

    Patients with hypertension are primarily treated in general practice. However, major studies of patients with hypertension are rarely based on populations from primary care. Knowledge of blood pressure (BP) control rates in patients with diabetes and/or cardiovascular diseases (CVDs), who have ad...

  15. General practitioners (GPs) and palliative care: perceived tasks and barriers in daily practice.

    NARCIS (Netherlands)

    Groot, C.M.; Vernooy-Dassen, M.J.F.J.; Crul, B.J.P.; Grol, R.P.T.M.

    2005-01-01

    BACKGROUND: General practitioners (GPs) play a crucial part in palliative care. The quality of care can be improved by investigating and addressing barriers perceived by GPs in daily practice. The aim of this study was to investigate GPs' task perception and barriers involved in palliative care. MET

  16. Gender differences in practice style: a Dutch study of general practitioners.

    NARCIS (Netherlands)

    Bensing, J.M.; Brink-Muinen, A. van den; Bakker, D.H. de

    1993-01-01

    The differences between female and male general practitioners (GPs) were studied regarding three different factors: 1) Do female GPs see more female patients than their male colleagues in the same practice?; 2) Are female GPs confronted with different types of health problems from their male colleag

  17. Sickness certification for mental health problems: an analysis of a general practice consultation database

    OpenAIRE

    Mallen, CD; Wynne-Jones, G.; Dunn, KM

    2011-01-01

    Although mental illness remains the leading cause of both sickness absence and incapacity benefit in most high-income countries, little is known about how frequently patients with mental ill-health receive sickness certificates and what conditions are most commonly certified for. This study aims to use general practice consultation data to determine the rate of sickness certification for common mental health problems.

  18. Resistance profiles of urinary tract infections in general practice - an observational study

    Directory of Open Access Journals (Sweden)

    Schmiemann Guido

    2012-11-01

    Full Text Available Abstract Background Guideline recommendations on therapy in urinary tract infections are based on antibiotic resistance rates. Due to a lack of surveillance data, little is known about resistance rates in uncomplicated urinary tract infection (UTI in general practice in Germany. In a prospective observational study, urine cultures of all women presenting with urinary tract infections in general practice were analysed. Resistance rates against antibiotics recommended in German guidelines on UTI are presented. Methods In a prospective, multi-center observational study general practitioner included all female patients ≥ 18 years with clinically suspected urinary tract infection. Only patients receiving an antibiotic therapy within the last two weeks were excluded. Results 40 practices recruited 191 female patients (mean age 52 years; range 18–96 with urinary tract infections. Main causative agent was Escherichia coli (79% followed by Enterococcus faecalis (14% and Klebsiella pneumoniae (7.3%. Susceptibiliy of E.coli as the main causative agent was highest against fosfomycin and nitrofurantoin, with low resistance rates of 4,5%; 2,2%. In 17,5%, E.coli was resistant to trimethoprim and in 8,5% to ciprofloxacin. Conclusions Resistance rates of uropathogens from unselected patients in general practice differ from routinely collected laboratory data. These results can have an impact on antibiotic prescribing and treatment recommendations.

  19. Clinical inertia in general practice : widespread and related to the outcome of diabetes care

    NARCIS (Netherlands)

    van Bruggen, Rykel; Gorter, Kees; Stolk, Ronald; Klungel, Olaf; Rutten, Guy

    2009-01-01

    Materials and methods. Baseline and follow-up data of a Dutch randomized controlled trial on the implementation of a locally adapted guideline were used. The study involved 30 general practices and 1283 patients. Treatment targets differed between study groups [HbA1c <8.0% and blood pressure (BP) <1

  20. Food parenting practices and child dietary behavior. Prospective relations and the moderating role of general parenting.

    Science.gov (United States)

    Sleddens, Ester F C; Kremers, Stef P J; Stafleu, Annette; Dagnelie, Pieter C; De Vries, Nanne K; Thijs, Carel

    2014-08-01

    Research on parenting practices has focused on individual behaviors while largely failing to consider the context of their use, i.e., general parenting. We examined the extent to which food parenting practices predict children's dietary behavior (classified as unhealthy: snacking, sugar-sweetened beverage; and healthy: water and fruit intake). Furthermore, we tested the moderating role of general parenting on this relationship. Within the KOALA Birth Cohort Study, in the Netherlands, questionnaire data were collected at 6 and 8 years (N = 1654). Correlations were computed to assess the association between food parenting practices and general parenting (i.e., nurturance, behavioral control, structure, coercive control, and overprotection). Linear regression models were fitted to assess whether food parenting practices predict dietary behavior. Instrumental and emotional feeding, and pressure to eat were found to have associations with undesirable child dietary behavior (increased unhealthy intake/decreased healthy intake), whereas associations were in the desirable direction for covert control, encouragement and restriction. Moderation analyses were performed by evaluating interactions with general parenting. The associations of encouragement and covert control with desirable child dietary behaviors were found to be stronger for children who were reared in a positive parenting context. Future research should assess the influence of contextual parenting factors moderating the relationships between food parenting and child dietary behavior as the basis for the development of more effective family-based interventions. PMID:24727101

  1. Health problems of people with intellectual disabilities: the impact for general practice.

    NARCIS (Netherlands)

    Straetmans, J.M.J.A.A.; Schrojenstein Lantman-de Valk, H.M.J. van; Schellevis, F.G.; Dinant, G.J.

    2007-01-01

    This study aimed to analyse the health problems and prescriptions of people with intellectual disabilities registered with GPs. Within the Second Dutch National Survey of General practice evidence was gathered on the differences in health problems between people with intellectual disabilities and co

  2. Atopic dermatitis, asthma and allergic rhinitis in general practice and the open population: a systematic review

    Science.gov (United States)

    Pols, D. H. J.; Wartna, J. B.; Moed, H.; van Alphen, E. I.; Bohnen, A. M.; Bindels, P. J. E.

    2016-01-01

    Objective To examine whether significant differences exist between the self-reported prevalence of atopic disorders in the open population compared with physician diagnosed prevalence of atopic disorders in general practice. Methods Medline (OvidSP), PubMed Publisher, EMBASE, Google Scholar and the Cochrane Controlled Clinical Trials Register databases were systematically reviewed for articles providing data on the prevalence of asthma, allergic rhinitis and eczema in a GP setting. Studies were only included when they had a cross-sectional or cohort design and included more than 100 children (aged 0-18 years) in a general practice setting. All ISAAC studies (i.e. the open population) that geographically matched a study selected from the first search, were also included. A quality assessment was conducted. The primary outcome measures were prevalence of eczema, asthma and allergic rhinitis in children aged 0-18 years. Results The overall quality of the included studies was good. The annual and lifetime prevalences of the atopic disorders varied greatly in both general practice and the open population. On average, the prevalence of atopic disorders was higher in the open population. Conclusion There are significant differences between the self-reported prevalence of atopic disorders in the open population compared with physician diagnosed prevalence of atopic disorders in general practice. Data obtained in the open population cannot simply be extrapolated to the general practice setting. This should be taken into account when considering a research topic or requirements for policy development. GPs should be aware of the possible misclassification of allergic disorders in their practice. Key PointsEpidemiological data on atopic disorders in children can be obtained from various sources, each having its own advantages and limitations.On average, the prevalence of atopic disorders is higher in the open population.GPs should take into account the possible

  3. An inclusive approach to raising standards in general practice: working with a 'community of practice' in Western Australia

    Directory of Open Access Journals (Sweden)

    Wilcox Helen

    2009-02-01

    Full Text Available Abstract Background In this study we explored the challenges to establishing a community of practice (CoP to address standards in general practice. We focused on the issue of improving referral letters which are the main form of communication between general practitioners (GPs and specialists. There is evidence to suggest that the information relayed to specialists at the time of referral could be improved. Methods We aimed to develop a community of practice consisting of GPs in Western Australia to improve the quality of referral letters to six specialty clinics. Three phases included: establishing the CoP, monitoring the progress of the CoP and sustaining and managing the CoP. The CoP's activity centred on referral letters to each of six selected specialties. A local measure for the quality of the referral letters was developed from a survey of participants about specific items of history and weighted for their perceived importance in the referral letter. Referral letters by participants written before and after the benchmarking exercise were scored for quality based on the standards set by the CoP. Feedback to participants regarding the 'quality' of their individual referrals was provided by a nominated member of the CoP, including a comparison of before and after scores. Results 15 GPs were recruited. Only five GPs submitted referral letters both before and after benchmarking. The five GPs that participated in both study phases submitted a total of 102 referral letters (53 before and 49 after. There was a 26 point (95% CI 11–41 improvement in the average scores of the second set of letters after taking clustering by speciality into account, indicating the quality of referral letters improved substantially after feedback. Conclusion There are many challenges to forming a CoP to focus on improving a specific issue in general practice. However we were able to demonstrate that those practitioners who participated in all aspects of the project

  4. Patient safety culture measurement in general practice. Clinimetric properties of 'SCOPE'

    Directory of Open Access Journals (Sweden)

    Zwart Dorien LM

    2011-11-01

    Full Text Available Abstract Background A supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. To that end, we studied internal consistency and construct validity of a safety culture questionnaire for general practice (SCOPE which was derived from a comparable questionnaire for hospitals (Dutch-HSOPS. Methods The survey was conducted among caregivers of Dutch general practice as part of an ongoing quality accreditation process using a 46 item questionnaire. We conducted factor analyses and studied validity by calculating correlations between the subscales and testing the hypothesis that respondents' patient safety grade of their practices correlated with their scores on the questionnaire. Results Of 72 practices 294 respondents completed the questionnaire. Eight factors were identified concerning handover and teamwork, support and fellowship, communication openness, feedback and learning from error, intention to report events, adequate procedures and staffing, overall perceptions of patient safety and expectations and actions of managers. Cronbach's alpha of the factors rated between 0.64 and 0.85. The subscales intercorrelated moderately, except for the factor about intention to report events. Respondents who graded patient safety highly scored significantly higher on the questionnaire than those who did not. Conclusions The SCOPE questionnaire seems an appropriate instrument to assess patient safety culture in general practice. The clinimetric properties of the SCOPE are promising, but future research should confirm the factor structure and construct of the SCOPE and delineate its responsiveness to changes in safety culture over time.

  5. Long-term prognosis of acute back pain in patients seen in general practice

    DEFF Research Database (Denmark)

    Schiøttz-Christensen, Berit; Nielsen, Gunnar Lauge; Hansen, Vivian Kjær;

    1999-01-01

    OBJECTIVES: We aimed to examine the prognosis of acute low back pain (LBP) in patients in general practice and to identify prognostic factors associated with the long-term prognosis based on information immediately available to the GP. METHOD: We conducted a prospective cohort study in general......% remained on sick leave. At the 1-year follow-up, 45% of the patients continued to complain of LBP. Logistic regression analyses showed that the factors most significantly associated with poor long-term LBP outcome were (i) severity of LBP at inclusion, (ii) assessments by the GP of susceptibility to...... develop chronic LBP and (iii) a history of LBP having caused previous sick leave. CONCLUSIONS: LBP in general practice has a good prognosis with regard to sick leave, but a high proportion of patients continue to complain of LBP. We were not able to identify objective measures that strongly predict the...

  6. Long-term prognosis of acute low back pain in patients seen in general practice

    DEFF Research Database (Denmark)

    Schiøttz-Christensen, Berit; Nielsen, G L; Hansen, V K;

    1999-01-01

    OBJECTIVES: We aimed to examine the prognosis of acute low back pain (LBP) in patients in general practice and to identify prognostic factors associated with the long-term prognosis based on information immediately available to the GP. METHOD: We conducted a prospective cohort study in general......% remained on sick leave. At the 1-year follow-up, 45% of the patients continued to complain of LBP. Logistic regression analyses showed that the factors most significantly associated with poor long-term LBP outcome were (i) severity of LBP at inclusion, (ii) assessments by the GP of susceptibility to...... develop chronic LBP and (iii) a history of LBP having caused previous sick leave. CONCLUSIONS: LBP in general practice has a good prognosis with regard to sick leave, but a high proportion of patients continue to complain of LBP. We were not able to identify objective measures that strongly predict the...

  7. Subjective memory complaints in general practice predicts future dementia: a 4-year follow-up study

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Vogel, Asmus Mejling; Siersma, Volkert Dirk;

    2012-01-01

    OBJECTIVE: Many older patients in general practice have subjective memory complaints (SMC); however, not all share this information with their general practitioner (GP). The association between SMC and future cognitive decline or dementia is not clear, especially in a general practice population......-nursing home residents aged 65 years and older consulted their GP in October and November 2002, and, when asked, 177 (24%) reported memory problems, and 50 (6.6%) received a hospital-based dementia diagnosis within the 4-years follow-up. SMC had an adjusted Hazard Ratio (HR) of 2.27 for subsequent dementia...... independent predictor for subsequent hospital-based dementia diagnosis. Thus, the GP could consider inquiring for memory complaints to identify vulnerable older patients....

  8. Predictive validity of a written knowledge test of skills for an OSCE in postgraduate training for general practice.

    NARCIS (Netherlands)

    Kramer, A.W.M.; Jansen, J.J.; Zuithoff, P.; Dusman, H.; Tan, L.; Grol, R.P.T.M.; Vleuten, C.P.M. van der

    2002-01-01

    PURPOSE: To examine the validity of a written knowledge test of skills for performance on an OSCE in postgraduate training for general practice. METHODS: A randomly-selected sample of 47 trainees in general practice took a knowledge test of skills, a general knowledge test and an OSCE. The OSCE incl

  9. Assessment and management of lifestyle risk factors in rural and urban general practices in Australia.

    Science.gov (United States)

    Passey, Megan; Fanaian, Mahnaz; Lyle, David; Harris, Mark F

    2010-01-01

    Prevention of cardiovascular disease is a major public health challenge. Many chronic health problems are amenable to lifestyle interventions, which can ameliorate progression of disease and contribute to primary prevention. Prior to a large randomised controlled trial we assessed preventive care in trial practices. General practitioners and practice nurses completed a preventive care questionnaire covering frequency of assessing and managing behavioural and physiological risk factors, which was developed from previously validated instruments. Factor analysis confirmed 10 scales. Scores for rural and urban respondents were contrasted using univariate statistics. Sixty-three general practitioners and practice nurses completed the questionnaire (27 urban and 36 rural). The clinicians reported high levels of assessment and advice for cardiovascular risk factors but less frequent referral. There were no differences between urban and rural practitioners in relation to assessment of risk or stage of change, referral or barriers to referral or management of high blood pressure. Rural practitioners had lower scores for frequency of advice, and management of obesity/overweight, pre-diabetes and high lipids. Although clinicians report frequently advising high risk patients to exercise more, there remain significant gaps in provision of dietary advice and referral. Greater attention to addressing these issues is required to maximise the potential benefits for cardiovascular disease prevention in general practice. PMID:21133303

  10. Direct mail improves knowledge of basic life support guidelines in general practice: a randomised study

    Directory of Open Access Journals (Sweden)

    Secher Niels

    2012-10-01

    Full Text Available Abstract Background Implementation of new guidelines into clinical practice is often incomplete. Direct mail is a simple way of providing information to physicians and may improve implementation of new guidelines on basic life support (BLS. The aim of this study was to describe knowledge of the most recent European Resuscitation Council (ERC Guidelines for BLS among general practitioners (GPs and investigate whether direct mail improves theoretical knowledge of these guidelines. Methods All general practice clinics (n=351 in Central Denmark Region were randomised to receive either direct mail (intervention or no direct mail (control. The direct mail consisted of the official ERC BLS/AED poster and a cover letter outlining changes in compression depth and frequency in the new guidelines. In general practice clinics randomised to intervention, every GP received a direct mail addressed personally to him/her. Two weeks later, a multiple-choice questionnaire on demographics and BLS guidelines were mailed to GPs in both groups. Results In total, 830 GPs were included in this study (direct mail, n=408; control, n=422. The response rate was 58%. The majority (91% of GPs receiving direct mail were familiar with BLS Guidelines 2010 compared to 72% in the control group (P Conclusion Direct mail improved knowledge of changes in BLS guidelines and thus facilitated the implementation of this knowledge into clinical practice. Resuscitation councils and medical societies may consider using direct mail as a simple strategy to facilitate implementation of changes in clinical guidelines.

  11. The payment for performance model and its influence on British general practitioners' principles and practice

    Directory of Open Access Journals (Sweden)

    Armando Henrique Norman

    2014-01-01

    Full Text Available This article explores some effects of the British payment for performance model on general practitioners’ principles and practice, which may contribute to issues related to financial incentive modalities and quality of primary healthcare services in low and middle-income countries. Aiming to investigate what general practitioners have to say about the effect of the British payment for performance on their professional ethos we carried out semi-structured interviews with 13 general practitioner educators and leaders working in academic medicine across the UK. The results show a shift towards a more biomedical practice model and fragmented care with nurse practitioners and other health care staff focused more on specific disease conditions. There has also been an increased medicalisation of the patient experience both through labelling and the tendency to prescribe medications rather than non-pharmacological interventions. Thus, the British payment for performance has gradually strengthened a scientific-bureaucratic model of medical practice which has had profound effects on the way family medicine is practiced in the UK.

  12. Associations between child emotional eating and general parenting style, feeding practices, and parent psychopathology.

    Science.gov (United States)

    Braden, Abby; Rhee, Kyung; Peterson, Carol B; Rydell, Sarah A; Zucker, Nancy; Boutelle, Kerri

    2014-09-01

    Emotional eating is the tendency to eat in response to negative emotions. Prior research has identified a relationship between parenting style and child emotional eating, but this has not been examined in clinical samples. Furthermore, the relationship between specific parenting practices (e.g., parent feeding practices) and child emotional eating has not yet been investigated. The current study examined relationships between child emotional eating and both general and specific parenting constructs as well as maternal symptoms of depression and binge eating among a treatment-seeking sample of overweight children. Participants included 106 mother-child dyads who attended a baseline assessment for enrollment in a behavioral intervention for overeating. Ages of children ranged from 8 to 12  years old. Mothers completed self-report measures of their child's emotional eating behavior, their own feeding practices, and symptoms of depression and binge eating. Children completed a self-report measure of their mothers' general parenting style. A stepwise regression analysis was conducted to identify the parent variable that was most strongly related to child emotional eating, controlling for child age and gender. Emotional feeding behavior (i.e., a tendency to offer food to soothe a child's negative emotions) was the parent factor most significantly related to child emotional eating. Findings suggest that emotional feeding practices in parents may be related to emotional eating in children. Treatment with overweight children who engage in emotional eating may be improved by targeting parent feeding practices. PMID:24780349

  13. Patient safety in primary care: incident reporting and significant event reviews in British general practice.

    Science.gov (United States)

    Rea, David; Griffiths, Sarah

    2016-07-01

    Over the past 20 years, healthcare has adapted to the 'quality revolution' by moving away from direct provision and hierarchical control mechanisms. In their place, new structures based on contractual relationships are being developed coupled with attempts to create an organisational culture that shares learning and that scrutinises existing practice so that it can be improved. The issue here is that contractual arrangements require surveillance, monitoring, regulation and governance systems that can be perceived as antipathetic to the examination of practice and subsequent learning. Historically, reporting levels from general practice have remained low; little information is shared and consequently lessons are not shared across the general practice community. Given large-scale under-engagement of general practitioners (GPs) in incident reporting systems, significant event analysis is advocated to encourage sharing of information about incidents to inform the patient safety agenda at a local and national level. Previous research has concentrated on the secondary care environment and little is known about the situation in primary care, where the majority of patient contacts with healthcare occur. To explore attitudes to incident reporting, the study adopted a qualitative approach to GPs working in a mixture of urban and rural practices reporting to a Welsh Local Health Board. The study found that GPs used significant event analysis methodology to report incidents within their practice, but acknowledged under-reporting. They were less enthusiastic about reporting externally. A number of barriers exist to reporting, including insufficient time to report, lack of feedback, fear of blame, and damage to reputations and patient confidence in a competitive environment. If incident reporting processes are perceived as supportive and formative, and where protected time is allocated to discuss incidents, then GPs are willing to participate. They also need to know how the

  14. Benefits and challenges of multi-level learner rural general practices – an interview study with learners, staff and patients

    OpenAIRE

    Morrison, Tracy; Brown, James; Bryant, Melanie; Nestel, Debra

    2014-01-01

    Background General practices vary in the provision of training and education. Some practices have training as a major focus with the presence of multi-level learners and others host single learner groups or none at all. This study investigates the educational benefits and challenges associated with ‘multi-level learner’ practices. Methods This paper comprised three case studies of rural general practices with multiple levels of learners. Qualitative data were collected from 29 interviews with...

  15. Determinants of the clinical course of musculoskeletal complaints in general practice: design of a cohort study

    Directory of Open Access Journals (Sweden)

    van der Windt Daniëlle AWM

    2003-02-01

    Full Text Available Abstract Background Musculoskeletal complaints are frequent and have large consequences for public health. Information about the prognosis after presentation in general practice is far from complete. Knowledge about determinants of the clinical course of musculoskeletal complaints is essential for management decisions and to inform patients about their prognosis. The purpose of this study is to provide information about the prognosis of musculoskeletal complaints other than low back pain by studying the course of these complaints in general practice and to identify determinants of this course. Methods Patients of 18 years and older, who present in general practice with a new episode of a musculoskeletal complaint of the neck, shoulder, elbow, wrist, hand, arm, hip, knee, ankle or foot, are recruited by their general practitioner (GP. Participants will receive complaint-specific questionnaires by mail at baseline and after 3, 6, 12 and 18 months. The following putative determinants of the course of the complaints will be investigated: sociodemographic characteristics, characteristics of the complaint, psychosocial job characteristics, physical workload, physical activity during leisure time, pain coping, mood, kinesiophobia, social support, optimism. The primary outcomes are perceived recovery, pain, functional status, sick leave and overall quality of life.

  16. Foundation Assessment of the Influence of IT Management Practices on Customer Relationship Management (CRM) in a Large Australian Federal Government Agency

    OpenAIRE

    Judy Young; Paul Gregg; Carol Pollard

    2007-01-01

    The research presented in this paper was motivated by the thrust in Australia to move to whole of e-government. The aim was to determine the level of readiness towards the implementation of customer relationship management (CRM) in Australian Federal Government departments and agencies. As such the research presented in this paper represents an initial phase of research that focusses on CRM implementation in the highest level of government in this country. To address the research objective,...

  17. ‘Giving the dope’: Australian Army Nurse Anaesthetists during World War I

    Directory of Open Access Journals (Sweden)

    Dr. Kirsty Harris

    2013-09-01

    Full Text Available More than 2500 trained Australian army nurses served overseas during World War I. Many were called upon to act outside their normal nursing practice and one new area was that of anaesthetics. Due to a lack of medical officers in the latter part of the war, a number of Australian theatre sisters trained and worked as nurse anaesthetists in Casualty Clearing Stations in France. The British Army provided three months’ training for Australian, British and New Zealand nurses in the use of chloroform and ether. Australian nurses were enthusiastic volunteers as trained nurses at home had already carved out a small but unofficial place for the profession in this role. In addition, Canadian and American army and civil nurses were already trained and used as nurse anaesthetists. While nurses were successfully used without recorded incident, at the end of the first training course, the Director General of Medical Services, Australian Imperial Force, decreed that the nurses would not be further trained or used. This was out of step with the other countries participating, and this paper examines some possible reasons for the change of heart.

  18. Foundation Assessment of the Influence of IT Management Practices on Customer Relationship Management (CRM in a Large Australian Federal Government Agency

    Directory of Open Access Journals (Sweden)

    Judy Young

    2007-12-01

    Full Text Available The research presented in this paper was motivated by the thrust in Australia to move to whole of e-government. The aim was to determine the level of readiness towards the implementation of customer relationship management (CRM in Australian Federal Government departments and agencies. As such the research presented in this paper represents an initial phase of research that focusses on CRM implementation in the highest level of government in this country. To address the research objective, data were collected through the distribution of an electronic questionnaire to 23 Australian Federal Government departments and agencies using a previously validated questionnaire. The main finding of the research was that a majority of the departments and agencies are only in the early stages of moving toward implementation of collaborative CRM. This suggests that a concerted effort needs to be made to encourage less developed departments and agencies to make this transition. Until collaborative CRM is accomplished, the ultimate goal of whole of e-government in Australia cannot become a reality. However, a positive aspect of the results is that some departments and agencies are in a position of collaborative CRM. This means that those not so positioned can benefit from the ‘best practice’ processes already adopted in the more CRM advanced Australian Federal government departments and agencies.

  19. Screening and brief intervention targeting risky drinkers in Danish general practice - a pragmatic controlled trial

    DEFF Research Database (Denmark)

    Beich, A.; Gannik, D.; Saelan, H.;

    2007-01-01

    AIMS: Recommendations for routine alcohol screening and brief counselling intervention in primary health care rest on results from intervention efficacy studies. By conducting a pragmatic controlled trial (PCT), we aimed at evaluating the effectiveness of the WHO recommendations for screening and...... brief intervention (SBI) in general practice. METHODS: A randomized PCT (brief counselling intervention vs no intervention) involving 39 Danish general practitioners (GPs). Systematic screening of 6897 adults led to inclusion of 906 risky drinkers, and research follow-up on 537 of these after 12...

  20. Symptoms in patients receiving palliative care: a study on patient-physician encounters in general practice.

    OpenAIRE

    Borgsteede, S.D.; Deliens, L.; Beentjes, B.; Schellevis, F.; Stalman, W.A.B.; van Eijk, J T. M; Wal, G. van der

    2007-01-01

    Most people with an incurable disease prefer to stay and die at home, cared for by their general practitioner (GP). This paper aims at describing the prevalence of symptoms in patients receiving palliative care at home. Within the framework of a nation wide survey of general practice in the Netherlands, GPs received a questionnaire for all patients who died within the 1-year survey period to determine whether patients received palliative care (n = 2,194). The response rate was 73% (n = 1,608)...

  1. [Practice guideline 'Urinary incontinence in women' from the Dutch College of General Practitioners].

    Science.gov (United States)

    Damen-van Beek, Z; Wiersma, Tj

    2016-01-01

    - The Dutch College of General Practitioners' (NHG) practice guideline 'Urinary incontinence in women' provides guidelines for diagnosis and management of stress, urgency and mixed urinary incontinence in adult women.- General practitioners (GPs) should be alert to signals for urinary incontinence in women and offer active diagnosis and treatment if necessary.- Shared decision making is central in the guideline; the GP and the patient should discuss therapeutic options and decide on treatment policy in mutual consultation.- Women with stress urinary incontinence can choose between pelvic floor exercises or a pessary as initial treatment. Placing a midurethral sling (MUS) will be discussed if initial treatment is insufficiently effective or in the case of serious symptoms.- When bladder training is ineffective in urgency incontinence, the GP will discuss the pros and cons of adding an anticholinergic agent.- Exercise therapy can take place in the GPs practice or under supervision of a pelvic physical therapist. PMID:27484432

  2. The danish model for improvement of diabetes care in general practice

    DEFF Research Database (Denmark)

    Schroll, Henrik; Christensen, René Depont; Thomsen, Janus Laust;

    2012-01-01

    /L and not receiving lipid-lowering treatment. Conclusions. Structured collection of electronic data from general practice and feedback with reports on quality of care for diabetes patient seems to give a significant reduction in proportion of patients with no medical treatment over one year for...... individually for each practice on the basis of the accumulated data and are available online only for the specific practice. Objective. To describe the development of the quality of care concerning drug prescriptions for diabetes patients listed with GPs using the Data Capture module. Methods. In a cohort...... study, among 8320 registered patients with diabetes, we analyzed the change in the proportion of medication for uncontrolled cases of diabetes. Results. From 2009 to 2010, there was an absolute risk reduction of 1.35% (0.89-1.81: P <0.001) in proportion of persons not in antidiabetic medication despite...

  3. Frequent attenders in general practice: problem solving treatment provided by nurses [ISRCTN51021015

    Directory of Open Access Journals (Sweden)

    van Oppen P

    2005-10-01

    Full Text Available Abstract Background There is a need for assistance from primary care mental health workers in general practice in the Netherlands. General practitioners (GPs experience an overload of frequent attenders suffering from psychological problems. Problem Solving Treatment (PST is a brief psychological treatment tailored for use in a primary care setting. PST is provided by nurses, and earlier research has shown that it is a treatment at least as effective as usual care. However, research outcomes are not totally satisfying. This protocol describes a randomized clinical trial on the effectiveness of PST provided by nurses for patients in general practice. The results of this study, which currently being carried out, will be presented as soon as they are available. Methods/design This study protocol describes the design of a randomized controlled trial to investigate the effectiveness and cost-effectiveness of PST and usual care compared to usual care only. Patients, 18 years and older, who present psychological problems and are frequent attenders in general practice are recruited by the research assistant. The participants receive questionnaires at baseline, after the intervention, and again after 3 months and 9 months. Primary outcome is the reduction of symptoms, and other outcomes measured are improvement in problem solving skills, psychological and physical well being, daily functioning, social support, coping styles, problem evaluation and health care utilization. Discussion Our results may either confirm that PST in primary care is an effective way of dealing with emotional disorders and a promising addition to the primary care in the UK and USA, or may question this assumption. This trial will allow an evaluation of the effects of PST in practical circumstances and in a rather heterogeneous group of primary care patients. This study delivers scientific support for this use and therefore indications for optimal treatment and referral.

  4. Practical Evaluation and Management of Atrophic Acne Scars: Tips for the General Dermatologist

    OpenAIRE

    Fife, Douglas

    2011-01-01

    Atrophic acne scarring is an unfortunate, permanent complication of acne vulgaris, which may be associated with significant psychological distress. General dermatologists are frequently presented with the challenge of evaluating and providing treatment recommendations to patients with acne scars. This article reviews a practical, step-by-step approach to evaluating the patient with atrophic acne scars. An algorithm for providing treatment options is presented, along with pitfalls to avoid. A ...

  5. Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act

    OpenAIRE

    Alphen, J.E. van; Donker, G A; Marquet, R.L.

    2010-01-01

    The Netherlands was the first country in the world to implement a Euthanasia Act in 2002. It is unknown whether legalising euthanasia under strict conditions influences the number and nature of euthanasia requests. AIM: To investigate changes in the number of, and reasons for, requests for euthanasia in Dutch general practice after implementation of the Euthanasia Act. DESIGN OF STUDY: Retrospective dynamic cohort study comparing 5 years before (1998-2002) and 5 years after (2003-2007) implem...

  6. Learning preferences and learning styles: a study of Wessex general practice registrars.

    OpenAIRE

    Lesmes-Anel, J; Robinson, G; Moody, S.

    2001-01-01

    BACKGROUND: Experienced trainers know that individual registrars react very differently to identical learning experiences generated during the year in practice. This divergence reflects differences in registrars' learning styles. Only one study of United Kingdom (UK) general practitioners' learning styles has been undertaken. Learning style theory predicts that matching learning preference with learning style will enhance learning. This paper researches for the first time the evidence in the ...

  7. Macrolide overuse for treatment of respiratory tract infections in general practice

    DEFF Research Database (Denmark)

    Hinnerskov, Mette; Therkildsen, Julie Maria; Cordoba, Gloria;

    2011-01-01

    High consumption of macrolides has been linked to increased macrolide resistance in the common pathogens of respiratory tract infections (RTIs). According to Danish recommendations, penicillin is the first-choice treatment for RTIs and macrolides should only be prescribed when a patient is allergic...... to penicillin or for treatment of mycoplasma pneumonias. The aim of the present study was to explore the prescription of macrolides for different RTIs to patients without penicillin allergy in general practice in Denmark....

  8. Integrating undergraduate and postgraduate education in general practice: experience in Tayside.

    OpenAIRE

    Bain, J.; Scott, R.; Snadden, D

    1995-01-01

    Several forces have resulted in the creation in Tayside of the first formally integrated unit of undergraduate and postgraduate education in general practice in the United Kingdom. Forces that helped this integration included the desire for change, national developments in education, financial support through funds set aside to cover the additional cost of teaching, and a management structure which concentrates on shared leadership. Forces that hindered the integration included uneasiness abo...

  9. Addressing the credibility gap in general practice research: better theory; more feeling; less strategy.

    OpenAIRE

    Howie, J G

    1996-01-01

    A substantial international network of general practice researchers has grown up over the past 30 years, and the literature of the discipline is now extensive and diverse. Nevertheless, there is considerable ambivalence within the profession about what research can offer, where its weight should be being put and how best the opportunities its insights create can be taken advantage of. The sometimes disappointingly low credibility of research and researchers needs to be addressed. The issues o...

  10. Diagnostic evaluation of dementia in general practice in Denmark. A national survey

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Møller, S

    2001-01-01

    OBJECTIVE: To examine GPs' self-reported basic diagnostic evaluation of dementia according to the recommendations in multidisciplinary consensus guidelines and to analyse explanatory factors for GP performance. DESIGN: Postal questionnaire study, spring 1998. SETTING: General practice in Denmark...... identify dementia (OR 1.7). Gender, attitude to development of clinical guidelines and being able to refer patients to specialists were not influential. CONCLUSION: We conclude that the previously reported reluctant attitude of GPs is now more positive....

  11. Defaulters in general practice: reasons for default and patterns of attendance.

    OpenAIRE

    Cosgrove, M P

    1990-01-01

    A series of 40 patients in general practice who failed to attend for their appointments were studied to look at their patterns of attendance over the previous five years, together with their reasons for default. The group not only defaulted more often than a group of age and sex matched controls but made significantly more visits to the surgery. Seventeen of the patients increased their default rate as their attendance rate increased over the five year period. The main reasons patients gave f...

  12. General practice in urban and rural Europe: the range of curative services.

    OpenAIRE

    Boerma, W.G.W.; Groenewegen, P.P.; Zee, J. van der

    1998-01-01

    The variation in the range of services provided by general practitioners (GPs) is not only related to personal characteristics and features of the country's health care system but also to the geographical circumstances of the practice location. In conurbations health services are more widely available than in the countryside, were GPs often are the only providers. With highly mobile populations and a plentiful supply of doctors, in cities the prevailing regulations for access and use of servi...

  13. Problem patients in general practice: identifying young women with recurrent abnormal illness behaviour

    OpenAIRE

    Deighton, C.M.

    1985-01-01

    The concept of recurrent illness behaviour and the importance of problem patients in general practice are discussed. The need for further research and the early identification of these patients is emphasized. The medical records of 1134 women between the ages of 16 and 25 years were analysed. The annual rate of potentially functional complaints was determined for each woman. The 51 women with the highest annual rates were selected as cases for interview, along with 51 randomly selected controls.

  14. Child overweight in general practice - parents' beliefs and expectations - a questionnaire survey study

    DEFF Research Database (Denmark)

    Andersen, Merethe K; Christensen, Bo; Søndergaard, Jens

    2013-01-01

    Care for overweight children in general practice involves collaboration with parents. Acknowledging the parents' frames of references is a prerequisite for successful management. We therefore aimed to analyse parental beliefs about the presumed causes and consequences of overweight in children an...... expectations towards the GP. Moreover, we aimed at comparing the beliefs and expectations of parents of non-overweight children (NOWC) and parents of overweight children (OWC)....

  15. Measuring the effects of acupuncture and homoeopathy in general practice: An uncontrolled prospective documentation approach

    OpenAIRE

    Walach Harald; Lange Oliver; Güthlin Corina

    2004-01-01

    Abstract Background Despite the increasing demand for acupuncture and homoeopathy in Germany, little is known about the effects of these treatments in routine care. We set up a pragmatic documentation study in general practice funded within the scope of project launched by a German health insurer. Patients were followed-up for up to four years. Methods The aim of the project was to study the effects and benefits of acupuncture and/or homoeopathy, and to assess patient satisfaction within a pr...

  16. Teamwork, myth or reality: community nurses' experience with general practice attachment.

    OpenAIRE

    McClure, L. M.

    1984-01-01

    A survey of 93 community nurses, 48 health visitors, and 45 district nurses was carried out in one area health authority where nurses had been attached to general practice schemes for up to 10 years. The purpose of the study was to determine the nurses' impression of teamwork within their attachment arrangements. Half the group surveyed had either a geographical area or other area health authority responsibilities, or both, in addition to their primary attachment commitment. No structured pla...

  17. Struggling for clarity : cultural context, gender and a concept of depression in general practice

    OpenAIRE

    Lehti, Arja

    2009-01-01

    Many depressed patients attend primary health care, and minority-group patients often see general practitioners for depressive symptoms. The diagnosis and classification criteria of depression and guidelines for management are based on symptoms. However,expressions of depression can vary with culture and gender but the diagnostic tools and guidelines are not adapted to gendered or cultural context and have shown to be poorly applicable in clinical practice. The purpose of this thesis was to a...

  18. Patients' views of the consultation: comparison of a prison and general practice population.

    OpenAIRE

    martin, E.; Russell, D; Goodwin, S

    1991-01-01

    Prisoners' perceptions of why they consulted the doctor, how ill they thought they were and what happened during the consultation were studied in Bedford prison using a questionnaire. Patients' perceptions were compared before and after the consultation and with the perception of the doctor. The figures from this study were compared with comparable groups in a similar general practice survey. Prisoners perceived themselves to be more ill than comparable groups living in the community and both...

  19. Evaluation of job satisfaction of practice staff and general practitioners: an exploratory study.

    OpenAIRE

    Goetz Katja; Campbell Stephen M; Steinhaeuser Jost; Broge Bjoern; Willms Sara; Szecsenyi Joachim

    2011-01-01

    Abstract Background Primary care teams' job satisfaction is an important issue in quality of care. The purpose of our study was to evaluate the job satisfaction of general practitioners (GPs) and non-physician staff and to explore the elements that may impact on overall job satisfaction for GPs and non-physician staff separately. Methods The study was based on data from the European Practice Assessment and used an observational design. Job satisfaction was measured with the 10-items Warr-Cook...

  20. Distribution of episodes of mental illness in general practice: results from the Second National Morbidity Survey.

    OpenAIRE

    Smeeton, N C

    1986-01-01

    The Second National Morbidity Survey, conducted in England and Wales between 1970 and 1976, contains a unique body of information on episodes of mental illness experienced by individuals registered in a representative sample of general practices around the country. This information is used to construct the episode distribution among the individuals surveyed. The Poisson and negative binomial distributions are then used to model the episodes. The Poisson model gives a very poor fit but the neg...

  1. Attitude toward oral biopsy among general dental practitioners: Awareness and practice

    OpenAIRE

    Anwar B Bataineh; Hammad, Huda M; Iyas A Darweesh

    2015-01-01

    Aims: The aim of this study was to investigate the theoretical and practical skill levels of the general dental practitioners (GDPs) toward oral biopsy and to compare these results with other developed countries. Materials and Methods: A total of 500 Jordanian GDP from the 12 major governances of the Hashemite Kingdom of Jordan were conveniently sampled and included in this cross-sectional study. Participants were asked to complete a self-reported questionnaire that was specially designed to ...

  2. Post-marketing surveillance of enalapril: experience in 11 710 hypertensive patients in general practice

    OpenAIRE

    Cooper, Warren D.; Sheldon, David; Brown, Derek; Kimber, Graham R.; Isitt, Valerie L.; Currie, William J.C.

    1987-01-01

    Post-marketing surveillance in general practice represents an important part of the monitoring of adverse events associated with newly introduced drugs. Such a study of the angiotensin-converting enzyme inhibitor enalapril maleate has been undertaken in 11 710 patients with essential hypertension. Serious adverse events occurred in 1.7% of patients, though most of these were not thought to be related to the treatment. The incidence rates of death (0.09%), stroke (0.11%) and myocardial infarct...

  3. Use of the Internet in the diffusion of GIS for General Practices in Victoria, Australia

    OpenAIRE

    Escobar Martínez, Francisco Javier; Williamson, Ian; Green, Julie; Waters, Elizabeth

    1988-01-01

    This paper describes the delivery of a Geographic Information System (GIS) product through the Internet for primary health care services provided at general medical practices in the State of Victoria, Australia. The paper details a collaborative research project, the principal aim of which was to develop a methodology for creating a GIS as a decision support system, for more effective use of information about population and health services at a given location. The methodology employed i...

  4. Attitudes to taking a sexual history in general practice in Victoria, Australia

    OpenAIRE

    Temple-Smith, M J; Mulvey, G; Keogh, L

    1999-01-01

    OBJECTIVE: To examine general practitioners' (GPs') attitudes towards taking a sexual history. METHODS: Questions on sexual history taking were included in a random survey on the STD knowledge, attitudes, and practices of 600 GPs practising in Victoria, Australia. RESULTS: Most GPs commonly asked patients about safe sex (79%), number of sex partners (63%), and injecting drug use (60%) while fewer asked about recent overseas travel (50%) and sex with sex workers (31%). GPs who performed ...

  5. Child overweight in general practice – parents’ beliefs and expectations – a questionnaire survey study

    OpenAIRE

    Andersen, Merethe K; Christensen, Bo; Søndergaard, Jens

    2013-01-01

    Background Care for overweight children in general practice involves collaboration with parents. Acknowledging the parents’ frames of references is a prerequisite for successful management. We therefore aimed to analyse parental beliefs about the presumed causes and consequences of overweight in children and expectations towards the GP. Moreover, we aimed at comparing the beliefs and expectations of parents of non-overweight children (NOWC) and parents of overweight children (OWC). Methods A ...

  6. Vocational trainees’ views and experiences regarding the learning and teaching of communication skills in general practice

    OpenAIRE

    Van Nuland, Marc; Thijs, Gaby; Van Royen, Paul; Van Den Noortgate, Wim; Goedhuys, Jo

    2010-01-01

    Objective: To explore the views and experiences of general practice (GP) vocational trainees regarding communication skills (CS) and the teaching and learning of these skills. METHODS: A purposive sample of second and third (final) year GP trainees took part in six focus group (FG) discussions. Transcripts were coded and analysed in accordance with a grounded theory approach by two investigators using Alas-ti software. Finally results were triangulated by means of semi-structured telephone in...

  7. The effectiveness of an acupuncturist working in General Practice: an audit.

    OpenAIRE

    Harborow, P; Ogden, J

    2004-01-01

    This audit was based in general practice and examined 49 consecutive referrals to a UK trained traditional Chinese acupuncturist. It aimed to assess the type of patients referred to an acupuncturist, subsequent changes in health status, whether the effectiveness of acupuncture was related to the type of presenting problem and to examine which factors were predictive of the success of acupuncture. The referred patients had a wide variety of conditions which were categorised as to whether or no...

  8. Determinants of the clinical course of musculoskeletal complaints in general practice: design of a cohort study

    OpenAIRE

    van der Windt Daniëlle AWM; Terwee Caroline B; Bot Sandra DM; van der Waal Johanna M; Bouter Lex M; Dekker Joost

    2003-01-01

    Abstract Background Musculoskeletal complaints are frequent and have large consequences for public health. Information about the prognosis after presentation in general practice is far from complete. Knowledge about determinants of the clinical course of musculoskeletal complaints is essential for management decisions and to inform patients about their prognosis. The purpose of this study is to provide information about the prognosis of musculoskeletal complaints other than low back pain by s...

  9. Adherence to diabetes care processes at general practices in the National Capital Region-Delhi, India

    Directory of Open Access Journals (Sweden)

    Roopa Shivashankar

    2016-01-01

    Full Text Available Aim: To assess the level of adherence to diabetes care processes, and associated clinic and patient factors at general practices in Delhi, India. Methods: We interviewed physicians (n = 23 and patients with diabetes (n = 406, and reviewed patient charts at general practices (government = 5; private = 18. We examined diabetes care processes, specifically measurement of weight, blood pressure (BP, glycated hemoglobin (HbA1c, lipids, electrocardiogram, dilated eye, and a foot examination in the last one year. We analyzed clinic and patient factors associated with a number of care processes achieved using multilevel Poisson regression model. Results: The average number of clinic visits per patient was 8.8/year (standard deviation = 5.7, and physicians had access to patient's previous records in only 19.7% of patients. Dilated eye exam, foot exam, and electrocardiogram were completed in 7.4%, 15.1%, and 29.1% of patients, respectively. An estimated 51.7%, 88.4%, and 28.1% had ≥1 measurement of HbA1c, BP, and lipids, respectively. Private clinics, physician access to patient's previous records, use of nonphysicians, patient education, and the presence of diabetes complication were positively associated with a number of care processes in the multivariable model. Conclusion: Adherence to diabetes care processes was suboptimal. Encouraging implementation of quality improvement strategies like Chronic Care Model elements at general practices may improve diabetes care.

  10. Living large: the experiences of large-bodied women when accessing general practice services

    Directory of Open Access Journals (Sweden)

    Russell N

    2013-09-01

    Full Text Available INTRODUCTION: Numerous studies report high levels of stigma and discrimination experienced by obese/overweight women within the health care system and society at large. Despite general practice being the most utilised point of access for health care services, there is very little international or national exploration of the experiences of large-bodied women (LBW accessing these services. The aim of this study was to explore LBW's experiences of accessing general practice services in New Zealand. METHODS: This is a qualitative, descriptive, feminist study. Local advertising for participants resulted in eight self-identified, large-bodied women being interviewed. A post-structural feminist lens was applied to the data during thematic analysis. FINDINGS: The women in this study provided examples of verbal insults, inappropriate humour, negative body language, unmet health care needs and breaches of dignity from health care providers in general practice. Seven themes were identified: early experiences of body perception, confronting social stereotypes, contending with feminine beauty ideals, perceptions of health, pursuing health, respecting the whole person, and feeling safe to access care. CONCLUSION: Pressure for body size vigilance has, in effect, excluded the women in this study from the very locations of health that they are 'encouraged' to attend-including socialising and exercising in public, screening opportunities that require bodily exposure, and accessing first point of care health services.

  11. Cancer screening in a middle-aged general population: factors associated with practices and attitudes

    Directory of Open Access Journals (Sweden)

    Perneger Thomas V

    2009-04-01

    Full Text Available Abstract Background The aim of this study was to identify factors associated with cancer screening practices and with general attitudes toward cancer screening in a general population. Methods Mailed survey of 30–60 year old residents of Geneva, Switzerland, that included questions about screening for five cancers (breast, cervix uteri, prostate, colon, skin in the past 3 years, attitudes toward screening, health care use, preventive behaviours and socio-demographic characteristics. Cancer screening practice was dichotomised as having done at least one screening test in the past 3 years versus none. Results The survey response rate was 49.3% (2301/4670. More women than men had had at least one cancer screening test in the past 3 years (83.2% vs 34.5%, p Conclusion Attitudes play an important role in cancer screening practices among middle-aged adults in the general population, independent of demographic variables (age and sex that determine in part screening recommendations. Negative attitudes were the most frequent among men and the most socio-economically disadvantaged. The moderate participation rate raises the possibility of selection bias.

  12. The disappearance of the “revolving door” patient in Scottish general practice: successful policies

    Directory of Open Access Journals (Sweden)

    Williamson Andrea E

    2012-10-01

    Full Text Available Abstract Background We describe the health of "revolving door" patients in general practice in Scotland, estimate changes in their number over the timescale of the study, and explore reasons for changes, particularly related to NHS and government policy. Methods A mixed methods predominantly qualitative study, using a grounded theory approach, set in Scottish general practice. Semi-structured interviews were conducted with professional key informants, 6 Practitioner Services staff who administer the GP registration system and 6 GPs with managerial or clinical experience of working with “revolving door” patients. Descriptive statistical analysis and qualitative analysis of patient removal episodes linked with routine hospital admissions, outpatient appointments, drug misuse treatment episodes and deaths were carried out with cohorts of “revolving door” patients identified from 1999 to 2005 in Scotland. Results A “revolving door” patient is removed 4 or more times from GP lists in 7 years. Patients had complex health issues including substance misuse, psychiatric and physical health problems and were at high risk of dying. There was a dramatic reduction in the number of “revolving door” patients during the course of the study. Conclusions “Revolving door” patients in general practice had significant health problems. Their numbers have reduced dramatically since 2004 and this probably resulted from improved drug treatment services, pressure from professional bodies to reduce patient removals and the positive ethical regulatory and financial climate of the 2004 GMS GP contract. This is a positive development for the NHS.

  13. Knowledge, Attitudes and Practices regarding Rabies among general practitioners of Belgaum City

    Directory of Open Access Journals (Sweden)

    R.K. Nayak

    2013-07-01

    Full Text Available Introduction: Rabies in humans is highly fatal and ends in an extremely painful and tortuous death. Unfortunately we still have highest number of deaths due to rabies, ironically a disease preventable by modern prophylactic measures. The post-exposure prophylaxis is a life saving treatment in a definite rabid animal bite. General Practitioners (GP’s act as first line care-givers for the treatment of dog bite and they are also easily approachable by the victim for the treatment to prevent rabies. Objective: To assess the knowledge, attitude and practices regarding rabies among general practitioners. Methodology: This cross sectional survey was carried out from July – August 2011 in Belgaum city among 100 general practitioners using a pre tested questionnaire. Data was entered and analyzed using SPSS 18 trial version. Frequencies were tabulated for demographic variables and association between variables was tested using Chi-square test. Results: Out of the total 100 general practitioners interviewed, 93 were males and 7 were females. The mean age of GP’s was 42.89 years. The mean duration of practice for MBBS doctors was 19 years and for other doctors (BAMS, BHMS, RMP’s was 11 years. Knowledge about various aspects of rabies was comparatively better among MBBS doctors. The knowledge regarding vaccine was very poor among the general practitioners. Conclusion: The major issue was lack of hands on training or updating the knowledge of general practitioners regarding the newer vaccines and their administration. We recommend continued medical education for general practitioners, both (MBBS and non MBBS on prevention of Rabies.

  14. Factors influencing the speed of cancer diagnosis in rural Western Australia: a General Practice perspective

    Directory of Open Access Journals (Sweden)

    Smith Marthe

    2007-05-01

    Full Text Available Abstract Introduction The speed of diagnosis impacts on prognosis and survival in all types of cancer. In most cases survival and prognosis are significantly worse in rural and remote Australian populations who have less access to diagnostic and therapeutic services than metropolitan communities in this country. Research suggests that in general delays in diagnosis were a factor of misdiagnosis, the confounding effect of existing conditions and delayed or misleading investigation of symptoms. The aim of this study is to further explore the factors that impact on the speed of diagnosis in rural Western Australia with direct reference to General Practitioners (GPs working in this setting. Methods The methodology consisted of a structured discussion of specific cases. GPs based in two rural locations in Western Australia were asked to identify up to eight clinical cases for discussion. A diversity of cases was requested encompassing those with timely and delayed diagnosis of cancer. Focus groups were held with the practitioners to identify which factors under six headings delayed or facilitated the diagnosis in each case. A structured summary of the discussion was relayed to a wider group of GPs to seek additional views or comments on specific factors that impact on the speed of cancer diagnosis in rural and remote locations in Australia. Results A number of factors affecting the speed of diagnosis were identified: the demographic shift towards a frailer and older population, presenting with multiple and complex diseases, increases the challenge to identify early cancer symptoms; seasonal and demanding work patterns leading to procrastination in presenting for medical care; unhelpful scheduling of specialist appointments; and the varying impact of informal networks and social relationships. Conclusion Within the limitations of this study we have generated a number of hypotheses that require formal evaluation: (1 GPs working within informal

  15. Infection control in general practices in Buffalo City and OR Tambo District Municipalities, South Africa

    Directory of Open Access Journals (Sweden)

    Don O'Mahony

    2012-02-01

    Full Text Available Background: Good infection control practices are effective in reducing rates of infection in health care settings. Studies in primary care in developed countries indicate that many general practitioners (GPs do not comply with optimal infection control practices. There are no published studies from developing countries in Southern Africa.Objectives: The aim of this study was to describe infection control practices in private GP surgeries in the Buffalo City and OR Tambo District Municipalities in the Eastern Cape Province, South Africa.Method: A literature review was conducted to appraise current best practice with respect to Standard Infection Control and Transmission Based Precautions. A questionnaire, inquiring into GPs’ actual practices, was posted to each surgery.Results: The valid response rate was 34% (47/140. Methods used to sterilise instruments in 40 practices were: ultraviolet sterilisation (23, chemical disinfection (14, boiling water (7, and steam autoclave (2. Compounds used for chemical disinfection included organotin quaternary, chlorhexidine and benzyl ammonium chloride with a quaternary complex. Twenty-two (47% used a hand rub. Sixteen (35% GPs stated that they had a policy to promptly triage patients who are coughing, and 23 (50% had a policy for airflow movement in the surgery. All practices appropriately disposed of sharps. Thirty-seven (80% expressed interest in a seminar on infection control.Conclusions: Overall, GPs were aware of infection control precautions. Ultraviolet sterilisers and chlorhexidine are not recommended, however, for sterilisation or high level disinfection of medical instruments, and their use should be discontinued. Hand rubs are underutilised. GPs should implement Transmission Based Precautions to prevent airborne and droplet infections.

  16. Inter-practice variation in diagnosing hypertension and diabetes mellitus: a cross-sectional study in general practice

    OpenAIRE

    Schellevis François G; Nielen Markus MJ; Verheij Robert A

    2009-01-01

    Abstract Background Previous studies of inter-practice variation of the prevalence of hypertension and diabetes mellitus showed wide variations between practices. However, in these studies inter-practice variation was calculated without controlling for clustering of patients within practices and without adjusting for patient and practice characteristics. Therefore, in the present study inter-practice variation of diagnosed hypertension and diabetes mellitus prevalence rates was calculated by ...

  17. Women's evaluation of abuse and violence care in general practice: a cluster randomised controlled trial (weave

    Directory of Open Access Journals (Sweden)

    Feder Gene

    2010-01-01

    Full Text Available Abstract Background Intimate partner abuse (IPA is a major public health problem with serious implications for the physical and psychosocial wellbeing of women, particularly women of child-bearing age. It is a common, hidden problem in general practice and has been under-researched in this setting. Opportunities for early intervention and support in primary care need to be investigated given the frequency of contact women have with general practice. Despite the high prevalence and health consequences of abuse, there is insufficient evidence for screening in primary care settings. Furthermore, there is little rigorous evidence to guide general practitioners (GPs in responding to women identified as experiencing partner abuse. This paper describes the design of a trial of a general practice-based intervention consisting of screening for fear of partner with feedback to GPs, training for GPs, brief counselling for women and minimal practice organisational change. It examines the effect on women's quality of life, mental health and safety behaviours. Methods/Design weave is a cluster randomised controlled trial involving 40 general practices in Victoria, Australia. Approximately 500 women (16-50 years seen by the GP in the previous year are mailed a short lifestyle survey containing an item to screen for IPA. Women who indicate that they were afraid of a partner/ex-partner in the last year and provide contact details are invited to participate. Once baseline data are collected, GPs are randomly assigned to either a group involving healthy relationship and responding to IPA training plus inviting women for up to 6 sessions of counselling or to a group involving basic education and usual care for women. Outcomes will be evaluated by postal survey at 6 and 12 months following delivery of the intervention. There will be an economic evaluation, and process evaluation involving interviews with women and GPs, to inform understanding about implementation

  18. [Selective screening for hypercholesterolemia. Results from a screening model in general practice].

    Science.gov (United States)

    Agner, E; Christensen, T E; Mahnfeldt, M S; Baastrup, A; Jacobsen, K; Jensen, S E

    1990-11-01

    At present, it appears to be probable that both dietary changes and medicinal treatment can reduce the risk of development of coronary disease in middle-aged men with moderately to severely raised blood cholesterol values. Internationally, the limits for cholesterol intervention are considerably lower than in Denmark. Extensive cholesterol screening is, however, very expensive and the identified persons with high cholesterol values will frequently be found in sex and age groups where the beneficial effect of intervention is probably limited. A model for selective cholesterol screening in high risk groups in general practice is described here. In 20 general practices, all of the men aged 45-59 years belonging to the practice were invited to examination of cholesterol and blood pressure. Plasma cholesterol was measured by means of a Reflotron (results are available within three minutes) and the blood pressure and tobacco consumption were registered. After this, the patient's own general practitioner calculated with each of the persons the risk for development of myocardial infarction within the next ten years and intervention could be commenced immediately. 41% of those invited came for examination. Out of these, 29% had cholesterol values greater than or equal to 7.0 mmol/l (Danish limiting value), 44% greater than or equal to 6.5 mmol/l (limiting value in the remainder of Western Europe), and 5% greater than or equal to 9.0 mmol/l (severe hypercholesterolaemia) while only 18% had completely normal cholesterol less than 5.2 mmol/l. In every practice, two patients on an average were found with severe hypercholesterolaemia greater than or equal to 9.0 mmol/l. 28% of the participants had at least two of the three risk factors investigated. (ABSTRACT TRUNCATED AT 250 WORDS) PMID:2238223

  19. Photoageing Intervention ( PAINT: A proposal for a randomised controlled trial in Australian Primary Care

    Directory of Open Access Journals (Sweden)

    Oksana Burford

    2009-07-01

    Full Text Available The adverse health impacts of tobacco smoking are adrain on national resources. This study will test anintervention to promote smoking cessation among youngadults aged 18-30years. The intervention will be deliveredwithin two settings in Australian health care; communitypharmacies and general practice. The new study builds onthe pilot data, reported here, which inform the feasibility,recruitment strategy, outcome measure, effect size andattrition rate. The new study is a randomised controlledtrial with 200 clients recruited from general practice andcommunity pharmacies in Western Australia.

  20. Sexual function in older women with pelvic floor symptoms : a cross-sectional study in general practice

    NARCIS (Netherlands)

    Panman, Chantal M. C. R.; Wiegersma, Marian; Talsma, Marrit N.; Kollen, Boudewijn J.; Berger, Marjolein Y.; Lisman-Van Leeuwen, Yvonne; Dekker, Janny H.

    2014-01-01

    Background Pelvic floor symptoms are common and are negatively associated with sexual function which, in turn, is an important aspect of quality of life. The majority of older women with pelvic floor symptoms are treated in general practice but evidence from studies in general practice on the sexual

  1. Living Smart Homes: A Pilot Australian Sustainability Education Programme

    Science.gov (United States)

    Miller, Evonne; Buys, Laurie; Bell, Lorraine

    2009-01-01

    This article documents the rationale and experience of a pilot Australian sustainability education programme, "Living Smart Homes" (LSH) based on a community-based social marketing model. Inspired by the Australian "Land for Wildlife" scheme, LSH is designed to engage homeowners with sustainable practices through face-to-face workshops, an…

  2. Defining and Assessing Generic Competencies in Australian Universities: Ongoing Challenges

    Science.gov (United States)

    Chapman, Elaine; O'Neill, Marnie

    2010-01-01

    In this paper, we discuss ongoing challenges in defining and assessing generic competencies in Australian universities. The paper begins with a discussion of factors that led to, and later fuelled, the focus on generic competencies in Australian higher education. Broad constructs that have underpinned research and practice in the field are then…

  3. The Teaching of First Year Economics in Australian Universities*

    OpenAIRE

    Nilss Olekalns

    2002-01-01

    This paper surveys current pedagogical practice in the teaching of introductory macroeconomics and microeconomics in Australian universities. Survey results are presented detailing lecturers’ approaches to their teaching over 2001 and other aspects of their teaching environment. A comparison of the content and methodology of the main textbooks used in Australian introductory economic courses is also presented.

  4. Inter-practice variation in diagnosing hypertension and diabetes mellitus: a cross-sectional study in general practice

    NARCIS (Netherlands)

    Nielen, M.M.J.; Schellevis, F.G.; Verheij, R.A.

    2009-01-01

    BACKGROUND: Previous studies of inter-practice variation of the prevalence of hypertension and diabetes mellitus showed wide variations between practices. However, in these studies inter-practice variation was calculated without controlling for clustering of patients within practices and without adj

  5. Inter-practice variation in diagnosing hypertension and diabetes mellitus: a cross-sectional study in general practice.

    NARCIS (Netherlands)

    Nielen, M.M.J.; Schellevis, F.G.; Verheij, R.A.

    2009-01-01

    BACKGROUND: Previous studies of inter-practice variation of the prevalence of hypertension and diabetes mellitus showed wide variations between practices. However, in these studies inter-practice variation was calculated without controlling for clustering of patients within practices and without adj

  6. Evaluation of a theory-informed implementation intervention for the management of acute low back pain in general medical practice

    DEFF Research Database (Denmark)

    French, Simon D; McKenzie, Joanne E; O'Connor, Denise A;

    2013-01-01

    Introduction: This cluster randomised trial evaluated an intervention to decrease x-ray referrals and increase giving advice to stay active for people with acute low back pain (LBP) in general practice. Methods: General practices were randomised to either access to a guideline for acute LBP (cont...... intervention led to small changes in GP intention to practice in a manner that is consistent with an evidence-based guideline, but it did not result in statistically significant changes in actual behaviour....

  7. How psychosocial factors affect well-being of practice assistants at work in general medical care? – a questionnaire survey

    OpenAIRE

    Götz, Katja; Berger, Sarah; Gavartina, Amina; Zaroti, Stavria; Szecsenyi, Joachim

    2015-01-01

    Background: Well-being at work is an important aspect of a workforce strategy. The aim of the study was to explore and evaluate psychosocial factors and health and work-related outcomes of practices assistants depending on their employment status in general medical practices. Methods: This observational study was based on a questionnaire survey to evaluate psychosocial aspects at work in general medical practices. A standardized questionnaire was used, the Copenhagen Psychosocial Questionna...

  8. A clinical trial alert tool to recruit large patient samples and assess selection bias in general practice research

    OpenAIRE

    Scheidt-Nave Christa; Schäfer Tobias; Wedeken Sven; Thüring Sabine; Heinemann Stephanie; Ketterer Mirko; Himmel Wolfgang

    2011-01-01

    Abstract Background Many research projects in general practice face problems when recruiting patients, often resulting in low recruitment rates and an unknown selection bias, thus limiting their value for health services research. The objective of the study is to evaluate the recruitment performance of the practice staff in 25 participating general practices when using a clinical trial alert (CTA) tool. Methods The CTA tool was developed for an osteoporosis survey of patients at risk for oste...

  9. Relation of out of hours activity by general practice and accident and emergency services with deprivation in Nottingham: longitudinal survey.

    OpenAIRE

    Carlisle, R; Groom, L. M.; Avery, A J; Boot, D; Earwicker, S.

    1998-01-01

    OBJECTIVES: To investigate the relation between out of hours activity of general practice and accident and emergency services with deprivation and distance from accident and emergency department. DESIGN: Six month longitudinal study. SETTING: Six general practices and the sole accident and emergency department in Nottingham. SUBJECTS: 4745 out of hours contacts generated by 45,182 patients from 23 electoral wards registered with six practices. MAIN OUTCOME MEASURES: Rates of out of hours cont...

  10. Acceptance and perceived barriers of implementing a guideline for managing low back in general practice

    Directory of Open Access Journals (Sweden)

    Pfingsten Michael

    2008-02-01

    Full Text Available Abstract Background Implementation of guidelines in clinical practice is difficult. In 2003, the German College of General Practitioners and Family Physicians (DEGAM released an evidence-based guideline for the management of low back pain (LBP in primary care. The objective of this study is to explore the acceptance of guideline content and perceived barriers to implementation. Methods Seventy-two general practitioners (GPs participating in quality circles within the framework of an educational intervention study for guideline implementation evaluated the LBP-guideline and its practicability with a standardised questionnaire. In addition, statements of group discussions were recorded using the metaplan technique and were incorporated in the discussion. Results Most GPs agree with the guideline content but believe that guideline stipulations are not congruent with patient wishes. Non-adherence to the guideline and contradictory information for patients by other professionals (e.g., GPs, orthopaedic surgeons, physiotherapists are important barriers to guideline adherence. Almost half of the GPs have no access to recommended multimodal pain programs for patients with chronic LBP. Conclusion Promoting adherence to the LBP guideline requires more than enhancing knowledge about evidence-based management of LBP. Public education and an interdisciplinary consensus are important requirements for successful guideline implementation into daily practice. Guideline recommendations need to be adapted to the infrastructure of the health care system. Trial registration BMBF Grant Nr. 01EM0113. FORIS (database for research projects in social science Reg #: 20040116 25.

  11. Comprehensive Geriatric Assessment (CGA in general practice: Results from a pilot study in Vorarlberg, Austria

    Directory of Open Access Journals (Sweden)

    Mann Eva

    2004-05-01

    Full Text Available Abstract Background Most comprehensive geriatric assessment (CGA programs refer to hospital-based settings. However the body of geriatric healthcare is provided by general practitioners in their office. Structured geriatric problem detection by means of assessment instruments is crucial for efficient geriatric care giving in the community. Methods We developed and pilot tested a German language geriatric assessment instrument adapted for general practice. Nine general practices in a rural region of Austria participated in this cross-sectional study and consecutively enrolled 115 persons aged over 75 years. The prevalence of specific geriatric problems was assessed, as well as the frequency of initiated procedures following positive and negative tests. Whether findings were new to the physician was studied exemplarily for the items visual and hearing impairment and depression. The acceptability was recorded by means of self-administered questionnaires. Results On average, each patient reported 6.4 of 14 possible geriatric problems and further consequences resulted in 43.7% (27.5% to 59.8% of each problem. The items with either the highest prevalence and/or the highest number of initiated actions by the GPs were osteoporosis risk, urinary incontinence, decreased hearing acuity, missing pneumococcal vaccination and fall risk. Visual impairment was newly detected in only 18% whereas hearing impairment and depression was new to the physician in 74.1% and 76.5%, respectively. A substantial number of interventions were initiated not only following positive tests (43.7% per item; 95% CI 27.5% to 59.8%, but also as a consequence of negative test results (11.3% per item; 95% CI 1.7% to 20.9%. The mean time expenditure to accomplish the assessment was 31 minutes (SD 10 min. Patients (89% and all physicians confirmed the CGA to provide new information in general on the patient's health status. All physicians judged the CGA to be feasible in everyday

  12. Benzodiazepine prescribing behaviour and attitudes: a survey among general practitioners practicing in northern Thailand

    Directory of Open Access Journals (Sweden)

    Critchley Julia

    2005-06-01

    Full Text Available Abstract Background Over-prescribing of benzodiazepines appears common in many countries, a better understanding of prescribing practices and attitudes may help develop strategies to reduce prescribing. This study aimed to evaluate benzodiazepine prescribing behaviour and attitudes in general practitioners practising in Chiang Mai and Lampoon, Thailand. Methods Questionnaire survey of general practitioners in community hospitals, to estimate: i use of benzodiazepines for anxiety/insomnia, panic disorder, depression, essential hypertension, and uncomplicated low back pain and ii views on the optimal duration of benzodiazepine use. Results Fifty-five of 100 general practitioners returned the completed questionnaires. They reported use of benzodiazepines for anxiety/insomnia (n = 51, 93%, panic disorder (n = 43, 78%, depression (n = 26, 43%, essential hypertension (n = 15, 27 % and uncomplicated low back pain (n = 10, 18%. Twenty-eight general practitioners would prescribe benzodiazepines for non-psychiatric conditions, 17 for use as muscle relaxants. Seventy-five per cent, 62% and 29% of the general practitioners agreed or totally agreed with the use of benzodiazepines for insomnia, anxiety and depression, respectively. Practitioners agreed that prescribing should be less than one week (80%; or from 1 week to 1 month (47%; or 1 to 4 months (16%; or 4 to 6 months (5% or more than 6 months (2%. Twenty-five general practitioners (45% accepted that they used benzodiazepines excessively in the past year. Conclusion A considerable proportion of general practitioners in Chiang Mai and Lampoon, Thailand inappropriately use benzodiazepines for physical illnesses, especially essential hypertension and uncomplicated low back pain. However, almost half of them thought that they overused benzodiazepines. General practitioner's lack of time, knowledge and skills should be taken into account in improving prescribing behaviour and attitudes.

  13. Implementing evidence-based recommended practices for the management of patients with mild traumatic brain injuries in Australian emergency care departments: study protocol for a cluster randomised controlled trial

    Science.gov (United States)

    2014-01-01

    Background Mild head injuries commonly present to emergency departments. The challenges facing clinicians in emergency departments include identifying which patients have traumatic brain injury, and which patients can safely be sent home. Traumatic brain injuries may exist with subtle symptoms or signs, but can still lead to adverse outcomes. Despite the existence of several high quality clinical practice guidelines, internationally and in Australia, research shows inconsistent implementation of these recommendations. The aim of this trial is to test the effectiveness of a targeted, theory- and evidence-informed implementation intervention to increase the uptake of three key clinical recommendations regarding the emergency department management of adult patients (18 years of age or older) who present following mild head injuries (concussion), compared with passive dissemination of these recommendations. The primary objective is to establish whether the intervention is effective in increasing the percentage of patients for which appropriate post-traumatic amnesia screening is performed. Methods/design The design of this study is a cluster randomised trial. We aim to include 34 Australian 24-hour emergency departments, which will be randomised to an intervention or control group. Control group departments will receive a copy of the most recent Australian evidence-based clinical practice guideline on the acute management of patients with mild head injuries. The intervention group will receive an implementation intervention based on an analysis of influencing factors, which include local stakeholder meetings, identification of nursing and medical opinion leaders in each site, a train-the-trainer day and standardised education and interactive workshops delivered by the opinion leaders during a 3 month period of time. Clinical practice outcomes will be collected retrospectively from medical records by independent chart auditors over the 2 month period following

  14. Models of collaboration between general practice and mental health services in Italy

    Directory of Open Access Journals (Sweden)

    Domenico Berardi

    2007-03-01

    Full Text Available Background and objectives: Anxiety and Depressive disorders represent an important public health problem, which involves not only the mental health services, but the General Practice as well. This paper examines models of Collaboration between General Practice and Community Mental Health Services developed in Italy. Methods: Different Consultation -Liaison activities are presented. For every Collaboration model advantages and disadvantage are discussed. Results: The structured Consultation Liaison Service is based on supplying diagnostic consultation and therapeutic interventions in support of General Practitioners (GPs. The service could be based in either a Community Mental Health Centre (CMHC or externally. Diagnostic evaluation can be followed by brief and focal therapeutic interventions, in support of the GP's therapeutic plan. The spontaneous collaboration in small centres are frequent in rural areas where the contained dimensions of the services and the direct acquaintance between psychiatrists and GPs encourage the personalization of the collaboration. The model of Liaison and Group-Training focuses on direct contact between consultant and GPs. In the course of regular meetings, the consultant gives the GPs supervision and education, and they can discuss the therapeutic plans for patients requiring specialist intervention. Conclusion: The empiric classification presented should be considered an attempt to represent a complex reality. Every service, in fact, carries out activities that are necessarily wider than abstract typologies and that overlap with other models' activities.

  15. Breast conserving surgery versus mastectomy: cancer practice by general surgeons in Iran

    International Nuclear Information System (INIS)

    There appear to be geographical differences in decisions to perform mastectomy or breast conserving surgery for early-stage breast cancer. This study was carried out to evaluate general surgeons' preferences in breast cancer surgery and to assess the factors predicting cancer practice in Iran. A structured questionnaire was mailed to 235 general surgeons chosen from the address list of the Iranian Medical Council. The questionnaire elicited information about the general surgeons' characteristics and about their work experience, posts they have held, number of breast cancer operations performed per year, preferences for mastectomy or breast conserving surgery, and the reasons for these preferences. In all, 83 surgeons returned the completed questionnaire. The results indicated that only 19% of the surgeons routinely performed breast conserving surgery (BCS) and this was significantly associated with their breast cancer case load (P < 0.01). There were no associations between BCS practice and the other variables studied. The most frequent reasons for not performing BCS were uncertainty about conservative therapy results (46%), uncertainty about the quality of available radiotherapy services (32%), and the probability of patients' non-compliance in radiotherapy (32%). The findings indicate that Iranian surgeons do not routinely perform BCS as the first and the best treatment modality. Further research is recommended to evaluate patients' outcomes after BCS treatment in Iran, with regard to available radiotherapy facilities and cultural factors (patients' compliance)

  16. Organisational change theory and the use of indicators in general practice.

    Science.gov (United States)

    Rhydderch, M; Elwyn, G; Marshall, M; Grol, R

    2004-06-01

    General practices are making greater use of indicators to help shape and develop organisational arrangements supporting the delivery of health care. Debate continues concerning what exactly such indicators should measure and how they should be used to achieve improvement. Organisational theories can provide an analytical backdrop to inform the design of indicators, critique their construction, and evaluate their use. Systems theory, organisational development, social worlds theory, and complexity theory each has a practical contribution to make to our understanding of how indicators work in prompting quality improvements and why they sometimes don't. This paper argues that systems theory exerts the most influence over the use of indicators. It concludes that a strategic framework for quality improvement should take account of all four theories, recognising the multiple realities that any one approach will fail to reflect. PMID:15175493

  17. Management of joint and soft tissue injuries in three general practices: value of on-site physiotherapy.

    OpenAIRE

    Hackett, G I; Bundred, P; HUTTON, J.L.; O'Brien, J.; Stanley, I.M.

    1993-01-01

    A prospective study was undertaken to determine the potential benefits in patient management and cost effectiveness of physiotherapists employed by general practitioners compared with direct hospital access and access via consultants. The study involved 401 patients from three rural general practices in south Cheshire and north Staffordshire and took place over six months. On-site physiotherapy in general practice premises resulted in higher referral rates to the physiotherapist compared with...

  18. Health-related and overall quality of life of patients with chronic hip and knee complaints in general practice

    OpenAIRE

    Waal, de, M.; Terwee, C. B.; Windt - Mens, van der, D.A.W.M.; Bouter, L M; Dekker, J

    2005-01-01

    BACKGROUND: Information about quality of life of patients with chronic hip or knee complaints in general practice is scarce. This study describes the health-related and overall quality of life (HRQL) of these complaints. METHODS: Data were obtained from a cohort study in general practice. HRQL at three months follow-up was analysed. HRQL was measured as: symptoms, physical, psychological and social functioning, and general health perceptions, using the Western Ontario and McMaster Universitie...

  19. Prevalent Practices of Thyroid Diseases During Pregnancy Among Endocrinologists, Internists and General Practitioners

    Directory of Open Access Journals (Sweden)

    Azizi

    2015-11-01

    Full Text Available Background Maternal thyroid disease in pregnancy is associated with adverse impact on both mother and fetus. Both the American thyroid association and the endocrine society have recently published guidelines for the management of thyroid disease in pregnancy. Objectives The objective of this survey was to assess and compare the current practices of various East-Asian physicians in the screening and management of thyroid disease in pregnancy. Materials and Methods Completed survey questionnaires were collected from 112 physicians of six East-Asian countries. The survey was based on clinical case scenarios, asking questions about the clinical practices related to diagnosis and management of thyroid disease during pregnancy. Reponses from 76 endocrinologists and 33 internists and general practitioners (generalists were analyzed. Results There were minor differences in treatment preferences for Graves’ disease in pregnancy and tests to monitor antithyroid drugs between endocrinologists and generalists; the major difference being targeted free thyroxin, and also thyroxin, depicted in the upper end of normal range, by the majority of endocrinologist and within the normal range, by generalists. Compared to generalists, endocrinologists perform more targeted screening and are more familiar with its risk factors. Predominantly, endocrinologists increase levothyroxine dose in hypothyroid women, upon confirmation of pregnancy and also indicate full dose in a pregnant woman, diagnosed with overt hypothyroidism, and treat thyroid peroxidase antibody positive or negative pregnant women with thyroid stimulating hormone (2.5 - 5 mU/L, as compared to generalists. Conclusions There is wide variation in the clinical practices of screening and management of thyroid disorders during pregnancy in East-Asia, with many clinicians, in particular general practitioners, not adhering to clinical practice guidelines, unfortunately.

  20. Developing a computer delivered, theory based intervention for guideline implementation in general practice

    Directory of Open Access Journals (Sweden)

    Ashworth Mark

    2010-11-01

    Full Text Available Abstract Background Non-adherence to clinical guidelines has been identified as a consistent finding in general practice. The purpose of this study was to develop theory-informed, computer-delivered interventions to promote the implementation of guidelines in general practice. Specifically, our aim was to develop computer-delivered prompts to promote guideline adherence for antibiotic prescribing in respiratory tract infections (RTIs, and adherence to recommendations for secondary stroke prevention. Methods A qualitative design was used involving 33 face-to-face interviews with general practitioners (GPs. The prompts used in the interventions were initially developed using aspects of social cognitive theory, drawing on nationally recommended standards for clinical content. The prompts were then presented to GPs during interviews, and iteratively modified and refined based on interview feedback. Inductive thematic analysis was employed to identify responses to the prompts and factors involved in the decision to use them. Results GPs reported being more likely to use the prompts if they were perceived as offering support and choice, but less likely to use them if they were perceived as being a method of enforcement. Attitudes towards using the prompts were also related to anticipated patient outcomes, individual prescriber differences, accessibility and presentation of prompts and acceptability of guidelines. Comments on the prompts were largely positive after modifying them based on participant feedback. Conclusions Acceptability and satisfaction with computer-delivered prompts to follow guidelines may be increased by working with practitioners to ensure that the prompts will be perceived as valuable tools that can support GPs' practice.