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Substantial Barriers (substantial + barrier)

Distribution by Scientific Domains

Medical Sciences	50%

Selected Abstracts

Barriers to provision of dental care in long-term care facilities: the confrontation with ageing and death

GERODONTOLOGY, Issue 3 2005
Ina Nitschke
Objective:, The aim of the study was to reveal barriers to providing dental care for residents in long-term care (LTC) facilities. Design:, Participants were selected randomly from the dentist register in Berlin and Saxony, Germany. The sample consisted of 60 self-employed and 60 employed dentists, a further 60 dentists worked in their own dental practice but also part-time in an LTC facility. In semi-structured interviews a questionnaire with 36 statements concerning working conditions, administration and cost, insecurity concerning treatment decisions as well as confrontation with ageing and death was employed. Subsequently, the study participants were asked to rank the four dimensions concerning their impact on the decision against providing dental care in an LTC facility. Results:, The random sample was representative in age and gender for the dental register in Berlin and Saxony. Fifty-six per cent of the participants (63% of the men and 51% of the women; 52% of the self-employed, 60% of the employed and 56% of the consultant dentists) indicated unfavourable working conditions as biggest obstacle in providing dental care in an LTC-facility. Thirty-two per cent of participants rated administration and cost, 7% the insecurity in treatment decisions as major hindrance. Only 5% of the participants rated the confrontation with age and death as substantial barrier. There were no age and gender differences. Dentists in Berlin seemed more concerned about administration and cost of a consultancy activity and less secure in their therapy decisions than the colleagues from Saxony (p < 0.001). Dentists who work partly in LTC facilities were the least concerned about the confrontation with ageing and death (not significant), employed dentist showed the least secure in their treatment decisions (p > 0.001). Conclusion:, It can be concluded that the awareness of infra-structural and financial aspects in providing dental care in LTC facilities should be raised with health politicians and that these aspects should be considered when inaugurating or re-structuring the consultancy services to LTC facilities. Further it would be desirable to establish more postgraduate training programmes to increase clinical and ethical competence in the area of gerodontology. [source]

Role of the general practitioner in smoking cessation

DRUG AND ALCOHOL REVIEW, Issue 1 2006
NICHOLAS A. ZWAR
Abstract This paper reflects on the role of general practitioners in smoking cessation and suggests initiatives to enhance general practice as a setting for effective smoking cessation services. This paper is one of a series of reflections on key issues in smoking cessation. In this article we highlight the extent that general practitioners (GPs) have contact with the population, evidence for effectiveness of GP advice, barriers to greater involvement and suggested future directions. General practice has an extensive population reach, with the majority of smokers seeing a GP at least once per year. Although there is level 1 evidence of the effectiveness of smoking cessation advice from general practitioners, there are substantial barriers to this advice being incorporated routinely into primary care consultations. Initiatives to overcome these barriers are education in smoking cessation for GPs and other key practice staff; teaching of medical students about tobacco and cessation techniques, clinical practice guidelines; support for guideline implementation; access to pharmacotherapies; and development of referral models. We believe the way forward for the role of the GPs is to develop the practice as a primary care service for providing smoking cessation advice. This will require education relevant to the needs of a range of health professionals, provision of and support for the implementation of clinical practice guidelines, access for patients to smoking cessation pharmacotherapies and integration with other cessation services such as quitlines [source]

Is Privately-provided Electronic Money Next?

ECONOMIC AFFAIRS, Issue 1 2000
Catherine England
To survive, any new electronic money will need to provide some advantage to its users, such as lower transaction costs, increased privacy, a greater ability to avoid taxes, or a more stable value than its government-provided competitors. Any successful new money will have to overcome substantial barriers to entry, however. These barriers to entry occur primarily in the form of the costs of switching to a different means of payment and require an understanding of the role played by ,network economics.' Unless a substantial number of the individuals and businesses with whom a person trades use the same money, any new means of payment will have little value. A temptation facing government regulators will be to extend and expand regulations to apply to new means of payment and forms of money. A more productive role of governments is to attempt to protect their own money-creation franchises by minimising the advantages offered by privately-provided alternatives. Governments should enforce contracts and punish fraud while remaining vigilant with respect to inflation, keep tax rates low and protect the privacy of their citizens. [source]

Active learning in nursing education (ALINE): New model for teaching and learning

NURSING & HEALTH SCIENCES, Issue 2 2004
Vaunette Fay
Traditional teaching and learning pedagogical models do not adequately address the needs of students and often present substantial barriers to incorporating the benefits of technology enhanced learning. Active learning in nursing education (ALINE) is a practical teaching and learning model that: (a) provides a well-defined framework for accurate assessment of learning outcomes/objectives by requiring each outcome and/or objective be linked to an identified primary nursing competency; (b) identifies and defines the core components of a course (elements, objects and modules) and provides a framework for development of each of the components; (c) requires active learning principles be applied to every action taken by the learner throughout the course. The purpose of this presentation is to discuss the ALINE learning model and the first virtual conference on aging that was held between 21 April to 2 May 2003. [source]