Home About us Contact
|
Home About us Contact | ||
|
|
||
Doctors
Kinds of Doctors Terms modified by Doctors Selected AbstractsWHY ALCOHOL AND DRUGS IS AN UNATTRACTIVE CAREER OPTION FOR MOST YOUNG DOCTORSADDICTION, Issue 2 2009ALEX WODAK No abstract is available for this article. [source] A SHORTAGE OF MEDICAL DOCTORS TO MEET THE CHALLENGES OF A GROWING ADDICTION PROBLEM IN LOW AND MIDDLE INCOME COUNTRIES: THE CASE IN MEXICOADDICTION, Issue 2 2009MARIA ELENA MEDINA-MORA No abstract is available for this article. [source] MANAGING NEWBORN PROBLEMS: A GUIDE FOR DOCTORS, NURSES and MIDWIVESJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2005Dr T Duke No abstract is available for this article. [source] CLINICAL ANATOMY: APPLIED ANATOMY FOR STUDENTS AND JUNIOR DOCTORS.ANZ JOURNAL OF SURGERY, Issue 10 200711th EDITION - BY HAROLD ELLIS No abstract is available for this article. [source] RURAL DOCTORS, SATISFACTION IN JAPAN: A NATIONWIDE SURVEYAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2004Masatoshi Matsumoto Objectives: The purpose of this paper was to discover to what degree Japanese rural doctors are satisfied with various aspects of their jobs and lives, and to find out whether they intend to continue their rural careers. Design: Nationwide postal survey Setting: Public clinics or hospitals in municipalities that are authorised as ,rural' by the national government. Subjects: A total of 4896 doctors working for public clinics or hospitals. Interventions: Self-evaluation questionnaires were mailed. The rural doctors were asked to evaluate their satisfaction with 19 items related to their job conditions and 10 items concerning life conditions, using a four-point scale. They also were asked to evaluate their intent to stay in rural practice until retirement. Results: The response rate was 64%. Overall, rural doctors were satisfied with both their work and life conditions. However, only 27% of respondents hoped to continue rural practice beyond the usual age of retirement. Among job-related items, continuing medical education and interactions with municipal governments were rated as least satisfactory. Among lifestyle-related items, duration of holidays and workload were unsatisfactory. Subgroup analysis revealed male doctors showed greater intent to stay in rural practice. Doctors aged > 50 years were more satisfied with most aspects of their job and lifestyle than younger doctors. A strong correlation was found between the degree of intent to stay and several items such as interactions with municipal government, human interactions salary and job fulfilment. Conclusions: Strategies, based on the results of this survey, should be implemented. Particularly in Japan, positive interaction between doctors and municipal governments is crucial. [source] WORK OF FEMALE RURAL DOCTORSAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2004Jo Wainer Objectives: To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Design: Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. Setting: General and specialist practice. Subjects: Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3,7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Main outcome measure: Interaction of hours and type of work with family responsibilities. Results: Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for oncall and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. [source] BREAKTHROUGH FOR RURAL DOCTORSAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2003Article first published online: 28 JUN 200 No abstract is available for this article. [source] STUDY GUIDES DOCTORS ON PREVENTIVE SERVICES FOR IMPROVING HEALTHCA: A CANCER JOURNAL FOR CLINICIANS, Issue 5 2001Article first published online: 31 DEC 200 No abstract is available for this article. [source] Severe mental illness and criminal victimization: a systematic reviewACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2009R. Maniglio Objective:, To estimate the prevalence of criminal victimization among people with severe mental illness and to explore risk factors. Method:, Four databases (MEDLINE, ScienceDirect, ERIC, and AMED) were searched for articles published between January 1966 and August 2007, supplemented with hand-search of reference lists from retrieved papers. The author and a Medical Doctor independently abstracted data and assessed study quality. Disagreements were resolved by consensus after review of the article and the review protocol. Results:, Nine studies, including 5195 patients, were identified. Prevalence estimates of criminal victimization ranged from 4.3% to 35.04%. Rates of victimization among severely mentally ill persons were 2.3,140.4 times higher than those in the general population. Criminal victimization was most frequently associated with alcohol and/or illicit drug use/abuse, homelessness, more severe symptomatology, and engagement in criminal activity. Conclusion:, Prevention and intervention programs should target high-risk groups and improve patients' mental health and quality of life. [source] Trust me I'm a,Doctor?INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2007G. Jackson No abstract is available for this article. [source] Interview with a Quality Leader: Dale W. Bratzler, DO, MPH on Performance MeasuresJOURNAL FOR HEALTHCARE QUALITY, Issue 2 2010Jason Trevor Fogg Abstract: Dale Bratzler, DO, MPH, currently serves as the President and CEO of the Oklahoma Foundation for Medical Quality (OFMQ). In addition, he provides support as the Medical Director of the Patient Safety Quality Improvement Organization Support Center at OFMQ. In these roles, he provides clinical and technical support for local and national hospital quality improvement initiatives. He is a Past President of the American Health Quality Association and a recent member of the National Advisory Council for the Agency for Healthcare Research and Quality. Dr. Bratzler has published extensively and frequently presents locally and nationally on topics related to healthcare quality, particularly associated with improving care for pneumonia, increasing vaccination rates, and reducing surgical complications. He received his Doctor of Osteopathic Medicine degree at the Kansas City University of Medicine and Biosciences, and his Master of Public Health degree from the University of Oklahoma Health Sciences Center College of Public Health. Dr. Bratzler is board certified in internal medicine. [source] Doctor,patient relations in dermatology: obligations and rights for a mutual satisfactionJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 11 2009F Poot [source] Doctor,Patient Gender Concordance and Patient Satisfaction in Interpreter-Mediated Consultations: An Exploratory StudyJOURNAL OF TRAVEL MEDICINE, Issue 1 2008Alexander Bischoff PhD Background Research suggests that doctor,patient communication patterns and patient satisfaction are influenced by gender. However, little is known about the effect of gender in consultations with foreign language,speaking patients and in interpreter-mediated consultations. Methods The objective of the study was to explore the effect of doctor,patient gender concordance on satisfaction of foreign language,speaking patients in consultations with and without a professional interpreter. Its design consists of a cross-sectional analysis of patients' reports. A total of 363 consultations with foreign language,speaking patients were included in the analysis. We measured the mean scores of six items on the quality of communication (answer scale 0,10): the doctor's response to the patient's needs, the doctors' explanations, the doctor's respectfulness toward the patient, the quality of communication in general, the overall consultation process, and information provided regarding follow-up. Results When interpreters were used, mean scores were similar for doctor,patient concordant and discordant pairs. However, in the absence of interpreters, doctor,patient gender discordance was associated with lower overall ratings of the quality of communication (,0.46, p= 0.01). Conclusions Our results suggest that the presence of a professional interpreter may reduce gender-related communication barriers during medical encounters with foreign language,speaking patients. [source] Long-term Management of the Liver Transplant Patient: Recommendations for the Primary Care DoctorAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2009B. M. McGuire No official document has been published for primary care physicians regarding the management of liver transplant patients. With no official source of reference, primary care physicians often question their care of these patients. The following guidelines have been approved by the American Society of Transplantation and represent the position of the association. The data presented are based on formal review and analysis of published literature in the field and the clinical experience of the authors. These guidelines address drug interactions and side effects of immunosuppressive agents, allograft dysfunction, renal dysfunction, metabolic disorders, preventive medicine, malignancies, disability and productivity in the workforce, issues specific to pregnancy and sexual function, and pediatric patient concerns. These guidelines are intended to provide a bridge between transplant centers and primary care physicians in the long-term management of the liver transplant patient. [source] A Doctor(s) dilemma: ETV6-ABL1 positive acute lymphoblastic leukaemiaBRITISH JOURNAL OF HAEMATOLOGY, Issue 1 2010Andrea Malone No abstract is available for this article. [source] Murder: A Psychotherapeutic Investigation , Edited by Ronald DoctorBRITISH JOURNAL OF PSYCHOTHERAPY, Issue 1 2009Patricia Polledri First page of article [source] "Even if I Don't Know What I'm Doing I Can Make It Look like I Know What I'm Doing": Becoming a Doctor in the 1990s,CANADIAN REVIEW OF SOCIOLOGY/REVUE CANADIENNE DE SOCIOLOGIE, Issue 3 2001Brenda L. Beagan Les processus de socialisation des médecins documentés dans Boys in White et d'autres textes classiques n'ont guère changé, 40 ans plus tard, malgré une population étudiante manifestement plus variée. La plus grande différence se trouve dans la façon dont les étudiants d'aujourdhui intègrent leur identité professionnelle naissante au moi établi avant l'école de médecine. L'identité professionnelle pourrait moins bien correspondre au moi quand les étudiants sont des femmes, plus âgés, de la classe ouvrière, homosexuels ou de groupes minoritaires. Pourtant, ces étudiants pourraient posséder une certaine capacité de résistance à la socialisation professionnelle. The processes of medical professional socialization documented in Boys in White and other classics remain remarkably unchanged 40 years later, despite a markedly more diverse student population. The greatest difference lies in how students today integrate their emerging professional identities with the selves they were before medical school. The professional identity may "fit" less easily when students are women, older, working-class, gay or lesbian, or from visible minority groups. Yet these students may also enjoy a particular ability to resist professional socialization. [source] Doctors, Borders, and Life in CrisisCULTURAL ANTHROPOLOGY, Issue 3 2005Peter Redfield The politics of life and death is explored from the perspective of Doctors Without Borders (Médecins sans frontières [MSF]), an activist nongovernmental organization explicitly founded to respond to health crises on a global scale. Following the work of Michel Foucault and Giorgio Agamben, I underline key intersections between MSF's operations that express concern for human life in the midst of humanitarian disaster and the group's self-proclaimed ethic of engaged refusal. Adopting the analytic frame of biopolitics, I suggest that the actual practice of medical humanitarian organizations in crisis settings presents a fragmentary and uncertain form of such power, extended beyond stable sovereignty and deployed within a restricted temporal horizon. [source] The capacity of Australian ED to absorb the projected increase in intern numbersEMERGENCY MEDICINE AUSTRALASIA, Issue 2 2010Anthony Chong Abstract As a reaction to the medical workforce shortage in Australia, a large expansion of undergraduate medical education has occurred through the provision of funding of additional medical student places. As a consequence, the number of medical graduates is anticipated to increase by as much as 90% with a peak in numbers anticipated in 2012. With ED already under pressure, this increase has serious implications for ED, particularly the delivery of intern and student teaching. This integrated review describes potential challenges that might arise from the predicted increase in intern numbers working in ED. A structured literature search was conducted from which 44 directly relevant articles were identified. We discuss the possible impact of an increased number of medical graduates on emergency medical staff, education, supervision and feedback to interns, and given the potential impacts on the education of junior doctors; we review the purpose and implementation of the Australian Curriculum framework for Junior Doctors in relation to their learning requirements. Although there is consensus by most postgraduate bodies that the core emergency term in emergency medicine should be retained, the impact of increased intern numbers might dramatically affect the clinical experiences, supervision and educational resources in the ED. This might necessitate cultural changes in medical education and ED function. [source] Why patients attend emergency departments for conditions potentially appropriate for primary care: Reasons given by patients and clinicians differEMERGENCY MEDICINE AUSTRALASIA, Issue 4 2007Malcolm Masso Abstract Objectives: To compare reasons identified by clinical staff for potential primary care attendances to the ED with those previously identified by patients. Methods: Survey of staff and primary care patients in five ED in New South Wales, Australia using questionnaire based on reasons identified in published studies. Results: Clinicians in the survey identify a broader spectrum of reasons for potential primary care cases presenting to the ED than the patients themselves report. Doctors reported on average 4.1 very important reasons and nurses 4.8 compared with patients 2.4 very important reasons. The main reasons identified by both doctors and nurses were similar and quite different to those identified by patients. Clinicians were more likely to emphasize cost and access issues rather than acuity and complexity issues. There was no difference within the clinician group between doctors and nurses nor by varying levels of experience. Furthermore doctors with significant experience in both primary care and emergency medicine did not differ from the overall clinicians' pattern. Conclusions: These data confirm that clinician perspectives on reasons for potential primary care patients' use of ED differ quite markedly from the perspectives of patients themselves. Those differences do not necessarily represent a punitive or blaming philosophy but will stem from the very different paradigms from which the two protagonists approach the interactions, reflecting the standard tension in a provider , consumer relationship. If policy is to be developed to improve system use and access, it must take both perspectives into account with respect to redesign, expectations and education. [source] Measurements in the Magnetic FieldGERMAN RESEARCH, Issue 2 2005Wolfgang Bauer Prof. Dr. Dr. Doctors are banking on the new possibilities offered by magnetic resonance imaging to give them a better view of the blood circulation in the human cardiac muscle [source] When doctors disagree: a qualitative study of doctors' and parents' views on the risks of childhood food allergyHEALTH EXPECTATIONS, Issue 3 2008Wendy Hu MBBS Dip Paed MHA PhD FRACGP Abstract Objective, To examine the views of doctors which underpin clinical practice variation concerning an uncertain health risk, and the views of parents who had sought advice from these doctors, using the example of childhood food allergy. Study design, Qualitative study involving in-depth interviews and participant observation over 16 months. Focus groups and consultation audio-recordings provided corroborative data. Setting, Three specialist allergy clinics located in one metropolitan area. Participants, Eighteen medical specialists and trainees in allergy, and 85 parents (from 69 families) with food allergic children. Results, Doctors expressed a spectrum of views. The most divergent views were characterized by: scientific scepticism rather than precaution in response to uncertainty; emphasis on quantifiable physical evidence rather than parental histories; professional roles as providers of physical diagnosis and treatment rather than of information and advocacy; libertarian rather than communitarian perspectives on responsibility for risk; and values about allergy as a disease and normal childhood. Parents held a similar, but less divergent range of views. The majority of parents preferred more moderate doctors' views, with 43% (30 of 69) of families expressing their dissatisfaction by seeking another specialist opinion. Many were confused by variation in doctors' opinions, preferring relationships with doctors that recognized their concerns, addressed their information needs, and confirmed that they were managing their child's allergy appropriately. Conclusions, In uncertain clinical situations, parents do not expect absolute certainty from doctors; inflexible certainty may not allow parental preferences to be acknowledged or accommodated, and is associated with the seeking of second opinions. [source] Why do primary care doctors diagnose depression when diagnostic criteria are not met?INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2000Michael Höfler Abstract This study examines predictors of false positive depression diagnoses by primary care doctors in a sample of primary care attendees, taking the patients' diagnostic status from a self-report measure (Depression Screening Questionnaire, DSQ) as a yardstick against which to measure doctors' correct and false positive recognition rates. In a nationwide study, primary care patients aged 15,99 in 633 doctors' offices completed a self-report packet that included the DSQ, a questionnaire that assesses depression symptoms on a three-point scale to provide diagnoses of depression according to the criteria of DSM-IV and ICD-10. Doctors completed an evaluation form for each patient seen, reporting the patient's depression status, clinical severity, and treatment choices. Predictor analyses are based on 16,909 patient-doctor records. Covariates examined included depression symptoms, the total DSQ score, number and persistence of depression items endorsed, patient's prior treatment, history of depression, age and gender. According to the DSQ, 11.3% of patients received a diagnosis of ICD-10 depression, 58.9% of which were correctly identified by the doctor as definite threshold, and 26.2% as definite subthreshold cases. However, an additional 11.7% of patients not meeting the minimum DSQ threshold were rated by their doctors as definitely having depression (the false positive rate). Specific DSQ depression items endorsed, a higher DSQ total score, more two-week depression symptoms endorsed, female gender, higher age, and patient's prior treatment were all associated with an elevated rate of false positive diagnoses. The probability of false positive diagnoses was shown to be affected more by doctors ignoring the ,duration of symptoms' criterion than by doctors not following the ,number of symptoms' criterion for an ICD or DSM diagnosis of depression. A model selection procedure revealed that it is sufficient to regress the ,false positive diagnoses' on the DSQ-total score, symptoms of depressed mood, loss of interest, and suicidal ideation; higher age; and patient's prior treatment. Further, the total DSQ score was less important in prediction if there was a prior treatment. The predictive value of this model was quite good, with area under the ROC-curve = 0.86. When primary care doctors use depression screening instruments they are oversensitive to the diagnosis of depression. This is due to not strictly obeying the two weeks duration required by the diagnostic criteria of ICD-10 and DSM-IV. False positive rates are further increased in particular by the doctor's knowledge of a patient's prior treatment history as well as the presence of a few specific depression symptoms. Copyright © 2000 Whurr Publishers Ltd. [source] An evaluation of pharmacist-written hospital discharge prescriptions on general surgical wardsINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 3 2005Mohamed H. Rahman Principal pharmacist, surgical services Objective To evaluate the quality of pharmacist-written hospital discharge prescriptions (DPs) in comparison to those written by doctors. Method The study was carried out in two, week-long phases on the general surgical wards in one UK hospital. In phase 1, doctors wrote the DPs, which were then checked by the ward pharmacist. In phase 2, ward pharmacists wrote the DPs which were then checked by the patient's junior doctor. In both phases, the clinical dispensary pharmacist made their routine check of the prescription prior to dispensing. All interventions were recorded on a pre-piloted data collection form. Key findings In phase 1, doctors wrote 128 DPs; in phase 2, pharmacists wrote 133 DPs. There were 755 interventions recorded during phase 1 in comparison to 76 during phase 2. In phase 1, transcription errors accounted for 118 interventions, 149 were due to ambiguity/illegibility; 488 amendments were to facilitate the dispensing process e.g. clarification of patient, medical and drug details, and dosage form discrepancies. In phase 2, transcription errors accounted for one intervention, 50 interventions were due to ambiguities or illegibility; 25 amendments were to facilitate the dispensing process. During phase 2, doctors made 10 minor alterations to pharmacist-written DPs. On 52 occasions during phase 2, the ward pharmacist had to clarify, prior to writing the DP, either the dose of a drug, or, whether a drug should be continued on discharge, and if so, for what duration. Conclusion Pharmacist-written DPs contained considerably fewer errors, omissions and unclear information in comparison to doctor-written DPs. Doctors recorded no significant alterations when validating pharmacist-written DPs. [source] "Luring Overseas Trained Doctors to Australia: Issues of Training, Regulating and Trading"INTERNATIONAL MIGRATION, Issue 4 2009Robyn Iredale Australia is at a crossroads. Its long history of relying on overseas trained medical practitioners and the last decade's changes, in terms of the introduction of policies to recruit large numbers of temporary doctors, both require examination. Not only is Australia alone in its overt policy initiatives but it also fails to be aware of the consequences for some sending countries. Australia has not entered into the spirit of international attempts to ameliorate the potential effects of developing-to-developed country medical migration and trade. This paper will provide an overview of the current international situation regarding supply and demand, major ethical issues, Australia's immigration policies and regulatory framework and the situation with respect to the labour market integration of overseas trained doctors (OTDs). It will be argued that Australia ,lures' with little concern for the consequences for source countries. [source] Peopling Skilled International Migration: Indian Doctors in the UKINTERNATIONAL MIGRATION, Issue 1 2000Vaughan Robinson This article uses a case-study approach in relation to the migration of Indian doctors to the UK in order to illustrate the complexity and multi-levelled nature of explanations for international migration. It argues that whereas, at the level of discursive consciousness, the movement of Indian doctors to the UK appears an economically driven and shapedphenomenon akin to other examples of highly skilled international migration, when the practical consciousness of participants is investigated through qualitative methods, the migration can also be seen as a cultural and social phenomenon. Although migrants move to "better themselves", they also make choices based on factors such as the kind of novels they read as children or "taken for granted" familial obligations rooted in the everyday life of their culture. [source] A Multidisciplinary Program for Delivering Primary Care to the Underserved Urban Homebound: Looking Back, Moving ForwardJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2006Kristofer L. Smith BA The coming decades will see a dramatic rise in the number of homebound adults. These individuals will have multiple medical conditions requiring a team of caregivers to provide adequate care. Home-based primary care (HBPC) programs can coordinate and provide such multidisciplinary care. Traditionally, though, HBPC programs have been small because there has been little institutional support for growth. Three residents developed the Mount Sinai Visiting Doctors (MSVD) program in 1995 to provide multidisciplinary care to homebound patients in East Harlem, New York. Over the past 10 years, the program has grown substantially to 12 primary care providers serving more than 1,000 patients per year. The program has met many of its original goals, such as helping patients to live and die at home, decreasing caregiver burden, creating a home-based primary care training experience, and becoming a research leader. These successes and growth have been the result of careful attention to providing high-quality care, obtaining hospital support through the demonstration of an overall positive cost,benefit profile, and securing departmental and medical school support by shouldering significant teaching responsibilities. The following article will detail the development of the program and the current provision of services. The MSVD experience offers a model of growth for faculty and institutions interested in starting or expanding a HBPC program. [source] The Acute Care Nurse Practitioner: challenging existing boundaries of emergency nurses in the United KingdomJOURNAL OF CLINICAL NURSING, Issue 3 2006Tracey Norris BSc Hons Aim., This study explored the opinions of nurses and doctors working in emergency departments towards the development of the Acute Care Nurse Practitioner service in the United Kingdom. Background., Studies carried out in the United States and Canada suggest that the Acute Care Nurse Practitioner can have a positive impact on the critically ill or injured patients' experiences in the emergency department. This role is well developed in the United States and Canada, but is still in its infancy in the United Kingdom. Design and methods., A descriptive, exploratory design incorporating questionnaires (n = 98) and semi-structured interviews (n = 6) was employed. The sample included nurses and doctors from seven emergency departments and minor injury units. Results., Respondents felt it was important for the Acute Care Nurse Practitioner to have obtained a specialist nurse practitioner qualification and that the Acute Care Nurse Practitioner should retain a clinical remit. While participants seemed comfortable with nurses undertaking traditional advanced skills such as suturing, reluctance was displayed with other advanced skills such as needle thoracocentesis. Three main themes were identified from the interviews: inter-professional conflict, autonomy and the need for the Acute Care Nurse Practitioner. Discussions., Doctors were reluctant to allow nurses to practise certain additional advanced skills and difficulties appear to be centred on the autonomy and other associated inter-professional conflicts with the role of the Acute Care Nurse Practitioner. Conclusion., Nurses and doctors identified a need for the Acute Care Nurse Practitioner, but the blurring of boundaries between doctors and nurses can result in inter-professional conflict unless this is addressed prior to the introduction of such advanced practitioners. Relevance to clinical practice., As the role of the emergency nurse diversifies and expands, this study re-affirms the importance of inter-professional collaboration when seeking approval for role expansions in nursing. [source] Changes in perceived effect of practice guidelines among primary care doctorsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2007Lee Cheng MD MSc Abstract Rationale, aims and objectives, Evidence suggests that when doctors use systematically developed clinical practice guidelines they have the potential to improve the safety, quality and value of health care. The purpose of this study was to evaluate recent changes in the perceptions of practice guidelines among US primary care doctors. Methods, Data were collected from the Community Tracking Survey 1996,97 and 2000,01. All results were weighted and adjusted to reflect the complex survey design. Results, Over the 5 years, the proportion of primary care doctors who said that practice guidelines had at least a moderate effect on their practice of medicine increased from 45.8% to 60.7%. This increase was nearly equal among primary care doctors of family medicine, internal medicine and paediatrics. In the 2001 survey, a higher perceived effect of practice guidelines was described by female doctors (OR = 1.39, 95% CI 1.19,1.63) and doctors who were practising in a large model group (OR = 1.73; 95% CI 1.04,2.89). Doctors who graduated from medical school within 10 years of the survey were more likely to report that practice guidelines had a positive effect on their practice of medicine than doctors who graduated 10 or more years before the survey. Conclusion, The perceived effect of practice guidelines on primary care doctors increased over time. Improved dissemination of guidelines and curriculum changes may have led recent primary care graduates to view practice guidelines as more important. [source] Repeat participation in colorectal cancer screening utilizing fecal occult blood testing: A community-based project in a rural settingJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 10 2010Monika Janda Abstract Background and Aim:, To investigate participation in a second round of colorectal cancer screening using a fecal occult blood test (FOBT) in an Australian rural community, and to assess the demographic characteristics and individual perspectives associated with repeat screening. Methods:, Potential participants from round 1 (50,74 years of age) were sent an intervention package and asked to return a completed FOBT (n = 3406). Doctors of participants testing positive referred to colonoscopy as appropriate. Following screening, 119 participants completed qualitative telephone interviews. Multivariable logistic regression models evaluated the association between round-2 participation and other variables. Results:, Round-2 participation was 34.7%; the strongest predictor was participation in round 1. Repeat participants were more likely to be female; inconsistent screeners were more likely to be younger (aged 50,59 years). The proportion of positive FOBT was 12.7%, that of colonoscopy compliance was 98.6%, and the positive predictive value for cancer or adenoma of advanced pathology was 23.9%. Reasons for participation included testing as a precautionary measure or having family history/friends with colorectal cancer; reasons for non-participation included apathy or doctors' advice against screening. Conclusion:, Participation was relatively low and consistent across rounds. Unless suitable strategies are identified to overcome behavioral trends and/or to screen out ineligible participants, little change in overall participation rates can be expected across rounds. [source] | ||||||||||||||||||||||||||||||||||||||||||||||