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Specialist Practice (specialist + practice)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Validation of the deCODE Migraine Questionnaire (DMQ3) for use in genetic studies

EUROPEAN JOURNAL OF NEUROLOGY, Issue 11 2006
M. Kirchmann
We assessed the reliability of the diagnosis of migraine with aura (MA) and migraine without aura (MO) based on the third edition of the deCODE Migraine Questionnaire (DMQ3) using a physician-conducted interview as an empirical index of validity. Amongst Danish migraine families recruited from specialist practice we selected 200 cases diagnosed according to the International Classification of Headache Disorders 2nd Edition in a validated physician-conducted telephone interview: 50 patients with exclusively MA, 50 with both MA and MO, 50 with exclusively MO and 50 controls. A written copy of the DMQ3 was mailed to the participant. The DMQ3-based diagnosis was compared with the interview-based diagnosis. Overall, the DMQ3 diagnosed migraine (MA, MO or both) with a sensitivity of 99% (109/110), a specificity of 86% (32/37) and a kappa statistic of 0.89. The most reliable subtype of migraine was MA (with or without co-occurring attacks of MO) which was diagnosed with a sensitivity of 92% (71/77), a specificity of 93% (65/70) and a kappa statistic of 0.85. Exclusively MO was diagnosed with a sensitivity of 91% (30/33), a specificity of 93% (106/114) and a kappa statistic of 0.80. Weakest was the diagnosis of both MO and MA which was diagnosed with a sensitivity of 63% (24/38), a specificity of 92% (100/109) and a kappa statistic of 0.57. In conclusion, the DMQ3 is a valid tool for diagnosing patients with migraine for genetic studies. [source]

Attitudes and use of rubber dam by Irish general dental practitioners

INTERNATIONAL ENDODONTIC JOURNAL, Issue 6 2007
C. D. Lynch
Abstract Aim, To investigate the attitudes towards and use of rubber dam by Irish general dental practitioners. Methodology, A pre-piloted questionnaire was distributed amongst a group of 600 dentists randomly selected from the Irish Register of Dentists. Replies from dentists working in specialist practice or the hospital dental service were excluded. Dentists were surveyed in relation to their use of rubber dam during a variety of operative and root canal treatments, as well as their attitudes to the use of rubber dam in dental practice. Results, A total of 300 replies were considered from a total of 324 that were received. Seventy-seven per cent of respondents (n = 231) worked in general dental practice and 23% (n = 69) worked in the Irish Health Board/Community Dental Service. Rubber dam was ,never' used by 77% of respondents (n = 228) when placing amalgam restorations in posterior teeth, 52% (n = 147) when placing composite restorations in posterior teeth, and 59% (n = 177) when placing composite restorations in anterior teeth. Rubber dam was ,never' used by 39% of respondents (n = 114) when performing root canal treatment on anterior teeth; 32% (n = 84) when performing root canal treatment on premolar teeth; and 26% (n = 51) when performing root canal treatment on molar teeth. Fifty-seven per cent (n = 171) considered rubber dam ,cumbersome and difficult to apply', and 41% (n = 123) considered throat pack ,as good a prevention against inhalation of endodontic instruments as rubber dam'. Conclusions, Whilst rubber dam is used more frequently for root canal treatment than operative treatment, its use is limited. This presents quality issues, as well as medico-legal and safety concerns for both the profession and patients. [source]

WORK OF FEMALE RURAL DOCTORS

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2004
Jo 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]

The definition and diagnosis of Asthma

CLINICAL & EXPERIMENTAL ALLERGY, Issue 11 2009
F. E. Hargreave
Summary The diagnosis of asthma depends on what we mean by the word. Its definition continues to be controversial because there is no single genetic or environmental cause. Addressed from a descriptive point of view, the disease components include airway inflammation, symptoms, variable airflow limitation and chronic airflow limitation. The essentialist definition conveys the message that asthma is a separate disease entity, fails to identify a primary defining characteristic which separates it from other diseases and is long winded. These disadvantages are overcome by the nominalist definition of asthma in which the word ,asthma'refers to an abnormality of airway function, specifically to wide variations in airflow limitation over short periods of time. In patients with asthma the other components of airway disease need to be considered. These have separate nominalist definitions and especially include different types of bronchitis for airway inflammation and chronic obstructive pulmonary disease for chronic airflow limitation. What is present will vary between and within patients. The accurate diagnosis of asthma and of other components of disease all require objective measurements. Currently spirometry and airway responsiveness should be available to the general practitioner, who sees milder disease, and additional quantitative sputum cell counts in specialist practice, where moderate to severe disease is more prevalent. Such measurements characterize the patient, identify heterogeneity and allow treatment to be personalized. [source]