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Full-Text Articles in Medicine and Health Sciences
General Practice Research Training: Impact Of The Australian Registrar Research Workshop On Research Skills, Confidence, Interest And Involvement Of Participants, 2002-2006, Karin Ried, Brett D. Montgomery, Nigel P. Stocks, Elizabeth A. Farmer
General Practice Research Training: Impact Of The Australian Registrar Research Workshop On Research Skills, Confidence, Interest And Involvement Of Participants, 2002-2006, Karin Ried, Brett D. Montgomery, Nigel P. Stocks, Elizabeth A. Farmer
Elizabeth Farmer
Background. An intensive 3-day training programme, the ‘Registrar Research Workshop’ (RRW), has aimed to build research capacity among Australian general practice registrars since 1994. Objectives. To investigate the impact of the RRW on participants' skills, confidence, interest in research and research activity. Methods. Cross-sectional postal survey in 2006 of five groups of registrars who participated in the annual workshop in 2002–2006 (response rate: 64%; 77 of 121). Outcome measures included research experience and skills prior to and after the workshop; impact of the workshop on capacity, confidence, attitude and interest in research; and research involvement as measured by publications and …
Assessing General Practice Knowledge Base: The Applied Clinical Knowledge Test , Elizabeth Farmer, Joachim Sturmberg
Assessing General Practice Knowledge Base: The Applied Clinical Knowledge Test , Elizabeth Farmer, Joachim Sturmberg
Elizabeth Farmer
No abstract provided.
Does Practice Make Perfect? The Effect Of Coaching And Retesting On Selection Tests Used For Admission To An Australian Medical School, Barbara Griffin, David Harding, Ian Wilson, Neville Yeomans
Does Practice Make Perfect? The Effect Of Coaching And Retesting On Selection Tests Used For Admission To An Australian Medical School, Barbara Griffin, David Harding, Ian Wilson, Neville Yeomans
Ian G Wilson
Objective: To assess the practice effects from coaching on the Undergraduate Medicine and Health Sciences Admission Test (UMAT), and the effect of both coaching and repeat testing on the Multiple Mini Interview (MMI). Design, setting and participants: Observational study based on a self-report survey of a cohort of 287 applicants for entry in 2008 to the new School of Medicine at the University of Western Sydney. Participants were asked about whether they had attended UMAT coaching or previous medical school interviews, and about their perceptions of the relative value of UMAT coaching, attending other interviews or having a “practice run” …
Psychiatric Comorbidity In General Practice, David Pierce, Ian Wilson
Psychiatric Comorbidity In General Practice, David Pierce, Ian Wilson
Ian G Wilson
BACKGROUND Much of teachlng and resean:h has concentrated on single disease entities. In general practice, however, many patients suffer from a number of Interacting Ulnesses at the same time. It is unlikely we' wll1 ever have randomlsed controlled trlaIs to gulde the management of such patients. OBJECTIVE This article alms to develop a framework that will assist general practitioners In day·to-day cllnlcal work with patients presenting with concurrent multiple physical and mental health problems. DISCUSSION A positive, caring, patient centred approach is requIred and ~ultiple diagnoses need to be managed within an IntegratOd'treatment plan. The quality of the therapeutic relationship …
A 5-Year Follow-Up Of General Practice Patients Experiencing Depression, Ian Wilson, Katherine Duszynski, Andrea Mant
A 5-Year Follow-Up Of General Practice Patients Experiencing Depression, Ian Wilson, Katherine Duszynski, Andrea Mant
Ian G Wilson
Background. Depression is a common disease in primary care and produces significant morbidity in the community. Little is known about the outcomes of depression in general practice. Objectives. This research set out to explore both the longitudinal management and outcomes of depression as seen in general practice. Methods. The Medic-GP database is a collection of the medical records of 50 000 people seen in nine Australian general practices. It was used to follow the management of depressed patients over 4-5 years. Records from 1994-1995 were searched for depression or similar words. Individual records of patients whose notes mentioned depression were …
The Management Of Bipolar Disorder In General Practice, Phillip Mitchell, Jillian Ball, James Best, Bronwyn Gould, Gin Malhi, Geoffrey Riley, Ian Wilson
The Management Of Bipolar Disorder In General Practice, Phillip Mitchell, Jillian Ball, James Best, Bronwyn Gould, Gin Malhi, Geoffrey Riley, Ian Wilson
Ian G Wilson
•General practitioners have a key role in managing patients with bipolar disorder, a condition which affects at least one in 200 Australians each year and is the sixth leading cause of disability in the population. • Although diagnosis and treatment of the illness is complex, effective treatment can lead to good outcomes for many patients. • GPs can contribute significantly to early recognition of bipolar disorder, avoiding the long delays in accurate diagnosis that have been reported. As in other complex recurrent or persistent illnesses, GPs are well placed to coordinate multidisciplinary "shared care" with specialists and other health care …
Long-Term Effects Of Childhood Abuse On The Quality Of Life And Health Of Older People: Results From The Depression And Early Prevention Of Suicide In General Practice Project, Brian Draper, Jon Pfaff, Jane Pirkis, John Snowdon, Nicola Lautenschlager, Ian Wilson, Osvaldo Almeida
Long-Term Effects Of Childhood Abuse On The Quality Of Life And Health Of Older People: Results From The Depression And Early Prevention Of Suicide In General Practice Project, Brian Draper, Jon Pfaff, Jane Pirkis, John Snowdon, Nicola Lautenschlager, Ian Wilson, Osvaldo Almeida
Ian G Wilson
OBJECTIVES: To determine whether childhood physical and sexual abuse are associated with poor mental and physical health outcomes in older age. DESIGN: Cross-sectional, postal questionnaire survey. SETTING: Medical clinics of 383 general practitioners (GPs) in Australia. PARTICIPANTS: More than 21,000 older adults (aged >=60) currently under the care of GPs participating in the Depression and Early Prevention of Suicide in General Practice (DEPS-GP) Study. Participants were divided into two groups according to whether they acknowledged experiencing childhood physical or sexual abuse. MEASUREMENTS: Main outcome measures targeted participants’ current physical health (Medical Outcomes Study 12-item Short Form Survey, Version 2 and …
General Practice Training And Virtual Communities Of Practice - A Review Of The Literature, Stephen Barnett, Sandra C. Jones, Sue Bennett, Donald C. Iverson, Andrew D. Bonney
General Practice Training And Virtual Communities Of Practice - A Review Of The Literature, Stephen Barnett, Sandra C. Jones, Sue Bennett, Donald C. Iverson, Andrew D. Bonney
Don C. Iverson
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 …
General Practice Training, Web 2.0 And Virtual Communities Of Practice: An Interview Study, Stephen Barnett, Sandra Jones, Lance Barrie, Andrew Bonney, Donald Iverson
General Practice Training, Web 2.0 And Virtual Communities Of Practice: An Interview Study, Stephen Barnett, Sandra Jones, Lance Barrie, Andrew Bonney, Donald Iverson
Don C. Iverson
Aims and Rationale General Practice training faces geographic barriers to efficient knowledge sharing, collaboration and professional and social support amongst its participants. In industry, large companies use internet tools to create Virtual Communities of Practice which improve collaboration, information sharing and support amongst staff. This study examined the feasibility of using Web 2.0 tools to create a Virtual Community of Practice for GP training. Methods Following a previous quantitative survey study, a qualitative telephone interview study was undertaken with GP Registrars and Supervisors in a Regional Training Provider. Participants were selected on the basis of highest internet usage in the …
Using Nanda, Nic, And Noc In An Undergraduate Nursing Practicum, K. Smith, Martha Craft-Rosenberg
Using Nanda, Nic, And Noc In An Undergraduate Nursing Practicum, K. Smith, Martha Craft-Rosenberg
Martha J. Craft-Rosenberg
Although use of diagnoses originally developed by NANDA (now known as NANDA-I), NIC, and NOC in education and practice is increasing, many faculty members have not been educated in their use and may be reluctant to teach these languages. This article provides guidance on the use of NANDA-I, NIC, and NOC in clinical education. This guidance will facilitate both faculty and student learning.
Collaborative Goal Technology: Theory & Practice, Samantha Clarke, Lindsay G. Oades, Trevor P. Crowe, Frank P. Deane
Collaborative Goal Technology: Theory & Practice, Samantha Clarke, Lindsay G. Oades, Trevor P. Crowe, Frank P. Deane
Frank Deane
Goal striving promotes hope and enhances motivation, which is important for psychosocial rehabilitation and recovery. The Collaborative Goal Technology (CGn is a new goal striving intervention that is used to support the autonomy and recovery processes of the person with a psychiatric disability. The CGT protocol and its utility are outlined. Theory and research from goal striving, motivation and mental health recovery domains that informed the development of CGT are described. A case example is also provided.
Calculating Clinically Significant Change: Applications Of The Clinical Global Impressions (Cgi) Scale To Evaluate Client Outcomes In Private Practice, Peter Kelly
Peter Kelly
The Clinical Global Impressions (CGI) scale is a therapist-rated measure of client outcome that has been widely used within the research literature. The current study aimed to develop reliable and clinically significant change indices for the CGI, and to demonstrate its application in private psychological practice. Following the guidelines developed by Clement, a file review was conducted of the authors’ first six years working in private practice. A reliable change on the CGI required the participants score to change by 2-points. Depending on the method used to calculate the clinical change indices, between 23% and 50% of the total participants …
Staff Attitudes Towards Evidence Based Practice In A Residential Drug And Alcohol Rehabilitation Service, M Lovett, Peter Kelly, Frank Deane, Trevor Crowe
Staff Attitudes Towards Evidence Based Practice In A Residential Drug And Alcohol Rehabilitation Service, M Lovett, Peter Kelly, Frank Deane, Trevor Crowe
Peter Kelly
No abstract provided.
Working With Substance Misuse Problems In Private Practice, Peter Kelly
Working With Substance Misuse Problems In Private Practice, Peter Kelly
Peter Kelly
Individuals experiencing alcohol and other drug (AOD) problems have typically been under represented within private practice. For example, in the general population the prevalence of substance use disorders (7.7%) is comparable to that of anxiety (9.7%) and affective disorders (5.8%; Andrews, Hall, Teesson & Henderson, 1999). However, a recent APS survey showed that while 48 per cent of people treated by psychologists under the Better Access initiative presented with anxiety or depression, only 6 per cent presented for assistance with substance misuse problems (Giese, Littlefield & Mathews, 2008). Recent changes to the Medicare system have largely reduced financial barriers, presenting …
A Study Of Headache In North American Primary Care: Report For The Ambulatory Sentinel Practice Network, L A. Becker, Donald C. Iverson, F M. Read, N Calogne, R S. Miller, W L. Freeman
A Study Of Headache In North American Primary Care: Report For The Ambulatory Sentinel Practice Network, L A. Becker, Donald C. Iverson, F M. Read, N Calogne, R S. Miller, W L. Freeman
Don C. Iverson
Headache is a common symptom in primary care about which surprisingly little is known. Over a 14-month period 3847 patients making 4940 consecutive visits for headache to 38 primary care practices in the USA and Canada were studied. The clinical characteristics of patients, as well as the diagnostic and therapeutic strategies employed by their doctors, were examined. Visits for headache represented 1.5% of all visits during this period. Most patients (72.0%) made only one visit, and nearly half of the headaches reported were new. Only a small number of patients (3.0%) received a computerized tomographic scan; other investigations were used …
Do Australian Adolescent Female Fake Tan (Sunless Tan) Users Practice Better Sun-Protection Behaviors Than Non-Users?, Melinda Williams, Sandra Jones, Peter Caputi, Donald Iverson
Do Australian Adolescent Female Fake Tan (Sunless Tan) Users Practice Better Sun-Protection Behaviors Than Non-Users?, Melinda Williams, Sandra Jones, Peter Caputi, Donald Iverson
Don C. Iverson
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 self-reported fake tan usage in the past 12 months, frequency of sunburns and habitual sun-protection behaviours. Setting: Surveys were completed in New South Wales, Australia. Results: The prevalence of self-reported use of fake tanning products in the past 12 months among Australian adolescent females was 34.5%. Female fake tan users were significantly …
The School Health Curriculum Project: Its Theory, Practice, And Measurement Experience, Lawrence Green, Phil Heit, Donald Iverson, Lloyd Kolbe, Marshall Kreuter
The School Health Curriculum Project: Its Theory, Practice, And Measurement Experience, Lawrence Green, Phil Heit, Donald Iverson, Lloyd Kolbe, Marshall Kreuter
Don C. Iverson
The School Health Curriculum Project(SHCP), initiated over a decade ago to provide a health education curriculum package for elemen tary students, has been widely and variously evaluated. In analyzing studies designed to assess the effectiveness of the SHCP, it was recognized that the measured impact of this project (or any health education intervention) would derive from the adequacy of the theory upon which the program is based, the adequacy of its implementation, and the adequacy of its measurement. Hence, an examination of the theoretical base of the SHCP and its variance in practice was conducted. In addition, a metaevaluation of …
How Representative Of Typical Practice Are Practice-Based Research Networks?, Larry Green, Rebecca Miller, Frank Reed, Donald Iverson, Gwyn Barley
How Representative Of Typical Practice Are Practice-Based Research Networks?, Larry Green, Rebecca Miller, Frank Reed, Donald Iverson, Gwyn Barley
Don C. Iverson
OBJECTIVE: To evaluate the patients and practices of family physicians in a national practice-based research network to understand whether results from practice-based research networks are likely to be relevant to other practicing clinicians. STUDY DESIGN: Survey focused on family physicians that replicated the National Ambulatory Medical Care Survey (NAMCS). SETTING: The Ambulatory Sentinel Practice Network Inc (ASPN), a practice-based research network, consisting of volunteer primary care practices that serve approximately 350,000 patients. OUTCOME MEASURES: Comparison of visits reported in ASPN with the visits reported in the 1990 NAMCS in terms of patient demographics, reasons for visit, diagnostic and therapeutic services, …
Family Practice Residents' Identification And Management Of Obesity, R Mcartor, Donald Iverson, D Benken, L Dennis
Family Practice Residents' Identification And Management Of Obesity, R Mcartor, Donald Iverson, D Benken, L Dennis
Don C. Iverson
This study, involving 25 family practice residents and 2746 patients in a family practice residency programme, addressed four hypotheses regarding the identification and management of obesity in the primary care setting: (i) the physician-identified prevalence of obesity is significantly lower than the actual prevalence in the population, (ii) obesity is more likely to be addressed with management actions when it is recorded on the medical record problem list than when it is not recorded, (iii) physician actions dealing with obesity are influenced by the patient's age, sex, level of motivation, and body mass index (BMI) value, and (iv) the type …
Carpal Tunnel Syndrome In Primary Care: A Report From Aspn. Ambulatory Sentinel Practice Network, R Miller, Donald Iverson, R Fried, L Green, Paul Nutting
Carpal Tunnel Syndrome In Primary Care: A Report From Aspn. Ambulatory Sentinel Practice Network, R Miller, Donald Iverson, R Fried, L Green, Paul Nutting
Don C. Iverson
Carpaltunnelsyndrome is the entrapment neuropathy of the medign nerve at the wrist. It is the most common nerve compression disorder seen by physicians, affecting women up to five times more frequently than men, especially during the reproductive years. Carpaltunnelsyndrome is known to be aggravated during pregnancy and menopause. Primary care physicians can expect to see approximately 1.01 cases of carpaltunnelsyndrome per 1,000 office encounters, with a female age-adjusted rate of 1.49 per 1,000 person-years. Physicians can identify this syndrome with an accurate and detailed history and physical exam. In most cases, electrodiagnostic studies, such as nerve conduction velocities and/or electromyography, …
Does Family Practice At Residency Teaching Sites Reflect Community Practice?, Valerie Gilchrist, William Gillanders, Donald Iverson, Mark Krell, Everett Logue, Rebecca Miller, D Scheid, A Oprandi, D Weldy
Does Family Practice At Residency Teaching Sites Reflect Community Practice?, Valerie Gilchrist, William Gillanders, Donald Iverson, Mark Krell, Everett Logue, Rebecca Miller, D Scheid, A Oprandi, D Weldy
Don C. Iverson
Family medicine has aspired to train residents and conduct research in settings that closely resemble community practice. The purposre of this study was to compare the patient characteristics of the ambulatory teaching centers of a consortium of seven community-based university-affiliated familyu practice residency programs in northeast Ohio with the National Ambulatory Medical Care Survey (NAMCS) results for family physicians (FPs) and general practitioners (GPs). Ninety-eight faculty and resident physicians at the residency training site of the Northeastern Ohio Universities College of Medicine collected data on all ambulatory patient visits (N = 1498) for one randomly chosen week between July 1, …
What Do Older Patients Want? Understanding Older Patients' Attitudes Towards General Practice Trainees, Andrew D. Bonney, Sandra C. Jones, Donald Iverson, Christopher Magee
What Do Older Patients Want? Understanding Older Patients' Attitudes Towards General Practice Trainees, Andrew D. Bonney, Sandra C. Jones, Donald Iverson, Christopher Magee
Don C. Iverson
Context: Older patients constitute an increasing proportion of the caseloads in general practice (GP) training practices, but are relatively reluctant to consult trainees. Understanding their attitudes is a first step in improving older patient-trainee interaction. Objectives: Characterise the attitudes of older patients to GP trainees. Design: Cross-sectional survey; exploratory factor analysis; logistic regression. Setting: Randomised, stratified sample of 38 training practices across five Australian states. Participants: Patients aged 60 years and over (N=911; response rate 47.9%). Instrument: Questionnaire for self-completion: previously piloted and subjected to factor analysis. Main and secondary outcome measures: Identification of attitude factors; patient characteristics predicting high …
Patients' Attitudes To General Practice Registrars: A Review Of The Literature, Andrew Bonney, Lyn Phillipson, Samantha Reis, Sandra Jones, Donald Iverson
Patients' Attitudes To General Practice Registrars: A Review Of The Literature, Andrew Bonney, Lyn Phillipson, Samantha Reis, Sandra Jones, Donald Iverson
Don C. Iverson
Introduction With the population ageing, it is imperative for training practices to provide GP registrars with sound experience in managing the health problems of older persons, especially chronic conditions. However, it is reported that a significant proportion of these patients will be resistant to consulting registrars, with concerns regarding disruption of continuity of care being a significant factor. The challenge for training practices is to identify approaches to engage registrars in the management of older patients whilst maintaining patient satisfaction. This paper presents a review of the literature on patient attitudes to general practice registrars to better understand the nature …
Older Patients' Attitudes To General Practice Registrars: A Qualitative Study, Andrew Bonney, Lyn Phillipson, Sandra Jones, Donald Iverson
Older Patients' Attitudes To General Practice Registrars: A Qualitative Study, Andrew Bonney, Lyn Phillipson, Sandra Jones, Donald Iverson
Don C. Iverson
Background Research suggests that older patients may be reluctant to engage general practice registrars (GPRs) in their care. The authors undertook a qualitative study of the attitudes of older patients to GPRs to investigate this issue. Method Thirty-eight patients aged 60 years and over from three training practices participated in semistructured telephone interviews, which explored patients responses to GPRs. The interviews were recorded, transcribed and analysed using a template analysis approach. Results Analysis of the interviews produced five major themes concerning patient attitudes to GPRs: desire for continuity, desire for access, openness, trust and a desire for meaningful communication. Discussion …
The Conference For General Practice 2009, Andrew Bonney, Lyn Phillipson, Sandra Jones, Donald Iverson
The Conference For General Practice 2009, Andrew Bonney, Lyn Phillipson, Sandra Jones, Donald Iverson
Don C. Iverson
Objectives The medical literature suggests that older patients may be reluctant to engage general practice registrars in their medical care. This can lead to distortions in the clinical caseload of general practice registrars and dissatisfaction for older patients when seeing general practice registrars. The authors undertook a qualitative study of older patients to investigate their attitudes to having general practice registrars involved in their medical care to address this issue. Methods The study was conducted in three general practice (GP) training practices in southeast NSW, Australia. Appropriate ethics approval was obtained before commencing the research. Reception staff handed patients invitations …
General Practice Registrars: Attitudes Of Older Patients, Andrew D. Bonney, Sandra C. Jones, Lyn Phillipson, Donald C. Iverson
General Practice Registrars: Attitudes Of Older Patients, Andrew D. Bonney, Sandra C. Jones, Lyn Phillipson, Donald C. Iverson
Don C. Iverson
Previous research indicates that older patients may be less willing to consult general practice registrars (GPRs), reducing training opportunities in chronic/complex care. This survey explores older patients’ attitudes in order to inform models of interaction that would be acceptable to patients. METHODS Ten training general practices distributed questionnaires for self completion to 50 patients aged 60 years and over. Chi-square, Spearman’s rho and logistic regression were used for analysis. RESULTS The response rate was 47%. Ninetysix percent wanted ongoing contact with their general practitioner if they saw a GPR. Twenty-four percent were comfortable with GPR chronic/complex care, increasing to 73% …
Preparing For An Ageing Population: A Survey Of Older Patients' Attitudes To General Practice Registrars, Andrew D. Bonney, Sandra C. Jones, Lyn Phillipson, Donald C. Iverson
Preparing For An Ageing Population: A Survey Of Older Patients' Attitudes To General Practice Registrars, Andrew D. Bonney, Sandra C. Jones, Lyn Phillipson, Donald C. Iverson
Don C. Iverson
The ageing population makes it imperative to provide appropriate training for general practice registrars (GPRs) in the community-based care of older patients. However, data suggest that older patients may be less willing to consult GPRs for chronic/complex care; adversely affecting training opportunities and potentially the satisfaction of older patients in training practices. This cross-sectional study was undertaken to investigate this concern in the Australian context and develop models of older patient-GPR interaction that are acceptable to patients.
The Application Of Coach Leadership Models To Coaching Practice: Current State And Future Directions, Stewart Vella, Lindsay G. Oades, Trevor P. Crowe
The Application Of Coach Leadership Models To Coaching Practice: Current State And Future Directions, Stewart Vella, Lindsay G. Oades, Trevor P. Crowe
Trevor Crowe
No abstract provided.
Collaborative Goal Technology: Theory & Practice, Samantha Clarke, Lindsay G. Oades, Trevor P. Crowe, Frank P. Deane
Collaborative Goal Technology: Theory & Practice, Samantha Clarke, Lindsay G. Oades, Trevor P. Crowe, Frank P. Deane
Trevor Crowe
Goal striving promotes hope and enhances motivation, which is important for psychosocial rehabilitation and recovery. The Collaborative Goal Technology (CGn is a new goal striving intervention that is used to support the autonomy and recovery processes of the person with a psychiatric disability. The CGT protocol and its utility are outlined. Theory and research from goal striving, motivation and mental health recovery domains that informed the development of CGT are described. A case example is also provided.