Social and Behavioral Sciences Commons^™

Addressing The Deficiencies In The Evidence-Base For Primary Practice In Regional Australia - Sentinel Practices Data Sourcing (Spds) Project: A Pilot Study, Abhijeet Ghosh, Karen E. Charlton, Lisa Girdo, Marijka J. Batterham, Keith Mcdonald

Dr Marijka Batterham

Background Chronic disease risk on a population level can be quantified through health surveys, either continuous or periodic. To date, information gathered from primary care interactions, using sentinel sites, has not been investigated as a potentially valuable surveillance system in Australia. Methods A pilot study was conducted in a single General Practice in a regional area of New South Wales, Australia to assess the feasibility of accessing data obtained through a computerised chronic disease management program that has been designed for desktop application (Pen Computer Systems (PCS) Clinical Audit Tool: ™ PCS CAT). Collated patient data included information on chronic …

Clinical Placements In General Practice: Relationships Between Practice Nurses And Tertiary Institutions, Kath Peters, Elizabeth J. Halcomb, Susan Mcinnes

Susan McInnes

As a practice-based discipline a key component of undergraduate nurse education is clinical practice experience. The quality of clinical experiences has a significant impact on the students' ability to function competently post graduation. The relationship between higher education institutions (HEIs) and health service placement providers impacts upon the quality of clinical placements. In Australia, the growth of primary care nursing and the shortage of acute clinical places has prompted HEIs to explore the placement of students in general practice. Given the increasing attention being paid to non-traditional clinical placements, it is timely to explore how universities are establishing relationships and …

Practice Nurses Experiences Of Mentoring Undergraduate Nursing Students In Australian General Practice, Elizabeth Halcomb, Kathleen Peters, Susan Mcinnes

Susan McInnes

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 …

Barriers And Facilitators For Colorectal Cancer Screening Practices In The Latino Community: Perspectives From Community Leaders, Ana Natale-Pereira, Jonnie Marks, Marielos Vega, Dawne Mouzon, Shawna Hudson, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

BACKGROUND: Colorectal cancer (CRC) is the second-leading cause of cancer-related death in the United States and the third most commonly diagnosed cancer among Latinos. While Latinos represent one of the fastest-growing ethnic groups in the United States, their participation in cancer prevention and treatment trials is low. METHODS: Thirty-six Latino community leaders participated in five focus groups that examined factors affecting CRC screening practices among Latinos. RESULTS: The top four barriers identified were low knowledge and awareness of CRC, language barriers, lack of insurance, and undocumented legal status. Additional barriers included seeking health care only when sick, fatalism, fear, denial …

Using Formative Feedback To Identify And Support First Year Chemistry Students With Missing Or Misconceptions. A Practice Report, Gwen Lawrie, Anthony Wright, Madeleine Schultz, Timothy Dargaville, Glennys O'Brien, Simon B. Bedford, Mark Williams, Roy Tasker, Hayden Dickson, Christopher Thompson

Anthony Wright

Students entering tertiary studies possess a diverse range of prior experiences in their academic preparation for tertiary chemistry so academics need tools to enable them to respond to issues in diversity in conceptual models possessed by entering students. Concept inventories can be used to provide formative feedback to help students identify concepts that they need to address to improve construction of subsequent understanding enabling their learning. Modular, formative learning activities that can be administered inside or outside of class in first year chemistry courses have been developed. These activities address key missing and mis-conceptions possessed by incoming student. Engagement in …

Homelessness Research: Shaping Policy And Practice, Now And Into The Future, Dennis P. Culhane, Vince R. Kane, Mark Johnston

Dennis P. Culhane

Social Media Experiments: Scholarly Practice And Collegiality, Chris Gibson, Leah Gibbs

Chris Gibson

We draw out and seek to build on two key insights in Kitchin et al. (2013), namely the possibilities of social media for transforming knowledge production practices and for generating new spaces of collegiality and communality. Most promising are capacities to shape the terms of academic labour and to disrupt binaries of core/periphery, research/impact and academic/public.

Social Media Experiments: Scholarly Practice And Collegiality, Chris Gibson, Leah Gibbs

Leah Maree Gibbs

We draw out and seek to build on two key insights in Kitchin et al. (2013), namely the possibilities of social media for transforming knowledge production practices and for generating new spaces of collegiality and communality. Most promising are capacities to shape the terms of academic labour and to disrupt binaries of core/periphery, research/impact and academic/public.

Uptake Of Medicare Chronic Disease Items In Australia By General Practice Nurses And Aboriginal Health Workers, Elizabeth J. Halcomb, Patricia M. Davidson, Nicola Brown

Elizabeth Jane Halcomb Professor

The Australian health care system is currently in a state of reform and there is increasing pressure to provide care in community settings. Rising costs, demands and population ageing underscore the importance of adopting models of health care delivery to address changing epidemiological patterns. Population ageing and the increase of chronic conditions challenge models based on acute care. Changes to the Medicare benefits schedule have facilitated the development of a range of expanded nursing services in the general practice setting. In particular, item number 10997 was introduced to reimburse practice nurses and Aboriginal health workers (AHWs) for providing monitoring and …

Development Of A Clinician-Led Research Agenda For General Practice Nurses, Elizabeth J. Halcomb, Louise Hickman

Elizabeth Jane Halcomb Professor

Objective: This study sought to identify and prioritise research issues as perceived by Australian general practice nurses. In this context, a research priority refers to the most pressing research problems that necessitate exploration to improve clinical practice. Design: This paper reports the findings of a two-round Delphi study. Initially, focus groups identified research issues. Subsequently, an online survey facilitated ranking of these issues on a 5-point Likert scale. Setting: Australian general practices. Subjects: Twenty-five practice nurses participated in the focus groups and 145 practice nurses responded to an online survey. Main outcome measure(s): The main outcome measure was the prioritisation …

Practice Nurses Experiences Of Mentoring Undergraduate Nursing Students In Australian General Practice, Elizabeth J. Halcomb, Kathleen Peters, Susan Mcinnes

Elizabeth Jane Halcomb Professor

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 …

A Qualitative Evaluation Of New Zealand Consumers Perceptions Of General Practice Nurses, Elizabeth J. Halcomb, Kath Peters, Deborah Davies

Elizabeth Jane Halcomb Professor

Background An important consideration in health service delivery is ensuring that services meet consumer needs and that consumers are satisfied with service delivery. Patient satisfaction can impact on compliance with suggested treatments and therefore impact on health outcomes. Comparatively few studies have explored consumer satisfaction with nurses in general practice. Methods A sub-group of 18 consumers from a larger quantitative evaluation of consumer satisfaction with New Zealand general practice nurses participated in semi-structured telephone interviews. Interview data was analysed using thematic analysis. Results Four major themes emerged from the data. These themes highlighted that, despite confusion experienced by some consumers …

Clinical Placements In General Practice: Relationships Between Practice Nurses And Tertiary Institutions, Kath Peters, Elizabeth J. Halcomb, Susan Mcinnes

Elizabeth Jane Halcomb Professor

As a practice-based discipline a key component of undergraduate nurse education is clinical practice experience. The quality of clinical experiences has a significant impact on the students' ability to function competently post graduation. The relationship between higher education institutions (HEIs) and health service placement providers impacts upon the quality of clinical placements. In Australia, the growth of primary care nursing and the shortage of acute clinical places has prompted HEIs to explore the placement of students in general practice. Given the increasing attention being paid to non-traditional clinical placements, it is timely to explore how universities are establishing relationships and …

Quit In General Practice: A Cluster Randomised Trial Of Enhanced In-Practice Support For Smoking Cessation, Nicholas Arnold Zwar, Robyn Richmond, Elizabeth Halcomb, John Furler, Julie Smith, Oshana Hermiz, Irene Blackberry, Ron Borland

Elizabeth Jane Halcomb Professor

Background This study will test the uptake and effectiveness of a flexible package of smoking cessation support provided primarily by the practice nurse (PN) and tailored to meet the needs of a diversity of patients. Methods/Design This study is a cluster randomised trial, with practices allocated to one of three groups 1) Quit with Practice Nurse 2) Quitline referral 3) GP usual care. PNs from practices randomised to the intervention group will receive a training course in smoking cessation followed by access to mentoring. GPs from practices randomised to the Quitline referral group will receive information about the study and …

Ward Rounds: Developing A Collaborative Best Practice Model Of Interdisciplinary Teaching For Multidisciplinary Practice, Patrea Andersen, Noel Tait, Kenneth Walsh, Pauline Gaetani, Alison Jones, Angela Brown

Alison L Jones

Ward rounds are an everyday occurrence in clinical practice. They provide the means for assessing patient care needs and communicating these within a multidisciplinary team. The literature demonstrates poor ward round practice contributes to poor patient care outcomes (O'Hare, 2008). Garling (2008) identifies that there is a need to change current practise and facilitate more effective interdisciplinary communication. This presentation reports collaborative research between The Illawarra Shoalhaven Local Health District (ISL HD) and The University of Wollongong. Using a Practice Development methodology, the aim of the research is to develop and test a best practice model for conducting ward rounds …

Do Australian Adolescent Female Fake Tan (Sunless Tan) Users Practice Better Sun-Protection Behaviors Than Non-Users?, Melinda Williams, Sandra C. Jones, Peter Caputi, Donald C. Iverson

Sandra Jones

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 …

Non-Advertising Alcohol Promotions In Licensed Premises: Does The Code Of Practice Ensure Responsible Promotion Of Alcohol?, Sandra C. Jones, Melissa Lynch

Sandra Jones

Introduction and Aims. Binge drinking is a major public health issue in Australia, particularly among young people. There has been a considerable focus on alcohol advertising, among both researchers and policy makers, resulting in efforts to bring about some level of regulation of unacceptable advertising practices. However - despite the existence of a Code of Practice for Responsible Promotion of Liquor Products which provides 'a framework of practices which are considered acceptable and reasonable' for licensed premises - there are few, if any, data on the nature and extent of promotions which could arguably fall under either 'acceptable' or 'unacceptable' …

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

Peter Kelly

No abstract provided.

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

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

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

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

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

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

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

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, …

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

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 …