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Sample records for research general practice

  1. [European general practice research agenda].

    PubMed

    Mäntyselkä, Pekka; Koskela, Tuomas

    2014-01-01

    The EGPRN (European General Practice Research Network) research agenda is a review compiling the strengths and areas of development of European general practice, based on a systematic literature survey and its versatile analysis. The research agenda is a framework paper sharpening the definition and functions of general practice as well as its significance for researchers and decisionmakers. The agenda is useful in structuring the research, evaluation of research needs, strengthening of infrastructure and strategic planning of new research.

  2. Building Family/General Practice Research Capacity

    PubMed Central

    Del Mar, Chris; Askew, Deborah

    2004-01-01

    To promote the range of interventions for building family/general practice (family medicine) research capacity, we describe successful international examples. Such examples of interventions that build research capacity focus on diseases and illness research, as well as process research; monitor the output of research in family/general practice (family medicine); increase the number of family medicine research journals; encourage and enable research skills acquisition (including making it part of professional training); strengthen the academic base; and promote research networks and collaborations. The responsibility for these interventions lies with the government, colleges and academies, and universities. There are exciting and varied methods of building research capacity in family medicine. PMID:15655086

  3. Generalizing and Skepticism: Bringing Research to Practice

    ERIC Educational Resources Information Center

    Yopp, David A.; Ellsworth, Jacob L.

    2016-01-01

    Empirical arguments rely on examples without necessarily addressing all cases. Students should be skeptical of empirical evidence and should seek more secure arguments for generalizations, such as those that explain why a generalization is true for all cases. Generalizing on the basis of patterns in data is an important mathematical practice;…

  4. Generalizing and Skepticism: Bringing Research to Practice

    ERIC Educational Resources Information Center

    Yopp, David A.; Ellsworth, Jacob L.

    2016-01-01

    Empirical arguments rely on examples without necessarily addressing all cases. Students should be skeptical of empirical evidence and should seek more secure arguments for generalizations, such as those that explain why a generalization is true for all cases. Generalizing on the basis of patterns in data is an important mathematical practice;…

  5. A general dental practice research network: impact of oral health in general dental practice patients.

    PubMed

    Kay, E J; Ward, N; Locker, D

    2003-06-14

    To measure the subjective impact of oral health in a group of patients attending general dental practices in the North West of England and to investigate the attributes of dentists and practices in order to examine how such attributes might relate to patients' subjective perceptions of oral health. Fifteen general dental practices conducting a simultaneous survey of attending patients and 15 practitioners from these practices providing information about their attitudes to treatment, prevention and various aspects of their surgery. General dental Patient subjective impact scores. Relationships between practice and practitioner variables and patients' subjectively perceived oral health. Fifteen practitioners with diverse practice attributes provided data on 718 patients. The mean total oral health impact score was 18.4. Twenty two per cent of patients had experienced pain in the four weeks before the survey and 11% had been unable to chew some foods. Fifty five per cent of the surveyed population had, in the previous year, worried about the appearance of their mouth and 65% had worried about their oral health in general. Dentists' beliefs were related to patient impact scores but practice attributes were not significantly associated with patients' impacts. Fourteen percent of the differences in patients' subjectively perceived oral health can be attributed to dentist attitudes and attributes. Further research regarding the influence of dentists personality and professional beliefs on patients well-being needs to be undertaken.

  6. An exemplar of naturalistic inquiry in general practice research.

    PubMed

    McInnes, Susan; Peters, Kath; Bonney, Andrew; Halcomb, Elizabeth

    2017-01-23

    Background Before beginning any research project, novice researchers must consider which methodological approach will best address their research questions. The paucity of literature describing a practical application of naturalistic inquiry adds to the difficulty they may experience. Aim To provide a practical example of how naturalistic inquiry was applied to a qualitative study exploring collaboration between registered nurses and general practitioners working in Australian general practice. Discussion Naturalistic inquiry is not without its critics and limitations. However, by applying the axioms and operational characteristics of naturalistic inquiry, the authors captured a detailed 'snapshot' of collaboration in general practice in the time and context that it occurred. Conclusion Using qualitative methods, naturalistic inquiry provides the scope to construct a comprehensive and contextual understanding of a phenomenon. No individual positivist paradigm could provide the level of detail achieved in a naturalistic inquiry. Implications for practice This paper presents a practical example of naturalistic inquiry for the novice researcher. It shows that naturalistic inquiry is appropriate when the researcher seeks a rich and contextual understanding of a phenomenon as it exists in its natural setting.

  7. Doing qualitative research in general practice: methodological utility and engagement.

    PubMed

    Jaye, Chrystal

    2002-10-01

    General practice uses an eclectic range of research methodology. This includes increasing reliance upon qualitative research methods. There seem to be two distinct treatments of qualitative research within primary care and, in particular, within general practice research. The first is characterized by a purely utilitarian and technical focus, using a qualitative method because it is the most appropriate means of realizing the aims of the research, while the second is characterized by in-depth engagement with the philosophical and paradigmatic aspects of qualitative methodology. In-depth engagement with methodology and theory, and theory building, is an important aspect of masterate and doctoral research within social sciences such as education and anthropology, and in the discipline of nursing, but has not been a feature of qualitative research in medicine. A practical difficulty encountered within postgraduate programmes such as the one in which the author teaches is that when innovative qualitative techniques are used by GPs in their postgraduate research dissertations and theses, it is often beyond GP examiners' own knowledge and experience, yet it fails to measure up to standards established in social sciences, particularly in sociology and anthropology where in-depth reflexive engagement with the theory and philosophy of qualitative methodology is expected. This paper suggests that the value of in-depth engagement with methodology when conducting qualitative research results in creative and innovative ways of conducting research that are consonant with the nature of general practice itself, and strengthens research findings. Therefore, as teachers of research methods and supervisors of research theses, it is important to encourage students conducting qualitative research to engage fully with theoretical and methodological issues.

  8. General practice research and research skill needs--attitudes of GP supervisors.

    PubMed

    Gartlan, Jan; Cooling, Nicholas; Nelson, Mark

    2006-12-01

    General practice research is an important learning area in general practice registrar training. General practitioner supervisors have a central role in registrar training. Registrar training in Tasmania has the added component of a research project. Little is known about supervisors' research attitudes, confidence to support registrar research projects, and research skill needs. A postal survey was sent to all 40 GP supervisors with General Practice Training Tasmania. Response rate was 90% (n=36): 33% were interested in becoming involved in general practice research; 53% wanted to improve their research skills; and 55% did not feel confident supporting a registrar with a research project. Those supervisors who were confident were more likely to have previous research involvement. There is potential for increasing research capacity in GP supervisors. It is important to build the confidence of supervisors in their support of general practice registrars engaged in research projects.

  9. Research in general practice: international problems--international solutions.

    PubMed

    Howie, J G

    1994-12-01

    Although research in primary care has a higher profile than ever before, its impact on professional practice and on government planning often seems less than it should be. In the first part of the paper, the different research agendas of governments, health departments, professional associations and colleges, and of universities are explored. In the second part of the paper a research project which attempts to define and measure quality of care given to patients with a 'marker' health problem (arthritic pain) is developed from the stage of asking questions to interpreting findings. In the third part of the paper, a number of conflicts between research agendas, styles of research, and needs and expectations of different 'purchasers' and 'providers' are explored using the themes and the details of the earlier parts of the paper as illustration, and a model is constructed to help explain why research, practice and policy making often live less easily together than is good for each. The importance of creating a supportive climate for research, of providing adequate infrastructure, and of making appropriate training available is emphasized.

  10. Themes and methods of research presented at European General Practice Research Network conferences.

    PubMed

    Kruschinski, Carsten; Lange, Maaike; Lionis, Christos; van Weel, Chris; Hummers-Pradier, Eva

    2010-08-01

    The World Organization of Family Doctors (Wonca) defined core characteristics of general practice and general practitioners' competencies. It is unclear to which extent research has addressed these issues so far. To determine themes and research methods of general practice research as reflected by presentations at the European General Practice Research Network (EGPRN) meetings. Descriptive and retrospective study. All abstracts presented at each of the 14 EGPRN conferences between June 2001 and October 2007 were analysed for content and study design/methodology. Categories for content were developed inductively; a predefined hierarchical scheme was used for study designs. A total of N=614 abstracts were classified. The main research topics were related to GP/health service issues (n=232), clinical (n=148) and patient-related themes (n=118). Original data (n=558) were mainly derived from cross-sectional designs (38.7%). Intervention studies (11.0%), longitudinal designs including case-control and cohort studies (13.3%) as well as instrumental research (2.2%) were less common. More than one-fourth of all original studies were qualitative studies (27.6%). Stratified analysis revealed that cross-sectional designs were less frequent in the second half of conferences. Analysis by country showed that, in contrast to different quantitative designs, the proportion of qualitative studies was comparable. To test effectiveness of diagnostic and therapeutic interventions under primary care conditions, a higher proportion of experimental studies would be preferable. This could increase the acceptance of general practitioners' specific approaches and provide clear guidance on approaches and procedures, especially in health care systems not predominantly based on primary care.

  11. Research in general practice: a survey of incentives and disincentives for research participation

    PubMed Central

    2013-01-01

    Background Recruitment rates of general practitioners (GPs) to do research vary widely. This may be related to the ability of a study to incorporate incentives for GPs and minimise barriers to participation. Method A convenience sample of 30 GPs, ten each from the Sydney intervention and control groups Ageing in General Practice ‘Detection and Management of Dementia’ project (GP project) and 10 GPs who had refused participation, were recruited to determine incentives and barriers to participating in research. GPs completed the 11-item ‘Meeting the challenges of research in general practice: general practitioner questionnaire’ (GP survey) between months 15 and 24 of the GP project, and received brief qualitative interviews from a research GP to clarify responses where possible. Results The most important incentives the 30 GPs gave for participating in the project were a desire to update knowledge (endorsed by 70%), to help patients (70%), and altruism (60%). Lack of time (43%) was the main barrier. GPs also commented on excessive paperwork and an inadequate explanation of research. Conclusions While a desire to update knowledge and help patients as well as altruism were incentives, time burden was the primary barrier and was likely related to extensive paperwork. Future recruitment may be improved by minimising time burden, making studies simpler with online data entry, offering remuneration and using a GP recruiter. PMID:24427184

  12. [Renaissance of general practice].

    PubMed

    Braun, R N; Fink, W; Kamenski, G

    2002-01-01

    Special research work has taught that general practice (family medicine) is a specialization of its own. It requires specific education and vocational training. As far as universities and administrative bodies have accepted it no doctor can start practising family medicine unless he has passed a vocational training of many years duration. That fact together with a successful continued research concerning applied general practice should initiate a true renaissance of general practice.

  13. Idaho forestry best management practices: Compilation of research on their effectiveness. Forest Service general technical report

    SciTech Connect

    Seyedbagheri, K.A.

    1996-10-01

    A search was conducted for quantitative Idaho research results on the effectiveness of the Idaho Forest Practices Act rules and regulations pertaining to timber harvest and forest road construction and maintenance. These rules and regulations are designated as the `best management practices` for the prevention of nonpoint source pollution from silviculture under provisions of the Federal Clean Water Act. For each practice, the relevant research results are summarized; more general summaries for related groups of practices are also provided.

  14. WestREN: a description of an Irish academic general practice research network.

    PubMed

    Kavanagh, Kim E; O'Brien, Niamh; Glynn, Liam G; Vellinga, Akke; Murphy, Andrew W

    2010-10-06

    Primary care research networks have been established internationally since the 1960s to enable diverse practitioners to engage in and develop research and education and implement research evidence.The newly established Western Research and Education Network (WestREN) is one such network consisting of a collaboration between the Discipline of General Practice at NUI Galway and 71 West of Ireland general practices. In September 2009 all member practices were issued with a questionnaire with two objectives: to describe the structure and characteristics of the member practices and to compare the results to the national profile of Irish general practice. A postal survey was used followed by one written and one email reminder. A response rate of 73% (52/71) was achieved after two reminders.Half of practices were in a rural location, one quarter located in an urban setting and another quarter in a mixed location.Ninety-four per cent of general practitioners practice from purpose-built or adapted premises with under 6% of practices being attached to the general practitioner's residence. Over 96% of general practitioners use appointment systems with 58% using appointment only.All practices surveyed were computerised, with 80% describing their practices as 'fully computerised'. Almost 60% of general practitioners are coding chronic diagnoses with 20% coding individual consultations. Twenty-five per cent of general practitioners were single-handed with the majority of practices having at least two general practitioners, and a mean number of general practitioners of 2.4. Ninety-two per cent of practices employed a practice nurse with 30% employing more than one nurse.Compared to the national profile, WestREN practices appear somewhat larger, and more likely to be purpose-built and in rural areas. National trends apparent between 1982 and 1992, such as increasing computerisation and practice nurse availability, appear to be continuing. WestREN is a new university

  15. General practice research--does gender affect the decision to participate?

    PubMed

    Jones, Kay M; Dixon, Maureen E; Dixon, John B

    2012-06-01

    Recruitment of general practitioners for research in Australia is problematic. We aimed to explore general practice demographics and recent research experience for effects on research attitudes and enablers and inhibitors of research participation. A survey was developed and distributed to GPs via two divisions of general practice in Melbourne, Victoria. Seven hundred and fifty-six questionnaires were mailed and 215 (28%) returned; 50% of respondents were women and 51% of all GPs had previously participated in general practice research. Gender differences were found in factors affecting the decision to participate. Women were significantly more concerned about out-of-hours commitment (p<0.001), paperwork volume (p<0.001), recruitment criteria (p=0.009) and research methodology complexity (p=0.016). They were more likely to want to work as a general practice group (p=0.007) and to be inhibited by having to present results to peers (OR 2.4, 95% CI: 1.5-3.8). Research challenges, reduced interest in research participation and feminisation of the workforce have major implications for the future of research in general practice. Systemic changes are needed to address these issues.

  16. Patient and professional attitudes towards research in general practice: the RepR qualitative study

    PubMed Central

    2014-01-01

    Background Since the 1990s, professional institutions worldwide have emphasised the need to develop research in general practice to improve the health of the population. The recent creation of professorships in general practice in French Universities should foster research in this field. Our aim was to explore the views of patients and relevant professionals on research in general practice. Methods Qualitative study, using the grounded theory approach according to Strauss and Corbin, conducted in 2010 in three French regions. Nine focus groups were run to data saturation, and included 57 participants in four different categories: patients, non-academic GPs, academic GPs, academics in other disciplines. Results Most of the participants in the four categories described research in general practice as specific to the population managed and relevant for health care. They considered that its grounding in day-to-day practice enabled pragmatic approaches. The influence of the pharmaceutical industry, rivalries between university disciplines and a possible gap between research and practice were considered as pitfalls. The barriers identified were representations of the medical researcher as a “laboratory worker”, the lack of awareness of any research in the discipline, and lack of time and training. While the views of patients and non-academic GPs are mostly focused on professional issues and the views of academics other than GPs on technical issues, academic GPs are in a position to play a role of interface between the universities and general practices. Conclusions Although the role of GPs in research is perceived differently by the various protagonists, research in general practice has an undisputed legitimacy in France. Solutions for overcoming the identified barriers include research networks with appropriate resources and training and scientifically sound collaborative research projects, as already implemented in leading countries. PMID:25047280

  17. Patient and professional attitudes towards research in general practice: the RepR qualitative study.

    PubMed

    Cadwallader, Jean-Sébastien; Lebeau, Jean-Pierre; Lasserre, Evelyne; Letrilliart, Laurent

    2014-07-21

    Since the 1990s, professional institutions worldwide have emphasised the need to develop research in general practice to improve the health of the population. The recent creation of professorships in general practice in French Universities should foster research in this field. Our aim was to explore the views of patients and relevant professionals on research in general practice. Qualitative study, using the grounded theory approach according to Strauss and Corbin, conducted in 2010 in three French regions. Nine focus groups were run to data saturation, and included 57 participants in four different categories: patients, non-academic GPs, academic GPs, academics in other disciplines. Most of the participants in the four categories described research in general practice as specific to the population managed and relevant for health care. They considered that its grounding in day-to-day practice enabled pragmatic approaches. The influence of the pharmaceutical industry, rivalries between university disciplines and a possible gap between research and practice were considered as pitfalls. The barriers identified were representations of the medical researcher as a "laboratory worker", the lack of awareness of any research in the discipline, and lack of time and training. While the views of patients and non-academic GPs are mostly focused on professional issues and the views of academics other than GPs on technical issues, academic GPs are in a position to play a role of interface between the universities and general practices. Although the role of GPs in research is perceived differently by the various protagonists, research in general practice has an undisputed legitimacy in France. Solutions for overcoming the identified barriers include research networks with appropriate resources and training and scientifically sound collaborative research projects, as already implemented in leading countries.

  18. Action research led to a feasible lifestyle intervention in general practice for people with prediabetes.

    PubMed

    Maindal, Helle Terkildsen; Bonde, Ane; Aagaard-Hansen, Jens

    2014-04-01

    To develop and pilot a feasible lifestyle intervention for people with prediabetes tailored for general practice. The study was designed to explore (i) what resources and competencies would be required and (ii) which intervention components should be included. In the first of two action research cycles various interventions were explored in general practice. The second cycle tested the intervention described by the end of the first cycle. In total, 64 patients, 8 GPs and 10 nurses participated. An intervention comprising six consultations to be delivered during the first year after identified prediabetes was found feasible by the general practice staff in terms of resources. Practice nurses possessed the adequate competences to undertake the core part of the intervention. The intervention comprised fixed elements according to structure, time consumption and educational principles, and flexible elements according to educational material and focus points for behaviour change. Clinical relevant reductions in patients' BMI and HbA1c were found. A prediabetes lifestyle intervention for Danish general practice with potential for diabetes prevention was developed based on action research. The transferability of the developed intervention to other general practices depends on the GPs priorities, availability of practice nurses to deliver the core part, and the remuneration system for general practice. The long-term feasibility in larger patient populations is unknown. Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  19. Mackenzie's puzzle--the cornerstone of teaching and research in general practice.

    PubMed Central

    Murdoch, J C

    1997-01-01

    The new-found popularity of generalism as a political force has emphasized the need to clarify the essential philosophy that underpins its practice, teaching, and research. Drawing on the example of Sir James Mackenzie, the author seeks to clarify certain essential issues that need to be emphasized if we are to promote and develop general practice as a distinct academic discipline. Dissatisfaction, uncertainty about our role, and continuing contact with real people seems to be essential to continuing creativity. PMID:9474833

  20. Barriers to the development of collaborative research in general practice: a qualitative study.

    PubMed Central

    Gray, R W; Woodward, N J; Carter, Y H

    2001-01-01

    General practice-based research activity is increasing rapidly, particularly for large, collaborative, multi-centre studies. We conducted semi-structured interviews with general practitioners and other professionals at practices in the East London and the City Health Authority area, to investigate the difficulties presented by becoming involved in these studies. Interviewees' main concerns were: time constraints; team motivation; the perception that external researchers have unrealistic expectations; the need for good communications throughout and, specifically, for good feedback from these researchers. PMID:11255904

  1. Compatibility of scientific research and specialty training in general practice. A cross-sectional study.

    PubMed

    Kötter, Thomas; Carmienke, Solveig; Herrmann, Wolfram J

    2014-01-01

    In many departments of General Practice (GP) in Germany, young doctors who are trainees also work as researchers. Often these trainees work part time at the university and part time as a trainee in clinical practice. However, little is known about the situation of the actors involved. The aim of the study was to investigate the perspectives of GP trainees, heads of departments and GP trainers regarding the combination of research and GP training. We conducted a web-based survey with the heads of all German departments of General Practice, GP trainees who also conduct research and their GP trainers. The questionnaires consisted of open and closed questions. The results were analyzed using descriptive statistics and qualitative methods. 28 heads of GP departments and 20 GP trainees responded. The trainees were mostly very satisfied with their situation as a trainee. However, the trainees considered the combination of research and GP training as difficult. The respondents name as problems the coordination of multiple jobs and the lack of credibility given to research in General Practice. They name as solutions research-enabling training programs and uniform requirements in training regarding research. The combination of GP training and scientific research activity is perceived as difficult. However, well-organized and designed programs can improve the quality of the combination.

  2. Increasing the general level of academic capacity in general practice: introducing mandatory research training for general practitioner trainees through a participatory research process.

    PubMed

    Tulinius, Charlotte; Nielsen, Anni Brit Sternhagen; Hansen, Lars J; Hermann, Christian; Vlasova, Lioudmila; Dalsted, Rikke

    2012-01-01

    To obtain good quality evidence-based clinical work there needs to be a culture of critical appraisal, and strong bridges between the clinical and the academic worlds in general practice. The aim was to educate the general practitioner (GP) trainees to obtain critical appraisal skills, and through the development and implementation of the mandatory programme to gradually empower the GP community to achieve academic capacity by creating a link between the GP researchers and the GP training community. This was done by developing a faculty, giving teaching skills to GP academics, and research skills to GP clinicians; and creating an awareness of the potential benefits of critical appraisal in training GP surgeries. Development and implementation of a faculty and a programme through a participatory action research-inspired project, with process evaluation from the beginning of the planning phase. From 2006 to 2009, we built a teaching faculty of 25 teachers among clinical GPs and GP academics; developed the training programme; and delivered the programme to 95 GP trainees. Some of the GP trainees later showed an interest in more substantial research projects, and GP trainers with no previous association with the research environment started to show an interest through their function as GP trainers. The GP academics of the faculty, however, felt that it was difficult to continue the engagement because of the still increasing demand for published knowledge production in academia. It is possible to support the development of general academic capacity in general practice using participatory design in collaboration with GP academics and clinicians, building bridges between academia and clinical work, as well as within academia between research publication and teaching. There is, however, a generic barrier in the regulation of academia itself.

  3. Trends in research time, fellowship training, and practice patterns among general surgery graduates.

    PubMed

    Ellis, Michelle C; Dhungel, Birat; Weerasinghe, Roshanthi; Vetto, John T; Deveney, Karen

    2011-01-01

    A comparison of research experience, fellowship training, and ultimate practice patterns of general surgery graduates at a university-based surgical residency program. Research experience correlated with pursuing fellowship training and predicted an eventual academic career. More recently, graduates have been able to obtain fellowships without a dedicated research year, perhaps reflecting shifting fellowship training opportunities. We hypothesized that the relationships among dedicated research experience during residency, fellowship training, and career choices is changing as research and fellowship opportunities evolve. Comparison of research experience, fellowship training, and ultimate practice patterns of general surgery graduates for 2 decades (1990-1999, n = 82; 2000-2009, n = 98) at a university-based residency program. Main outcome measures were number of years and area of research, fellowship training, and practice setting. Compared by decade, graduates became increasingly fellowship-trained (51.2% vs 67.3%; p < 0.05) and pursuit of fellowship training increased for both research and nonresearch participating graduates. The number of residents completing more than 1 year of research doubled (9.8% vs 22.4%, p < 0.05). By decade, the percentage of female graduates increased significantly (22% vs 41%, p = 0.005), with more women participating in dedicated research (17% vs 51%, p < 0.001) and seeking fellowships. The number of graduates going into specialty practice and academic/clinical faculty positions increased over time. Surgical residents have completed more dedicated research years and became increasingly fellowship-trained over time. The proportion of female graduates has increased with similar increases in research time and fellowship training in this subgroup. In the earlier decade, dedicated research experiences during surgical residency correlated with pursuing fellowship training, and predicted an eventual academic career. More recently

  4. Introducing undergraduate medical teaching into general practice: an action research study.

    PubMed

    Grant, Andy; Robling, Michael

    2006-11-01

    Following the publication of Tomorrow's Doctors and as a result of increasing numbers of students recruited to medical school it is necessary to involve more general practitioners (family physicians) in undergraduate medical education. Students have responded positively regarding experiences in general practices with a broad spectrum of clinical conditions to be seen and greater involvement in clinical decision-making. This action research study followed a small group general practice in South Wales through the required preparation for undergraduate medical education and its first year of teaching. Preparatory work for the practice focused mainly on summarizing patient notes, setting up a practice library and arranging accommodation for the students. Members of the Primary Health Care Team (PHCT) found that having students in the practice gave them a sense of achievement and enhanced self-worth. Individuals within the practice felt more confident in their professional role and the team ethic within the practice was strengthened. Doctors' anxieties regarding the adequacy of their clinical skills proved unfounded. Patients were reported to feel more included in their care and to have enjoyed hearing their condition being discussed with the students. Students valued the one-to-one teaching, seeing common illnesses and a variety of consulting styles. It is hoped that this paper will be of value to those responsible for recruiting GP practices into undergraduate teaching. It demonstrates benefits for the primary health care team in terms of improved morale and sense of professional self-worth. Patients felt more involved in their care. Generalization from these findings is limited by only one practice having been involved. Undergraduate teaching offers advantages, particularly in terms of professional self-esteem and team morale.

  5. Protecting the privacy of individual general practice patient electronic records for geospatial epidemiology research.

    PubMed

    Mazumdar, Soumya; Konings, Paul; Hewett, Michael; Bagheri, Nasser; McRae, Ian; Del Fante, Peter

    2014-12-01

    General practitioner (GP) practices in Australia are increasingly storing patient information in electronic databases. These practice databases can be accessed by clinical audit software to generate reports that inform clinical or population health decision making and public health surveillance. Many audit software applications also have the capacity to generate de-identified patient unit record data. However, the de-identified nature of the extracted data means that these records often lack geographic information. Without spatial references, it is impossible to build maps reflecting the spatial distribution of patients with particular conditions and needs. Links to socioeconomic, demographic, environmental or other geographically based information are also not possible. In some cases, relatively coarse geographies such as postcode are available, but these are of limited use and researchers cannot undertake precision spatial analyses such as calculating travel times. We describe a method that allows researchers to implement meaningful mapping and spatial epidemiological analyses of practice level patient data while preserving privacy. This solution has been piloted in a diabetes risk research project in the patient population of a practice in Adelaide. The method offers researchers a powerful means of analysing geographic clinic data in a privacy-protected manner. © 2014 Public Health Association of Australia.

  6. Use of electronic patient records for research: views of patients and staff in general practice.

    PubMed

    Stevenson, Fiona; Lloyd, Nigel; Harrington, Louise; Wallace, Paul

    2013-04-01

    Electronic patient records offer unique opportunities to undertake population-based research. The Health Research Support Service (HRSS) pilot project sought to extract electronic records on a national basis from across health and social care and transfer them together with identifiers to a designated 'safe haven'. To determine the feasibility and acceptability of the HRSS pilot in primary care. Interviews and focus groups with patients and practice staff. There was general support from both patients and staff for the principle of the HRSS. The 'opt-out' basis for participation in the HRSS drew mixed responses from patients and staff, with an appreciation of the advantages in relation to participation by default, but concerns about the extent to which this constituted true consent. Concerns were expressed about confidentiality and the safety and security of the extracted data. The patient information pack was roundly criticized by both patients and staff. Trust in individual GPs, practices and the National Health Service (NHS) was a crucial factor in patients' decisions about participation. Although patients and staff were generally supportive of the HRSS, they require clear information about the proposed use of medical records for research purposes. The question of 'opt out' versus 'opt in' remains controversial and further consideration will be needed if research using routine medical records is to achieve its full potential as a 'core' activity in the NHS.

  7. General practices as emergent research organizations: a qualitative study into organizational development.

    PubMed

    Macfarlane, Fraser; Shaw, Sara; Greenhalgh, Trisha; Carter, Yvonne H

    2005-06-01

    An increasing proportion of research in primary care is locally undertaken in designated research practices. Capacity building to support high quality research at these grass roots is urgently needed and is a government priority. There is little previously published research on the process by which GP practices develop as research organizations or on their specific support needs at organizational level. Using in-depth qualitative interviews with 28 key informants in 11 research practices across the UK, we explored their historical accounts of the development of research activity. We analysed the data with reference to contemporary theories of organizational development. Participants identified a number of key events and processes, which allowed us to produce a five-phase model of practice development in relation to research activity (creative energy, concrete planning, transformation/differentiation, consolidation and collaboration). Movement between these phases was not linear or continuous, but showed emergent and adaptive properties in which specific triggers and set-backs were often critical. This developmental model challenges previous categorical taxonomies of research practices. It forms a theory-driven framework for providing appropriate support at the grass roots of primary care research, based on the practice's phase of development and the nature of external triggers and potential setbacks. Our findings have important implications for the strategic development of practice-based research in the UK, and could serve as a model for the wider international community.

  8. A feasibility study using geographic access to general practices and routinely collected data in public health and health services research.

    PubMed

    Chong, Shanley; Byun, Roy; Jalaludin, Bin B

    2015-09-30

    Advances in geographic information systems (GIS) and increased availability of routinely collected data have the potential to contribute to public health and health services research. The aim of this feasibility study was to explore the use of GIS to measure access to general practices and its relationship to selected antenatal behaviours. We obtained the Perinatal Data Collection, 2004-2008, for South Western Sydney Local Health District from the New South Wales Ministry of Health. Using a GIS, we generated circular and polygon-based 1 km and 2 km road network buffers from a maternal residential address and then calculated the number of general practices within those buffers (density measures). Distances to general practices from maternal residences were also calculated in the GIS as another measure of geographic access to general practices (proximity measures). We used generalised estimating equations logistic regression to examine associations between access to general practices, and smoking during pregnancy and late first antenatal visit. The numbers of general practices within circular buffers were significantly greater than within polygon-based road network buffers. The average distance to the five closest general practices from a mother's residence was 2.3 km ± 3.0 km (median 1.4 km, range 0.05 km to 40.0 km). For two of the five measures of access, a higher number of general practices was associated with increased risk for late first antenatal visit. However, the associations were weak, with odds ratios very close to unity. Choice of metrics of geographic access to general practices did not alter the associations with smoking during pregnancy or late first antenatal visit. GIS can be used to quantify measures of geographic access to health services for public health and health services research. Geographic access to general practices was generally not associated with smoking during pregnancy or late first antenatal visit. GIS and routinely collected health

  9. General practitioners in Styria - who is willing to take part in research projects and why? : A survey by the Institute of General Practice and Health Services Research.

    PubMed

    Poggenburg, Stephanie; Reinisch, Manuel; Höfler, Reinhild; Stigler, Florian; Avian, Alexander; Siebenhofer, Andrea

    2017-08-09

    Increasing recognition of general practice is reflected in the growing number of university institutes devoted to the subject and Health Services Research (HSR) is flourishing as a result. In May 2015 the Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, initiated a survey of Styrian GPs. The aim of the survey was to determine the willingness to take part in HSR projects, to collect sociodemographic data from GPs who were interested and to identify factors affecting participation in research projects. Of the 1015 GPs who received the questionnaire, 142 (14%) responded and 135 (13%) were included in the analysis. Overall 106 (10%) GPs indicated their willingness to take part in research projects. Factors inhibiting participation were lack of time, administrative workload, and lack of assistance. Overall, 10% of Styrian GPs were willing to participate in research projects. Knowledge about the circumstances under which family doctors are prepared to participate in HSR projects will help in the planning of future projects.

  10. What research agenda could be generated from the European General Practice Research Network concept of Multimorbidity in Family Practice?

    PubMed

    Le Reste, J Y; Nabbe, P; Lingner, H; Kasuba Lazic, D; Assenova, R; Munoz, M; Sowinska, A; Lygidakis, C; Doerr, C; Czachowski, S; Argyriadou, S; Valderas, J; Le Floch, B; Deriennic, J; Jan, T; Melot, E; Barraine, P; Odorico, M; Lietard, C; Van Royen, P; Van Marwijk, H

    2015-09-17

    Multimorbidity is an intuitively appealing, yet challenging, concept for Family Medicine (FM). An EGPRN working group has published a comprehensive definition of the concept based on a systematic review of the literature which is closely linked to patient complexity and to the biopsychosocial model. This concept was identified by European Family Physicians (FPs) throughout Europe using 13 qualitative surveys. To further our understanding of the issues around multimorbidity, we needed to do innovative research to clarify this concept. The research question for this survey was: what research agenda could be generated for Family Medicine from the EGPRN concept of Multimorbidity? Nominal group design with a purposive panel of experts in the field of multimorbidity. The nominal group worked through four phases: ideas generation phase, ideas recording phase, evaluation and analysis phase and a prioritization phase. Fifteen international experts participated. A research agenda was established, featuring 6 topics and 11 themes with their corresponding study designs. The highest priorities were given to the following topics: measuring multimorbidity and the impact of multimorbidity. In addition the experts stressed that the concept should be simplified. This would be best achieved by working in reverse: starting with the outcomes and working back to find the useful variables within the concept. The highest priority for future research on multimorbidity should be given to measuring multimorbidity and to simplifying the EGPRN model, using a pragmatic approach to determine the useful variables within the concept from its outcomes.

  11. Direct pulp capping of permanent teeth in New Zealand general dental practice--a practice based research study.

    PubMed

    Friedlander, L; McElroy, K; Daniel, B; Cullinan, M; Hanlin, S

    2015-06-01

    This study aimed to investigate treatment protocols and opinions towards direct pulp capping (DPC) amongst New Zealand (NZ) general dental practitioners (GDP) through a Practice Based Research Network (PBRN) study. Mixed-methods approach using qualitative thematic and quantitative analysis. An on-line survey containing Likert scale items and open-ended questions was distributed to GDPs on the Dental Council of New Zealand (DCNZ) register (2012) to collect information on practitioner demographics, treatment protocols, continuing professional development (CPD) and philosophies towards DPC. RESULTs: Two hundred and ten GDPs from North and South Islands providing care in main centres and rural areas engaged with the PBRN and participated in the study. Almost all performed DPC treatment although it was not a common procedure. DPC was perceived as 'successful' or 'very successful' by 95% of respondents, mostly for cases of reversible pulpitis. Most provided DPC for patients of all ages but younger patients were perceived to have the best clinical outcomes. Calcium hydroxide and MTA were the most commonly used materials for DPC. MTA was believed to have the best outcome but cost and handling properties were barriers to its use. The majority of respondents had participated in CPD related to vital pulp therapy and regarded this treatment as conservative and providing time and financial benefits compared with more invasive treatment. Clinicians' timeframes for assessing healing were variable, and combined clinical and radiographic findings were considered most useful. New Zealand dentists perceive DPC as a successful and conservative treatment in selected cases. The findings have provided insights into engagement of NZ dentists in using research to inform everyday clinical practice through a PBRN study.

  12. Patient satisfaction surveys as a market research tool for general practices.

    PubMed

    Khayat, K; Salter, B

    1994-05-01

    Recent policy developments, embracing the notions of consumer choice, quality of care, and increased general practitioner control over practice budgets have resulted in a new competitive environment in primary care. General practitioners must now be more aware of how their patients feel about the services they receive, and patient satisfaction surveys can be an effective tool for general practices. A survey was undertaken to investigate the use of a patient satisfaction survey and whether aspects of patient satisfaction varied according to sociodemographic characteristics such as age, sex, social class, housing tenure and length of time in education. A sample of 2173 adults living in Medway District Health Authority were surveyed by postal questionnaire in September 1991 in order to elicit their views on general practice services. Levels of satisfaction varied with age, with younger people being consistently less satisfied with general practice services than older people. Women, those in social classes 1-3N, home owners and those who left school aged 17 years or older were more critical of primary care services than men, those in social classes 3M-5, tenants and those who left school before the age of 17 years. Surveys and analyses of this kind, if conducted for a single practice, can form the basis of a marketing strategy aimed at optimizing list size, list composition, and service quality. Satisfaction surveys can be readily incorporated into medical audit and financial management.

  13. Patient satisfaction surveys as a market research tool for general practices.

    PubMed Central

    Khayat, K; Salter, B

    1994-01-01

    BACKGROUND. Recent policy developments, embracing the notions of consumer choice, quality of care, and increased general practitioner control over practice budgets have resulted in a new competitive environment in primary care. General practitioners must now be more aware of how their patients feel about the services they receive, and patient satisfaction surveys can be an effective tool for general practices. AIM. A survey was undertaken to investigate the use of a patient satisfaction survey and whether aspects of patient satisfaction varied according to sociodemographic characteristics such as age, sex, social class, housing tenure and length of time in education. METHOD. A sample of 2173 adults living in Medway District Health Authority were surveyed by postal questionnaire in September 1991 in order to elicit their views on general practice services. RESULTS. Levels of satisfaction varied with age, with younger people being consistently less satisfied with general practice services than older people. Women, those in social classes 1-3N, home owners and those who left school aged 17 years or older were more critical of primary care services than men, those in social classes 3M-5, tenants and those who left school before the age of 17 years. CONCLUSION. Surveys and analyses of this kind, if conducted for a single practice, can form the basis of a marketing strategy aimed at optimizing list size, list composition, and service quality. Satisfaction surveys can be readily incorporated into medical audit and financial management. PMID:8204335

  14. Action to Support Practices Implement Research Evidence (ASPIRE): protocol for a cluster-randomised evaluation of adaptable implementation packages targeting 'high impact' clinical practice recommendations in general practice.

    PubMed

    Willis, Thomas A; Hartley, Suzanne; Glidewell, Liz; Farrin, Amanda J; Lawton, Rebecca; McEachan, Rosemary R C; Ingleson, Emma; Heudtlass, Peter; Collinson, Michelle; Clamp, Susan; Hunter, Cheryl; Ward, Vicky; Hulme, Claire; Meads, David; Bregantini, Daniele; Carder, Paul; Foy, Robbie

    2016-02-29

    There are recognised gaps between evidence and practice in general practice, a setting which provides particular challenges for implementation. We earlier screened clinical guideline recommendations to derive a set of 'high impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. We aim to evaluate the effectiveness and cost-effectiveness of a multifaceted, adaptable intervention package to implement four targeted, high impact recommendations in general practice. The research programme Action to Support Practice Implement Research Evidence (ASPIRE) includes a pair of pragmatic cluster-randomised trials which use a balanced incomplete block design. Clusters are general practices in West Yorkshire, United Kingdom (UK), recruited using an 'opt-out' recruitment process. The intervention package adapted to each recommendation includes combinations of audit and feedback, educational outreach visits and computerised prompts with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. In trial 1, practices are randomised to adapted interventions targeting either diabetes control or risky prescribing and those in trial 2 to adapted interventions targeting either blood pressure control in patients at risk of cardiovascular events or anticoagulation in atrial fibrillation. The respective primary endpoints comprise achievement of all recommended target levels of haemoglobin A1c (HbA1c), blood pressure and cholesterol in patients with type 2 diabetes, a composite indicator of risky prescribing, achievement of recommended blood pressure targets for specific patient groups and anticoagulation prescribing in patients with atrial fibrillation. We are also randomising practices to a fifth, non-intervention control group to further assess Hawthorne effects. Outcomes will be assessed using routinely collected data

  15. Strategies for identifying pregnancies in the automated medical records of the General Practice Research Database.

    PubMed

    Hardy, Janet R; Holford, Theodore R; Hall, Gillian C; Bracken, Michael B

    2004-11-01

    To develop a method for identifying the beginning and ending records of pregnancies in the automated medical records of the General Practice Research Database (GPRD). Women's records from 1991 to 1999 were searched for codes from 17 pregnancy marker and 7 pregnancy outcome categories. Using the retrieved records, all possible pregnancy marker-outcome combinations were formed per woman. For each combination, the difference in days between record event dates was calculated. Restrictions were applied to select the combination with the earliest pregnancy marker mapped to the first outcome for each pregnancy. Iterations of the algorithm identified multiple pregnancies per woman when present. The algorithm was evaluated by analyzing time between marker and outcome event dates of mapped pregnancies and by analyzing unmapped pregnancy markers and outcomes. A total of 297,082 pregnancies were identified: 80% by general practitioner (GP) visit codes as the earliest pregnancy marker and 14% by laboratory or procedure codes. Limiting pregnancies to one per woman aged 15-44 years yielded 209,266 pregnancies. Pregnancy mapping success was greater than 80%. Plotting the pregnancies by weeks from earliest pregnancy marker to outcome and by pregnancy marker category showed two peaks in the distribution: 2-3 weeks and 33 weeks. Arranging codes and time into algorithms provides a useful tool for pregnancy identification in databases whose size prohibits the audit of printed records. Evaluation of our algorithm confirmed a high degree of mapping success and a sensible time distribution from pregnancy marker to outcome. Copyright 2004 John Wiley & Sons, Ltd.

  16. Juvenile Huntington's disease: a population-based study using the General Practice Research Database

    PubMed Central

    Douglas, Ian; Evans, Stephen; Rawlins, Michael D; Smeeth, Liam; Tabrizi, Sarah J; Wexler, Nancy S

    2013-01-01

    Background The juvenile form of Huntington's disease (HD) is a rare disorder. There are no population-based estimates of either its incidence or prevalence in any population in the world. The present study was undertaken to estimate the frequency of juvenile HD in the UK and to examine the range of pharmacological treatments used in its management. Method The records of individuals under the age of 21 who had recorded diagnoses of HD were retrieved from the General Practice Research Database from 1990 through 2010. From these data estimates of incidence and prevalence were made as well as the specific treatments used in the treatment of its physical and psychological manifestations. Results 12 incident and 21 prevalent patients with juvenile HD were identified. The 21 prevalent cases included the 12 incident cases. The minimum population-based estimate of incidence is 0.70 (95% CI 0.36 to 1.22) per million patient-years. The minimum estimate of prevalence is 6.77/million (95% CI 5.60 to 8.12) per million patient-years. Patients were most frequently prescribed antidepressants, hypnotics, antipsychotics and treatments for motor abnormalities. Conclusions In the UK, juvenile HD is an extremely rare and complex disorder. The prescribing data demonstrate that the clinical management of juvenile HD is undertaken with no formal evidence base for the efficacy or safety of the treatments used. Research into the safety and efficacy of appropriate therapies is urgently required to offset the haphazard nature of prescribing. Multinational collaboration will be necessary to enrol sufficient numbers. Exploratory studies, though, should begin now. PMID:23558730

  17. Head lice diagnosed in general practice in the West Midlands between 1993 and 2000: a survey using the General Practice Research Database.

    PubMed

    Smith, S; Smith, G; Heatlie, H; Bashford, J; Ashcroft, D; Millson, D

    2003-06-01

    The potential of the General Practice Research Database (GPRD) for communicable disease surveillance was explored using head lice as an example. All diagnoses of head lice and prescriptions for parasiticidal agents from 1993 to 2000 in the West Midlands were analysed. Diagnoses reached a peak of 28.2 per 1,000 patient years at risk and total prescriptions reached a peak of 27.1 per 1,000 patient years at risk in 1997. Malathion and permethrin were prescribed most often. The proportion of further parasiticidal prescriptions issued within 30 days of the initial prescription increased to a peak of 11.5% of prescriptions in 1997. The ratio of the same:different further prescriptions changed during the study period, reaching a high of 5:1 in 2000. These trends are mirrored by the Royal College of General Practitioners (RCGP) Weekly Returns Service and Prescribing Analysis and Cost (PACT) data. Use of GPRD provides additional insights into patient data, particularly on prescribing, that would not be available from other sources.

  18. Missing laboratory test data in electronic general practice records: analysis of rheumatoid factor recording in the clinical practice research datalink.

    PubMed

    Sammon, Cormac J; Miller, Anne; Mahtani, Kamal R; Holt, Tim A; McHugh, Neil J; Luqmani, Raashid A; Nightingale, Alison L

    2015-05-01

    To investigate whether information from the literature could be used to identify periods of practice data in an electronic healthcare database during which rheumatoid factor (RF) test results are likely to be missing-not-at-random (MNAR). RF tests recorded in the Clinical Practice Research Datalink (CPRD) were identified and defined as having a positive, negative or missing result. The proportion of positive test results was then calculated based on (i) complete-case analysis (ii) after restriction to tests from practice years with no missing test results and (iii) following multiple imputation of missing test results. The same three analyses were then carried out after excluding practice years with a proportion of positive tests incompatible with the missing completely at random (MCAR) assumption. We identified 127,969 RF test records, 30.4% of which did not have an associated test result. Among tests with results available, 19% were positive. Both multiple imputation of the 38,867 missing test results and restriction of the study population to the 491 practice years with complete data had little impact on the percentage of positive tests. Following exclusion of the 544 practice years in which data were likely to be MNAR the percentage of positive tests in all analyses decreased to ~7%. Recording of RF tests and RF test results in the CPRD is incomplete, with data likely to be MNAR in many practices. Exclusion of practice years with a high proportion of positive tests brought the distribution of positive tests in the study in line with the literature. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Introducing dental hygienists in general practice to research - an in-practice evaluation programme in the United Kingdom.

    PubMed

    Eaton, K A; Suvan, J E; Saraf, S; Rist, A

    2015-08-01

    To introduce dental hygienists (DHs) in the UK to the principles of research through a practice-based product evaluation programme. The programme consisted of an initial training and orientation day with presentations on evidence-based practice, research methods and the structure of research papers. The programme and its aims were explained in detail, and participants were briefed on the methods to be used. Participants then recruited seven to ten patients from their practices (offices), carried out a baseline assessment of: plaque, gingival health, calculus and staining at anterior teeth, and gave the patients a questionnaire asking about their teeth and then provided a 3-month supply of a test toothpaste. About 10 weeks later, a follow-up assessment of the same variables was performed and the questionnaire was repeated. A second training day followed during which the DHs provided feedback of their experiences and received training in literature searching and critical appraisal of literature including interpretation of results. Sixty-five DHs attended the first training day; 31 were able to recruit sufficient patients and attend the second training day. The DHs recruited 168 patients who received baseline and follow-up assessments. All the variables improved overall. Feedback from the DHs was very positive, and patients expressed delight with the care they had received. Qualitative feedback for participating DHs suggests the programme met its aim and could be used in the future as a mechanism for helping DHs who want to increase their understanding of research methodology. © 2014 The Authors International Journal of Dental Hygiene Published by John Wiley & Sons Ltd.

  20. Provision of specific dental procedures by general dentists in the National Dental Practice-Based Research Network: questionnaire findings.

    PubMed

    Gilbert, Gregg H; Gordan, Valeria V; Korelitz, James J; Fellows, Jeffrey L; Meyerowitz, Cyril; Oates, Thomas W; Rindal, D Brad; Gregory, Randall J

    2015-01-22

    Objectives were to: (1) determine whether and how often general dentists (GDs) provide specific dental procedures; and (2) test the hypothesis that provision is associated with key dentist, practice, and patient characteristics. GDs (n = 2,367) in the United States National Dental Practice-Based Research Network completed an Enrollment Questionnaire that included: (1) dentist; (2) practice; and (3) patient characteristics, and how commonly they provide each of 10 dental procedures. We determined how commonly procedures were provided and tested the hypothesis that provision was substantively related to the three sets of characteristics. Two procedure categories were classified as "uncommon" (orthodontics, periodontal surgery), three were "common" (molar endodontics; implants; non-surgical periodontics), and five were "very common" (restorative; esthetic procedures; extractions; removable prosthetics; non-molar endodontics). Dentist, practice, and patient characteristics were substantively related to procedure provision; several characteristics seemed to have pervasive effects, such as dentist gender, training after dental school, full-time/part-time status, private practice vs. institutional practice, presence of a specialist in the same practice, and insurance status of patients. As a group, GDs provide a comprehensive range of procedures. However, provision by individual dentists is substantively related to certain dentist, practice, and patient characteristics. A large number and broad range of factors seem to influence which procedures GDs provide. This may have implications for how GDs respond to the ever-changing landscape of dental care utilization, patient population demography, scope of practice, delivery models and GDs' evolving role in primary care.

  1. [Manual therapy in general practice].

    PubMed

    Березуцкий, Владимир И

    2016-01-01

    The article is devoted to manual therapy practice for diagnostics and treatment of vertebrogenic pain syndrome in general practice. Analytical roundup of sources proves medical advantage of implementation of manual therapy basic methods by general practice specialists.

  2. Health and treatment priorities in patients with multimorbidity: report on a workshop from the European General Practice Network meeting 'Research on multimorbidity in general practice'.

    PubMed

    Junius-Walker, Ulrike; Voigt, Isabel; Wrede, Jennifer; Hummers-Pradier, Eva; Lazic, Djurdjica; Dierks, Marie-Luise

    2010-03-01

    Setting health and treatment priorities is necessary when caring for multiple and complex patient issues. This is already done in the doctor-patient consultation-yet implicitly rather than explicitly. The aim of this European General Practice Network workshop was to advance a consultation approach that deals with shared priority setting. The workshop was divided into three parts: (1) how to gain a comprehensive health overview for patients with multiple problems as a basis for priority setting; (2) how to establish priorities considering patient and doctor perspectives; and (3) how to practice a communication style that achieves shared priority setting. The workshop participants preferred to gain information on patients' health status using documentations from patient records rather than conducting systematic assessments. The group emphasized that medical as well as everyday life problems need to be considered when determining priorities, a procedure that requires time and resources not readily available in daily practice. Existing skills for person-centred communication with patients should be applied in order to agree on priorities. Overall it became apparent how challenging it is to arrange and prioritize an array of health problems in a consultation with patients. Existing concepts augmented by innovative systematic methods may be the way forward.

  3. General Dentists’ Use of Isolation Techniques During Root Canal Treatment: from the National Dental Practice-Based Research Network

    PubMed Central

    Lawson, Nathaniel C.; Gilbert, Gregg H.; Funkhouser, Ellen; Eleazer, Paul D.; Benjamin, Paul L.; Worley, Donald C.

    2015-01-01

    Introduction A preliminary study done by a National Dental Practice-Based Research Network precursor observed that 44% of general dentists (GDs) reported always using a rubber dam (RD) during root canal treatment (RCT). This full-scale study quantified use of all isolation techniques, including RD use. Methods Network practitioners completed a questionnaire about isolation techniques used during RCT. Network Enrollment Questionnaire data provided practitioner characteristics. Results 1,490 of 1,716 eligible GDs participated (87%); 697 (47%) reported always using a RD. This percentage varied by tooth type. These GDs were more likely to always use a RD: do not own a private practice; perform less than 10 RCT/month; have postgraduate training. Conclusions Most GDs do not use a RD all the time. Ironically, RDs are used more frequently by GDs who do not perform molar RCT. RD use varies with tooth type and certain dentist, practice, and patient characteristics. PMID:26015159

  4. Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 5: Needs and implications for future research and policy.

    PubMed

    van Royen, Paul; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri E J H; Topsever, Pinar; Ungan, Mehmet; Hummers-Pradier, Eva

    2010-12-01

    The recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and highlights related needs and implications for future research and policy. The European Journal of General Practice publishes a series of articles based on this document. In a first article, background, objectives, and methodology were discussed. In three subsequent, articles the results for the six core competencies of the European Definition of GP/FM were presented. This article formulates the common aims for further research and appropriate research methodologies, based on the missing evidence and research gaps identified form the comprehensive literature review. In addition, implications of this research agenda for general practitioners/family doctors, researchers, research organizations, patients and policy makers are presented. The concept of six core competencies should be abandoned in favour of a model with four dimensions, including clinical, person related, community oriented and management aspects. Future research and policy should consider more the involvement and rights of patients; more attention should be given to how new treatments or technologies are effectively translated into routine patient care, in particular primary care. There is a need for a European ethics board. The promotion of GP/FM research demands a good infrastructure in each country, including access to literature and databases, appropriate funding and training possibilities.

  5. Researching Practice and Practicing Research

    ERIC Educational Resources Information Center

    DiPardo, Anne

    2011-01-01

    When works of teacher scholars were recognized with major National Council of Teachers of English (NCTE) research awards, and the sections and conferences instituted research initiatives of their own, many were filled with the soaring hope that a new synergy was in the making. The "Research in the Teaching of English" (RTE) Alan C. Purves Award,…

  6. Costs associated with treatment of chronic low back pain: an analysis of the UK General Practice Research Database.

    PubMed

    Hong, Jihyung; Reed, Catherine; Novick, Diego; Happich, Michael

    2013-01-01

    Retrospective cohort study of health care costs associated with the treatment of chronic low back pain (CLBP) in the United Kingdom. To assess 12-month health care costs associated with the treatment of CLBP, using the UK General Practice Research Database. CLBP is a common health problem. Data were obtained from the General Practice Research Database, a computerized database of UK primary care patient data. Patients with CLBP were identified for the study period (January 1, 2007, to December 31, 2009) using diagnostic records and pain relief prescriptions (n = 64,167), and 1:1 matched to patients without CLBP (n = 52,986) on the basis of age, sex, and general practitioner's practice. Index date was defined as the first date of CLBP record; the same index date was assigned to matched controls. Multivariate analyses were performed to compare resource use costs (2009 values) in the 12 months after the index date between patients with and without CLBP. A sensitivity analysis was carried out with a more stringent definition for the control group by excluding a broad range of pain conditions. Total health care costs for patients with CLBP were double those of the matched controls (£1074 vs. £516; P < 0.05). Of the cost difference, 58.8% was accounted for by general practitioner's consultations, 22.3% by referrals to secondary care, and the rest by pain relief medications. The sensitivity analysis revealed an even greater cost difference between the 2 groups (£1052 vs. £304; P < 0.05). Because of the use of a retrospective administrative claims database, this study is subject to selection bias between study cohorts, misidentification of comorbidities, and an inability to confirm adherence to therapy or assess indirect costs and costs of over-the-counter medications. Our findings confirm the substantial economic burden of CLBP, even with direct costs only.

  7. Recruitment of general practices: Is a standardised approach helpful in the involvement of healthcare professionals in research?

    PubMed Central

    Riis, Allan; Jensen, Cathrine E; Maindal, Helle T; Bro, Flemming; Jensen, Martin B

    2016-01-01

    Introduction: Health service research often involves the active participation of healthcare professionals. However, their ability and commitment to research varies. This can cause recruitment difficulties and thereby prolong the study period and inflate budgets. Solberg has identified seven R-factors as determinants for successfully recruiting healthcare professionals: relationships, reputation, requirements, rewards, reciprocity, resolution, and respect. Method: This is a process evaluation of the seven R-factors. We applied these factors to guide the design of our recruitment strategy as well as to make adjustments when recruiting general practices in a guideline implementation study. In the guideline implementation study, we studied the effect of outreach visits, quality reports, and new patient stratification tools for low back pain patients. Results: During a period of 15 months, we recruited 60 practices, which was fewer than planned (100 practices). In this evaluation, five of Solberg’s seven R-factors were successfully addressed and two factors were not. The need to involve (reciprocity) end users in the development of new software and the amount of time needed to conduct recruitment (resolution) were underestimated. Conclusion: The framework of the seven R-factors was a feasible tool in our recruitment process. However, we suggest further investigation in developing systematic approaches to support the recruitment of healthcare professionals to research. PMID:27551424

  8. Using Propensity Scores in Educational Research: General Principles and Practical Applications

    ERIC Educational Resources Information Center

    Graham, Suzanne E.; Kurlaender, Michal

    2011-01-01

    Educational researchers frequently study the impact of treatments or interventions on educational outcomes. However, when observational or quasiexperimental data are used for such investigations, selection bias can adversely impact researchers' abilities to make causal inferences about treatment effects. One way to deal with selection bias is to…

  9. The development of general practice as an academic discipline in Germany - an analysis of research output between 2000 and 2010.

    PubMed

    Schneider, Antonius; Großmann, Nadine; Linde, Klaus

    2012-06-15

    Governmental funding support is seen as a prerequisite for the growth of research in general practice. Several funding programs in the amount of € 13.2 Mio were introduced in Germany from 2002 to February 2012. We aim to provide an overview of publications reporting original data and systematic reviews from German academic family medicine published between 2000 and 2010. Publications were identified by searching the database Scopus and screening publication lists of family medicine divisions or institutes. Papers had to report original primary research studies or systematic reviews; at least one of the authors had to be affiliated to a German academic family medicine division or institute. 794 articles were included. The number of publications increased steadily starting from 107 in the period from 2000 to 2003, to 273 from 2004 to 2007, and finally to 414 from 2008 to 2010. Less than 25% were published in English in the first period. This proportion increased to 60.6% from 2008 to 2010. Articles published in a journal without impact factor decreased from 59.8% to 31.9%. Nevertheless, even in the most recent period only 31.6% of all articles were published in a journal with an impact factor above 2. The median impact factor increased from 0 in the first period to 1.2 in the last. The output of original research publications from academic research divisions and institutes for general practice in Germany greatly increased during the last decade. However, professionalism of German primary care research still needs to be developed.

  10. Aggregation, Validation, and Generalization of Qualitative Data - Methodological and Practical Research Strategies Illustrated by the Research Process of an empirically Based Typology.

    PubMed

    Weis, Daniel; Willems, Helmut

    2017-06-01

    The article deals with the question of how aggregated data which allow for generalizable insights can be generated from single-case based qualitative investigations. Thereby, two central challenges of qualitative social research are outlined: First, researchers must ensure that the single-case data can be aggregated and condensed so that new collective structures can be detected. Second, they must apply methods and practices to allow for the generalization of the results beyond the specific study. In the following, we demonstrate how and under what conditions these challenges can be addressed in research practice. To this end, the research process of the construction of an empirically based typology is described. A qualitative study, conducted within the framework of the Luxembourg Youth Report, is used to illustrate this process. Specifically, strategies are presented which increase the likelihood of generalizability or transferability of the results, while also highlighting their limitations.

  11. Systems and complexity thinking in general practice. Part 2: application in primary care research.

    PubMed

    Sturmberg, Joachim P

    2007-04-01

    Systems organise themselves upward toward larger wholes, and downward toward ever smaller parts. The upward view describes holism or emergence (complexity science view), the downward view reductionism or analysis (Newtonian science view). Both views provide valid and valuable information, one being contextual, the other specific. A systems and complexity view allows a simultaneous understanding of a phenomenon from different perspectives, providing the opportunity to identify potentially different outcomes from a single action. The findings from studies on prescribing antibiotics and continuity of care will demonstrate and draw attention to the potential of this approach for primary care research.

  12. Outcomes of endodontic therapy in general practice: a study by the Practitioners Engaged in Applied Research and Learning Network.

    PubMed

    Bernstein, Susan D; Horowitz, Allan J; Man, Martin; Wu, Hongyu; Foran, Denise; Vena, Donald A; Collie, Damon; Matthews, Abigail G; Curro, Frederick A; Thompson, Van P; Craig, Ronald G

    2012-05-01

    The authors undertook a study involving members of a dental practice-based research network to determine the outcome and factors associated with success and failure of endodontic therapy. Members in participating practices (practitioner-investigators [P-Is]) invited the enrollment of all patients seeking treatment in the practice who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years previously. If a patient had more than one tooth so treated, the P-I selected as the index tooth the tooth treated earliest during the three- to five-year period. The authors excluded from the study any teeth that served as abutments for removable partial dentures or overdentures, third molars and teeth undergoing active orthodontic endodontic therapy. The primary outcome was retention of the index tooth. Secondary outcomes, in addition to extraction, that defined failure included clinical or radiographic evidence (or both) of periapical pathosis, endodontic retreatment or pain on percussion. P-Is in 64 network practices enrolled 1,312 patients with a mean (standard deviation) time to follow-up of 3.9 (0.6) years. During that period, 3.3 percent of the index teeth were extracted, 2.2 percent underwent retreatment, 3.6 percent had pain on percussion and 10.6 percent had periapical radiolucencies for a combined failure rate of 19.1 percent. The presence of preoperative periapical radiolucency with a diagnosis of either irreversible pulpitis or necrotic pulp was associated with failure after multivariate analysis, as were multiple canals, male sex and Hispanic/Latino ethnicity. These results suggest that failure rates for endodontic therapy are higher than previously reported in general practices, according to results of studies based on dental insurance claims data. The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for teeth with irreversible pulpitis, necrotic pulp or periapical

  13. Taxonomy of difficulties in general practice.

    PubMed Central

    Beaulieu, M. D.; Leclère, H.; Bordage, G.

    1993-01-01

    A questionnaire combining qualitative and quantitative methods was used to compile a taxonomy of the difficulties experienced by general practitioners in their practices. Difficulties are grouped in 11 categories, ranging from clinical diagnosis to physicians' personal feelings. The taxonomy can be used as a guide for planning medical education or as a starting point for further research in general practice. PMID:8324406

  14. Involving migrants in the development of guidelines for communication in cross-cultural general practice consultations: a participatory learning and action research project

    PubMed Central

    O'Reilly-de Brún, Mary; MacFarlane, Anne; de Brún, Tomas; Okonkwo, Ekaterina; Bonsenge Bokanga, Jean Samuel; Manuela De Almeida Silva, Maria; Ogbebor, Florence; Mierzejewska, Aga; Nnadi, Lovina; van den Muijsenbergh, Maria; van Weel-Baumgarten, Evelyn; van Weel, Chris

    2015-01-01

    Objective The aim of this research was to involve migrants and other key stakeholders in a participatory dialogue to develop a guideline for enhancing communication in cross-cultural general practice consultations. In this paper, we focus on findings about the use of formal versus informal interpreters because dialogues about these issues emerged as central to the identification of recommendations for best practice. Design This qualitative case study involved a Participatory Learning and Action (PLA) research methodology. Participants The sample comprised 80 stakeholders: 51 from migrant communities; 15 general practitioners (GPs) and general practice staff; 7 established migrants as peer researchers; 5 formal, trained interpreters; and 2 service planners from the national health authority. Setting Galway, Ireland. Results There was 100% consensus across stakeholder groups that while informal interpreters have uses for migrants and general practice staff, they are not considered acceptable as best practice. There was also 100% consensus that formal interpreters who are trained and working as per a professional code of practice are acceptable as best practice. Conclusions Policymakers and service planners need to work in partnership with service providers and migrants to progress the implementation of professional, trained interpreters as a routine way of working in general practice. PMID:26391628

  15. Involving migrants in the development of guidelines for communication in cross-cultural general practice consultations: a participatory learning and action research project.

    PubMed

    O'Reilly-de Brún, Mary; MacFarlane, Anne; de Brún, Tomas; Okonkwo, Ekaterina; Bonsenge Bokanga, Jean Samuel; Manuela De Almeida Silva, Maria; Ogbebor, Florence; Mierzejewska, Aga; Nnadi, Lovina; van den Muijsenbergh, Maria; van Weel-Baumgarten, Evelyn; van Weel, Chris

    2015-09-21

    The aim of this research was to involve migrants and other key stakeholders in a participatory dialogue to develop a guideline for enhancing communication in cross-cultural general practice consultations. In this paper, we focus on findings about the use of formal versus informal interpreters because dialogues about these issues emerged as central to the identification of recommendations for best practice. This qualitative case study involved a Participatory Learning and Action (PLA) research methodology. The sample comprised 80 stakeholders: 51 from migrant communities; 15 general practitioners (GPs) and general practice staff; 7 established migrants as peer researchers; 5 formal, trained interpreters; and 2 service planners from the national health authority. Galway, Ireland. There was 100% consensus across stakeholder groups that while informal interpreters have uses for migrants and general practice staff, they are not considered acceptable as best practice. There was also 100% consensus that formal interpreters who are trained and working as per a professional code of practice are acceptable as best practice. Policymakers and service planners need to work in partnership with service providers and migrants to progress the implementation of professional, trained interpreters as a routine way of working in general practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. The Melbourne East Monash General Practice Database (MAGNET): Using data from computerised medical records to create a platform for primary care and health services research.

    PubMed

    Mazza, Danielle; Pearce, Christopher; Turner, Lyle Robert; De Leon-Santiago, Maria; McLeod, Adam; Ferriggi, Jason; Shearer, Marianne

    2016-07-04

    The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET) research platform was launched in 2013 to provide a unique data source for primary care and health services research in Australia.  MAGNET contains information from the computerised records of 50 participating general practices and includes data from the computerised medical records of more than 1,100,000 patients.  The data extracted is patient-level episodic information and includes a variety of fields related to patient demographics and historical clinical information, along with the characteristics of the participating general practices.  While there are limitations to the data that is currently available, the MAGNET research platform continues to investigate other avenues for improving the breadth and quality of data, with the aim of providing a more comprehensive picture of primary care in Australia.

  17. Questionable research practices among italian research psychologists.

    PubMed

    Agnoli, Franca; Wicherts, Jelte M; Veldkamp, Coosje L S; Albiero, Paolo; Cubelli, Roberto

    2017-01-01

    A survey in the United States revealed that an alarmingly large percentage of university psychologists admitted having used questionable research practices that can contaminate the research literature with false positive and biased findings. We conducted a replication of this study among Italian research psychologists to investigate whether these findings generalize to other countries. All the original materials were translated into Italian, and members of the Italian Association of Psychology were invited to participate via an online survey. The percentages of Italian psychologists who admitted to having used ten questionable research practices were similar to the results obtained in the United States although there were small but significant differences in self-admission rates for some QRPs. Nearly all researchers (88%) admitted using at least one of the practices, and researchers generally considered a practice possibly defensible if they admitted using it, but Italian researchers were much less likely than US researchers to consider a practice defensible. Participants' estimates of the percentage of researchers who have used these practices were greater than the self-admission rates, and participants estimated that researchers would be unlikely to admit it. In written responses, participants argued that some of these practices are not questionable and they have used some practices because reviewers and journals demand it. The similarity of results obtained in the United States, this study, and a related study conducted in Germany suggest that adoption of these practices is an international phenomenon and is likely due to systemic features of the international research and publication processes.

  18. Questionable research practices among italian research psychologists

    PubMed Central

    Wicherts, Jelte M.; Veldkamp, Coosje L. S.; Albiero, Paolo; Cubelli, Roberto

    2017-01-01

    A survey in the United States revealed that an alarmingly large percentage of university psychologists admitted having used questionable research practices that can contaminate the research literature with false positive and biased findings. We conducted a replication of this study among Italian research psychologists to investigate whether these findings generalize to other countries. All the original materials were translated into Italian, and members of the Italian Association of Psychology were invited to participate via an online survey. The percentages of Italian psychologists who admitted to having used ten questionable research practices were similar to the results obtained in the United States although there were small but significant differences in self-admission rates for some QRPs. Nearly all researchers (88%) admitted using at least one of the practices, and researchers generally considered a practice possibly defensible if they admitted using it, but Italian researchers were much less likely than US researchers to consider a practice defensible. Participants’ estimates of the percentage of researchers who have used these practices were greater than the self-admission rates, and participants estimated that researchers would be unlikely to admit it. In written responses, participants argued that some of these practices are not questionable and they have used some practices because reviewers and journals demand it. The similarity of results obtained in the United States, this study, and a related study conducted in Germany suggest that adoption of these practices is an international phenomenon and is likely due to systemic features of the international research and publication processes. PMID:28296929

  19. General practice nursing education in Australia.

    PubMed

    Pascoe, Tessa; Hutchinson, Ronelle; Foley, Elizabeth; Watts, Ian; Whitecross, Lyndall; Snowdon, Teri

    2006-04-01

    The quality of care delivered by nurses working in Australian general practices rests on a strong foundation of nursing educatlon and training. A national study of nurses working in general practice was conducted using qualitative and quantitative research techniques to explore their role and educational needs. Results from this research suggest that education for general practice nurses is seen by nurses and General Practitioners to be largely non-formal in nature and is seen by GPs and nurses to be tailored towards general practice nursing needs. Such education is often available locally through general practice support organisations; is strongly focused on National Health Priority Areas and clinical care; and is more appropriate for registered rather than enrolled nurses. The educational opportunities currently available to support nursing in general practice are largely ad hoc and vary in relation to quality, appropriateness and accessibility. Nurses working in general practices in Australia need a system of ongoing training and education to support their responsibilities and foster the development of the position as a viable career option for nurses.

  20. Training for general practice: a national survey.

    PubMed Central

    Crawley, H S; Levin, J B

    1990-01-01

    OBJECTIVES--(a) To compare current vocational training in general practice with that ascertained by a survey in 1980; (b) to compare the training of trainees in formal training schemes with that of trainees arranging their own hospital and general practice posts. DESIGN--National questionnaire survey of United Kingdom and armed services trainees who were in a training practice on 1 April 1989. Questionnaires were distributed by course organisers. SETTING--Research project set up after an ad hoc meeting of trainees at the 1988 national trainee conference. SUBJECTS--2132 Of the 2281 trainees (93%) known to be in a training practice on 1 April 1989. RESULTS--1657 Trainees returned the questionnaires, representing 73% of all trainees known to be in a training practice on 1 April 1989. Between 1980 and 1989 there were significant improvements in the trainee year, and there was also evidence of improvements in general practice study release courses. There was no evidence of improvement in other aspects of training. General practice trainees spent an average of three years in junior hospital posts, which provided very little opportunity for study related to general practice. Training received during tenure of hospital posts differed significantly between trainees in formal schemes and those arranging their own hospital posts. During the trainee year training was almost the same for those in formal schemes and those arranging their own posts. Regions varied significantly in virtually all aspects of general practice training. CONCLUSIONS--The trainee year could be improved further by enforcing the guidelines of the Joint Committee on Postgraduate Training for General Practice. The poor training in junior hospital posts reflected the low priority that training is generally given during tenure of these posts. A higher proportion of general practice trainees should be attached to vocational training schemes. More hospital trainees could attend general practice study release

  1. Oral contraceptives and venous thromboembolic disease. Analyses of the UK General Practice Research Database and the UK Mediplus database.

    PubMed

    Farmer, R D; Lawrenson, R A; Todd, J C; Williams, T J; MacRae, K

    1999-01-01

    The results of three independent studies of venous thromboembolic disease (VTE) and oral contraceptives are reviewed together with two further cohort/case-control studies which we conducted using the MediPlus and General Practice Research Database (GPRD) databases. These latter studies jointly involved 395 cases and uniquely examined the association between VTE and individual combined oral contraceptive (COC) formulations. The two studies yielded very similar results. Crude incidence rates for idiopathic VTE of 4.6 and 3.8 were found per 10,000 exposed woman-years (EWY), in the MediPlus and GPRD studies respectively. Incidence rates increased markedly with age, and in both databases the rates amongst users of levonorgestrel products were lower than those amongst users of desogestrel and gestodene products. A case fatality rate of 3% and a mortality rate of 10 per million EWY were estimated. Odds ratios (OR) were calculated for confounding variables and different COC formulations. Both database studies indicated an excess of current smokers and women with high body mass indices amongst cases. There were significantly more cases with asthma in the GPRD study and cases who had been using their COC for less than a year. No statistically significant differences between COC formulations were found in the analyses where controls were matched to cases by practice and year of birth in both the MediPlus and GPRD studies. In the GPRD study we also ran a study where controls were matched by practice and within 5 year age bands. In this study the OR were consistently higher for the newer or 'third generation' products than when controls were matched by year of birth. However only the acne formulation/OC containing cyproterone acetate and 35 microg ethinyloestradiol yielded a significant OR of 2.3. It may be concluded that improvements in prescribing are paramount as the results strongly indicate that overweight women and those who smoke are at a greater risk of VTE. Further

  2. Negotiating Practice Research

    ERIC Educational Resources Information Center

    Julkunen, Ilse; Uggerhoj, Lars

    2016-01-01

    The complexity of carrying out practice research in social service organizations is often matched by the complexity of teaching future social work practitioners to use and engage in practice research. To appreciate the scope of the teaching challenge, it is important to reflect on the evolving definition of practice research and issues involved in…

  3. Negotiating Practice Research

    ERIC Educational Resources Information Center

    Julkunen, Ilse; Uggerhoj, Lars

    2016-01-01

    The complexity of carrying out practice research in social service organizations is often matched by the complexity of teaching future social work practitioners to use and engage in practice research. To appreciate the scope of the teaching challenge, it is important to reflect on the evolving definition of practice research and issues involved in…

  4. Qualitative outcome assessment and research on chronic disease management in general practice. Highlights from a keynote lecture, EGPRN May 2011, Nice.

    PubMed

    Griffiths, Frances

    2012-03-01

    At its 2011 conference in Nice, France, the European General Practice Research Network (EGPRN), considered the issue of Relevant Outcome Measures in General Practice Research into Chronic Diseases. This paper, which is adapted from a keynote lecture given during that conference, considers the role of qualitative outcome assessments in research. Such assessments have a great deal in common with the patient-centred approach of general practice as they can capture the overall state of a patient rather than capturing only certain aspects. Research suggests that patients can be categorized, based on qualitative outcome assessment, and over time might change category. This approach to assessment brings to our attention alternative ways of considering the future: future as currently being made or future as predictable, at least to some extent. Although general practice needs the evidence from research that predicts the future, it also needs to engage in research that seeks to understand patients as they make their future, and to understand the impact of clinical interventions on this process.

  5. Patients' views about the use of their personal information from general practice medical records in health research: a qualitative study in Ireland.

    PubMed

    Clerkin, P; Buckley, B S; Murphy, A W; MacFarlane, A E

    2013-02-01

    National policies are being developed, which may limit access to patients' records for health research. This could reduce the ability of health research to benefit society as a whole. It is important to develop an in-depth understanding of people's views across demographic groups to inform such policy development. Aims. To explore patients' views about the use of their general practice records in health research with attention to gender and age. Design of study. Qualitative study using focus groups. Six General Practices in the west of Ireland. Focus Group interviews with 35 people who were patients at the practices. Overall, participants were positively inclined towards the idea of information from their records (anonymous and identifiable) being used in research for the 'greater good' although there were some concerns about personal information being 'leaked'. Males emphasized risks in relation to employment and finances, whereas females emphasized risks in relation to social discomfort and embarrassment. Participants were supportive of consent models that enable patients to give prior ongoing consent for specific agreed 'levels' of data use, affording patients self-determination without the need for consent request on study-by-study basis. Overall male and female patients of different ages are supportive of the use of their general practice records in health research and of general practitioners as data protectors.

  6. Prevalence of pain in the orofacial regions in patients visiting general dentists in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry research network.

    PubMed

    Horst, Orapin V; Cunha-Cruz, Joana; Zhou, Lingmei; Manning, Walter; Mancl, Lloyd; DeRouen, Timothy A

    2015-10-01

    This study aimed to measure prevalence of pain in the orofacial regions and determine association with demographics, treatment history, and oral health conditions in dental patients visiting clinics in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT) research network. Data were recorded in a survey with systematic random sampling of patients (n = 1,668, 18 to 93 years old, 56% female) visiting 100 general dentists in the Northwest PRECEDENT research network. Prevalence ratios (PR) of orofacial pain by each variable were estimated by generalized estimating equations for Poisson regression. The prevalence of orofacial pain during the past year was 16.1% (95% confidence interval [CI], 13.4-18.9), of which the most prevalent pain locations were dentoalveolar (9.1%; 95% CI, 7.0-11.2) and musculoligamentous tissues (6.6%; 95% CI, 4.5-8.7). Other locations included soft tissues (0.5%; 95% CI, 0.2-0.8) and nonspecific areas (0.6%; 95% CI, 0.2-1.0). The prevalence of dentoalveolar but not musculoligamentous pain decreased with age. When comparing the 18- to 29-year-old patients, dentoalveolar pain decreased significantly in 45- to 64-year-old patients (PR, 0.59; 95% CI, 0.4-0.9) and in those 65 years or older (PR, 0.5; 95% CI, 0.3-0.9). Sex significantly affected the prevalence of musculoligamentous but not dentoalveolar pain. Women (PR, 3.2; 95% CI, 2.0-5.1) were more likely to have musculoligamentous pain. The prevalence of dentoalveolar and musculoligamentous pain did not vary significantly by ethnicity. Dentoalveolar pain was reported more frequently in patients who did not receive dental maintenance (PR, 2.9; 95% CI, 2.1-4.2) and those visiting community-based public health clinics (PR, 2.2; 95% CI, 1.2-3.7). One in 6 patients visiting a general dentist had experienced orofacial pain during the past year. Dentoalveolar and musculoligamentous pains were the most prevalent types of pain. Pain in the muscles and

  7. CHAracteristics of research studies that iNfluence practice: a GEneral survey of Canadian orthopaedic Surgeons (CHANGES): a pilot survey.

    PubMed

    de Sa, Darren; Thornley, Patrick; Evaniew, Nathan; Madden, Kim; Bhandari, Mohit; Ghert, Michelle

    2015-01-01

    Evidence Based Medicine (EBM) is increasingly being applied to inform clinical decision-making in orthopaedic surgery. Despite the promotion of EBM in Orthopaedic Surgery, the adoption of results from high quality clinical research seems highly unpredictable and does not appear to be driven strictly by randomized trial data. The objective of this study was to pilot a survey to determine if we could identify surgeon opinions on the characteristics of research studies that are perceived as being most likely to influence clinical decision-making among orthopaedic surgeons in Canada. A 28-question electronic survey was distributed to active members of the Canadian Orthopaedic Association (COA) over a period of 11 weeks. The questionnaire sought to analyze the influence of both extrinsic and intrinsic characteristics of research studies and their potential to influence practice patterns. Extrinsic factors included the perceived journal quality and investigator profiles, economic impact, peer/patient/industry influence and individual surgeon residency/fellowship training experiences. Intrinsic factors included study design, sample size, and outcomes reported. Descriptive statistics are provided. Of the 109 members of the COA who opened the survey, 95 (87%) completed the survey in its entirety. The overall response rate was 11% (95/841). Surgeons achieved consensus on the influence of three key designs on their practices: 1) randomized controlled trials 94 (99%), 2) meta-analysis 83 (87%), and 3) systematic reviews 81 (85%). Sixty-seven percent of surgeons agreed that studies with sample sizes of 101-500 or more were more likely to influence clinical practice than smaller studies (n = <100). Factors other than design influencing adoption included 1) reputation of the investigators (99%) and 2) perceived quality of the journal (75%). Although study design and sample size (i.e. minimum of 100 patients) have some influence on clinical decision making, surgeon

  8. Interpersonal counselling in general practice.

    PubMed

    Judd, Fiona; Weissman, Myrna; Davis, Julian; Hodgins, Gene; Piterman, Leon

    2004-05-01

    Interpersonal counselling (IPC) derives from interpersonal psycho-therapy (IPT) but is briefer in the number and duration of sessions and is particularly suited to the primary care setting. While depression and other psychological symptoms are not necessarily 'caused' by interpersonal problems, they do occur in a social and interpersonal context. Problem areas commonly associated with the onset of depression are unresolved grief, interpersonal disputes, role transition and interpersonal deficits such as social isolation. This article discusses IPC and how it can be used in the general practice setting. The structure of IPC is of a brief treatment of six sessions, each with an explicit focus: assessment, education about the interaction between interpersonal relationships and psychological symptoms, identifying current stress areas and helping the patient deal with these more positively and termination of the IPC relationship. Interpersonal counselling can be utilised general practice to reduce psychological symptoms, restore morale, improve self esteem and the quality of the patient's social adjustment and interpersonal relationships.

  9. Educational Researchers and Practicality

    ERIC Educational Resources Information Center

    Van Velzen, Joke H.

    2013-01-01

    In this article, an attempt to identify further directions in research designs that researchers can use to contribute to the relevance of educational research findings, by including teachers' practicality issues, is presented. Sixty experienced teachers in secondary education read the reporting of modified experimental research findings about an…

  10. Social Workers and General Practice

    PubMed Central

    Evans, J. W.; Lovel, T. W. I; Eaton, K. K.

    1969-01-01

    Weekly case conferences have been found valuable in the management of problem families in a general practice in a new town. These are attended by health visitors, mental welfare and child care officers, welfare officers, and psychiatric social workers, as well as by the family doctors. The conferences are a quick and easy way of exchanging important information and leading to rapid decisions. PMID:5761898

  11. Near patient testing in general practice: a review.

    PubMed Central

    Hilton, S

    1990-01-01

    Until recently, technological advances in general practice have generally been thought of as the applications of microcomputers in practice organization and record keeping. Advances in miniaturization and versatility of diagnostic technology will have a similarly large impact on the way general practitioners practice medicine in the next decade. This article reviews some of the newer tests that are already available to general practitioners, particularly in diagnostic biochemistry and microbiology. Preliminary evaluative work and research studies in general practice are also described. PMID:2107838

  12. [Computer-based health care research in the competence network inflammatory bowel disease. Handling of bowel diseases in general practice].

    PubMed

    Heintze, Christoph; Esch, Tobias; Braun, Vittoria

    2006-05-15

    Consultations due to most different bowel diseases and abdominal symptoms are common in primary care. However, little is known about the concrete situation in the general practitioner's office so far. In this study, practitioners involved in the actual treatment of patients with bowel diseases document their medical strategies by the use of an internet-based data entry system. Hence, with the support of an internet-based data collection tool, health care research has started to break new ground. Following the programming of a digital data collection system and the installation of a nationwide research network of general practitioners interested in this matter, participating physicians communicated anonymised data on medical care of patients with various abdominal problems and intestinal/bowel diseases to the principal study investigators for 12 months, thereby using a computer-based data entry system (via internet). Within the 12 months of observation, 94 general practitioners documented 1,584 patient contacts by using the new data collection system. Accordingly, the most frequent reasons for consultation were abdominal pain (39%) and a change in stool habits (28%), each over a period of > 21 days. Women reported abdominal pain more often than men. Furthermore, the willingness to cooperate with specialists (hospitalization, referrals) was high among participating physicians, in reference to abdominal problems, thereby not demonstrating gender specificity. In the majority of cases, computer-assisted data entry took place outside regular consultation hours, and physicians frequently documented more than one patient within one session. High numbers of hospitalizations and specialist referrals, as shown in this study, points toward a high intensity of medical attendance necessary for patients with unspecific symptoms of the bowel or related abdominal problems. Computer-assisted data entry systems, however, represent a challenging yet still realizable way of data

  13. The research agenda for general practice/family medicine and primary health care in Europe. Part 3. Results: person centred care, comprehensive and holistic approach.

    PubMed

    Van Royen, Paul; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri E J H; Topsever, Pinar; Ungan, Mehmet; Hummers-Pradier, Eva

    2010-06-01

    The recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a first article, background, objectives, and methodology were discussed. In a second article, the results for the two core competencies 'primary care management' and 'community orientation' were presented. This article reflects on the three core competencies, which deal with person related aspects of GP/FM, i.e. 'person centred care', 'comprehensive approach' and 'holistic approach'. Though there is an important body of opinion papers and (non-systematic) reviews, all person related aspects remain poorly defined and researched. Validated instruments to measure these competencies are lacking. Concerning patient-centredness, most research examined patient and doctor preferences and experiences. Studies on comprehensiveness mostly focus on prevention/care of specific diseases. For all domains, there has been limited research conducted on its implications or outcomes.

  14. General practitioner psychological management of common emotional problems (II): A research agenda for the development of evidence-based practice.

    PubMed Central

    Cape, J; Barker, C; Buszewicz, M; Pistrang, N

    2000-01-01

    The majority of patients with common emotional or psychological problems are treated solely by general practitioners (GPs). Such treatment frequently includes some form of psychological management within the consultation, whether limited to listening and discussion or involving more specific techniques. This paper sets out a research agenda for the development of effective approaches to GP psychological management. Evidence is reviewed on three core components of all psychological treatments: establishing a positive therapeutic relationship, developing a shared understanding of the problem, and promoting change in behaviour, thoughts or emotions. The application of these components in GP psychological management is outlined and methodological issues in the development and evaluation of GP management approaches are discussed. Since the number of patients with emotional problems seen by each GP is so large, the population effects of even small improvements in psychological management would be sizeable. PMID:10897540

  15. Use of caries preventive agents on adult patients compared to pediatric patients by general practitioners: findings from The Dental Practice-Based Research Network

    PubMed Central

    Riley, Joseph L.; Gordan, Valeria V.; Rindal, D. Brad; Fellows, Jeffrey L.; Williams, O. Dale; Ritchie, Lloyd K.; Gilbert, Gregg H.

    2010-01-01

    Background Evidence suggests that caries prevention reduces caries in adults. This study tested the frequency of recommended caries prevention agents for children compared to adult patients. Methods This study surveyed 467 Dental Practice-Based Research Network general dentists who practice within the United States and treat both pediatric and adult patients. Dentists were asked the percentage of their patients who are administered or recommended dental sealants, in-office and at-home fluoride, chlorhexidine rinse, and xylitol gum. Results Adults were less likely to receive in-office caries preventive agents compared to pediatric patients. However, the rate of recommendation for at-home preventive regimens was very similar. Dentists with a conservative approach to caries treatment were the most likely to use caries prevention at similar rates in adults as in children. In addition, practices with a greater number of patients with dental insurance were significantly less likely to provide in-office fluoride or sealants to adult patients than to their pediatric patients. Conclusion In-office caries prevention agents are more commonly used by general dentists for their pediatric patients compared to their adult patients. Practice Implications Some general dentists should consider providing additional in-office prevention agents for their adult patients who are at increased risk for dental caries. PMID:20516100

  16. Improving the Identification of Out-of-Hospital Sudden Cardiac Deaths in a General Practice Research Database.

    PubMed

    Varas-Lorenzo, Cristina; Arana, Alejandro; Johannes, Catherine B; McQuay, Lisa J; Rothman, Kenneth J; Fife, Daniel

    2016-09-01

    The ascertainment of sudden cardiac death (SCD) in electronic health databases is challenging. Our objective was to evaluate the applicability of the validated computer definition of SCD developed by Chung et al. in a retrospective study of SCD and domperidone exposure in the Clinical Practice Research Datalink (CPRD). We assessed out-of-hospital SCD by applying the validated computer definition and linking data with Hospital Episode Statistics and death certificates. We developed a separate algorithm to identify end-of-life care in noninstitutionalized patients and excluded associated deaths from the analysis to address their misclassification as SCD. Of the 681,104 patients in the study cohort, 3444 were initially classified as out-of-hospital SCD. Next, 163 deaths were identified as expected deaths by our algorithm for end-of-life home care. After review of patient profiles, 162 were classified as expected deaths because of evidence that the patient received palliative or end-of-life care, but one was a false negative. The exclusion of such cases appreciably changed the odds ratio for current exposure to domperidone compared with non-use of study medications from 2.09 (95 % confidence interval [CI] 1.16-3.74) to 1.71 (95 % CI 0.92-3.18). A similar effect on the odds ratio was observed for current exposure to metoclopramide but not to proton pump inhibitors. Our algorithm to identify end-of-life care at home in the CPRD performed well, with only one false negative. The exclusion of misclassified cases of SCD reduced the magnitude of the odds ratios for SCD associated with domperidone and metoclopramide exposure by controlling protopathic bias.

  17. [Pneumococcal vaccination in general practice].

    PubMed

    Vajer, Péter; Tamás, Ferenc; Urbán, Róbert; Torzsa, Péter; Kalabay, László

    2015-02-01

    The prevalence of invasive pneumococcal disease, which is depending on risk factors and comorbidities, is increasing over the age of 50 years. Most developed countries have recommendations but vaccination rates remain low. To assess the general practitioners' daily practice in relation to pneumococcal vaccination and analyse the effect of informing the subjects about the importance of pneumococcal vaccination on vaccination routine. Subjects over 50 years of age vaccinated against influenza during the 2012/2013 campaign were informed about the importance of pneumococcal vaccination and asked to fill in a questionnaire. Of the 4000 subjects, 576 asked for a prescription of pneumococcal vaccine (16.5% of females and 11.6% of males, OR 1.67 CI 95% 1.37-2.04, p<0.001) and 310 were vaccinated. The mean age of females and males was 70.95 and 69.8 years, respectively (OR 1.01; CI 95% 1.00-1.02; p<0.05). Information given by physicians resulted in 33,6% prescription rate, while in case it was 8% when nurses provided information (OR 6.33; CI 95% 5.23-7.67; p<0.001). As an effect of this study the vaccination rate was 6.3 times higher than in the previous year campaign (p<0.001). General practitioners are more effective in informing subjects about the importance of vaccination than nurses. Campaign can raise the vaccination rate significantly.

  18. General practitioners' use of caries-preventive agents in adult patients versus pediatric patients: findings from the dental practice-based research network.

    PubMed

    Riley, Joseph L; Gordan, Valeria V; Rindal, D Brad; Fellows, Jeffrey L; Williams, O Dale; Ritchie, Lloyd K; Gilbert, Gregg H

    2010-06-01

    In this study, the authors tested the frequency of dentists' recommendations for and use of caries-preventive agents for children as compared with adults. The authors surveyed 467 general dentists in the Dental Practice-Based Research Network who practice within the United States and treat both pediatric and adult patients. They asked dentists to identify the percentage of their patients for whom they had administered or recommended dental sealants, in-office and at-home fluoride, chlorhexidine rinse and xylitol gum. Dentists were less likely to provide adult patients than pediatric patients with in-office caries-preventive agents. However, the rate at which they recommended at-home preventive regimens for the two groups of patients was similar. Dentists with a conservative approach to caries treatment were the most likely to use and recommend the use of caries-preventive agents at similar rates in adults as in children. In addition, dentists in practices with a greater number of patients who had dental insurance were significantly more likely to provide in-office fluoride or sealants to adult patients than to pediatric patients. General dentists use in-office caries-preventive agents more commonly with their pediatric patients than with their adult patients. General dentists should consider providing additional in-office caries-preventive agents for their adult patients who are at increased risk of experiencing dental caries.

  19. Research into Practice.

    ERIC Educational Resources Information Center

    Bergen, Doris

    1994-01-01

    Comments on the articles presented in this issue with respect to their implications for classroom practices. Stresses that in this issue, the researchers describe how social context factors (such as adult viewpoints and adult-child interaction patterns) and physical context factors (such as variations in classroom space-time organization and…

  20. Research into Practice.

    ERIC Educational Resources Information Center

    Bergen, Doris

    1994-01-01

    Comments on the articles presented in this issue with respect to their implications for classroom practices. Stresses that in this issue, the researchers describe how social context factors (such as adult viewpoints and adult-child interaction patterns) and physical context factors (such as variations in classroom space-time organization and…

  1. Best practices research.

    PubMed

    Mold, James W; Gregory, Mark E

    2003-02-01

    "Best practices research," described in this paper, refers to a systematic process used to identify, describe, combine, and disseminate effective and efficient clinical and/or management strategies developed and refined by practicing clinicians. It involves five steps: development of a conceptual model or series of steps, definition of "best" based on values and standards, identification and evaluation of potentially effective methods for each component or step, combination of most-effective methods, and testing of combined methods. The chronological development of this process is described with case examples, and the methodological steps are discussed.

  2. Integrating research into operational practice

    PubMed Central

    Ross, Alastair

    2015-01-01

    Research and development can be classified into three categories: technology adoption, technology extension, and knowledge and technology creation. In general, technology adoption is embedded in operational forensic science laboratory practice but the latter two categories require partnerships with industry and/or academia both to conduct the research and implement the outcomes. In a 2012 survey, Australian and New Zealand forensic science laboratories identified a number of ‘roadblocks’ to undertaking research and operationalizing research outcomes. These included insufficient time and funding, a lack of in-house research experience and the absence of a tangible research culture. Allied to this is that, increasingly, forensic science research is conducted in a ‘commercial in confidence’ environment and the outcomes are not readily or cost-effectively available to be integrated into operational forensic science laboratories. The paper is predominantly reflective of the current situation in Australia and New Zealand PMID:26101286

  3. Integrating research into operational practice.

    PubMed

    Ross, Alastair

    2015-08-05

    Research and development can be classified into three categories: technology adoption, technology extension, and knowledge and technology creation. In general, technology adoption is embedded in operational forensic science laboratory practice but the latter two categories require partnerships with industry and/or academia both to conduct the research and implement the outcomes. In a 2012 survey, Australian and New Zealand forensic science laboratories identified a number of 'roadblocks' to undertaking research and operationalizing research outcomes. These included insufficient time and funding, a lack of in-house research experience and the absence of a tangible research culture. Allied to this is that, increasingly, forensic science research is conducted in a 'commercial in confidence' environment and the outcomes are not readily or cost-effectively available to be integrated into operational forensic science laboratories. The paper is predominantly reflective of the current situation in Australia and New Zealand.

  4. Outcomes of implants and restorations placed in general dental practices: a retrospective study by the Practitioners Engaged in Applied Research and Learning (PEARL) Network.

    PubMed

    Da Silva, John D; Kazimiroff, Julie; Papas, Athena; Curro, Frederick A; Thompson, Van P; Vena, Donald A; Wu, Hongyu; Collie, Damon; Craig, Ronald G

    2014-07-01

    The authors conducted a study to determine the types, outcomes, risk factors and esthetic assessment of implants and their restorations placed in the general practices of a practice-based research network. All patients who visited network practices three to five years previously and underwent placement of an implant and restoration within the practice were invited to enroll. Practitioner-investigators (P-Is) recorded the status of the implant and restoration, characteristics of the implant site and restoration, presence of peri-implant pathology and an esthetic assessment by the P-I and patient. The P-Is classified implants as failures if the original implant was missing or had been replaced, the implant was mobile or elicited pain on percussion, there was overt clinical or radiographic evidence of pathology or excessive bone loss (> 0.2 millimeter per year after an initial bone loss of 2 mm). They classified restorations as failures if they had been replaced or if there was abutment or restoration fracture. The authors enrolled 922 implants and patients from 87 practices, with a mean (standard deviation) follow-up of 4.2 (0.6) years. Of the 920 implants for which complete data records were available, 64 (7.0 percent) were classified as failures when excessive bone loss was excluded from the analysis. When excessive bone loss was included, 172 implants (18.7 percent) were classified as failures. According to the results of univariate analysis, a history of severe periodontitis, sites with preexisting inflammation or type IV bone, cases of immediate implant placement and placement in the incisor or canine region were associated with implant failure. According to the results of multivariate analysis, sites with preexisting inflammation (odds ratio [OR] = 2.17; 95 percent confidence interval [CI], 1.41-3.34]) or type IV bone (OR = 1.99; 95 percent CI, 1.12-3.55) were associated with a greater risk of implant failure. Of the 908 surviving implants, 20 (2.2 percent) had

  5. Intercultural communication in general practice.

    PubMed

    van Wieringen, Joke C M; Harmsen, Johannes A M; Bruijnzeels, Marc A

    2002-03-01

    Little is known about the causes of problems in communication between health care professionals and ethnic-minority patients. Not only language difficulties, but also cultural differences may result in these problems. This study explores the influence of communication and patient beliefs about health (care) and disease on understanding and compliance of native-born and ethnic-minority patients. In this descriptive study seven general practices located in a multi-ethnic neighbourhood in Rotterdam participated. Eighty-seven parents who visited their GP with a child for a new health problem took part: more than 50% of them belonged to ethnic-minorities. The consultation between GP and patient was recorded on video and a few days after the consultation patients were interviewed at home. GPs filled out a short questionnaire immediately after the consultation. Patient beliefs and previous experiences with health care were measured by different questionnaires in the home interview. Communication was analysed using the Roter Interaction Analysis System based on the videos. Mutual understanding between GP and patient and therapy compliance was assessed by comparing GP's questionnaires with the home interview with the parents. In 33% of the consultations with ethnic-minority patients (versus 13% with native-born patients) mutual understanding was poor. Different aspects of communication had no influence on mutual understanding. Problems in the relationship with the GP, as experienced by patients, showed a significant relation with mutual understanding. Consultations without mutual understanding more often ended in non-compliance with the prescribed therapy. Ethnic-minority parents more often report problems in their relationship with the GP and they have different beliefs about health and health care from native-born parents. Good relationships between GP and patients are necessary for mutual understanding. Mutual understanding has a strong correlation with compliance

  6. General practice: professional preparation for a pandemic.

    PubMed

    Collins, Nick; Litt, John; Moore, Michael; Winzenberg, Tania; Shaw, Kelly

    2006-11-20

    General practice will play a key role in both prevention and management of an influenza pandemic. Australian pandemic plans acknowledge a role for general practice, but there are few published data addressing the issues that general practitioners and their practices will face in dealing with such a crisis. The outcome will revolve around preparation in three key areas: Definition of the role of general practice within a broad primary care pandemic response, and adequate preparation within general practices so they can play that role well. Planning exercises and forums must include GPs, and rehearsals must include practical experience for general practices and their staff. Local Divisions of General Practice and GP practices can advocate for this, can define their role, and can prepare by using pandemic preparedness checklists; Definition and enactment of communication strategies to facilitate transfer of useful clinical and administrative data from practices and rapid dissemination of information into the community via general practice; Resource provision, which should be centrally funded but locally distributed, with personal protective equipment, vaccines and antivirals readily available for distribution. Resources must include support for human resource management to ensure appropriate health care professionals reach areas of workforce demand. Administrative, clinical and financial resources must be available to train GPs and practices in pandemic awareness and response.

  7. Assessing recording delays in general practice records to inform near real‐time vaccine safety surveillance using the Clinical Practice Research Datalink (CPRD)

    PubMed Central

    Andrews, Nick J.; Thomas, Sara L.

    2017-01-01

    Abstract Purpose Near real‐time vaccine safety surveillance (NRTVSS) is an option for post‐licensure vaccine safety assessment. NRTVSS requires timely recording of outcomes in the database used. Our main objective was to examine recording delays in the Clinical Practice Research Datalink (CPRD) for outcomes of interest for vaccine safety to inform the feasibility of NRTVSS using these data. We also evaluated completeness of recording and further assessed reporting delays for hospitalized events in CPRD. Methods We selected Guillain–Barré syndrome (GBS), Bell's palsy (BP), optic neuritis (ON) and febrile seizures (FS), from January 2005 to June 2014. We assessed recording delays (e.g. due to feedback from specialist referral) in stand‐alone CPRD by comparing the event and system dates and excluding delays >1 year. We used linked CPRD‐hospitalization data to further evaluate delays and completeness of recording in CPRD. Results Among 51 220 patients for the stand‐alone CPRD analysis (GBS: n = 830; BP: n = 12 602; ON: n = 1720; and FS: n = 36 236), most had a record entered within 1 month of the event date (GBS: 73.6%; BP: 93.4%; ON: 76.2%; and FS: 85.6%). A total of 13 482 patients, with a first record in hospital, were included for the analysis of linked data (GBS: n = 678; BP: n = 4060; ON: n = 485; and FS: n = 8321). Of these, <50% had a record in CPRD after 1 year (GBS: 41.3%; BP: 22.1%; ON: 22.4%; and FS: 41.8%). Conclusion This work shows that most diagnoses in CPRD for the conditions examined were recorded with delays of ≤30 days, making NRTVSS possible. The pattern of delays was condition‐specific and could be used to adjust for delays in the NRTVSS analysis. Despite low sensitivity of recording, implementing NRTVSS in CPRD is worthwhile and could be carried out, at least on a trial basis, for events of interest. © 2017 The Authors. Pharmacoepidemiology & Drug Safety Published by John Wiley & Sons Ltd. PMID:28156036

  8. The research critique. General criteria for evaluating a research report.

    PubMed

    Beck, C T

    1990-01-01

    General criteria for evaluating a research report are addressed. This outline of criteria can be used as a guide for nurses in critiquing research studies. A sample research report is summarized followed by a critique of the study. Readers have an opportunity to practice critiquing by doing their own analyses before reading the critique presented in the article.

  9. Techniques and Materials Used by General Dentists during Root Canal Treatment Procedures: Findings from the National Dental Practice-Based Research Network

    PubMed Central

    Eleazer, Paul D.; Gilbert, Gregg H.; Funkhouser, Ellen; Reams, G.J.; Law, A.S.; Benjamin, Paul L.

    2015-01-01

    Background Little is known about which materials and techniques general dentists (GDs) use during root canal procedures. The objectives were to: (1) quantify GD’s use of specific endodontic armamentarium; (2) quantify inappropriate use; and (3) ascertain if inappropriate use is associated with dentists’ practice characteristics. Methods GDs in the National Dental Practice-Based Research Network reported in a questionnaire materials and techniques they use during root canal procedures. Results 1,490 (87%) of eligible GDs participated. Most (93%; n=1,383) used sodium hypochlorite to irrigate. The most commonly used sealers were zinc oxide-eugenol (43%) and resin (40%), followed by calcium hydroxide (26%). A majority (62%; n=920) used a compaction obturation technique; 36% (n=534) used a carrier-based method. Most (96%; n=1,423) used gutta percha as a filler; 5% used paste fillers. Few used irrigants (n=46), sealers (n=4), techniques (n=49) or fillers (n=10) that investigators classified as ‘inappropriate’. Conclusions GDs use a broad range of endodontic techniques and materials, often adapting to newer technologies as they become available. Few GDs use armamentarium that the investigators classified as inappropriate. Practical Implications GDs use many types of endodontic techniques and materials, but only a very small percentage is not appropriate. PMID:26562726

  10. [Psychotic disorders: special aspects in general practice].

    PubMed

    Kurmann, Julius

    2015-09-30

    In emergency situations the general practitioner is often the first professional contact psychotic patients have. The following article conveys basic knowledge about psychotic disorders and their clinical features typically seen in general practice.

  11. Conducting randomized trials in general practice: methodological and practical issues.

    PubMed Central

    Ward, E; King, M; Lloyd, M; Bower, P; Friedli, K

    1999-01-01

    The evaluation of the outcome of health services technologies is a requirement for their efficient provision in clinical practice. The most reliable evidence for treatment efficacy comes from randomized trials. Randomized trials in general practice pose particular methodological and practical difficulties. In this paper, we discuss how best to plan and manage a clinical trial in this setting. We base our discussion on our experience of conducting randomized trials to evaluate the effectiveness of brief psychotherapy in general practice. PMID:10818663

  12. Research for the Classroom: Teachers Practicing Research

    ERIC Educational Resources Information Center

    Gorlewski, Julie, Ed.; Roberts, Mike

    2009-01-01

    How can teachers merge research and daily practice? Where can they find the time, information, and resources? In exploring this issue, it is important to clarify the definition of "research". "Research" might mean (1) using best practices that are already research-based or (2) doing research on one's own students. For purposes of discussion in…

  13. [General practice and early cancer diagnosis].

    PubMed

    Vedsted, Peter; Hansen, Rikke Pilegaard; Bro, Flemming

    2011-06-13

    About 85% of cancer patients present with symptoms to general practice. The health care system should be organised in a way that GPs are able to refer patients to timely and early cancer diagnosis. The GP works in an area where symptoms most often are benign and cancer is rare. Only a minority of the symptoms in the population are presented to the GP. The GP must refer many of these knowing that generally the positive predictive value is 2-10%. To be able to ensure the best primary cancer diagnostic pathway we need much more research on symptoms, use of diagnostics and the way to organise this in a health care system where every third citizen will get cancer.

  14. Temporal growth and geographic variation in the use of laboratory tests by NHS general practices: using routine data to identify research priorities

    PubMed Central

    Busby, John; Schroeder, Knut; Woltersdorf, Wolfram; Sterne, Jonathan AC; Ben-Shlomo, Yoav; Hay, Alastair; Hollingworth, William

    2013-01-01

    Background Laboratory tests are extensively used for diagnosis and monitoring in UK primary care. Test usage by GPs, and associated costs, have grown substantially in recent years. Aim This study aimed to quantify temporal growth and geographic variation in utilisation of laboratory tests. Design and setting Retrospective cohort study using data from general practices in the UK. Method Data from the General Practice Research Database, including patient demographics, clinical details, and laboratory test results, were used to estimate rates of change in utilisation between 2005 and 2009, and identify tests with greatest inter-regional variation, by fitting random-effects Poisson regression models. The study also investigated indications for test requests, using diagnoses and symptoms recorded in the 2 weeks before each test. Results Around 660 000 tests were recorded in 230 000 person-years of follow-up. Test use increased by 24.2%, from 23 872 to 29 644 tests per 10 000 person-years, between 2005 and 2009. Tests with the largest increases were faecal occult blood (121%) and C-reactive protein (86%). There was substantial geographic variation in test utilisation; GPs in some regions requested tests such as plasma viscosity and cardiac enzymes at a rate more than three times the national average. Conclusion Increases in the use of laboratory tests have substantial resource implications. Rapid increases in particular tests may be supported by evidence-based guidelines, but these are often vague about who should be tested, how often, and for how long. Substantial regional variation in test use may reflect uncertainty about diagnostic accuracy and appropriate indications for the laboratory test. There is a need for further research on the diagnostic accuracy, therapeutic impact, and effect on patient health outcomes of the most rapidly increasing and geographically variable tests. PMID:23540482

  15. [Psychotropic drugs in general practice].

    PubMed

    Zimmer, Alexander

    2014-06-18

    The article presents a user-friendly overview of psychotropic drugs which are helpful for the prescription in a primary care practice. The author recommends to get familiar with just a small selection of drugs first and second line. This means to know well about their effectiveness, short-and long-term side effects, interactions with other drugs and the necessary monitoring that should be done.

  16. A new hospital general practice teaching unit.

    PubMed

    Moorhead, R G

    1991-05-06

    The formation of the latest General Practice Teaching Unit in an Australian hospital is part of a national trend to teach undergraduates and post-graduates about some parts of general practice using patients separated at triage from the accident and emergency departments. Planning this unit required much negotiating between several institutions and a set of guidelines on organisational relationships was created. Innovative features of the Modbury General Practice Teaching Unit include payment of teachers to attend compulsory medical education workshops, dividing the Family Medicine Programme trainee's time between the unit and a neighbouring practice and payment of non-academic general practitioner teachers by the South Australian Government, which eliminates the risk that service interferes with teaching. The Modbury General Practice Teaching Unit is currently the only hospital based unit of this kind in South Australia.

  17. Techniques and materials used by general dentists during endodontic treatment procedures: Findings from The National Dental Practice-Based Research Network.

    PubMed

    Eleazer, Paul D; Gilbert, Gregg H; Funkhouser, Ellen; Reams, Gregg J; Law, Alan S; Benjamin, Paul L

    2016-01-01

    Little is known about which materials and techniques general dentists (GDs) use during endodontic procedures. The objectives were to quantify GDs' use of specific endodontic tools, quantify inappropriate use, and ascertain whether inappropriate use is associated with GDs' practice characteristics. GDs in The National Dental Practice-Based Research Network reported in a questionnaire materials and techniques they use during endodontic procedures. Among eligible GDs, 1,490 (87%) participated. Most (93%; n = 1,383) used sodium hypochlorite to irrigate. The most commonly used sealers were zinc oxide eugenol (43%) and resin (40%), followed by calcium hydroxide (26%). Most (62%; n = 920) used a compaction obturation technique; 36% (n = 534) used a carrier-based method. Most (96%; n = 1,423) used gutta-percha as a filler; 5% used paste fillers. Few used irrigants (n = 46), techniques (n = 49), or fillers (n = 10) that investigators classified as inappropriate. GDs use a broad range of endodontic techniques and materials, often adapting to newer technologies as they become available. Few GDs use tools that the investigators classified as inappropriate. GDs use many types of endodontic techniques and materials, but only a small percentage of them are inappropriate. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  18. Risk of Mortality (Including Sudden Cardiac Death) and Major Cardiovascular Events in Atypical and Typical Antipsychotic Users: A Study with the General Practice Research Database

    PubMed Central

    Murray-Thomas, Tarita; Jones, Meghan E.; Patel, Deven; Brunner, Elizabeth; Shatapathy, Chetan C.; Motsko, Stephen; Van Staa, Tjeerd P.

    2013-01-01

    Objective. Antipsychotics have been associated with increased cardiac events including mortality. This study assessed cardiac events including mortality among antipsychotic users relative to nonusers. Methods. The General Practice Research Database (GPRD) was used to identify antipsychotic users, matched general population controls, and psychiatric diseased nonusers. Outcomes included cardiac mortality, sudden cardiac death (SCD), all-cause mortality (excluding suicide), coronary heart disease (CHD), and ventricular arrhythmias (VA). Sensitivity analyses were conducted for age, dose, duration, antipsychotic type, and psychiatric disease. Results. 183,392 antipsychotic users (115,491 typical and 67,901 atypical), 544,726 general population controls, and 193,920 psychiatric nonusers were identified. Nonusers with schizophrenia, dementia, or bipolar disorder had increased risks of all-cause mortality compared to general population controls, while nonusers with major depression had comparable risks. Relative to psychiatric nonusers, the adjusted relative ratios (aRR) of all-cause mortality in antipsychotic users was 1.75 (95% CI: 1.64–1.87); cardiac mortality 1.72 (95% CI: 1.42–2.07); SCD primary definition 5.76 (95% CI: 2.90–11.45); SCD secondary definition 2.15 (95% CI: 1.64–2.81); CHD 1.16 (95% CI: 0.94–1.44); and VA 1.16 (95% CI: 1.02–1.31). aRRs of the various outcomes were lower for atypical versus typical antipsychotics (all-cause mortality 0.83 (95% CI: 0.80–0.85); cardiac mortality 0.89 (95% CI: 0.82–0.97); and SCD secondary definition 0.76 (95% CI: 0.55–1.04). Conclusions. Antipsychotic users had an increased risk of cardiac mortality, all-cause mortality, and SCD compared to a psychiatric nonuser cohort. PMID:24455199

  19. Risk of venous thromboembolism in users of oral contraceptives containing drospirenone or levonorgestrel: nested case-control study based on UK General Practice Research Database.

    PubMed

    Parkin, Lianne; Sharples, Katrina; Hernandez, Rohini K; Jick, Susan S

    2011-04-21

    To examine the risk of non-fatal idiopathic venous thromboembolism in current users of a combined oral contraceptive containing drospirenone, relative to current users of preparations containing levonorgestrel. Nested case-control study. UK General Practice Research Database. Women aged 15-44 years without major risk factors for venous thromboembolism who started a new episode of use of an oral contraceptive containing 30 µg oestrogen in combination with either drospirenone or levonorgestrel between May 2002 and September 2009. Cases were women with a first diagnosis of venous thromboembolism; up to four controls, matched by age, duration of recorded information, and general practice, were randomly selected for each case. Odds ratios and 95% confidence intervals estimated with conditional logistic regression; age adjusted incidence rate ratio estimated with Poisson regression. 61 cases of idiopathic venous thromboembolism and 215 matched controls were identified. In the case-control analysis, current use of the drospirenone contraceptive was associated with a threefold higher risk of non-fatal idiopathic venous thromboembolism compared with levonorgestrel use; the odds ratio adjusted for body mass index was 3.3 (95% confidence interval 1.4 to 7.6). Subanalyses suggested that referral, diagnostic, first time user, duration of use, and switching biases were unlikely explanations for this finding. The crude incidence rate was 23.0 (95% confidence interval 13.4 to 36.9) per 100,000 woman years in current users of drospirenone and 9.1 (6.6 to 12.2) per 100,000 woman years in current users of levonorgestrel oral contraceptives. The age adjusted incidence rate ratio was 2.7 (1.5 to 4.7). These findings contribute to emerging evidence that the combined oral contraceptive containing drospirenone carries a higher risk of venous thromboembolism than do formulations containing levonorgestrel.

  20. Outcomes of endodontic therapy in general practice

    PubMed Central

    Bernstein, Susan D.; Horowitz, Allan J.; Man, Martin; Wu, Hongyu; Foran, Denise; Vena, Donald A.; Collie, Damon; Matthews, Abigail G.; Curro, Frederick A.; Thompson, Van P.; Craig, Ronald G.

    2014-01-01

    Background The authors undertook a study involving members of a dental practice-based research network to determine the outcome and factors associated with success and failure of endodontic therapy. Methods Members in participating practices (practitioner-investigators [P-Is]) invited the enrollment of all patients seeking treatment in the practice who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years previously. If a patient had more than one tooth so treated, the P-I selected as the index tooth the tooth treated earliest during the three- to five-year period. The authors excluded from the study any teeth that served as abutments for removable partial dentures or overdentures, third molars and teeth undergoing active orthodontic endodontic therapy. The primary outcome was retention of the index tooth. Secondary outcomes, in addition to extraction, that defined failure included clinical or radiographic evidence (or both) of periapical pathosis, endodontic retreatment or pain on percussion. Results P-Is in 64 network practices enrolled 1,312 patients with a mean (standard deviation) time to follow-up of 3.9 (0.6) years. During that period, 3.3 percent of the index teeth were extracted, 2.2 percent underwent retreatment, 3.6 percent had pain on percussion and 10.6 percent had periapical radiolucencies for a combined failure rate of 19.1 percent. The presence of preoperative periapical radiolucency with a diagnosis of either irreversible pulpitis or necrotic pulp was associated with failure after multivariate analysis, as were multiple canals, male sex and Hispanic/Latino ethnicity. Conclusions These results suggest that failure rates for endodontic therapy are higher than previously reported in general practices, according to results of studies based on dental insurance claims data. Clinical Implications The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for

  1. Guidelines for computer security in general practice.

    PubMed

    Schattner, Peter; Pleteshner, Catherine; Bhend, Heinz; Brouns, Johan

    2007-01-01

    As general practice becomes increasingly computerised, data security becomes increasingly important for both patient health and the efficient operation of the practice. To develop guidelines for computer security in general practice based on a literature review, an analysis of available information on current practice and a series of key stakeholder interviews. While the guideline was produced in the context of Australian general practice, we have developed a template that is also relevant for other countries. Current data on computer security measures was sought from Australian divisions of general practice. Semi-structured interviews were conducted with general practitioners (GPs), the medical software industry, senior managers within government responsible for health IT (information technology) initiatives, technical IT experts, divisions of general practice and a member of a health information consumer group. The respondents were asked to assess both the likelihood and the consequences of potential risks in computer security being breached. The study suggested that the most important computer security issues in general practice were: the need for a nominated IT security coordinator; having written IT policies, including a practice disaster recovery plan; controlling access to different levels of electronic data; doing and testing backups; protecting against viruses and other malicious codes; installing firewalls; undertaking routine maintenance of hardware and software; and securing electronic communication, for example via encryption. This information led to the production of computer security guidelines, including a one-page summary checklist, which were subsequently distributed to all GPs in Australia. This paper maps out a process for developing computer security guidelines for general practice. The specific content will vary in different countries according to their levels of adoption of IT, and cultural, technical and other health service factors. Making

  2. A case-control study of autism and mumps-measles-rubella vaccination using the general practice research database: design and methodology

    PubMed Central

    Smeeth, Liam; Hall, Andrew J; Fombonne, Eric; Rodrigues, Laura C; Huang, Xiangning; Smith, Peter G

    2001-01-01

    Background An association between mumps-measles-rubella (MMR) vaccination and the onset of symptoms typical of autism has recently been suggested. This has led to considerable concern about the safety of the vaccine. Methods A matched case-control study using data derived form the United Kingdom General Practice Research Database. Children with a possible diagnosis of autism will be identified from their electronic health records. All diagnoses will be validated by a detailed review of hospital letters and by using information derived from a parental questionnaire. Ten controls per case will be selected from the database. Conditional logistic regression will be used to assess the association between MMR vaccination and autism. In addition case series analyses will be undertaken to estimate the relative incidence of onset of autism in defined time intervals after vaccination. The study is funded by the United Kingdom Medical Research Council. Discussion Electronic health databases offer tremendous opportunities for evaluating the adverse effects of vaccines. However there is much scope for bias and confounding. The rigorous validation of all diagnoses and the collection of additional information by parental questionnaire in this study are essential to minimise the possibility of misleading results. PMID:11231881

  3. Use of acid-suppressive drugs in pregnancy and the risk of childhood asthma: bidirectional crossover study using the general practice research database.

    PubMed

    Hak, Eelko; Mulder, Bianca; Schuiling-Veninga, Catharina C M; de Vries, Tjalling W; Jick, Susan S

    2013-11-01

    Recent studies have reported an association between maternal use of gastric acid-suppressive drugs during pregnancy and asthma in the offspring, but the association could have been confounded by unmeasured risk factors. We assessed the association between the use of acid-suppressive drugs during pregnancy and the risk of developing childhood asthma using a bidirectional crossover design. Mother-infant matched sets in the UK General Practitioners Research Database were used to identify children with a drug-treated asthma diagnosis during the years 2006-2010 who were matched to a sibling without asthma as controls. Primary exposure was use of any anti-suppressive drug during pregnancy, and subgroup analyses were conducted according to drug class (e.g. proton pump inhibitors or histamine 2 receptor antagonists) and trimester. Conditional logistic regression was used to estimate odds ratios (OR) with their corresponding 95 % confidence intervals (CIs). A total of 1,874 children with asthma and 1,874 control siblings were included in the analysis. The exposure rate among case and control pregnancies was 22 and 20 %, respectively. After adjustments for gender, birth order, mother's age and general practice visits, the exposure to any gastric-acid suppressive drug during pregnancy slightly increased the risk for developing asthma (OR 1.23, 95 % CI 1.01-1.51; p = 0.042). A trend towards increased risks was observed for those who used proton pump inhibitors and/or histamine 2 receptor antagonists (adjusted OR 1.72, 95 % CI 1.00-2.98; p = 0.048). These findings lend support to the emerging evidence that exposure to acid-suppressive drugs during pregnancy is associated with childhood asthma. More basic research is now warranted to investigate the mechanisms.

  4. Use of thermometers in general practice.

    PubMed Central

    Clarke, S.

    1992-01-01

    OBJECTIVE--To identify the attitudes of general practitioners towards the use of thermometers in general practice. DESIGN--Postal questionnaire survey. SETTING--All general practitioners in the catchment area of Frimley Park Hospital, Surrey. SUBJECTS--145 general practitioners. MAIN OUTCOME MEASURES--Answers to questions covering a variety of aspects concerning the use of thermometers in general practice. RESULTS--116 (80%) doctors replied. Seven doctors did not have any method of taking a patient's temperature; up to 12 more doctors did not use their thermometers and 56 doctors used them infrequently, less than once a fortnight. Mercury glass thermometers were most commonly used (80 doctors; 69%), but only 8% of doctors used them correctly. Six doctors failed to clean their thermometers between patients. The study failed to identify the roles of axillary and rectal temperature readings. CONCLUSION--There is a wide variation in attitudes towards the use of thermometers in general practice. PMID:1581720

  5. Recruiting new principals in general practice.

    PubMed Central

    Key, I

    1985-01-01

    New principals in general practice who were appointed from 1981 to 1983 by two family practitioner committees, one in an inner city and one in a combination of an inner city and suburban area, were surveyed to find out if they were making improvements to primary medical care in their new practices. Most were not. The highly trained, motivated, young doctors on the whole had joined group practices and practices in health centres, where facilities tended to be good. Older doctors, who may not be as concerned with change, had joined smaller practices, in which it was difficult to make changes owing to, for example, the type of premises and costs. PMID:3926235

  6. Computers in general practice: the patient's voice

    PubMed Central

    Potter, A. R.

    1981-01-01

    Analysis of answers to a questionnaire on the use of computers in general practice showed that 19 per cent of patients in two practices in Staffordshire would be worried if their general practitioner used a computer to store medical records. Twenty-seven per cent of patients would be unwilling to speak frankly about personal matters to their general practitioner if he or she used a computer and 7 per cent said that they would change to another doctor. Fifteen per cent stated that their general practitioner already had information about them that they would not want to be included in a computerized record of their medical history. PMID:7328555

  7. General practice fundholding: progress to date.

    PubMed Central

    Smith, R D; Wilton, P

    1998-01-01

    BACKGROUND: The cornerstone of the National Health Service (NHS) reforms was the establishment of an internal market, which separated purchasing and providing roles. As purchasers of care, general practice fundholders were seen as a pivotal part of the 'new patient-led NHS', which was intended to lead to improved cost-containment and cost-effectiveness, quality of care, and patient choice and empowerment. AIM: To review published evidence of the extent to which these objectives may have been achieved over the past six years. METHOD: Keyword search of on-line databases (MEDLINE and Econ-lit) from 1990 to 1996, plus manual search of references within those articles identified. RESULTS: In the absence of any formal evaluation of fundholding, it is difficult to assess the overall success of this reform. However, in terms of cost-containment and cost-effectiveness, there is mixed evidence. In some areas, such as prescribing, the evidence suggests cost-savings, although the evidence is less clear on reductions or changes in referrals. There is also evidence that suggests that improvements in prescribing may have been achieved at substantial additional administration and transaction costs. With respect to quality of care, the evidence suggests that, although quality in the procedural aspects of health provision has improved, there is little evidence about how health outcomes may have been affected. In terms of patient choice and empowerment, the evidence suggests that, whilst general practitioner choice of secondary providers has improved, little progress has been made with regard to increased consumer choice. CONCLUSION: Evidence concerning the success or otherwise of general practice fundholding over the past six years is incomplete and mixed. The major deficiency concerns any effect on health outcomes that may be the result of fundholding. Until such research is conducted, the jury will have to remain out on whether fundholding has secured improved efficiency in the

  8. Mentoring medical students in your general practice.

    PubMed

    Fraser, John

    2016-05-01

    Mentoring medical students in general practices is becoming more common in Australia due to formalised scholarship programs and informal approaches by students. This paper defines mentoring in Australian general practice. Practical suggestions are made on how to structure a mentorship program in your practice. Mentoring differs from leadership and teaching. It is a long-term relationship between a student and an experienced general practitioner. Avoiding summative assessment in mentorship is important to its success. Mentoring is about forming a safe place to confidentially discuss personal and professional issues between a mentor and student. This is based on defining roles and mutual trust. At the same time, students crave formative feedback. Unfortunately, present feedback models are based on teaching principles that can blur the differences between assessor, teacher and mentor. Mentorship can provide students with orientation and learning experiences so that they are prepared for practice as an intern.

  9. Risk of cholestatic liver disease associated with flucloxacillin and flucloxacillin prescribing habits in the UK: Cohort study using data from the UK General Practice Research Database

    PubMed Central

    Russmann, Stefan; Kaye, James A; Jick, Susan S; Jick, Hershel

    2005-01-01

    Aims To provide additional quantification of the risk of flucloxacillin-related liver disease and to describe time trends in flucloxacillin prescribing in the UK. Methods This was a cohort study using data from the UK General Practice Research Database. We identified patients with a first-time prescription for flucloxacillin or, for comparison, oxytetracycline from 1992 to 2002 and cases who developed clinically documented cholestatic liver disease of uncertain origin after first-time use of these drugs. We also determined the annual frequency of first-time use of flucloxacillin from 1991 to 2000. Results We identified 283 097 and 131 189 first-time users of flucloxacillin and oxytetracycline, respectively. The risk of cholestatic liver disease per 100 000 first-time users was 8.5 (95% CI 5.4, 12.6) in the 1–45 days and 1.8 (95% CI 0.6, 4.1) in the 46–90 days after starting flucloxacillin, and 0.8 (95% CI 0.02, 4.3) in the 1–45 days after starting oxytetracycline. The frequency of first-time use of flucloxacillin remained stable between 1991 and 2000. Conclusions Flucloxacillin is now established as an important cause of cholestatic liver disease. Warnings about the risk have not had an impact on prescribing practices in the UK, where it remains the predominantly prescribed antistaphylococcal oral antibiotic. This situation in the UK is in sharp contrast to regulatory actions and changes in prescribing habits in Australia after identification of the risk of cholestasis associated with flucloxacillin, and to the predominant use of the alternative drug dicloxacillin in the USA. PMID:15963097

  10. Linking HRD Practice and Research.

    ERIC Educational Resources Information Center

    1999

    This document contains four symposium papers on linking human resource development (HRD) theory and practice. "Partnership Research: Ensuring More Useful HRD Collaborations" (Ronald L. Jacobs), which proceeds from the premise that most HRD research has limited impact on practice because research problems are usually generated devoid of a…

  11. Small business, cash budgets and general practice.

    PubMed

    Jackson, A R

    1991-01-01

    In practice management, general practice falls into the category of small business with all its attendant generic problems. Disciplined planning and good financial management are not often seen in small business. These are required if general practitioners are to continue (or return to) the provision of high quality medical services. An effective budget process, especially cash-flow budgeting, is the key to successful planning and financial management. Budgeting will bring Control, Co-ordination, and Credibility to your practice. It will enable you to set goals and to achieve them.

  12. The impact of over-the-counter simvastatin on the number of statin prescriptions in the United Kingdom: a view from the General Practice Research Database.

    PubMed

    Filion, Kristian B; Delaney, J A Chris; Brophy, James M; Ernst, Pierre; Suissa, Samy

    2007-01-01

    The United Kingdom (UK) government changed the prescription policy of statins, making low-dose simvastatin (10 mg) available as an over-the-counter (OTC) drug in August 2004. We assessed the impact of this policy change on statin prescribing. We examined all statin prescriptions in the General Practice Research Database (GPRD), a well-validated database of approximately 3.5 million patients, from the first quarter of 2001 to the second quarter of 2005. From 2001, the number of statin prescriptions written for GPRD patients was increasing by approximately 437 prescriptions per 100,000 people per quarter until the time of the policy change. Over the four quarters post-policy implementation, however, this trend changed abruptly (p < 0.0001) with a decrease of 281 prescriptions per 100,000 people per quarter. This decrease was not restricted to prescriptions of 10 mg statins but was also observed for statin prescriptions of >or=20 mg. Several other cardiovascular medications displayed a similar trend as that observed in the number of statin prescriptions. This trend was not observed among non-cardiovascular control medications. Our study suggests that the policy allowing the OTC sale of 10 mg simvastatin has had a significant impact on statin prescriptions by general practitioners. However, this new policy may also be leading to less aggressive statin therapy. An alternative explanation for the observed decrease in statin prescriptions may be related to the unknown factors responsible for the overall decrease observed with other cardiovascular prescription drugs. Copyright (c) 2006 John Wiley & Sons, Ltd.

  13. Research into Practice.

    ERIC Educational Resources Information Center

    Martin, Rita J.

    1988-01-01

    Reminds teachers of sound practices of reading instruction, such as silent reading, the reading writing relationship, effective questioning strategies, proper reinforcement strategies, and ways to avoid wasting time. States that under the pressure of the demands of teaching, teachers may forget the sound practices they already know. (RS)

  14. Research in dental practice: a 'SWOT' analysis.

    PubMed

    Burke, F J T; Crisp, R J; McCord, J F

    2002-03-01

    Most dental treatment, in most countries, is carried out in general dental practice. There is therefore a potential wealth of research material, although clinical evaluations have generally been carried out on hospital-based patients. Many types of research, such as clinical evaluations and assessments of new materials, may be appropriate to dental practice. Principal problems are that dental practices are established to treat patients efficiently and to provide an income for the staff of the practice. Time spent on research therefore cannot be used for patient treatment, so there are cost implications. Critics of practice-based research have commented on the lack of calibration of operative diagnoses and other variables; however, this variability is the stuff of dental practice, the real-world situation. Many of the difficulties in carrying out research in dental practice may be overcome. For the enlightened, it may be possible to turn observations based on the volume of treatment carried out in practice into robust, clinically related and relevant research projects based in the real world of dental practice.

  15. The LUCK study: Laxative Usage in patients with GP-diagnosed Constipation in the UK, within the general population and in pregnancy. An epidemiological study using the General Practice Research Database (GPRD)

    PubMed Central

    Shafe, Anna C. E.; Lee, Sally; Dalrymple, Jamie S. O.; Whorwell, Peter J.

    2011-01-01

    Background: Despite the high prevalence of constipation and its related public health implications, there is relatively little research available on the condition from large epidemiological studies. The aim of this study was to investigate the epidemiology of general practitioner (GP)-diagnosed constipation and the prescribing trends for laxatives in the UK, within the general population and during pregnancy. Methods: A cohort study for the period from 2005 to 2009 was performed using the UK primary care database (General Practice Research Database), which contains information on over 3 million individuals. Results: The prevalence of GP-diagnosed constipation ranged from 12 per 1000 persons in 2005 (0.012 per person year) to 12.8 per 1000 in 2009 (0.013 per person year). The prevalence was almost twice as high in women as in men, and was higher in older patients. In 2005 the most commonly prescribed laxatives were lactulose (37%), senna (26%), macrogol (19%), ispaghula (6%), docusate sodium (5%), bisacodyl (4%) and glycerol suppositories (2%). By 2009, this pattern had changed: macrogol (31%), lactulose (29%), senna (22%), ispaghula (5%), docusate sodium (6%), bisacodyl (3%) and glycerol suppositories (3%). In pregnancy, lactulose accounted for 81% of laxative use in 2005, falling to 64% by 2009. In contrast, macrogol use in pregnancy rose from 13% in 2005 to 32% in 2009. Conclusions: GP-diagnosed constipation is common, accounting for a large number of consultations. Laxative prescribing trends have changed over the 5-year study period, prescriptions for macrogol becoming increasingly common and prescriptions for lactulose and senna less common. Macrogol also appears to have been replacing lactulose for treating constipation in pregnant women. PMID:22043228

  16. Survey of equipment in general practice.

    PubMed Central

    Bradley, N.; Watkins, S.

    1989-01-01

    Partners in general practice have to buy any equipment they want themselves. As a result partners in high investing practices have lower net incomes. Of the 297 practices in Devon and Cornwall, 265 responded to a questionnaire listing 115 possible items of practice equipment. Overall, practices seemed to be fairly well equipped. Key findings were that 193 of those who responded had an electrocardiograph, 206 had a kit for minor operations, 119 owned a computer, and less than one third owned a microscope. Most of these practices were high investors. There seems to be a shift away from some traditional instruments towards expensive information technology. Government policies are encouraging the use of computers and such equipment, though funds are not necessarily being made available for this purpose. PMID:2507005

  17. General practice registrar education beyond the practice: The public health role of general practitioners.

    PubMed

    Leeder, Stephen; Corbett, Stephen; Usherwood, Tim

    2016-05-01

    Public health is the organised efforts of society to prevent disease, promote health and prolong life in the population. While the focus of general practice is on the care of individuals and families, general practitioners (GPs) have an essential role in promoting the health of the population. The objectives of this article are to explore the links between public health and general practice, and to consider their implications for general practice registrar training. Clinical general practice contributes to promoting population health. In addition, many GPs undertake work that extends beyond clinical care. The Royal Australian College of General Practitioners' (RACGP's) curriculum includes population health and the context of practice as one of its five domains. Core skills include the incorporation of a population health perspective into clinical practice, and leadership and advocacy in addressing the health needs of the community effectively and equitably.

  18. Audit in general practice: factors influencing participation.

    PubMed Central

    Baker, R.; Robertson, N.; Farooqi, A.

    1995-01-01

    OBJECTIVE--To identify the factors influencing participation in a single topic audit initiated by a medical audit advisory group. DESIGN--Interview and questionnaire survey of general practitioners who had been invited to take part in an audit of vitamin B-12. SETTING--All 147 general practices in Leicestershire. MAIN OUTCOME MEASURES--Aspects of structure, attitude, and behaviour that influenced participation or non-participation. RESULTS--75 practices completed the audit, 49 withdrew after initial agreement, and 23 refused to take part at the outset. Participants were more likely than those who refused to view the advisory group as useful or a threat and to have positive thoughts about audit but less likely to have previously undertaken audit entailing implementation of change. Participants were more likely than those who withdrew to have positive thoughts about audit and to have discussed whether to take part within the practice but were less likely to view the advisory group as useful. The most common reason given for withdrawal was lack of time. CONCLUSIONS--Participation was influenced by attitudes towards audit in general and the advisory group in particular and by aspects of behaviour such as communication within the practice. Practical support and resources may help some practices undertake audit, but advisory groups must also deal with attitudes and unsatisfactory communication in practice teams. PMID:7613323

  19. Research into Practice: Vocabulary

    ERIC Educational Resources Information Center

    Nation, I. S. P.

    2011-01-01

    This article is a personal view of the application of research on vocabulary to teaching and how there are three different types or categories of relationship between that research and the teaching to which it is applied: first, where the research is not applied or not applied well, second, where it is reasonably well applied, and third, where it…

  20. The Practice of Research on Practice.

    ERIC Educational Resources Information Center

    Achilles, C. M.

    A major focus for research in preparation programs should be on the practice of administration. For some time, the preparation of educational administrators has been rooted in the traditional liberal arts approach--the approach of a discipline--as a model for preparing the practitioner. Emphasis has shifted to the concept of the accurate…

  1. Research Supporting Middle Grades Practice

    ERIC Educational Resources Information Center

    Hough, David L., Ed.

    2010-01-01

    Exemplary Middle Grades Research: Evidence-Based Studies Linking Theory to Practice features research published throughout 2009 in MGRJ that has been identified by the Information Age Publishing's review board as the most useful in terms of assisting educators with making practical applications from evidence-based studies to classroom and school…

  2. Research Supporting Middle Grades Practice

    ERIC Educational Resources Information Center

    Hough, David L., Ed.

    2010-01-01

    Exemplary Middle Grades Research: Evidence-Based Studies Linking Theory to Practice features research published throughout 2009 in MGRJ that has been identified by the Information Age Publishing's review board as the most useful in terms of assisting educators with making practical applications from evidence-based studies to classroom and school…

  3. Collaborative relationships in general practice projects.

    PubMed

    Walker, R; Adam, J

    1998-01-01

    This article reports on a national study of collaborative relationships between general practitioners and other health care providers in 20 Division of General Practice projects. It argues that health care organisations will need to collaborate with others in the future and that much can be learnt from the literature on collaborative networks in business and community organisations. Successful collaborations between general practitioners and others were found to be consistent with a model of collaboration in 'under-organised domains', where pre-existing links between organisations are weak. Lessons are identified from the study to assist future collaborative ventures involving general practitioners.

  4. Perceptions of general practice among homosexual men.

    PubMed Central

    Fitzpatrick, R; Dawson, J; Boulton, M; McLean, J; Hart, G; Brookes, M

    1994-01-01

    BACKGROUND. Primary care has an important role to play in the prevention and management of the human immunodeficiency virus (HIV). It has been suggested that homosexual men experience a variety of problems in relation to primary care. AIM. As part of a larger study, it was decided to examine the extent to which a sample of homosexually active men experienced difficulties in general practice and whether they consulted their general practitioner for problems related to HIV or the acquired immune deficiency syndrome (AIDS). METHOD. Homosexual men were recruited for interview in 1991-92 from a variety of sources including genitourinary clinics and homosexual organizations. RESULTS. Of 623 men registered with a general practitioner 44% had not informed their general practitioner of their sexual orientation and 44% of the 77 men who were HIV antibody positive, as confirmed by the study, had not informed their general practitioner of this fact. Men who viewed their practice as unsympathetic towards homosexual men were less likely to have informed their general practitioner of their sexual orientation or HIV status. The majority of men (87%) nevertheless viewed primary care as an appropriate source of HIV/AIDS advice. CONCLUSION. There is considerable scope for improvement in the acceptability of general practice to homosexual men. PMID:8179951

  5. Pneumococcal vaccine campaign based in general practice.

    PubMed Central

    McDonald, P.; Friedman, E. H.; Banks, A.; Anderson, R.; Carman, V.

    1997-01-01

    OBJECTIVE: To show whether a general practice setting is a practical and effective medium for increasing uptake of pneumococcal vaccine. DESIGN: Follow up study of responses of general practices (debriefing by questionnaire or small group session) and patients (questionnaire sent to 429 patients vaccinated in a two week period) to vaccination campaign. SETTING AND SUBJECTS: Patients registered with general practices of one family health services authority. INTERVENTIONS: Pneumococcal vaccination campaign including clinical guidelines and support materials. MAIN OUTCOME MEASURES: Proportion of general practitioners offering pneumococcal vaccine; proportion of patients at risk who were vaccinated between 1 May and 31 December 1995; number of splenectomised patients identified and vaccinated in same period; views of patients who were vaccinated. RESULTS: Proportion of general practitioners offering pneumococcal vaccine increased from 17% to 89% during the campaign. Estimated number of patients at risk who were vaccinated increased from 656 (4%) to 5982 (33%) during campaign. Of 61 splenectomised patients identified, 30 had been vaccinated previously and 27 were vaccinated during campaign. Practices in which a general practitioner took or shared the lead had higher vaccination rates and used vaccine up faster. Of the 384 patients whose questionnaires were used in analysis, only 35 had heard of pneumococcal vaccine before the campaign, 198 reported side effects (mostly minor and local, but systemic and severe local reactions were more common than expected), and 337 were pleased they had been vaccinated (only five expressed dissatisfaction). CONCLUSION: A practice based campaign is an effective method of increasing uptake of pneumococcal vaccine by high risk groups. PMID:9133894

  6. Incidence and prevalence of multiple sclerosis in the UK 1990-2010: a descriptive study in the General Practice Research Database.

    PubMed

    Mackenzie, I S; Morant, S V; Bloomfield, G A; MacDonald, T M; O'Riordan, J

    2014-01-01

    To estimate the incidence and prevalence of multiple sclerosis (MS) by age and describe secular trends and geographic variations within the UK over the 20-year period between 1990 and 2010 and hence to provide updated information on the impact of MS throughout the UK. A descriptive study. The study was carried out in the General Practice Research Database (GPRD), a primary care database representative of the UK population. Incidence and prevalence of MS per 100 000 population. Secular and geographical trends in incidence and prevalence of MS. The prevalence of MS recorded in GPRD increased by about 2.4% per year (95% CI 2.3% to 2.6%) reaching 285.8 per 100 000 in women (95% CI 278.7 to 293.1) and 113.1 per 100 000 in men (95% CI 108.6 to 117.7) by 2010. There was a consistent downward trend in incidence of MS reaching 11.52 per 100 000/year (95% CI 10.96 to 12.11) in women and 4.84 per 100 000/year (95% CI 4.54 to 5.16) in men by 2010. Peak incidence occurred between ages 40 and 50 years and maximum prevalence between ages 55 and 60 years. Women accounted for 72% of prevalent and 71% of incident cases. Scotland had the highest incidence and prevalence rates in the UK. We estimate that 126 669 people were living with MS in the UK in 2010 (203.4 per 100 000 population) and that 6003 new cases were diagnosed that year (9.64 per 100 000/year). There is an increasing population living longer with MS, which has important implications for resource allocation for MS in the UK.

  7. The risk of adverse outcomes in association with use of testosterone products: a cohort study using the UK-based general practice research database

    PubMed Central

    Jick, Susan S; Hagberg, Katrina Wilcox

    2013-01-01

    AIMS To study the relative safety of the intramuscular injection formulation of testosterone with oral testosterone undecanoate in relation to the risks for hypertension, polycythemia, prostate cancer, benign prostatic hypertrophy (BPH) and prostatism. METHODS We conducted a cohort study of men in the UK based General Practice Research Database who were users of the oral undecanoate and injectable forms of testosterone and calculated rates and relative risks of hypertension, polycythemia and prostate conditions (cancer, BPH and prostatism). RESULTS We identified 5841 men who received at least one study testosterone preparation. There were 202 cases of hypertension (crude incidence rates (IRs) for oral and injectable testosterone respectively 12.3/1000 person-years (PY) and 14.4/1000 PY). There were 146 cases of polycythemia (IRs 1.2/1000 PY and 10.1/1000 PY), 46 cases of prostate cancer (IRs 2.5/1000 PY and 1.8/1000 PY), 106 cases of BPH (IRs 4.1 /1000 PY and 2.1/1000 PY), and 251 cases of prostatism (IRs 8.4/1000 PY and 6.1/1000 PY respectively). Adjusted relative risks for oral compared with injectable testosterone were 0.8 (95% CI 0.6, 1.2) for hypertension, 0.13 (0.05, 0.35) for polycythemia, 1.1 (0.7, 1.7) for prostate cancer, 1.5 (1.1, 2.2) for BPH and 1.1 (0.8, 1.4) for prostatism. CONCLUSIONS Risks of prostate cancer and prostatism were similar in users of the two preparations, but risks were higher for hypertension and polycythemia in the injectable compared with the oral testosterone users. Risk of BPH was slightly higher in the oral users, but the difference was small and could have been due to bias. PMID:22574772

  8. Healthcare assistants in general practice: practical and conceptual issues of skill-mix change

    PubMed Central

    Bosley, Sara; Dale, Jeremy

    2008-01-01

    The emergence of healthcare assistants (HCAs) in general practice raises questions about roles and responsibilities, patients' acceptance, cost-effectiveness, patient safety and delegation, training and competence, workforce development, and professional identity. There has been minimal research into the role of HCAs and their experiences, as well as those of other staff working with HCAs in general practice. Lessons may be learned from their role and evidence of their effectiveness in hospital settings. Such research highlights blurred and contested role boundaries and threats to professional identity, which have implications for teamwork, quality of patient care, and patient safety. In this paper it is argued that transferability of evidence from hospital settings to the context of general practice cannot be assumed. Drawing on the limited research in general practice, the challenges and benefits of developing the HCA role in general practice are discussed. It is suggested that in the context of changing skill-mix models, viewing roles as fluid and dynamic is more helpful and reflective of individuals' experiences than endeavouring to impose fixed role boundaries. It is concluded that HCAs can make an increasingly useful contribution to the skill mix in general practice, but that more research and evaluation are needed to inform their training and development within the general practice team. PMID:18307856

  9. Healthcare assistants in general practice: practical and conceptual issues of skill-mix change.

    PubMed

    Bosley, Sara; Dale, Jeremy

    2008-02-01

    The emergence of healthcare assistants (HCAs) in general practice raises questions about roles and responsibilities, patients' acceptance, cost-effectiveness, patient safety and delegation, training and competence, workforce development, and professional identity. There has been minimal research into the role of HCAs and their experiences, as well as those of other staff working with HCAs in general practice. Lessons may be learned from their role and evidence of their effectiveness in hospital settings. Such research highlights blurred and contested role boundaries and threats to professional identity, which have implications for teamwork, quality of patient care, and patient safety. In this paper it is argued that transferability of evidence from hospital settings to the context of general practice cannot be assumed. Drawing on the limited research in general practice, the challenges and benefits of developing the HCA role in general practice are discussed. It is suggested that in the context of changing skill-mix models, viewing roles as fluid and dynamic is more helpful and reflective of individuals' experiences than endeavouring to impose fixed role boundaries. It is concluded that HCAs can make an increasingly useful contribution to the skill mix in general practice, but that more research and evaluation are needed to inform their training and development within the general practice team.

  10. The research potential of practice nurses.

    PubMed

    Davies, Jacqueline; Heyman, Bob; Bryar, Rosamund; Graffy, Jonathan; Gunnell, Caroline; Lamb, Bryony; Morris, Lana

    2002-09-01

    Little is known about the research aspirations and experiences of practice nurses. The study discussed in the present paper had three main aims: (1) to assess the level of research interest among practice nurses working in Essex and East London, UK; (2) to identify practice nurses' research priorities; and (3) to explore factors which facilitate and impede the development of practice nursing research. All practice nurses (n = 1,054) in the above areas were sent a questionnaire, and a total of 40% (n = 426) responded after two follow-up letters. Fifty-five respondents who volunteered for further participation were interviewed, either individually or in focus groups. About half (n = 207) of the survey respondents expressed an interest in undertaking research. One-third (n = 145) reported previous participation in research, and 20% (n = 85) had initiated their own research. Logistic regression showed that practice nurses educated to graduate level, and those working in practices with nurse training or participation in external research, were most likely to want to undertake research. Working in a medical training practice was found to be a negative predictor of research interest. Respondents prioritised research into long-term health problems with a high prevalence in the local population; for example, diabetes. Their reasons for wishing to engage in research included improving the service, career development, making work more interesting and reducing isolation. The main barriers identified were lack of time, lack of support from some general practitioners and poor access to higher education resources outside formal courses. The development of practice nurse research would provide a distinctive perspective on health need and service provision. It would contribute to the achievement of the national strategic objective of improving the quality of primary care, enhance the status of the profession, utilise the enthusiasm of individuals, increase job satisfaction and

  11. Counseling in General Practice: Issues and Opportunities.

    ERIC Educational Resources Information Center

    Monach, Jim; Monro, Surya

    1995-01-01

    Reports survey results of general practice (GP) counselors and primary health care teams concerning role and contribution of counselors in primary care. Identified principal tasks of GP counselors, their relationship with the host team, and some organizational and professional dilemmas which need to be addressed. A great deal of variation was…

  12. Studies in general practice with brotizolam

    PubMed Central

    Wheatley, D.

    1983-01-01

    1 Brotizolam (0.25 mg) was compared with placebo, and in a separate study, with nitrazepam (5.0 mg) in patients being treated for insomnia in general practice. 2 Brotizolam (0.25 mg) and nitrazepam (5.0 mg) were equally effective and there was no evidence of residual effects the next day with either drug. PMID:6661386

  13. Research to Practice Connections

    ERIC Educational Resources Information Center

    Patterson, Margaret Becker

    2016-01-01

    This article describes outcomes of group discussion sessions that took place as part of the Commission on Adult Basic Education April 2016 conference in Dallas, Texas. Researchers and practitioners in adult education were the primary attendees of the conference. Session topics and points of discussion in this paper include: the challenge of the…

  14. Research to Practice Connections

    ERIC Educational Resources Information Center

    Patterson, Margaret Becker

    2016-01-01

    This article describes outcomes of group discussion sessions that took place as part of the Commission on Adult Basic Education April 2016 conference in Dallas, Texas. Researchers and practitioners in adult education were the primary attendees of the conference. Session topics and points of discussion in this paper include: the challenge of the…

  15. Bridging Research and Practice

    PubMed Central

    Tabak, Rachel G.; Khoong, Elaine C.; Chambers, David; Brownson, Ross C.

    2013-01-01

    Context Theories and frameworks (hereafter called models) enhance dissemination and implementation (D&I) research by making the spread of evidence-based interventions more likely. This work organizes and synthesizes these models by: (1) developing an inventory of models used in D&I research; (2) synthesizing this information; and (3) providing guidance on how to select a model to inform study design and execution. Evidence acquisition This review began with commonly cited models and model developers and used snowball sampling to collect models developed in any year from journal articles, presentations, and books. All models were analyzed and categorized in 2011 based on three author-defined variables: construct flexibility, focus on dissemination and/or implementation activities (D/I), and the socio-ecological framework (SEF) level. Five-point scales were used to rate construct flexibility from broad to operational and D/I activities from dissemination-focused to implementation-focused. All SEF levels (system, community, organization, and individual) applicable to a model were also extracted. Models that addressed policy activities were noted. Evidence synthesis Sixty-one models were included in this review. Each of the five categories in the construct flexibility and D/I scales had/contained at least four models. Models were distributed across all levels of the SEF; the fewest models (n=8) addressed policy activities. To assist researchers in selecting and utilizing a model throughout the research process, the authors present and explain examples of how models have been used. Conclusions These findings may enable researchers to better identify and select models to inform their D&I work. PMID:22898128

  16. The new Australian after-hours general practice incentive payment mechanism: equity for rural general practice?

    PubMed

    Neil, Amanda L; Nelson, Mark; Palmer, Andrew J

    2016-07-01

    In July 2015, a national scheme for after-hours incentive funding for general practices was re-introduced in Australia, 2-years after funding was transferred to regional primary health care organisations (Medicare Locals). The re-introduction was recommended in a 2014 review of after-hours primary care reflecting the "overwhelming desire" among general practice. Given the centrality of after-hours care provision in rural and remote practices identified in the review, we compare and contrast the current and historical after-hours incentive funding mechanisms focussing on fairness towards rural general practices. While there are similarities between the current and historical mechanisms, significant differences exist. The comparison is not straightforward. The major consistency is utilisation of practice standardised whole patient equivalents (SWPE) as the basis of funding, inherently favouring large urban general practices. This bias is expected to increase given a shift in focus from practices with no option but to provide 24/7 care to any practice providing 24/7 care; and an associated increased funding per SWPE. Differences primarily pertain to classification processes, in which the realities of rural service provision and recognition of regional support mechanisms are given minimal consideration. Rapid introduction of the new general practice after-hours incentive funding mechanism has led to inconsistencies and has exacerbated inherent biases, particularly inequity towards rural providers. Impact on morale and service provision in non-urban areas should be monitored.

  17. Cost-Justification of Computers in General Practice in Canada

    PubMed Central

    McAlister, Neil Harding; Covvey, H. Dominic; McAlister, Nazlin K.

    1978-01-01

    In General Practice, computers might assist clinical decision-making,perform business procedures, and support health care delivery research. Before being used, however, computers first must be economically justifiable. The cost of computer systems is known. One can estimate their potential dollar benefit in primary care. Computer technology was therefore assessed for its potential to save money in a model General Practice. Information processing needs were noted, functional specifications were developed, and typical costs for systems appropriate to practices of varying size were calculated. Computers might improve primary care in many ways, but savings accrue only from support of billing and accounting. Savings might equal or exceed the cost of a computer system in groups of practitioners, optimally composed of between six and eight doctors. If computers could pay for themselves by performing essential business functions, they would then be readily available for other purposes in General Practice.

  18. Dependence on Hypnotic Drugs in General Practice

    PubMed Central

    Johnson, John; Clift, A. D.

    1968-01-01

    Of the patients in an industrial general practice 1.3% required hypnotic drugs regularly. They were predominantly in the older age groups (mean 62.7 years), with an excess of widows. Only 0.02% were severely dependent; the remainder were mildly so, though they had been taking hypnotics for long periods (mean 5.6 years). There were three main original indications for hypnotics—namely, medical (pain), psychiatric, and onset insomnia in anxious personality disorder. One-fifth of the patients first took hypnotics while in hospital. The group as a whole manifested a high degree of abnormal psychological disposition. It is suggested that many patients who take hypnotics regularly may be placebo reactors, and a more critical attitude to hypnotic prescribing is required both in hospital and in general practice. ImagesFig. 1Fig. 2Fig. 3 PMID:5723365

  19. Feasibility of contact surveys in general practice.

    PubMed Central

    Phillips, A; Mant, D

    1987-01-01

    Surveys to evaluate risk factors for disease in the general population are popular with health authorities for assessing the effectiveness of their preventive measures. A contact survey of the lifestyles of 2000 randomly selected patients aged 25-64 was conducted in five general practices over 18 months; the medical records of the patients selected were tagged, and when the patients first visited the surgery they were given a questionnaire by the receptionists, which they completed in the waiting room. Over the 18 months at least 1400 of these patients visited the practices, of whom 1106 (55%) completed a questionnaire and 20 refused to do so; 896 (81%) completed it within one year. Information on the patients who were not surveyed was obtained by sending the questionnaire by post and by audit of medical records. The population surveyed on contact with the surgeries contained a higher proportion of young women, and possibly a higher proportion of patients from social classes IIIM-V, than the other patients. No important or consistent bias towards unhealthy patients at high risk was identified in the contact survey. A one year contact survey of a random, tagged sample is feasible in estimating the risk factors in a population and may be the method of choice in general practice because of its low cost and adaptability. PMID:3120900

  20. Measuring learning by trainees in general practice

    PubMed Central

    Howie, J. G. R.; Dingwall-Fordyce, Ianthe

    1976-01-01

    Twenty simulated consultations with patients having a respiratory illness were carried out by 20 trainees at the start and finish of a training year in general practice, using the same method as used in a previous study of principals in general practice. During the course of the year, the trainees as a group closely approached the behaviour—in the defined terms of the study—of principals as a group. The trend was more marked for doctors on a three-year training programme than for those on a one-year programme. In 11 cases direct comparison between trainee and trainer was possible. It was difficult to identify changes in behaviour as being due to either group influences or individual trainer influences, but it appeared that atypical trainers do not necessarily produce atypical trainees and typical trainers do not prevent the development of individuality in trainees. The technique of simulated consultation may assist the difficult task of evaluating training for general practice. PMID:957308

  1. Faculty Research and Publication Practices

    ERIC Educational Resources Information Center

    Zoellner, Kate; Hines, Samantha; Keenan, Teressa; Samson, Sue

    2015-01-01

    Understanding faculty work practices can translate into improved library services. This study documents how education and behavioral science faculty locate, retrieve, and use information resources for research and writing and how they publish and store their research materials. The authors interviewed twelve professors using a structured interview…

  2. Faculty Research and Publication Practices

    ERIC Educational Resources Information Center

    Zoellner, Kate; Hines, Samantha; Keenan, Teressa; Samson, Sue

    2015-01-01

    Understanding faculty work practices can translate into improved library services. This study documents how education and behavioral science faculty locate, retrieve, and use information resources for research and writing and how they publish and store their research materials. The authors interviewed twelve professors using a structured interview…

  3. Systematic Review and Meta-Analysis of Studies Evaluating Diagnostic Test Accuracy: A Practical Review for Clinical Researchers-Part I. General Guidance and Tips

    PubMed Central

    Kim, Kyung Won; Lee, Juneyoung; Choi, Sang Hyun; Huh, Jimi

    2015-01-01

    In the field of diagnostic test accuracy (DTA), the use of systematic review and meta-analyses is steadily increasing. By means of objective evaluation of all available primary studies, these two processes generate an evidence-based systematic summary regarding a specific research topic. The methodology for systematic review and meta-analysis in DTA studies differs from that in therapeutic/interventional studies, and its content is still evolving. Here we review the overall process from a practical standpoint, which may serve as a reference for those who implement these methods. PMID:26576106

  4. Response to Intervention: Research and Practice

    ERIC Educational Resources Information Center

    Hall, Carol; Mahoney, Jamie

    2013-01-01

    Response to Intervention (RTI) is a service model designed to meet the learning needs of students prior to diagnosis and placement in special education settings. Results of a quantitative quasi-experimental research study to investigate the relationship between the RTI plan and self-reported implementation practices among general education…

  5. [Dealing with diagnostic uncertainty in general practice].

    PubMed

    Wübken, Magdalena; Oswald, Jana; Schneider, Antonius

    2013-01-01

    In general, the prevalence of diseases is low in primary care. Therefore, the positive predictive value of diagnostic tests is lower than in hospitals where patients are highly selected. In addition, the patients present with milder forms of disease; and many diseases might hide behind the initial symptom(s). These facts lead to diagnostic uncertainty which is somewhat inherent to general practice. This narrative review discusses different sources of and reasons for uncertainty and strategies to deal with it in the context of the current literature. Fear of uncertainty correlates with higher diagnostic activities. The attitude towards uncertainty correlates with the choice of medical speciality by vocational trainees or medical students. An intolerance of uncertainty, which still increases as medicine is making steady progress, might partly explain the growing shortage of general practitioners. The bio-psycho-social context appears to be important to diagnostic decision-making. The effect of intuition and heuristics are investigated by cognitive psychologists. It is still unclear whether these aspects are prone to bias or useful, which might depend on the context of medical decisions. Good communication is of great importance to share uncertainty with the patients in a transparent way and to alleviate shared decision-making. Dealing with uncertainty should be seen as an important core component of general practice and needs to be investigated in more detail to improve the respective medical decisions. Copyright © 2013. Published by Elsevier GmbH.

  6. Applying research to practice: exploring the barriers.

    PubMed

    Hewitt-Taylor, Jaqui; Heaslip, Vanessa; Rowe, Nicholas E

    Nurses are not averse to applying research findings to their clinical practice; however, there appears to be a number of barriers to achieving this. Generally, barriers include lack of time and the need to provide more education surrounding the use of research. While these are both valid points, the authors suggest that perhaps the solution to the problem is looking at how research is 'sold' to practitioners. For example, the use of jargon in research is off-putting to many practitioners, which creates an impression that research is associated with academia, rather than a tool for practitioners. Also, there may be an unrealistic expectation of what 'using research' might mean. Research is seen as the pinnacle of evidence, and not a part of evidence-based practice. In this article, the authors propose that teaching and expectations of research should focus on the application of research to practice. Reviewing and critiquing of research should serve the purpose of helping to make decisions about its practical applications, rather than for academic use.

  7. Advisory External Defibrillator Availability in General Practice.

    PubMed

    Barry, T; Bury, G

    2015-01-01

    This study aimed to describe the availability of advisory external defibrillators (AEDs) in Irish General Practice. The study utilised a computer generated random sample of Irish general practitioners and involved a postal questionnaire, with telephone follow up of non-responders. The cohort of GPs already known to possess an AED (via participation in the Merit Project) was excluded. 115 valid paper survey responses were received representing a response rate of 59%. 5 of the responding GPs identified themselves as Merit project participants and were excluded from data analysis. 74/110 GPs (67%) reported having one or more AED(s) available for use at their practice. 41/77 GPs (53%) who had not responded to the paper survey but were contactable by telephone had an AED available. When AED availability was examined by practice setting a higher proportion of rural and mixed settings had AEDs available than in urban and city areas. Cost was reported as the most common reason for not having an AED.

  8. Relationship between practice organization and cardiovascular risk factor recording in general practice.

    PubMed Central

    van Drenth, B B; Hulscher, M E; van der Wouden, J C; Mokkink, H G; Van Weel, C; Grol, R P

    1998-01-01

    BACKGROUND: Research findings suggest that the level of cardiovascular risk factor recording in general practice is not yet optimal. Several studies indicate a relation between the organization of cardiovascular disease prevention at practice level and cardiovascular risk factor recording. AIM: To explore the relation between the organization of cardiovascular disease prevention and risk factor recording in general practice. METHOD: A cross-sectional study was conducted using data on adherence to selected practice guidelines and on cardiovascular risk factor recording from 95 general practices. Practice guidelines were developed beforehand in a consensus procedure. Adherence was assessed by means of a questionnaire and practice observations. Risk factor recording was assessed by an audit of 50 medical records per practice. RESULTS: Factor analysis of risk factor recording revealed three dimensions explaining 76% of the variance: recording of health-related behaviour, recording of clinical parameters, and recording of medical background parameters. Adherence to the guideline 'proactively invite patients to attend for assessment of cardiovascular risk' was related to a higher recording level in all three dimensions. Practice characteristics did not show a consistent relationship to the level of risk factor recording. CONCLUSION: This study indicates that the presence of a system of proactive invitation was related to the recording of cardiovascular risk factors in medical records in general practice. PMID:9624746

  9. Autism: From Research to Practice

    PubMed Central

    Lord, Catherine

    2010-01-01

    Autism is the most commonly studied of a spectrum of developmental disorders that are believed to be neurobiologically based but which, at this point, for lack of good biomarkers, are defined purely by behavior. In the last 20 years, the definition of autism has shifted in emphasis from extreme aloofness and positive signs of abnormality in repetitive and sensori-motor behaviors to a greater awareness of the importance of more subtle reciprocal social-communication deficits as core features. Standard diagnostic instruments were developed for research purposes to acquire information both through caregiver interviews and direct clinical observation. Use of these instruments in clinical practice resulted in major improvements which in turn affected research results. These results yielded further improvements that led to changes in clinical practice over time. The synergism between research and clinical practice in the understanding of autism is discussed. PMID:21058793

  10. Opportunities for research in rural practice.

    PubMed Central

    Johnson, G. J.

    1979-01-01

    The contributions of Denis Burkitt, William Budd, Sir James MacKenzie and Will Pickles, among others, are examples of the research that can be accomplished by busy doctors in a general practice or a rural setting with a minimum of equipment. It is still possible to undertake worthwhile research in rural areas of Canada. This contention is supported by many examples of published work from northern Newfoundland and Labrador. The studies have dealt with conditions that are particularly frequent in each region, including those due to nutritional deficiency, infection, extremes of climate and genetic factors. Epidemiologic studies have compared the occurrence of disease in different geographic regions and in different races. The content of general practice and methods of health care delivery have also been investigated. It is suggested that some of these observations could have been made only in the context of rural medical practice. Images p1246-a p1246-b PMID:445268

  11. Engaging participants in a complex intervention trial in Australian General Practice

    PubMed Central

    Perkins, David; Harris, Mark F; Tan, Jocelyn; Christl, Bettina; Taggart, Jane; Fanaian, Mahnaz

    2008-01-01

    Background The paper examines the key issues experienced in recruiting and retaining practice involvement in a large complex intervention trial in Australian General Practice. Methods Reflective notes made by research staff and telephone interviews with staff from general practices which expressed interest, took part or withdrew from a trial of a complex general practice intervention. Results Recruitment and retention difficulties were due to factors inherent in the demands and context of general practice, the degree of engagement of primary care organisations (Divisions of General Practice), perceived benefits by practices, the design of the trial and the timing and complexity of data collection. Conclusion There needs to be clearer articulation to practices of the benefits of the research to participants and streamlining of the design and processes of data collection and intervention to fit in with their work practices. Ultimately deeper engagement may require additional funding and ongoing participation through practice research networks. Trial Registration Current Controlled Trials ACTRN12605000788673 PMID:18700984

  12. Management in general practice: the challenge of the new General Medical Services contract

    PubMed Central

    Checkland, Kath

    2004-01-01

    Background: Managers in general practice perform a variety of roles, from purely administrative to higher-level strategic planning. There has been little research investigating in detail how they perform these roles and the problems that they encounter. The new General Medical Services (GMS) contract contains new management challenges and it is not clear how practices will meet these. Aim: To improve understanding of the roles performed by managers in general practice and to consider the implications of this for the implementation of the new GMS contract. Design of study: In-depth qualitative case studies covering the period before and immediately after the vote in favour of the new GMS contract. Setting: Three general practices in England, chosen using purposeful sampling. Method: Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Results: Understanding about what constitutes the legitimate role of managers in general practice varies both within and between practices. Those practices in the study that employed a manager to work at a strategic level with input into the direction of the organisation demonstrated significant problems with this in practice. These included lack of clarity about what the legitimate role of the manager involved, problems relating to the authority of managers in the context of a partnership, and lack of time available to them to do higher-level work. In addition, general practitioners (GPs) were not confident about their ability to manage their managers' performance. Conclusion: The new GMS contract will place significant demands on practice management. These results suggest that it cannot be assumed that simply employing a manager with high-level skills will enable these demands to be met; there must first be clarity about what the manager should be doing, and attention must be directed at questions about the legitimacy enjoyed

  13. The Adequacy of Education for General Practice

    PubMed Central

    Stewart, C. B.

    1963-01-01

    The effect on medical education of the doubling of medical knowledge every 10 years is discussed. A brilliant student who might successfully master all the present facts and theories by graduation would be seriously out of date 10 years later, and hopelessly so by retirement age unless he continued his education while in practice. Lengthening the undergraduate course is not considered an effective solution, nor is increasing the general practice internship to two years. Emphasis should be placed on self-education by the medical student, on the inculcation of habits of study and motivation to encourage lifelong learning, and on the provision of more adequate programs of continuing education for the practising doctor. Teachers in medical schools require a better understanding of and interest in the learning processes of their students rather than concentrating on the exposition of their own knowledge. PMID:13984082

  14. [Therapy for urinary incontinence in general practice].

    PubMed

    Wiedemann, A; Füsgen, I

    2009-08-01

    In national and international guidelines the general practitioner plays an important role in the diagnosis and first-line therapy for urinary incontinence. Nevertheless, there is a lack of data concerning details of the management of incontinence in primary care in Germany. Therefore a series of nationwide educational events for general practitioners and gynaecologists was used to perform a survey dealing with the situation of urinary incontinence in general practice. With 2530 questionnaires filled out and returned, this is the largest European survey on this subject. General practitioners declare in 57.3 % to be often involved with urinary incontinence. They usually question elderly patients about urinary incontinence (73.7 %) or those patients with diseases carrying the risk of developing urinary incontinence (64.9 %). Based on the diagnostic options in primary care, an incontinence anamnesis and urine evaluation are performed. A sonography or micturition diary was more infrequent in primary care in this survey. General practitioners most frequent refer the patient to a specialist (76.6 %) or prescribe the incontinence-type anticholinergic drugs (59.4 %) or absorbent products (45.4 %); duloxetine (27.3 %) is less frequently prescribed. The knowledge about urinary incontinence is gained in educational events (72.2 %); the course of studies was the source of incontinence skills for general practitioners only in 35 %. In conclusion, this survey gives a realistic view on the incontinence management in primary care in Germany. The majority of general practitioners are engaged in incontinence, perform basic diagnostic features and prescribe drugs or absorbent products. The course of (university medical school) studies as a source of skills to diagnose or to treat incontinence should be improved.

  15. Computerisation of general practice in the Republic of Croatia: experience gained in general practice use.

    PubMed

    Bergman-Marković, Biserka; Katić, Milica; Kern, Josipa

    2007-01-01

    Well-organised medical records are the prerequisite for achieving a high level of performance in primary healthcare settings. Recording balanced structured and coded data as well as free text can improve both quality and organisation of work in the office. It provides a more substantiated support of financial transactions and accountancy, allows better communication with other facilities and institutions, and is a source of valuable scientific research material. This article is the result of an individual experience gained in general practice use of various programs/systems employed within the family medicine frame, and the frame of evaluation of available and commonly-exploited program solutions. The use of various programs allows for systematic adjustments as to the increasingly complex requirements imposed on electronic medical records (EMRs). The experience of a general practitioner, presented in this paper, confirms the assumption that an adequate program to be employed with EMRs should be developed, provided that family medicine practitioners, that is, the final users, have been involved in each and every stage of its development, adjustment, implementation and evaluation.

  16. General practice and the new renaissance.

    PubMed

    Dugdale, C

    1995-05-01

    Traditional medical education has tended to emphasise the acquisition of knowledge and analytical skills. But it is the author's belief that this system has some limitations when applied in the general practice situation. Dr Edward DeBono has described an alternative style of thinking that relies fundamentally on perceptive and creative skills; ideas that have great relevance in learning how to apply our acquired knowledge in a meaningful way to the health care of our patients. This paper describes the personal odyssey that led to this realisation.

  17. Linking research to practice: suggestions for reading a research article.

    PubMed

    Crocker, L M

    1977-01-01

    Although researchers and editorial review boards are obligated to communicate research information in readable fashion, journal readers also must assume responsibility for interpreting and evaluating research articles. The general format for reporting research results is described. In addition, seven major questions to be asked by cirtical readers are presented. These questions are designed to help readers identify the purpose of a study; assess its importance; evaluate the research design, sampling and data collecting procedures; interpret the results of data analyses; and form implications for practice.

  18. Provision of mental health care in general practice in Italy.

    PubMed Central

    Tansella, M; Bellantuono, C

    1991-01-01

    The main features of the psychiatric system and of the general practice system in Italy since the psychiatric reform and the introduction of a national health service are briefly described. Research conducted in Italy confirms that a large proportion of patients seen by general practitioners have psychological disorders and that only some of those patients whose psychological problems are identified by general practitioners are referred to specialist psychiatric care. Thus, the need to identify the best model of collaboration between psychiatric services and general practice services is becoming increasingly urgent. The chances of improving links between the two services and of developing a satisfactory liaison model are probably greater in countries such as Italy where psychiatric services are highly decentralized and community-based, than in countries where the psychiatric services are hospital-based. PMID:1807308

  19. The European General Practice Research Network Presents the Translations of Its Comprehensive Definition of Multimorbidity in Family Medicine in Ten European Languages

    PubMed Central

    Le Reste, Jean Yves; Nabbe, Patrice; Rivet, Charles; Lygidakis, Charilaos; Doerr, Christa; Czachowski, Slawomir; Lingner, Heidrun; Argyriadou, Stella; Lazic, Djurdjica; Assenova, Radost; Hasaganic, Melida; Munoz, Miquel Angel; Thulesius, Hans; Le Floch, Bernard; Derriennic, Jeremy; Sowinska, Agnieska; Van Marwijk, Harm; Lietard, Claire; Van Royen, Paul

    2015-01-01

    Background Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review. Objective To translate that English definition into European languages and to validate the semantic, conceptual and cultural homogeneity of the translations for further research. Method Forward translation of the EGPRN’s definition of multimorbidity followed by a Delphi consensus procedure assessment, a backward translation and a cultural check with all teams to ensure the homogeneity of the translations in their national context. Consensus was defined as 70% of the scores being higher than 6. Delphi rounds were repeated in each country until a consensus was reached Results 229 European medical expert FPs participated in the study. Ten consensual translations of the EGPRN comprehensive definition of multimorbidity were achieved. Conclusion A comprehensive definition of multimorbidity is now available in English and ten European languages for further collaborative research in FM and long-term care. PMID:25607642

  20. The European general practice research network presents the translations of its comprehensive definition of multimorbidity in family medicine in ten European languages.

    PubMed

    Le Reste, Jean Yves; Nabbe, Patrice; Rivet, Charles; Lygidakis, Charilaos; Doerr, Christa; Czachowski, Slawomir; Lingner, Heidrun; Argyriadou, Stella; Lazic, Djurdjica; Assenova, Radost; Hasaganic, Melida; Munoz, Miquel Angel; Thulesius, Hans; Le Floch, Bernard; Derriennic, Jeremy; Sowinska, Agnieska; Van Marwijk, Harm; Lietard, Claire; Van Royen, Paul

    2015-01-01

    Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review. To translate that English definition into European languages and to validate the semantic, conceptual and cultural homogeneity of the translations for further research. Forward translation of the EGPRN's definition of multimorbidity followed by a Delphi consensus procedure assessment, a backward translation and a cultural check with all teams to ensure the homogeneity of the translations in their national context. Consensus was defined as 70% of the scores being higher than 6. Delphi rounds were repeated in each country until a consensus was reached. 229 European medical expert FPs participated in the study. Ten consensual translations of the EGPRN comprehensive definition of multimorbidity were achieved. A comprehensive definition of multimorbidity is now available in English and ten European languages for further collaborative research in FM and long-term care.

  1. A qualitative study of collaboration in general practice: understanding the general practice nurse's role.

    PubMed

    McInnes, Susan; Peters, Kath; Bonney, Andrew; Halcomb, Elizabeth

    2017-07-01

    To explore the nature of collaboration between registered nurses and general practitioners in Australian general practice. There is international recognition that collaboration between health professionals can improve care coordination, enhance health outcomes, optimise the work environment and reduce healthcare costs. However, effective collaboration requires a clear understanding of each team member's role. A qualitative approach guided by Naturalistic Inquiry was used to elicit and interpret participant narratives. Eight general practitioners and fourteen registered nurses working in general practice were purposefully recruited. Data were collected via individual, semi-structured face-to-face interviews during February to May 2015. Interviews were audio recorded and transcribed verbatim. Data were analysed using thematic analysis. Data revealed three overarching themes. This study presents the data for the overarching theme 'Understanding the general practice registered nurse's role'. Many general practitioner participants lacked clarity around the role and scope of practice of the registered nurse. At the same time, nursing participants often articulated their role as an assistant rather than as an independent health professional. This limited collaboration and the nurses' role within the team. Collaboration was enhanced when general practitioners actively sought an understanding of the registered nurses scope of practice. Clarifying the nurses' role promotes collaboration and supports nurses to work to the full extent of their practice. This is important in terms of optimising the nurses' role within the team and reinforcing their professional identity. Identification of key issues around understanding the nurses' role may help inform strategies that improve collaboration and workplace relations. © 2016 John Wiley & Sons Ltd.

  2. Depression in general practice -- consultation duration and problem solving therapy.

    PubMed

    Pierce, David; Gunn, Jane

    2011-05-01

    General practitioners have expressed concern that consultations offering psychological therapy approaches will take up too much time. However, problem solving therapy (PST) for depression may be able to be used within the time constraints of general practice. This study investigates whether GPs' concerns that PST would result in unacceptably long consultations are justified. general practitioners were observed providing PST in simulated consultations before and after PST training - PST skill and duration of consultations were measured. Twenty-four GPs participated. Problem solving therapy skill increased markedly, but mean consultation duration changed minimally: 17.3 minutes and 17.9 minutes. This research suggests that GPs can provide an evidence supported psychological treatment for depression within the time constraints of routine practice. The structured nature of PST may allow GPs to provide additional mental healthcare for depression, without significantly increasing consultation duration. It suggests GPs' concerns about the time PST may take up in practice may be unjustified and that further research into the use of PST in routine general practice should be undertaken.

  3. Action Research as a Practice-Based Practice

    ERIC Educational Resources Information Center

    Kemmis, Stephen

    2009-01-01

    Action research changes people's practices, their understandings of their practices, and the conditions under which they practice. It changes people's patterns of "saying", "doing" and "relating" to form new patterns--new ways of life. It is a meta-practice: a practice that changes other practices. It transforms the…

  4. Action Research as a Practice-Based Practice

    ERIC Educational Resources Information Center

    Kemmis, Stephen

    2009-01-01

    Action research changes people's practices, their understandings of their practices, and the conditions under which they practice. It changes people's patterns of "saying", "doing" and "relating" to form new patterns--new ways of life. It is a meta-practice: a practice that changes other practices. It transforms the…

  5. French military general practitioner: ultrasound practice.

    PubMed

    Maurin, Olga; De Regloix, S; Lefort, H; Delort, G; Domanski, L; Tourtier, J-P; Palmier, B

    2014-09-01

    Ultrasound has been used in the field and in emergency departments for more than two decades. In a military setting, its use has grown rapidly as it has gained widespread acceptance among emergency physicians and as the range of diagnostic and triage applications has continued to expand. Technological changes have enabled ultrasound devices to become accessible to general practitioners (GP), and it could be of particular interest for military GPs in isolated environments. We have investigated both the training of French military GPs in the area of ultrasonography and the use of ultrasound devices, in daily practice and abroad, in isolated military settings. In 2011, a questionnaire was sent to all 147 in-the-field GPs of the French southeast regional military health service. The questionnaire evaluated the training of military GPs in ultrasonography, the use of ultrasound in France in daily practice, and during military operations in isolated environments abroad during 2010. The response rate was 52%. On the one hand, half the responding GPs had been specially trained in ultrasound, mainly (97%) in military institutes. On the other hand, only a quarter of doctors used ultrasound in daily practice. Among those GPs performing ultrasound examinations in France, 75% used it in 2010 during isolated operations abroad. Ultrasound examinations performed in such an austere environment were retrospectively declared useful to guide clinical reasoning (41% of examinations carried out), diagnosis (21%) and decision making as regards evacuation (11%). The challenge for the future is to make ultrasound courses mandatory for all military GPs going on overseas operations, to develop daily practice, and to investigate effective triage systems, combining both ultrasound imagery and physical examination. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. On research in clinical practice.

    PubMed

    Nanivadekar, Arun

    2010-01-01

    Clinical research implies advancing current knowledge about health care by continually developing and testing new ideas about diseases, products, procedures, and strategies. Although this trait is inherent in human nature, it needs to be encouraged, nurtured, groomed, and channelized by creating a suitable atmosphere for it, providing the necessary resources, inculcating the necessary conceptual and manual skills, and rewarding the efforts and achievements suitably. Language, logic, statistics, and psychology play an important role in acquiring and developing research capability. To be socially relevant and economically viable, clinical research will need to partner with patients and their doctors in identifying what their goals of health care are, what they value, and what they are willing to "buy" in terms of goods and services. Besides, clinical research will need to bring on one platform the sponsors, the researchers, the patients, the payers, and the regulators to ensure that they do not work at cross purposes, that the cost of developing health care measures is scaled down through innovative approaches such as large simple trials, sequential trials, early marketing conditional on post-marketing surveillance, and so on. All these will be possible if day-to-day practice is slowly and systemically transformed into the largest laboratory of clinical research, which it ought to be, by forming networks of research-oriented practices, and popularizing the use of data collection and analysis tools such as Epi Info which are in the public domain.

  7. Patient attitudes - training students in general practice.

    PubMed

    Sweeney, Kevin; Magin, Parker; Pond, Dimity

    2010-09-01

    While evidence from Australian studies is lacking, evidence from overseas suggests that patients are generally willing to have a medical student present during general practitioner consultations. This willingness, however, may be contingent upon factors related to the patient, student or consultation. Focus groups and two cross sectional surveys of 296 patients attending 16 general practices in New South Wales. Patients are willing to have students present, but not for all consultations. Patients find it problematic to have students present during consultations that involve worrying test results, emotional upset, internal examinations, and sexual problems. Younger patients are less willing to have a student present. For all patients the presence of a student may alter the dynamics and content of the consultation; patients are less willing to see a student without the GP also being present. Supervising GPs should be aware of circumstances where patients are less likely to want a student present and of ways in which the presence of a student may alter the consultation.

  8. [Midazolam sedation in the general dental practice].

    PubMed

    Bertens, J; Abraham-Inpijn, L; Meuwissen, P J

    1994-03-01

    The general dental practitioner is occasionally confronted with patients who, on the basis of psychological--and often somatic--criteria, are difficult to treat. Medicinal sedation in combination with anxiety reduction may be deemed appropriate for such patients. In the Netherlands inhalation sedation by means of a combination of oxygen and nitrous oxide is generally used. The limitations and disadvantages of this method have directed attention towards sedation by means of midazolam, a quick-acting benzodiazepine. In view of the complications which may accompany the administration of midazolam, the general practitioner working alone or in a group practice is advised against using midazolam sedation. Such use should be reserved for a dentist working in a hospital setting, who is able to consult with a physician regarding the advisability of administering midazolam. Even then, the safety of the patient requires that the practitioners have a proper insight into the physical state of the patient, work according to a protocol and in accordance with clearly defined responsibilities, and provide adequate accommodation during and after treatment.

  9. Organising a physiotherapy service in general practice

    PubMed Central

    Waters, W. H. R.; Udy, S. C.; Lunn, J. E.

    1975-01-01

    This paper describes three years' experience of running a domiciliary physiotherapy service based on general practice and financed by limited voluntary funds. The need arose from the remoteness of, and lack of, open access to, hospital physiotherapy. This was particularly so for elderly patients who were often frail and mentally confused. In addition there were obvious advantages in properly instructing relatives in management and treatment, especially since many of the patients and their relatives expressed a desire for home treatment. There was also a desire on the part of the general practitioners, nurses, and ancillary workers to develop further the teamwork in the health services of the four villages involved. Details of the constitution of the voluntary service and its financial arrangements are given. The results of the service and the nature of its work are described. There were no difficulties experienced in selecting the correct patients for treatment and the type of equipment required was almost all normally available through the health authority nursing service. There was no great need for expensive or heavy equipment and no transport problems arose. It was found that one hour of physiotherapist's time per 1,000 patients per week was adequate to cover all patients requiring short-term intensive therapy and to allow a small amount of palliative therapy in addition, although this had not been the original intention of the service. The physiotherapist averaged about 40 hours work per month and under these conditions the travelling and costs averaged 1·54 miles and 83 pence per visit. With self-determined hours of work and flexible timing, these conditions proved ideal for a married physiotherapist with the responsibility of a young family. Expansion of the hours of work in this particular area would have led to wasteful visits devoted to palliative and placebo therapy; and extension of the service beyond the area defined, would have increased travelling

  10. An approach to vertigo in general practice.

    PubMed

    Dommaraju, Sindhu; Perera, Eshini

    2016-04-01

    Dizziness is a common and very distressing presentation in general practice. In more than half of these cases, the dizziness is due to vertigo, which is the illusion of movement of the body or its surroundings. It can have central or peripheral causes, and determining the cause can be difficult. The aim of this article is to provide a clear framework for approaching patients who present with vertigo. A suggested approach to the assessment of vertigo is outlined. The causes of vertigo may be central (involving the brainstem or cerebellum) or peripheral (involving the inner ear). A careful history and physical examination can distinguish between these causes. The most common causes of vertigo seen in primary care are benign paroxysmal positional vertigo (BPPV), vestibular neuronitis (VN) and Ménière's disease. These peripheral causes of vertigo are benign, and treatment involves reassurance and management of symptoms.

  11. Audit of diabetes mellitus in general practice.

    PubMed

    Lee, T W; Chan, S C; Chua, W T; Harbinder, K; Khoo, Y L; Ow Yeang, Y L; Sethuraman, K; Teoh, L C

    2004-08-01

    An audit on diabetic management was done in seven Perak general practice (GP) clinics in December 2001. The results showed inadequacies in nine out of eleven criteria assessed. Remedial measures were implemented. A second audit in March 2003, at the completion of the audit cycle, showed improvements in all the criteria used. All clinics established a diabetic register compared to 28.6% in the first audit and 57.1% of the clinics set up a reminder mechanism compared to 0% in the first audit. In the process of care, recording of weight, height, blood pressure; feet examination, fundoscopy, blood sugar monitoring and urine for albumin improved at the end of the audit cycle. In the only outcome criteria, the blood sugar control improved from 21.8% to 31.3%.

  12. Improving infection control in general practice.

    PubMed

    Farrow, S C; Zeuner, D; Hall, C

    1999-03-01

    Infection control measures in the health care setting should protect patients and staff from cross-infection. The prevention of harm is an essential part of good medical practice and failure might result in professional misconduct proceedings by the General Medical Council (GMC) and prosecution under the Health and Safety at Work legislation, as well as civil liability. For a health authority, overall responsibility for public health includes arrangements for the control of communicable diseases and infection in hospital and the community (NHS Management Executive, 1993), a function usually led by the Consultant in Communicable Disease Control (CCDC). This paper describes one district's collaborative approach between public health and GPs to assess and improve local infection control standards.

  13. Mentoring for nurses in general practice: national issues and challenges.

    PubMed

    Heartfield, Marie; Gibson, Terri

    2005-04-01

    This paper reports the findings of a research project designed to identify national issues impacting on the development of a mentoring framework for nurses in general practice in Australia. The project comprised the first phase of a three-phase study commissioned by the Australian Government Department of Health and Ageing to develop a contemporary, flexible and sustainable mentoring framework that enhances the capacity of nurses to contribute to general practice outcomes. Key stakeholders and influential informants from around Australia were brought together via a national teleconference to identify issues surrounding the development of such a framework. Outcomes focussed on major themes concerning choice, relationships, structures and resources. Here, we consider the issues and challenges identified in light of some contemporary case studies from outside the field of nursing in the hope of sparking new ideas and strategies. A case study from an Australian practice nurse is included. No research has been conducted on mentoring for nurses in general practice in Australia to date, highlighting an urgent need for new models and their evaluation.

  14. Selecting general practice specialty trainees: where next?

    PubMed

    Irish, Bill; Patterson, Fiona

    2010-11-01

    Selection into GP speciality training is based on results of a multi-method job analysis study. Six key competency domains were identified as priorities to assess through the current national selection process, including empathy, communication, integrity, clinical expertise, problem-solving, and resilience. Each applicant is assessed using clinical problem-solving and situational judgement machine marked tests, followed by high fidelity exercises at regional selection centres. These show good internal reliability and predictive validity, with high correlations with subsequent job performance and outcomes in the MRCGP examinations. Candidate feedback is generally positive, where candidates prefer multiple opportunities to demonstrate their aptitude. When comparing selection methods, candidates perceive high fidelity assessments (for example, a consultation exercise with a simulated patient) as the most job relevant and fair. Emerging data provides opportunities to both streamline and re-engineer the process, so as to optimise efficiency (including cost-effectiveness) while further developing its robustness. Logistic considerations favour delivery of multiple equated versions of machine marked tests in invigilated test centres. As with other assessments in medical education, concerns remain about differential performance between UK and international medical graduates. There is an urgent need to review the job analysis and selection criteria given profound changes in UK general practice taking place over the last decade.

  15. Best Practices in Grading. Research into Practice

    ERIC Educational Resources Information Center

    Johnston, Howard

    2011-01-01

    Grading is one of the most enduring features of schooling. No matter what other reforms occur in a school, grading remains as one of the cornerstones of educational practice. But recently this long-standing tradition has come under scrutiny with some alarming results. Many traditional grading practices actually "depress" achievement, and may, in…

  16. Research in the General Motors Corporation

    NASA Astrophysics Data System (ADS)

    Muench, Nils L.

    1981-01-01

    In GM, research responds to the issues facing the auto industry: energy, air quality, safety and competition. To ensure that research is effective, GM does not isolate fundamental from applied research, and individual researchers are encouraged to understand the Corporation in their areas of expertise. Most research projects are initiated ''bottom-up.' Physics research is conducted primarily within the Physics Department of the General Motors Research Laboratories. However, physicists also work elsewhere on challenging research, and examples of this are given.

  17. 14 CFR 61.43 - Practical tests: General procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Practical tests: General procedures. 61.43... Practical tests: General procedures. (a) Completion of the practical test for a certificate or rating... rating sought within the approved practical test standards; (2) Demonstrating mastery of the aircraft...

  18. [Helicobacter pylori screening in a general practice].

    PubMed

    Hollenz, M; Stolte, M; Labenz, J

    1999-02-19

    The significance of Helicobacter pylori (Hp) infection in asymptomatic persons is largely unknown. This prospective study was undertaken to evaluate the diagnostic and, if appropriate, therapeutic relevance of a noninvasive screening for Hp. In addition, the practicality and validity of a simple serological test on whole blood was elucidated. 100 consecutive patients (29 males, 71 females, median age 46 [18-79] years) of a general medical practice, seen in November of 1997, were included. Three patients had to be subsequently excluded, because they had been treated for Hp infection. All patients were given a standard interview after which a serological whole-blood test (BM-Test Helicobacter pylori; Boehringer Mannheim) and a 13C-urea breath test were performed as noninvasive reference. Endoscopy of the upper gastrointestinal tract was offered if the serology and/or the breath test were gative. The Hp prevalence was 40%, rising significantly with age. The rapid serology test, when related to the breath test, had a negative and positive predictive value of < 80%. 44 of the 47 patients with a positive serological or breath test agreed to endoscopy. Eleven of them had a clinically significant abnormality macroscopically or histologically: four of them were found to have an Hp infection. Asymptomatic Hp-positive persons frequently have clinically abnormal findings in the upper gastrointestinal tract. These data point to the need for a large multi-centre study with cost-effect analysis to evaluate a noninvasive Hp screening test in nonsymptomatic persons as a public health measure. The 13C-urea breath test would be suitable as such a screening method.

  19. Open Access to General Practice Was Associated with Burnout among General Practitioners

    PubMed Central

    Sokolowski, Ineta; Olesen, Frede

    2013-01-01

    Walk-in open access in general practice may influence the general practitioner's (GP's) work, but very little research has been done on the consequences. In this study from Danish general practice, we compare the prevalence of burnout between GPs with a walk-in open access and those without. In a questionnaire study (2004), we approached all 458 active GPs in the county of Aarhus, Denmark, and 376 (82.8%) GPs returned the questionnaire. Walk-in open access was defined as at least 30 minutes every weekday where patients could attend practice without an appointment. Burnout was measured by the Maslach Burnout Inventory. Analyses using logistic regression were adjusted for gender, age, marital status, job satisfaction, minutes per consultation, practice organisation, working hours, number of listed patients per GP, number of contacts per GP, continuing medical education- (CME-) activities, and clusters of GPs. In all, 8% of GPs had open access and the prevalence of burnout was 24%. GPs with walk-in open access were more likely to suffer from burnout. Having open access was associated with a 3-fold increased likelihood of burnout (OR = 3.1 (95% CI: 1.1–8.8, P = 0.035)). Although the design cannot establish causality, it is recommended to closely monitor possible negative consequences of open access in general practice. PMID:23401770

  20. Open Access to General Practice Was Associated with Burnout among General Practitioners.

    PubMed

    Vedsted, Peter; Sokolowski, Ineta; Olesen, Frede

    2013-01-01

    Walk-in open access in general practice may influence the general practitioner's (GP's) work, but very little research has been done on the consequences. In this study from Danish general practice, we compare the prevalence of burnout between GPs with a walk-in open access and those without. In a questionnaire study (2004), we approached all 458 active GPs in the county of Aarhus, Denmark, and 376 (82.8%) GPs returned the questionnaire. Walk-in open access was defined as at least 30 minutes every weekday where patients could attend practice without an appointment. Burnout was measured by the Maslach Burnout Inventory. Analyses using logistic regression were adjusted for gender, age, marital status, job satisfaction, minutes per consultation, practice organisation, working hours, number of listed patients per GP, number of contacts per GP, continuing medical education- (CME-) activities, and clusters of GPs. In all, 8% of GPs had open access and the prevalence of burnout was 24%. GPs with walk-in open access were more likely to suffer from burnout. Having open access was associated with a 3-fold increased likelihood of burnout (OR = 3.1 (95% CI: 1.1-8.8, P = 0.035)). Although the design cannot establish causality, it is recommended to closely monitor possible negative consequences of open access in general practice.

  1. The cost of freezing general practice.

    PubMed

    Harrison, Christopher; Bayram, Clare; Miller, Graeme C; Britt, Helena C

    2015-04-06

    We aimed to assess the effect on general practitioners' income, and the amount of any copayment required for GPs to recoup lost income, of two policies (individually and combined) proposed by the Australian Government: a continued indexation freeze of Medicare schedule fees; and a $5 rebate reduction (now retracted). Analysis of data from the Bettering the Evaluation and Care of Health (BEACH) program, a continuous cross-sectional, national study of GP activity in Australia. We used data for April 2013 to March 2014 on direct encounters between patients and GPs for which at least one Medicare Benefits Schedule or Department of Veterans' Affairs general practice consultation item was claimable. The reduction in GP rebate income due to the policies and the size of any copayment needed to address this loss. The $5 rebate reduction would have reduced GPs' income by $219.53 per 100 consultations. This would have required a $4.81 copayment at all non-concessional patient consultations to recoup lost income. The freeze would cost GPs $384.32 in 2017-18 dollars per 100 consultations, requiring an $8.43 copayment per non-concessional patient consultation. Total estimated loss in rebate income to GPs would have been $603.85 in 2017-18 per 100 encounters, a reduction of 11.2%. The non-concessional consultation copayment required to cover lost income from both policies would have been $7-$8 in 2015-16, and $12-$15 by 2017-18. If both policies had gone ahead, GPs would have needed to charge substantially more than the suggested $5 copayment for consultations with non-concessional patients in order to maintain 2014-15 relative gross income. Even though the rebate reduction has been retracted, the freeze will have greater impact with time - nearly double the amount of the rebate reduction by 2017-18. For economic reasons, the freeze may still force GPs who currently bulk bill to charge copayments.

  2. Dermoscopy in General Dermatology: A Practical Overview.

    PubMed

    Errichetti, Enzo; Stinco, Giuseppe

    2016-12-01

    Over the last few years, dermoscopy has been shown to be a useful tool in assisting the noninvasive diagnosis of various general dermatological disorders. In this article, we sought to provide an up-to-date practical overview on the use of dermoscopy in general dermatology by analysing the dermoscopic differential diagnosis of relatively common dermatological disorders grouped according to their clinical presentation, i.e. dermatoses presenting with erythematous-desquamative patches/plaques (plaque psoriasis, eczematous dermatitis, pityriasis rosea, mycosis fungoides and subacute cutaneous lupus erythematosus), papulosquamous/papulokeratotic dermatoses (lichen planus, pityriasis rosea, papulosquamous sarcoidosis, guttate psoriasis, pityriasis lichenoides chronica, classical pityriasis rubra pilaris, porokeratosis, lymphomatoid papulosis, papulosquamous chronic GVHD, parakeratosis variegata, Grover disease, Darier disease and BRAF-inhibitor-induced acantholytic dyskeratosis), facial inflammatory skin diseases (rosacea, seborrheic dermatitis, discoid lupus erythematosus, sarcoidosis, cutaneous leishmaniasis, lupus vulgaris, granuloma faciale and demodicidosis), acquired keratodermas (chronic hand eczema, palmar psoriasis, keratoderma due to mycosis fungoides, keratoderma resulting from pityriasis rubra pilaris, tinea manuum, palmar lichen planus and aquagenic palmar keratoderma), sclero-atrophic dermatoses (necrobiosis lipoidica, morphea and cutaneous lichen sclerosus), hypopigmented macular diseases (extragenital guttate lichen sclerosus, achromic pityriasis versicolor, guttate vitiligo, idiopathic guttate hypomelanosis, progressive macular hypomelanosis and postinflammatory hypopigmentations), hyperpigmented maculopapular diseases (pityriasis versicolor, lichen planus pigmentosus, Gougerot-Carteaud syndrome, Dowling-Degos disease, erythema ab igne, macular amyloidosis, lichen amyloidosus, friction melanosis, terra firma-forme dermatosis, urticaria pigmentosa and

  3. [General practice--linear thinking and complexity].

    PubMed

    Stalder, H

    2006-09-27

    As physicians, we apply and teach linear thinking. This approach permits to dissect the patient's problem to the molecular level and has contributed enormously to the knowledge and progress of medicine. The linear approach is particularly useful in medical education, in quantitative research and helps to resolve simple problems. However, it risks to be rigid. Living beings (such as patients and physicians!) have to be considered as complex systems. A complex system cannot be dissected into its parts without losing its identity. It is dependent on its past and interactions with the outside are often followed by unpredictable reactions. The patient-centred approach in medicine permits the physician, a complex system himself, to integrate the patient's system and to adapt to his reality. It is particularly useful in general medicine.

  4. [Research in general medicine, role of the medical thesis].

    PubMed

    Levasseur, G; Schweyer, F X

    2003-06-01

    General practice doctors are naturally presented as being actors on the front lines of public health. The ability of general practitioners to be aware of and deal with public health questions largely depends upon their training. Perhaps one could consider the general practitioner's thesis as a preparatory analytical work within the area of their future field of practice. Do these theses serve to provide food for thought on general practice and its contribution to public health, and if not, could they? An analysis conducted within four medical schools in western France demonstrates that the work produced for general medicine identified as such only constitutes a fraction of the overall number of medical (non-university) theses (approximately 5%). Two possible explanations may be put forward. First, on the one hand, the theses highly depend on the context of the training and the work produced is a direct result of this. Second, on the other hand, the current methods of indexing notes in the university databases does not enable general medicine to be clearly seen and visibly recognised as an academic discipline. Two questions then remain: Can medical theses be considered as research? Should research in general medicine be carried out solely by general practitioners? It is vital that resources from outside the medical field be raised and mobilised for general practice research, whose themes are multi-disciplinary and not only clinical.

  5. Audit of hypertension in general practice.

    PubMed

    Chan, S C; Chandramani, T; Chen, T Y; Chong, K N; Harbaksh, S; Lee, T W; Lin, H G; Sheikh, A; Tan, C W; Teoh, L C

    2005-10-01

    An audit of hypertension management was done in October 2004 in nine general practice (GP) clinics. Two structure, ten process and two outcome indicators were assessed. Results showed that targets were achieved in only four indicators, i.e., weight recording (89%), BP monitoring (85.8%), follow-up interval not exceeding 6 months (87.9%) and mean diastolic BP (73.9%). The other indicators (hypertension registry, reminder mechanisms for defaulters, recording of smoking, height, fundoscopy, monitoring of lipid profile, blood sugar, ECG, renal function and achievement of target mean systolic pressure) showed adequacy percentages varying from 22.1 to 68.7. Out of the 1260 patients assessed, 743 (59%) achieved a mean BP < or = 140/90 (or < or = 130/80 mmHg with diabetes mellitus / renal insufficiency) in the last 3 recorded readings. There was a vast difference between individual clinics. Reasons for not achieving targets were discussed and remedial measures for implementation were recommended.

  6. Food-allergic asthma in general practice.

    PubMed

    Burr, M L; Fehily, A M; Stott, N C; Merrett, T G

    1985-10-01

    A survey was undertaken to assess the importance of food allergy in asthma. Seventy-two asthmatics aged 15-60 years were identified in a general practice and compared with 72 controls matched for age and sex. A diagnostic procedure involving dietary elimination and challenge was carried out on those who thought food exacerbated their symptoms, together with those with concurrent eczema, positive skin tests to food or positive food IgE-RAST. The asthmatics more frequently had positive skin tests of IgE-RAST to food than the controls, but these tests proved to be rather non-specific in identifying provoking foods. One patient was found to be allergic to wheat and his clinical condition improved when wheat was removed from his diet. Two patients seemed to respond to other foodstuffs, but the effects were small, the foods (honey and peppermint) unimportant, and the patients' symptoms appeared to be largely due to other factors. Most cases of alleged food-induced asthma could not be confirmed by challenge testing. This survey suggests that some degree of provocation by food (excluding drink) affects at least 4 per cent of adult asthmatics, although in some of these patients it plays an unimportant part in the disease.

  7. Supervising the highly performing general practice registrar.

    PubMed

    Morgan, Simon

    2014-02-01

    There is extensive literature on the poorly performing learner. In contrast, there is very little written on supervising the highly performing registrar. Outstanding trainees with high-level knowledge and skills can be a challenge for supervisors to supervise and teach. Narrative review and discussion. As with all learners, a learning-needs analysis is fundamental to successful supervision. The key to effective teaching of the highly performing registrar is to contextualise clinical knowledge and skills with the wisdom of accumulated experience. Moreover, supervisors must provide a stimulating learning environment, with regular opportunities for intellectual challenge. The provision of specific, constructive feedback is essential. There are potential opportunities to extend the highly performing registrar in all domains of general practice, namely communication skills and patient-centred care, applied knowledge and skills, population health, professionalism, and organisation and legal issues. Specific teaching strategies include role-play, video-consultation review, random case analysis, posing hypothetical clinical scenarios, role modelling and teaching other learners. © 2014 John Wiley & Sons Ltd.

  8. Catchments of general practice in different countries– a literature review

    PubMed Central

    2014-01-01

    The purpose of this paper is to review the current research on catchment areas of private general practices in different developed countries because healthcare reform, including primary health care, has featured prominently as an important political issue in a number of developed countries. The debates around health reform have had a significant health geographic focus. Conceptually, GP catchments describe the distribution, composition and profile of patients who access a general practitioner or a general practice (i.e. a site or facility comprising one or more general practitioners). Therefore, GP catchments provide important information into the geographic variation of access rates, utilisation of services and health outcomes by all of the population or different population groups in a defined area or aggregated area. This review highlights a wide range of diversity in the literature as to how GP catchments can be described, the indicators and measures used to frame the scale of catchments. Patient access to general practice health care services should be considered from a range of locational concepts, and not necessarily constrained by their place of residence. An analysis of catchment patterns of general practitioners should be considered as dynamic and multi-perspective. Geographic information systems provide opportunities to contribute valuable methodologies to study these relationships. However, researchers acknowledge that a conceptual framework for the analysis of GP catchments requires access to real world data. Recent studies have shown promising developments in the use of real world data, especially from studies in the UK. Understanding the catchment profiles of individual GP surgeries is important if governments are serious about patient choice being a key part of proposed primary health reforms. Future health planning should incorporate models of GP catchments as planning tools, at the micro level as well as the macro level, to assist policies on the

  9. Ethnic differences in consultation rates in urban general practice.

    PubMed

    Gillam, S J; Jarman, B; White, P; Law, R

    1989-10-14

    To determine the patterns of consultations with the general practitioner among different ethnic groups and the outcome of these consultations. Retrospective analysis of data from one urban group general practice collected during 1979-81 as part of a research project in seven practices. Group general practice in the London borough of Brent with a list size of 10,877 patients in July 1980. Patients registered with the practice during the 23 months to April 1981 who accounted for 67,197 consultations. Ethnic state, sex and social class distribution, and diagnosis of patients consulting and frequency of consultations analysed as standardised consultation ratios and standardised patient consultation ratios. Compared with other ethnic groups male Asians (that is, including those born in Britain and those originating from the Indian subcontinent and east Africa) had a substantially increased standardised patient consultation ratio. Consultation rates for mental disorders--in particular, anxiety and depression--were reduced in all groups of immigrant descent. West Indians consulted more frequently for hypertension and asthma, and their children less frequently with otitis media. Asians consulted more frequently with upper respiratory tract infections and non-specific symptoms. Native British patients were more likely to leave the surgery with a follow up appointment, prescription, or certificate. Notwithstanding the limitations of this study, ethnic differences in consultation rates were apparent. These differences require further investigation if the needs of minority ethnic groups are not to be overlooked.

  10. Mixed methodology approach in pharmacy practice research.

    PubMed

    Azhar, Saira; Latif, Usman; Murtaza, Ghulam; Khan, Shujaat A; Hussain, Izhar

    2013-01-01

    Healthcare providers play a major role in attending to all domains of health in a population. In terms of modem healthcare delivery, better health outcomes for population can be achieved by engaging multi-disciplinary expertise. In the last decade, pharmacy profession had transformed tremendously in terms of health and pharmaceutical service provision to both patients and general population. Within this practice transformation, pharmacists, especially those in developed countries, now occupy a respectable position within the healthcare system. In contrast, services and expertise offered by pharmacists in developing countries are still underutilized, and their role as healthcare professionals is not deemed to be important either by the community or by other healthcare providers, especially doctors and nurses. In order to explore the current perspectives regarding the role of pharmacists in the context of a developing country, a systematic research is needed. Mixed methodology research should be used for evidence generation. The philosophy of mixed method research came up decades ago. This approach is widely recommended for social and human sciences research. In recent existence, many researchers have begun to recommend mixed methods research as a separate methodology or design. Many factors have brought into the evolution of mixed methods research. A combination of both forms of data can provide the most complete analysis of the issues related to the pharmacy practice research. Numbers in quantitative and words in qualitative can be enclosed together to give the better understanding of research questions. Both forms of data are necessary for pharmacy practice research especially in case of developing countries where there is a need to generate the evidence for future health policy.

  11. Intervention Fidelity in Special and General Education Research Journals

    ERIC Educational Resources Information Center

    Swanson, Elizabeth; Wanzek, Jeanne; Haring, Christa; Ciullo, Stephen; McCulley, Lisa

    2013-01-01

    Treatment fidelity reporting practices are described for journals that published general and special education intervention research with high impact factors from 2005 through 2009. The authors reviewed research articles, reported the proportion of intervention studies that described fidelity measurement, detailed the components of fidelity…

  12. Intervention Fidelity in Special and General Education Research Journals

    ERIC Educational Resources Information Center

    Swanson, Elizabeth; Wanzek, Jeanne; Haring, Christa; Ciullo, Stephen; McCulley, Lisa

    2013-01-01

    Treatment fidelity reporting practices are described for journals that published general and special education intervention research with high impact factors from 2005 through 2009. The authors reviewed research articles, reported the proportion of intervention studies that described fidelity measurement, detailed the components of fidelity…

  13. Critical Researches on General Electrodynamics

    NASA Astrophysics Data System (ADS)

    Ritz, Walter; Fritzius, Robert

    1980-11-01

    Electric and electrodynamic phenomena have acquired in the course of these last years more and more importance. They include Optics, the laws of radiation and the innumerable molecular phenomena associated with the presence of charged centers, ions and electrons. Finally, with the notion of electromagnetic mass, Mechanics itself seems obliged to become a chapter of General Electrodynamics. In the form given to it by H. A. Lorentz, Maxwell's theory would thus become the turning point towards a new conception of nature, where the laws of electrodynamics, considered as primary, would contain the laws of motion as special cases and would play the fundamental role in the physical theories which, until now, have belonged to Mechanics. Under these circumstances, it is plainly desirable to have a rigorous criticism of the foundations of this theory, to give it the degree of clarity and precision that Mechanics itself reached only recently after much controversy. It is in order to ask which hypotheses are essential and can be deduced from observations, which others are logically useless or can be discarded without experience ceasing to be adequately represented, and finally, which are those which can be, and should be rejected; a question which is asked principally in regard to absolute motion.

  14. Thermal comfort: research and practice.

    PubMed

    van Hoof, Joost; Mazej, Mitja; Hensen, Jan L M

    2010-01-01

    Thermal comfort--the state of mind, which expresses satisfaction with the thermal environment--is an important aspect of the building design process as modern man spends most of the day indoors. This paper reviews the developments in indoor thermal comfort research and practice since the second half of the 1990s, and groups these developments around two main themes; (i) thermal comfort models and standards, and (ii) advances in computerization. Within the first theme, the PMV-model (Predicted Mean Vote), created by Fanger in the late 1960s is discussed in the light of the emergence of models of adaptive thermal comfort. The adaptive models are based on adaptive opportunities of occupants and are related to options of personal control of the indoor climate and psychology and performance. Both models have been considered in the latest round of thermal comfort standard revisions. The second theme focuses on the ever increasing role played by computerization in thermal comfort research and practice, including sophisticated multi-segmental modeling and building performance simulation, transient thermal conditions and interactions, thermal manikins.

  15. General practice training and virtual communities of practice - a review of the literature

    PubMed Central

    2012-01-01

    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 relevant to virtual communities of practice in General Practice training, identify evidence-based principles that might guide their construction and suggest further avenues for research. Methods Major online databases Scopus, Psychlit and Pubmed were searched for the terms “Community of Practice” (CoP) AND (Online OR Virtual OR Electronic) AND (health OR healthcare OR medicine OR “Allied Health”). Only peer-reviewed journal articles in English were selected. A total of 76 articles were identified, with 23 meeting the inclusion criteria. There were no studies on CoP or VCoP in General Practice training. The review was structured using a framework of six themes for establishing communities of practice, derived from a key study from the business literature. This framework has been used to analyse the literature to determine whether similar themes are present in the health literature and to identify evidence in support of virtual communities of practice for General Practice training. Results The framework developed by Probst is mirrored in the health literature, albeit with some variations. In particular the roles of facilitator or moderator and leader whilst overlapping, are different. VCoPs are usually collaborations between stakeholders rather than single company

  16. Clinical placements in general practice: relationships between practice nurses and tertiary institutions.

    PubMed

    Peters, Kathleen; Halcomb, Elizabeth J; McInnes, Susan

    2013-05-01

    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 models of clinical placement. This paper uses qualitative research methods to explore the perspectives of 12 Australian general practice nurses who have experience in facilitating undergraduate clinical placements about the relationships between HEIs and nurses. Findings are presented in the following three themes: (1) Appropriate preparation for placement: They don't know what primary health really means, (2) Seeking greater consultation in the organisation of clinical placements: they've got to do it one way for everyone, and (3) Uncertainty and lack of support: I had no contact with the university. Clinical placements in general practice can be an innovative strategy providing non-traditional, yet high quality, teaching and learning experiences for undergraduate nursing students. To optimise the quality of these placements, however, it is essential that HEIs provide appropriate support to the practice nurses mentoring these students.

  17. Some Contributions of General Systems Theory, Cybernetics Theory and Management Control Theory to Evaluation Theory and Practice. Research on Evaluation Program Paper and Report Series. Interim Draft.

    ERIC Educational Resources Information Center

    Cook, Desmond L.

    This document, one of a series of reports examining the possible contribution of other disciplines to evaluation methodology, describes the major elements of general systems theory (GST), cybernetics theory (CT) and management control theory (MCT). The author suggests that MCT encapsulates major concerns of evaluation since it reveals that…

  18. Exploring the Knowledge, Attitudes, Beliefs, and Communication Preferences of the General Public regarding HPV: Findings from CDC Focus Group Research and Implications for Practice

    ERIC Educational Resources Information Center

    Friedman, Allison L.; Shepeard, Hilda

    2007-01-01

    Genital human papillomavirus (HPV) infection is the most common sexually transmitted virus in the United States, causing genital warts, cervical cell abnormalities, and cervical cancer in women. To inform HPV education efforts, 35 focus groups were conducted with members of the general public, stratified by gender, race/ethnicity, and urban/rural…

  19. Exploring the Knowledge, Attitudes, Beliefs, and Communication Preferences of the General Public regarding HPV: Findings from CDC Focus Group Research and Implications for Practice

    ERIC Educational Resources Information Center

    Friedman, Allison L.; Shepeard, Hilda

    2007-01-01

    Genital human papillomavirus (HPV) infection is the most common sexually transmitted virus in the United States, causing genital warts, cervical cell abnormalities, and cervical cancer in women. To inform HPV education efforts, 35 focus groups were conducted with members of the general public, stratified by gender, race/ethnicity, and urban/rural…

  20. Operator priming and generalization of practice in adults' simple arithmetic.

    PubMed

    Chen, Yalin; Campbell, Jamie I D

    2016-04-01

    There is a renewed debate about whether educated adults solve simple addition problems (e.g., 2 + 3) by direct fact retrieval or by fast, automatic counting-based procedures. Recent research testing adults' simple addition and multiplication showed that a 150-ms preview of the operator (+ or ×) facilitated addition, but not multiplication, suggesting that a general addition procedure was primed by the + sign. In Experiment 1 (n = 36), we applied this operator-priming paradigm to rule-based problems (0 + N = N, 1 × N = N, 0 × N = 0) and 1 + N problems with N ranging from 0 to 9. For the rule-based problems, we found both operator-preview facilitation and generalization of practice (e.g., practicing 0 + 3 sped up unpracticed 0 + 8), the latter being a signature of procedure use; however, we also found operator-preview facilitation for 1 + N in the absence of generalization, which implies the 1 + N problems were solved by fact retrieval but nonetheless were facilitated by an operator preview. Thus, the operator preview effect does not discriminate procedure use from fact retrieval. Experiment 2 (n = 36) investigated whether a population with advanced mathematical training-engineering and computer science students-would show generalization of practice for nonrule-based simple addition problems (e.g., 1 + 4, 4 + 7). The 0 + N problems again presented generalization, whereas no nonzero problem type did; but all nonzero problems sped up when the identical problems were retested, as predicted by item-specific fact retrieval. The results pose a strong challenge to the generality of the proposal that skilled adults' simple addition is based on fast procedural algorithms, and instead support a fact-retrieval model of fast addition performance.

  1. Research Making Its Way into Classroom Practice

    ERIC Educational Resources Information Center

    Johnston, Peter; Goatley, Virginia

    2015-01-01

    Identifying researchers whose work has influenced classroom practice, raises questions about the nature of research and its relationship with practice, and the means through which knowledge is distributed. We argue that normally, influence arises through lines of research more than individuals, that knowing-in-practice distribution systems should…

  2. Research Making Its Way into Classroom Practice

    ERIC Educational Resources Information Center

    Johnston, Peter; Goatley, Virginia

    2015-01-01

    Identifying researchers whose work has influenced classroom practice, raises questions about the nature of research and its relationship with practice, and the means through which knowledge is distributed. We argue that normally, influence arises through lines of research more than individuals, that knowing-in-practice distribution systems should…

  3. The UMDS MSc in general practice: attainment of intended outcomes.

    PubMed Central

    Calvert, G; Britten, N

    1998-01-01

    BACKGROUND: The United Medical and Dental School's (UMDS's) MSc in general practice is one of the longest running courses of its kind. Although descriptive accounts of such courses have been published, little is known about their outcomes. AIM: To measure the extent to which graduates feel they have personally achieved 16 intended outcomes derived from the course objectives, and to record current academic activities, particularly teaching and research. METHOD: A postal questionnaire to graduates of the UMDS MSc in General Practice. RESULTS: The response rate was 93%. Of the 71 responders, 23 have gone on to register for or complete other degrees or diplomas. Over two-thirds of responders had an academic commitment following the MSc. Two-thirds were currently engaged in research and over half reported having had work accepted for publication. The majority of graduates confirmed the attainment of all 16 outcomes, although outcomes related to personal achievements were endorsed more strongly than those related to service delivery. CONCLUSION: UMDS graduates are making a significant contribution to their discipline and are unanimous in describing the course as an important event in their personal development. As a result of this study, the course organizers are seeking to increase the links between academic study and everyday practice. PMID:10198485

  4. The validity of dietary assessment in general practice

    PubMed Central

    Little, P.; Barnett, J.; Margetts, B.; Kinmonth, A. L.; Gabbay, J.; Thompson, R.; Warm, D.; Warwick, H.; Wooton, S.

    1999-01-01

    OBJECTIVE: To validate a range of dietary assessment instruments in general practice. METHODS: Using a randomised block design, brief assessment instruments and more complex conventional dietary assessment tools were compared with an accepted "relative" standard--a seven day weighed dietary record. The standard was checked using biomarkers, and by performing test-retest reliability in additional subjects (n = 29). OUTCOMES: Agreement with weighed record. Percentage agreement with weighed record, rank correlation from scatter plot, rank correlation from Bland-Altman plot. Reliability of the weighed record. SETTING: Practice nurse treatment room in a single suburban general practice. SUBJECTS: Patients with risk factors for cardiovascular disease (n = 61) or age/sex stratified general population group (n = 50). RESULTS: Brief self completion dietary assessment tools based on food groups caten during a week show reasonable agreement with the relative standard. For % energy from fat and saturated fat, non-starch polysaccharide, grams of fruit and vegetables and starchy foods consumed the range of agreement with the standard was: median % difference -6% to 12%, rank correlation 0.5 to 0.6. This agreement is of a similar order to the reliability of the weighed record, as good as or better than test standard agreement for more time consuming instruments, and compares favourably with research instruments validated in other settings. Under-reporting of energy intake was common (40%) and more likely if subjects were obese (body mass idex (BMI) > or = 30 60% under-reported; BMI < 30 29%, p < 0.001). CONCLUSION: Under-reporting of absolute energy intake is common, particularly among obese patients. Simple self assessment tools based on food groups, designed for practice nurse dietary assessment, show acceptable agreement with a standard, and suggest such tools are sufficiently accurate for clinical work, research, and possibly population dietary monitoring.   PMID:10396494

  5. Professional autonomy - is it the future of general practice?

    PubMed

    Fraser, John

    2006-05-01

    Internationally, rising financial costs and increasing expectations of health care delivery have increased regulation and decreased the autonomy of general practitioners and other health care professionals. This article explores professional autonomy within Australian general practice, and outlines the importance of autonomy in systems approaches to organisational change in general practice.

  6. Engaging Musical Practices: A Sourcebook for Middle School General Music

    ERIC Educational Resources Information Center

    Burton, Suzanne L., Ed.

    2012-01-01

    Middle school general music may be a student's last encounter with school music. A practical book with accessible pedagogical resources on middle school general music is needed for methods courses and music practitioners' use. The book "Engaging Musical Practices: A Sourcebook for Middle School General Music" presents numerous ways to engage…

  7. Engaging Musical Practices: A Sourcebook for Middle School General Music

    ERIC Educational Resources Information Center

    Burton, Suzanne L., Ed.

    2012-01-01

    Middle school general music may be a student's last encounter with school music. A practical book with accessible pedagogical resources on middle school general music is needed for methods courses and music practitioners' use. The book "Engaging Musical Practices: A Sourcebook for Middle School General Music" presents numerous ways to engage…

  8. Faculty development in general practice in Germany: experiences, evaluations, perspectives.

    PubMed

    Herrmann, Markus; Lichte, Thomas; Von Unger, Hella; Gulich, Markus; Waechtler, Hannelore; Donner-Banzhoff, Norbert; Wilm, Stefan

    2007-03-01

    From 1999 to 2001, the German Society of General Practice and Family Medicine (DEGAM) pioneered a faculty development programme to help general practitioners (GPs) interested in an academic career to develop their skills in teaching, primary care, quality assurance and research. The programme involves five weekend-training sessions over 18 months and applies a learner-centred approach. Participants choose the learning formats and switch between the roles of learners, teachers, chair persons and programme organizers. This article evaluates the acceptability and feasibility of the programme. Data were collected over a two-year period from the 16 participants who completed the first training programme. The evaluation involved a focus group, telephone interviews and email questionnaires. Participants appreciated the learner centred format of the programme and gained new teaching and research skills. They also learned to better assess and critically reflect on their professional work as GPs and reported improved academic 'survival skills' due to collaborative networks with colleagues. The faculty development programme proved advantageous for the personal and professional development of the participating GPs. It constitutes a promising tool for the further development of General Practice as an academic discipline that is still in the process of establishing itself at medical schools in Germany.

  9. Pharmacogenetics of smoking cessation in general practice: results from the patch II and patch in practice trials.

    PubMed

    David, Sean P; Johnstone, Elaine C; Churchman, Michael; Aveyard, Paul; Murphy, Michael F G; Munafò, Marcus R

    2011-03-01

    Cigarette smoking remains the leading cause of preventable death worldwide. However, the efficacy of available first-line therapies remains low, particularly in primary care practice where most smokers seek and receive treatment. These observations reinforce the notion that 'one size fits all' smoking cessation therapies may not be optimal. Therefore, a translational research effort was launched by the Imperial Cancer Research Fund (later Cancer Research UK) General Practice Research Group, who led a decade-long research enterprise that examined the influence of pharmacological hypothesis-driven research into genetic influences on drug response for smoking cessation with transdermal nicotine replacement therapy in general practice. New and previously published smoking cessation genetic association results of 30 candidate gene polymorphisms genotyped for participants in two transdermal nicotine replacement clinical trials based in UK general practices, which employed an intention to analyze approach. By this high bar, one of the polymorphisms (COMT rs4680) was robust to correction for multiple comparisons. Moreover, future research directions are outlined; and lessons learned as well as best-practice models for designing, analyzing, and translating results into clinical practice are proposed. The results and lessons learned from this general practice-based pharmacogenetic research programme provide transportable insights at the transition to the second generation of pharmacogenetic and genomic investigations of smoking cessation and its translation to primary care.

  10. Safe and effective cultural mentorship in general practice.

    PubMed

    Liaw, Siaw-Teng; Wade, Vicki; Lau, Phyllis; Hasan, Iqbal; Furler, John

    2016-06-01

    Closing the gap in health and welfare for Aboriginal and Torres Strait Islander peoples is an ongoing challenge. The objectives of this article are to conceptualise and operationalise models of cultural mentorship within a multifaceted practice-based program to facilitate culturally and clinically appropriate care. Participatory action research and workshops were conducted with Aboriginal Elders, Aboriginal health workers (AHWs), Indigenous health project officers (IHPOs) and staff from participating Medicare Locals (MLs). Roles and responsibilities in a cultural mentorship relationship were defined, along with potential benefits and harm. Mentors and mentees should be comfortable with their own identity and/or ethnicity before engaging in a mentorship relationship. Mutual trust is implicit and participants must be prepared, flexible and mutually respectful to achieve mutual goals. The cultural mentorship model includes Aboriginal Elders and local care partnerships of Aboriginal community-controlled and primary care organisations, and practice mentorship teams of a local AHW/IHPO, research project officer and, where available, ML practice support officer. A successful cultural mentorship model is multi-level and safe, and requires mutual trust and respect, time and resources. Potential benefits include equitable access to, and use of, safe quality care for Aboriginal and Torres Strait Islander patients in general practice.

  11. Involvement of general public in biomedical research

    PubMed Central

    Pramesh, C. S.; Venkataramanan, R.; Suvarna, Viraj; Goel, Nishu Singh; Lakshman, S.; Venkatesh, Viji; Gupta, Vandana; Badwe, Rajendra

    2016-01-01

    Biomedical research is crucial for any country's progress and the health of its ethnic population. This effort needs to be sustained and well supported for it to bear optimum results. The major stakeholders in medical research are the general public, patients, researchers, physicians (and medical institutions), the pharmaceutical industry, regulatory authorities, and the government. Much of the pressure to perform cutting edge research in developed countries is driven by the general public; however, this has been conspicuous by its absence in India. This is largely due to misconceptions that medical research in developing countries is an experimental exercise using human beings as guinea pigs, primarily benefiting only the pharmaceutical industry and a general lack of awareness about the importance of original research within the country. This editorial addresses various issues related to public involvement in biomedical research and suggests the need for solutions and imperative remedial measures. PMID:27843788

  12. The FACT-G7: a rapid version of the functional assessment of cancer therapy-general (FACT-G) for monitoring symptoms and concerns in oncology practice and research.

    PubMed

    Yanez, B; Pearman, T; Lis, C G; Beaumont, J L; Cella, D

    2013-04-01

    Health-related quality-of-life (HRQOL) assessments in research and clinical oncology settings are increasingly important. HRQOL instruments need to be rapid and still maintain the ability to capture the most relevant patient issues in a valid and reliable manner. The current study develops and validates the FACT-G7, a rapid version of the Functional Assessment of Cancer Therapy-General (FACT-G). Oncology patients with advanced cancer (N = 533) from 11 diseases sites ranked the symptoms and concerns they viewed as 'the very most important' when undergoing cancer treatment, completed the FACT-G, and additional HRQOL measures. Oncology patients' scores were referenced across a general US population sample (N = 2000). We selected the highest priority cancer-related symptoms and concerns endorsed by patients for inclusion in the FACT-G7. Fatigue and ability to enjoy life were ranked the most highly. The results provide preliminary support for the FACT-G7's internal consistency reliability (α = 0.74) and validity as evidenced by moderate-to-strong relationships with expected criteria. The references for the general population are summarized. The FACT-G7 can be used to assess top-rated symptoms and concerns for a broad spectrum of advanced cancers in clinical practice and research.

  13. General practice nursing: who is cherishing this workforce?

    PubMed Central

    Webley-Brown, Carol

    2017-01-01

    The remodelling of the NHS requires a strong general practice nurse (GPN) workforce within general practice. The challenges facing general practice nursing are set within the current policy context and recent available evidence and illustrated by drawing upon the experience of a current GPN working in London. It is argued that there is a need to support the professional development of GPNs and nurture the next generation of potential GPNs if the current shortage of GPNs is to be addressed. PMID:28356920

  14. Outcomes of implants and restorations placed in general dental practices

    PubMed Central

    Da Silva, John D.; Kazimiroff, Julie; Papas, Athena; Curro, Frederick A.; Thompson, Van P.; Vena, Donald A.; Wu, Hongyu; Collie, Damon; Craig, Ronald G.

    2017-01-01

    Objectives The authors conducted a study to determine the types, outcomes, risk factors and esthetic assessment of implants and their restorations placed in the general practices of a practice-based research network. Methods All patients who visited network practices three to five years previously and underwent placement of an implant and restoration within the practice were invited to enroll. Practitioner-investigators (P-Is) recorded the status of the implant and restoration, characteristics of the implant site and restoration, presence of peri-implant pathology and an esthetic assessment by the P-I and patient. The P-Is classified implants as failures if the original implant was missing or had been replaced, the implant was mobile or elicited pain on percussion, there was overt clinical or radiographic evidence of pathology or excessive bone loss (> 0.2 millimeter per year after an initial bone loss of 2 mm). They classified restorations as failures if they had been replaced or if there was abutment or restoration fracture. Results The authors enrolled 922 implants and patients from 87 practices, with a mean (standard deviation) follow-up of 4.2 (0.6) years. Of the 920 implants for which complete data records were available, 64 (7.0 percent) were classified as failures when excessive bone loss was excluded from the analysis. When excessive bone loss was included, 172 implants (18.7 percent) were classified as failures. According to the results of univariate analysis, a history of severe periodontitis, sites with preexisting inflammation or type IV bone, cases of immediate implant placement and placement in the incisor or canine region were associated with implant failure. According to the results of multivariate analysis, sites with preexisting inflammation (odds ratio [OR] = 2.17; 95 percent confidence interval [CI], 1.41–3.34]) or type IV bone (OR = 1.99; 95 percent CI, 1.12–3.55) were associated with a greater risk of implant failure. Of the 908 surviving

  15. Preparing practicing dentists to engage in practice-based research.

    PubMed

    DeRouen, Timothy A; Hujoel, Philippe; Leroux, Brian; Mancl, Lloyd; Sherman, Jeffrey; Hilton, Thomas; Berg, Joel; Ferracane, Jack

    2008-03-01

    The authors describe an educational program designed to prepare practicing dentists to engage in practice-based research in their practices--a trend receiving more emphasis and funding from the National Institute of Dental and Craniofacial Research (NIDCR). The Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT), an NIDCR-funded network of which the authors are members, developed a one-day educational program to educate practitioners in principles of good clinical research. The program has four components built around the following questions: "What is the question?"; "What are the options?"; "How do you evaluate the evidence?"; and "How do you conduct a study?" The intensive one-day program initially offered in early 2006, which concluded with applications of research principles to research topics of interest to practitioners, was well-received. Despite their admission that the research methodology by itself was not of great interest, the dentists recognized the importance of the background material in equipping them to conduct quality studies in their practices. Dentists interested in participating in practice-based research view training in research methodology as helpful to becoming better practitioner-investigators. The PRECEDENT training program seemed to reinforce their interest. As dentistry evolves to become more evidence-based, more and more of the evidence will come from practice-based research. This training program prepares practicing dentists to become engaged in this trend.

  16. Managing same day appointments--a qualitative study in Australian general practice.

    PubMed

    Garth, Belinda; Temple-Smith, Meredith; Clark, Malcolm; Hutton, Cathy; Deveny, Elizabeth; Biezen, Ruby; Pirotta, Marie

    2013-04-01

    General practices are required to have flexible systems to accommodate urgent appointments. Not all patients requesting a same day appointment receive one. There is scant research detailing how requests for same day appointments are managed. Our study examined this issue from the perspective of practice staff. Twenty practice staff (receptionists, practice managers, general practitioners, practice nurse) from 10 general practices participated in semistructured interviews, which were audiorecorded, transcribed and analysed thematically. All but three practices set aside appointments for patients requesting a same day appointment. Themes included contradictions between policy and practice and the role of experience in determining urgency. Five types of urgent needs for same day appointments were identified: medical, administrative, therapeutic, logistic and emotional. Practice policies must make clear roles and responsibilities for all staff managing patient appointments. Aspects of clinic policies and practices could be reviewed to reduce medicolegal risk and additional workload caused by non-medically urgent needs.

  17. The future of bereavement care in British general practice.

    PubMed

    Woof, W R

    1997-06-01

    This paper discusses the future of bereavement care in British general practice by providing an insight into existing practice and then speculating on influences that may shape developments. There have been calls for the specialty to build on this traditional role and expand its bereavement service. Specific suggestions for the content of such a service are summarised. This emphasis reflects the increasing awareness in bereavement by other health organisations. This image of an expanding service needs to be contextualised within a primary care system that is feeling more pressurised due to increasing workload. This will continue to inhibit extensive service development. In addition it is important for the profession to consider the appropriateness of this activity. This complex debate has received little attention and research is required to inform and provide the necessary direction.

  18. Laser therapy in general dental practice

    NASA Astrophysics Data System (ADS)

    Darbar, Arun A.

    2006-02-01

    This is a clinical presentation on the use of laser therapy in a private dental practice using a 810nm diode. A wide range of conditions involving pain management, treatment and as an adjunct to procedures to enhance patient comfort and experience. This will include cases treated for TMD (Temporo mandibular dysfunction), apthous ulcers, angular chelitis, cold sores, gingival retraction, periodontal treatment and management of failing dental implants. The case presentation will include the protocols used and some long term reviews. The results have been very positive and will be shared to enable this form of treatment to be used more frequently and with confidence within dental practice.

  19. Health care in patients 1 year post-stroke in general practice: research on the utilisation of the Dutch Transmural Protocol transient ischaemic attack/cerebrovascular accident.

    PubMed

    de Weerd, L; Rutgers, A W F; Groenier, K H; van der Meer, K

    2012-01-01

    This study evaluates the kind of aftercare that ischaemic stroke patients receive and the extent that aftercare fulfils the criteria of the 'Dutch Transmural Protocol transient ischaemic attack/cerebrovascular accident'. Fifty-seven patients were interviewed 1 year post-stroke about secondary prevention and aftercare. Forty general practitioners (GPs) completed a questionnaire about guidance and secondary prevention (concerning medication and lifestyle advice). Most patients would like to see their GP more regularly. More aftercare was required than was planned. The use of aspirin remained the same, fewer patients used statins and more used antihypertensives. Of the 40 GPs who participated, 12% did not apply prevention. Blood pressure, glucose and cholesterol were measured in 84%, 28% and 40% of patients. All of these measures were often elevated, but treatment was not given. Lifestyle advice was offered to one-quarter of patients. Considering all of the advice given in the Dutch Protocol, several aspects can be improved in relation to secondary prevention. Too little attention is paid to giving lifestyle advice, stricter medical checkups by GPs are necessary and there is a decrease in use of preventive medication, partly because GPs monitors use of medication inadequately. The use of the Dutch Protocol in aftercare can be improved by a more detailed description of advice.

  20. Chinese hotel general managers' perspectives on energy-saving practices

    NASA Astrophysics Data System (ADS)

    Zhu, Yidan

    As hotels' concern about sustainability and budget-control is growing steadily, energy-saving issues have become one of the important management concerns hospitality industry face. By executing proper energy-saving practices, previous scholars believed that hotel operation costs can decrease dramatically. Moreover, they believed that conducting energy-saving practices may eventually help the hotel to gain other benefits such as an improved reputation and stronger competitive advantage. The energy-saving issue also has become a critical management problem for the hotel industry in China. Previous research has not investigated energy-saving in China's hotel segment. To achieve a better understanding of the importance of energy-saving, this document attempts to present some insights into China's energy-saving practices in the tourist accommodations sector. Results of the study show the Chinese general managers' attitudes toward energy-saving issues and the differences among the diverse hotel managers who responded to the study. Study results indicate that in China, most of the hotels' energy bills decrease due to the implementation of energy-saving equipments. General managers of hotels in operation for a shorter period of time are typically responsible for making decisions about energy-saving issues; older hotels are used to choosing corporate level concerning to this issue. Larger Chinese hotels generally have official energy-saving usage training sessions for employees, but smaller Chinese hotels sometimes overlook the importance of employee training. The study also found that for the Chinese hospitality industry, energy-saving practices related to electricity are the most efficient and common way to save energy, but older hotels also should pay attention to other ways of saving energy such as water conservation or heating/cooling system.

  1. Assessment of management in general practice: validation of a practice visit method.

    PubMed Central

    van den Hombergh, P; Grol, R; van den Hoogen, H J; van den Bosch, W J

    1998-01-01

    BACKGROUND: Practice management (PM) in general practice is as yet ill-defined; a systematic description of its domain, as well as a valid method to assess it, are necessary for research and assessment. AIM: To develop and validate a method to assess PM of general practitioners (GPs) and practices. METHOD: Relevant and potentially discriminating indicators were selected from a systematic framework of 2410 elements of PM to be used in an assessment method (VIP = visit instrument PM). The method was first tested in a pilot study and, after revision, was evaluated in order to select discriminating indicators and to determine validity of dimensions (factor and reliability analysis, linear regression). RESULTS: One hundred and ten GPs were assessed with the practice visit method using 249 indicators; 208 of these discriminated sufficiently at practice level or at GP level. Factor analysis resulted in 34 dimensions and in a taxonomy of PM. Dimensions and indicators showed marked variation between GPs and practices. Training practices scored higher on five dimensions; single-handed and dispensing practices scored lower on delegated tasks, but higher on accessibility and availability. CONCLUSION: A visit method to assess PM has been developed and its validity studied systematically. The taxonomy and dimensions of PM were in line with other classifications. Selection of a balanced number of useful and relevant indicators was nevertheless difficult. The dimensions could discriminate between groups of GPs and practices, establishing the value of the method for assessment. The VIP method could be an important contribution to the introduction of continuous quality improvement in the profession. PMID:10198481

  2. [Assessment of suicidal behaviour in general practice].

    PubMed

    Vörös, Viktor; Osváth, Péter; Ruzsics, István; Nagy, Tünde; Kovács, László; Varga, József; Fekete, Sándor; Kovács, Attila

    2006-02-12

    To assess the prevalence of suicidal behavior (wish to die, suicidal thoughts, suicide attempts) and to determine the characteristics of suicide attempters in primary care, including screening for major mental disorders. A Hungarian urban general practitioner's district with 1248 inhabitants was screened for suicidal behavior as well as for major mental disorders. All the patients (n=382) who visited their general practitioner within a two-week period were asked to participate. 277 patients completed the Prime-MD questionnaire, an easy-to-use diagnostic instrument developed for general practitioners to recognize the most common psychiatric disorders, like depressive (major depressive disorder, minor depressive disorder), anxiety (panic disorder, generalized anxiety disorder), somatoform, eating and alcohol related disorders. Detailed data about suicidal thoughts and attempts were also collected by the structured questions of MINI-Plus diagnostic interview. Prevalence of suicide attempts in primary care was 2.9%. 9% of the patients had either suicidal thoughts or suicide attempts in the previous month. Suicidal patients were more ready to use psychotropic drugs, they assessed their health status more poorly, and had more mental symptoms than the control group (non-suicidal patients). 60% of suicidal patients and 11.5% of the investigated population had a current depressive episode. Beside depressive symptoms, anxiety disorders and alcohol problems were also more common among suicidal patients. The rate of previous psychiatric treatments was also higher in suicidal patients, who generally visited their general practitioners less frequently than non-suicidal patients. According to multivariate logistic regression, suicidal patients are more ready to take antidepressants, they tend to have more previous psychiatric treatments and suicidal attempts, and they visit their general practitioners less frequently and have a current depressive episode. Suicidal behavior and

  3. General practitioners' continuing medical education within and outside their practice.

    PubMed Central

    Owen, P. A.; Allery, L. A.; Harding, K. G.; Hayes, T. M.

    1989-01-01

    To study continuing medical education 96 out of 101 general practitioners chosen at random from the list held by a family practitioner committee were interviewed. The results provided little evidence of regular attendance at local postgraduate centre meetings, though practice based educational meetings were common. Thirty one of the general practitioners worked in practices that held one or more practice based educational meetings each month at which the doctors provided the main educational content. Performance review was undertaken in the practices of 51 of the general practitioners, and 80 of the doctors recognised its value. The general practitioners considered that the most valuable educational activities occurred within the practice, the most valued being contact with partners. They asked for increased contact with hospital doctors. The development of general practitioners' continuing medical education should be based on the content of the individual general practitioner's day to day work and entail contact with his or her professional colleagues. PMID:2504381

  4. Health promotion and ill-health prevention: the role of general practice.

    PubMed

    Peckham, Stephen; Hann, Alison; Boyce, Tammy

    2011-01-01

    This paper reports on research undertaken for the King's Fund inquiry into quality in general practice and examines the health promotion role of the general practitioner. Literature review of health promotion in general practice focusing on smoking cessation, childhood immunisation, coronary heart disease (CHD) and obesity. In addition the paper draws on interviews with practice and public health staff. General practitioners (GPs) and their practice teams have a crucial role in promoting health and preventing disease. Consultations provide an ideal opportunity for preventing illness and disease but general practice focuses primarily on secondary prevention. Many GPs state they lack the skills needed to deliver effective health promotion. Issues, such as GP commissioning, provide a new set of challenges for public health and ill-health prevention. The evidence base is growing but general practice, public health and academics need to work together to improve this.

  5. Research: General Semantics Training: Pride or Prejudice?

    ERIC Educational Resources Information Center

    Eckman, Bruce K.

    1978-01-01

    Argues that general semantics research into prejudice has made only minor contributions to an understanding of prejudice because of weak experimental designs. Suggests improvements in research methodology and urges that knowledge of the semantic world of minority groups be sought as a prerequisite to eliminating cultural bias in standardized…

  6. Research: General Semantics Training: Pride or Prejudice?

    ERIC Educational Resources Information Center

    Eckman, Bruce K.

    1978-01-01

    Argues that general semantics research into prejudice has made only minor contributions to an understanding of prejudice because of weak experimental designs. Suggests improvements in research methodology and urges that knowledge of the semantic world of minority groups be sought as a prerequisite to eliminating cultural bias in standardized…

  7. Improvisational Practices in Elementary General Music Classrooms

    ERIC Educational Resources Information Center

    Gruenhagen, Lisa M.; Whitcomb, Rachel

    2014-01-01

    Despite historic and ongoing support for the inclusion of improvisation in the elementary general music curriculum, music educators consistently report challenges with implementation of improvisational activities in their classes. This study was designed to examine (a) the extent to which improvisational activities were occurring in the…

  8. Improvisational Practices in Elementary General Music Classrooms

    ERIC Educational Resources Information Center

    Gruenhagen, Lisa M.; Whitcomb, Rachel

    2014-01-01

    Despite historic and ongoing support for the inclusion of improvisation in the elementary general music curriculum, music educators consistently report challenges with implementation of improvisational activities in their classes. This study was designed to examine (a) the extent to which improvisational activities were occurring in the…

  9. 47 CFR 76.1001 - Unfair practices generally.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1001 Unfair practices generally. (a) Unfair practices generally. No cable operator, satellite cable programming vendor in which a cable operator has an attributable interest, or satellite broadcast programming vendor...

  10. 47 CFR 76.1001 - Unfair practices generally.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1001 Unfair practices generally. (a) Unfair practices generally. No cable operator, satellite cable programming vendor in which a cable operator has an attributable interest, or satellite broadcast programming vendor...

  11. 47 CFR 76.1001 - Unfair practices generally.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1001 Unfair practices generally. (a) Unfair practices generally. No cable operator, satellite cable programming vendor in which a cable operator has an attributable interest, or satellite broadcast programming vendor...

  12. 47 CFR 76.1001 - Unfair practices generally.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1001 Unfair practices generally. (a) Unfair practices generally. No cable operator, satellite cable programming vendor in which a cable operator has an attributable interest, or satellite broadcast programming vendor...

  13. 47 CFR 76.1001 - Unfair practices generally.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1001 Unfair practices generally. (a) Unfair practices generally. No cable operator, satellite cable programming vendor in which a cable operator has an attributable interest, or satellite broadcast programming vendor...

  14. New Record Folder for Use in General Practice

    PubMed Central

    Hawkey, J. K.; Loudon, I. S. L.; Greenhalgh, G. P.; Bungay, G. T.

    1971-01-01

    A new concept for filing medical records in general practice is described, based on an A4-size folder; in experimental use in 40 practices doctors were generally in favour of the new system. ImagesFIG. 1FIG. 2 PMID:5134567

  15. Participatory Research: New Approaches to the Research to Practice Dilemma.

    ERIC Educational Resources Information Center

    Meyer, Luanna H.; Park, Hyun-Sook; Grenot-Scheyer, Marquita; Schwartz, Ilene; Harry, Beth

    1998-01-01

    This article presents a rationale for incorporating elements of participatory research approaches into intervention research intended to improve practice. After an overview of the research-to-practice problem, it illustrates how the incorporation of participatory research approaches applied to various decision points can enhance the construction…

  16. Participatory Research: New Approaches to the Research to Practice Dilemma.

    ERIC Educational Resources Information Center

    Meyer, Luanna H.; Park, Hyun-Sook; Grenot-Scheyer, Marquita; Schwartz, Ilene; Harry, Beth

    1998-01-01

    This article presents a rationale for incorporating elements of participatory research approaches into intervention research intended to improve practice. After an overview of the research-to-practice problem, it illustrates how the incorporation of participatory research approaches applied to various decision points can enhance the construction…

  17. The role of the general health questionnaire in general practice consultations.

    PubMed Central

    Smith, P

    1998-01-01

    BACKGROUND: The patient self-rating questionnaire is commonly used as a research tool to identify patients with 'unrecognized' depression. There is no evidence to support its use as a clinical tool in general practice. AIM: To determine whether use of the 30-item general health questionnaire (GHQ) is a practical means of increasing identification of 'new' episodes of emotional distress among patients consulting their general practitioner (GP). METHOD: A randomized controlled trial was carried out in a Scottish new town practice with eight partners. In the waiting room, 1912 patients aged over 14 years and consulting over a 10-month period attempted to complete the GHQ. The 'clinical judgement' group posted the questionnaire into a box then attended the doctor as normal. The 'screened' group presented the questionnaire to the doctor. After the consultation, the doctor completed an assessment questionnaire. The main outcome measures were GHQ scores and doctors' assessments of mental health. RESULTS: In total, 1589 patients were eligible to participate. However, 207 patients in the screened group were excluded because the doctor did not look at the questionnaire. The clinical judgement group (59.7% patients) and the screened group (40.3%) were compared. Although the doctors' diagnoses of distress were low in the clinical judgement group (8.1%), they were significantly greater in the screened group (13.9%) where the diagnosis of depression was doubled. The percentage of patients scoring greater than or equal to 9 (GHQ+) was 21.5% and 21.0% respectively. The level of agreement between the doctors' diagnoses of distress and the questionnaires scoring GHQ+ rose from 19% in the clinical judgement group to 35% in the screened group. CONCLUSIONS: The general health questionnaire used in a practice setting increases the identification of patients with emotional distress. However, the use made of the questionnaires in the screened group raises questions of doctor and patient

  18. Factors influencing pharmacy students’ attitudes towards pharmacy practice research and strategies for promoting research interest in pharmacy practice

    PubMed Central

    Kritikos, Vicky S.; Saini, Bandana; Carter, Stephen; Moles, Rebekah J.; Krass, Ines

    2015-01-01

    Objectives: To (1) investigate the relationships between students’ characteristics and their (a) perceptions of research in general and (b) attitudes towards pharmacy practice research; (2) identify strategies that could be used by pharmacy educators to promote research interest in pharmacy practice; and (3) identify perceived barriers to the pursuit or completion of a pharmacy practice research degree. Methods: A survey was administered to all students enrolled in each year of the four-year pharmacy undergraduate program, University of Sydney, Australia. Perceptions of research in general were measured using 4 items on a five-point semantic-differential scale and attitudes towards pharmacy practice research were measured using 16 items on a five-point Likert scale. Student characteristics were also collected as were responses to open-ended questions which were analysed using content analysis. Results: In total 853 students participated and completed the survey (83% response rate). Participants’ characteristics were associated with some but not all aspects of research and pharmacy practice research. It appeared that positive attitudes and perspectives were influenced strongly by exposure to the ‘research’ process through projects, friends or mentors, previous degrees or having future intentions to pursue a research degree. Results from both the quantitative and qualitative analyses suggest positive attitudes and perceptions of research can be nurtured through the formal inclusion in research processes, particularly the utility of practice research in clinical practice across the four years of study. Participants indicated there was a lack of awareness of the needs, benefits and career opportunities associated with pharmacy practice research and voiced clear impediments in their career path with respect to the choice of practice research-related careers. Conclusions: Future research should investigate changes in perceptions and attitudes in a single cohort

  19. Creating Research Practice Partnerships in Education

    ERIC Educational Resources Information Center

    Penuel, William R.; Gallagher, Daniel J.

    2017-01-01

    "Creating Research-Practice Partnerships in Education" is an invaluable resource for educators and researchers seeking to develop long-term collaborations in which educators and researchers work together to study and solve pressing problems of practice. Drawing on a wide range of examples, the authors describe the purposes for which…

  20. Teaching Research Synthesis to Advanced Practice Nurses.

    ERIC Educational Resources Information Center

    Upchurch, Sandra; Brosnan, Christine A.; Grimes, Deanna E.

    2002-01-01

    A process for teaching research synthesis to advanced practice nurses includes two courses: a first research applications course in which students build bibliographic databases, practice statistical analysis, and develop search skills; and a second course in which they complete literature reviews or meta analyses of research on clinical practice…

  1. Teaching Research Synthesis to Advanced Practice Nurses.

    ERIC Educational Resources Information Center

    Upchurch, Sandra; Brosnan, Christine A.; Grimes, Deanna E.

    2002-01-01

    A process for teaching research synthesis to advanced practice nurses includes two courses: a first research applications course in which students build bibliographic databases, practice statistical analysis, and develop search skills; and a second course in which they complete literature reviews or meta analyses of research on clinical practice…

  2. A Better Research-Practice Partnership

    ERIC Educational Resources Information Center

    Henrick, Erin; Munoz, Marco A.; Cobb, Paul

    2016-01-01

    District leaders often feel that working with researchers is not mutually beneficial. Researchers do not provide enough practical guidance, and they are often unable to present their findings in time to inform district decision making. Research-practice partnerships (RPPs) are a potential new strategy for addressing these challenges. RPPs are…

  3. A Better Research-Practice Partnership

    ERIC Educational Resources Information Center

    Henrick, Erin; Munoz, Marco A.; Cobb, Paul

    2016-01-01

    District leaders often feel that working with researchers is not mutually beneficial. Researchers do not provide enough practical guidance, and they are often unable to present their findings in time to inform district decision making. Research-practice partnerships (RPPs) are a potential new strategy for addressing these challenges. RPPs are…

  4. [Euthanasia and general practice in Belgium].

    PubMed

    Thomas, J M

    2014-09-01

    In Belgium, the GP can perform euthanasia or be called as a consultant. He must know the laws concerning the end of life and be able to explain his rights to his patients. He will know the best practices and techniques for euthanasia. If necessary, he will call help or refer to a more competent colleague. He negotiates with the patient an advanced care planning following the evolution of its pathologies and will witness its wishes regarding end of life against other institutions and doctors.

  5. Paying research participants: a study of current practices in Australia.

    PubMed

    Fry, C L; Ritter, A; Baldwin, S; Bowen, K J; Gardiner, P; Holt, T; Jenkinson, R; Johnston, J

    2005-09-01

    To examine current research payment practices and to inform development of clearer guidelines for researchers and ethics committees. Exploratory email based questionnaire study of current research participant reimbursement practices. A diverse sample of organisations and individuals were targeted. Australia. Contacts in 84 key research organisations and select electronic listservers across Australia. A total of 100 completed questionnaires were received with representations from a variety of research areas (for example, market, alcohol and drug, medical, pharmaceutical and social research). Open-ended and fixed alternative questions about type of research agency; type of research; type of population under study; whether payment is standard; amounts and mechanisms of payment; factors taken into account when deciding on payment practices; and whether payment policies exist. Reimbursement practice is highly variable. Where it occurs (most commonly for drug dependent rather than health professional or general population samples) it is largely monetary and is for time and out-of-pocket expenses. Ethics committees were reported to be often involved in decision making around reimbursement. Research subject payment practices vary in Australia. Researchers who do provide payments to research participants generally do so without written policy and procedures. Ethics committees have an important role in developing guidelines in this area. Specific guidelines are needed considering existing local policies and procedures; payment models and their application in diverse settings; case study examples of types and levels of reimbursement; applied definitions of incentive and inducement; and the rationale for diverse payment practices in different settings.

  6. The ethics of general practice and advertising.

    PubMed Central

    Colman, R D

    1989-01-01

    UK general practitioners (GPs) are self-employed entrepreneurs running small businesses with commercial considerations. In this situation there is no clear distinction between information, self-promotion and advertising. In response to the growing public demand for more information about medical services, the medical profession should voluntarily accept the notion of soft self-promotion in the form of 'notices' or 'announcements' placed in newspapers. Newspapers are the most effective way of giving easy access to information. The resistance to newspapers may be more concerned with preserving certain medical traditions than consideration of the public interest. The General Medical Council's (GMC's) arguments against soft self-promotion are seen as misguided paternalism, inconsistent and irrational. PMID:2746609

  7. Night cough and general practice research

    PubMed Central

    Toop, L.J.; Howie, J.G.R.; Paxton, F.M.

    1986-01-01

    Thirty-four children, aged between three and nine years, presenting with nocturnal cough, were studied on successive nights using an automatic voice activated tape recorder system. Children with a family history of atopy coughed significantly more than children without such a family history. A wide variation in cough frequency was found both between and within subjects. No effects of treatment on cough frequency were demonstrated. Some of the physiological and pathological mechanisms underlying night cough are discussed. PMID:3712337

  8. Improving the safety features of general practice computer systems.

    PubMed

    Avery, Anthony J; Savelyich, Boki S P; Teasdale, Sheila

    2003-01-01

    General practice computer systems already have a number of important safety features. However, there are problems in that general practitioners (GPs) have come to rely on hazard alerts when they are not foolproof. Furthermore, GPs do not know how to make best use of safety features on their systems. There are a number of solutions that could help to improve the safety features of general practice computer systems and also help to improve the abilities of healthcare professionals to use these safety features.

  9. Shoulder injuries - management in general practice.

    PubMed

    Brun, Shane

    2012-04-01

    Shoulder injuries are common in the primary care setting, yet general practitioners may feel unequipped to confidently assess the patient presenting with shoulder pain. This article provides a framework for the initial assessment of a patient presenting with an injured shoulder. A solid understanding of the anatomy and unique features of the shoulder is important to adequately assess any injury. A focused history needs to particularly explore the mechanism of injury, the type of dysfunction and the nature of the pain. On examination, particular attention should be paid to loss of symmetry, localisation of tenderness and the range of movement.

  10. Osteoarthritis - management options in general practice.

    PubMed

    McKenzie, Suzanne; Torkington, Amanda

    2010-09-01

    Osteoarthritis, characterised by joint pain and stiffness, is a common and significant chronic disease, reducing mobility and causing considerable impact on quality of life. Multiple evidence based management options are available. The aim of this article is to summarise the main management options suggested in The Royal Australian College of General Practitioners Guideline for the nonsurgical management of hip and knee osteoarthritis and to also highlight those that are not recommended. Following diagnosis based primarily on history and examination, management focuses on optimising quality of life by providing self management advice combined with appropriate pharmacological and nonpharmacological strategies, aiming to reduce acute exacerbations, prevent complications and delay progression.

  11. Early Reading and Practice-Inspired Research

    ERIC Educational Resources Information Center

    Hill, Susan

    2017-01-01

    Large-scale standardised, early reading assessments abound at the international and national levels, but research into urgent problems facing practitioners remains scarce. Practice-inspired research involves university-researchers in partnership with teacher-researchers undertaking high-quality research to provide relevant and useful knowledge.…

  12. Preparing practicing dentists to engage in practice-based research

    PubMed Central

    DeRouen, Timothy A.; Hujoel, Philippe; Leroux, Brian; Mancl, Lloyd; Sherman, Jeffrey; Hilton, Thomas; Berg, Joel; Ferracane, Jack

    2013-01-01

    Background The authors describe an educational program designed to prepare practicing dentists to engage in practice-based research in their practices—a trend receiving more emphasis and funding from the National Institute of Dental and Craniofacial Research (NIDCR). Methods The Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT), an NIDCR-funded network of which the authors are members, developed a one-day educational program to educate practitioners in principles of good clinical research. The program has four components built around the following questions: “What is the question?”; “What are the options?”; “How do you evaluate the evidence?”; and “How do you conduct a study?” Results The intensive one-day program initially offered in early 2006, which concluded with applications of research principles to research topics of interest to practitioners, was well-received. Despite their admission that the research methodology by itself was not of great interest, the dentists recognized the importance of the background material in equipping them to conduct quality studies in their practices. Conclusions Dentists interested in participating in practice-based research view training in research methodology as helpful to becoming better practitioner-investigators. The PRECEDENT training program seemed to reinforce their interest. Practice Implications As dentistry evolves to become more evidence-based, more and more of the evidence will come from practice-based research. This training program prepares practicing dentists to become engaged in this trend. PMID:18310739

  13. Vertical Integration in Teaching And Learning (VITAL): an approach to medical education in general practice.

    PubMed

    Dick, Marie-Louise B; King, David B; Mitchell, Geoffrey K; Kelly, Glynn D; Buckley, John F; Garside, Susan J

    2007-07-16

    There is increasing demand to provide clinical and teaching experiences in the general practice setting. Vertical integration in teaching and learning, whereby teaching and learning roles are shared across all learner stages, has the potential to decrease time demands and stress on general practitioners, to provide teaching skills and experience to GP registrars, and to improve the learning experience for medical students, and may also help meet the increased demand for teaching in general practice. We consider potential advantages and barriers to vertical integration of teaching in general practice, and provide results of focus group discussions with general practice principals and registrars about vertical integration. We recommend further research into the feasibility of using vertical integration to enhance the capacity to teach medical students in general practice.

  14. Patients' unvoiced agendas in general practice consultations: qualitative study

    PubMed Central

    Barry, Christine A; Bradley, Colin P; Britten, Nicky; Stevenson, Fiona A; Barber, Nick

    2000-01-01

    Objective To investigate patients' agendas before consultation and to assess which aspects of agendas are voiced in the consultation and the effects of unvoiced agendas on outcomes. Design Qualitative study. Setting 20 general practices in south east England and the West Midlands. Participants 35 patients consulting 20 general practitioners in appointment and emergency surgeries. Results Patients' agendas are complex and multifarious. Only four of 35 patients voiced all their agendas in consultation. Agenda items most commonly voiced were symptoms and requests for diagnoses and prescriptions. The most common unvoiced agenda items were: worries about possible diagnosis and what the future holds; patients' ideas about what is wrong; side effects; not wanting a prescription; and information relating to social context. Agenda items that were not raised in the consultation often led to specific problem outcomes (for example, major misunderstandings), unwanted prescriptions, non-use of prescriptions, and non-adherence to treatment. In all of the 14 consultations with problem outcomes at least one of the problems was related to an unvoiced agenda item. Conclusion Patients have many needs and when these are not voiced they can not be addressed. Some of the poor outcomes in the case studies were related to unvoiced agenda items. This suggests that when patients and their needs are more fully articulated in the consultation better health care may be effected. Steps should be taken in both daily clinical practice and research to encourage the voicing of patients' agendas. PMID:10797036

  15. 'Learners as teachers' in general practice: stakeholders' views of the benefits and issues.

    PubMed

    Silberberg, Peter; Ahern, Christine; van de Mortel, Thea F

    2013-09-01

    To explore stakeholders' perceptions of learners teaching (near-peer teaching) in general practice in order to inform training policy. Qualitative semi-structured interviews were conducted with 29 general practice stakeholders. Interviews continued until data saturation was reached. Transcribed interviews underwent thematic analysis. Nine general practices in NSW, Australia. Eleven general practitioner supervisors, eight general practice registrars, two prevocational general practice placement programme trainees, and eight medical students. Learners expressed positive attitudes towards learners teaching, and half were already teaching. Learners and supervisors felt near-peer teaching could enhance their own learning. Supervisors suggested near-peer teaching reduced time pressures on themselves, helped them to keep current, was a form of succession planning, and brought financial benefits to the practice. Having time to assess the capabilities of learners prior to allocating them teaching roles was considered important. Strategies suggested by learners to encourage near-peer teaching include asking learners to teach, mentoring, providing short but regular opportunities to teach, highlighting the clinical relevance of teaching skills, having longer placements for medical students, and allowing learners to teach in areas of interest, expertise or need. Participants looked favourably upon learners teaching in general practice, and felt it could enhance learning. Suggestions were made to facilitate near-peer teaching in general practice. Further quantitative research with a larger and more diverse sample is required to determine if these results can be generalised to the wider general practice population.

  16. URBAN STORMWATER BEST MANAGEMENT PRACTICE (BMP) RESEARCH

    EPA Science Inventory

    Presentation on urban best management practice research conducted by the Urban Watershed Research Branch. The presentation to Region 3 started with Branch history, discussed results of recent projects, identified mechanisms for collaboration between ORD and Regions and discussed ...

  17. A Qualitative Study of the Experiences of Training in General Practice: A Community of Practice?

    ERIC Educational Resources Information Center

    Cornford, Charles S.; Carrington, Bruce

    2006-01-01

    Doctors training to become general practitioners (GPs) enter new "communities of practice". For instance, they initially experience various types of isolation, need new skills and knowledge and find the organisation of general practice different to hospitals. "Communities of practice" concepts help explain some of their…

  18. A Qualitative Study of the Experiences of Training in General Practice: A Community of Practice?

    ERIC Educational Resources Information Center

    Cornford, Charles S.; Carrington, Bruce

    2006-01-01

    Doctors training to become general practitioners (GPs) enter new "communities of practice". For instance, they initially experience various types of isolation, need new skills and knowledge and find the organisation of general practice different to hospitals. "Communities of practice" concepts help explain some of their…

  19. Verbal prescribing in general practice consultations.

    PubMed

    Gibson, Mark; Neil Jenkings, K; Wilson, Rob; Purves, Ian

    2006-09-01

    This paper looks at aspects of doctor-patient communication and focuses on how prescribing decisions fit into the consultation within the context of the use (and non-use) of a technological clinical decision support system (CDSS) in the UK. Analysis of 6 simulated consultations filmed as part of the evaluation of a CDSS system indicated that the general practitioners (GPs) used their computers for a short time during consultations. The data showed that doctors' utterances, occurring at an early stage of the consultations, signalled the prescribing decision and eventual outcome of the consultation. The concept of 'verbal prescriptions' is used to describe these utterances of the GPs, and facilitates an understanding of how prescribing decisions are routinely achieved. Prescribing decisions can occur in the relatively early stages of the consultation, and both prior to and independently of the CDSS. Consequently, we suggest that the pattern of GP decision-making needs to be taken into account in CDSS design. However, this is not just an issue for CDSS design and implementation, as the verbal prescription phenomenon may impact upon patient involvement in decision-making, and even the appropriate use of evidence based medicine.

  20. Specialization and the Current Practices of General Surgeons

    PubMed Central

    Decker, Marquita R; Dodgion, Christopher M; Kwok, Alvin C; Hu, Yue-Yung; Havlena, Jeff A; Jiang, Wei; Lipsitz, Stuart R; Kent, K Craig; Greenberg, Caprice C

    2014-01-01

    Background The impact of specialization on the practice of general surgery has not been characterized. Our goal was to assess general surgeons’ operative practices to inform surgical education and workforce planning. Study Design We examined the practices of general surgeons identified in the 2008 State Inpatient and Ambulatory Surgery Databases of the Healthcare Cost and Utilization Project (HCUP) for three US states. Operations were identified using ICD-9 and CPT codes linked to encrypted physician identifiers. For each surgeon, total operative volume and the percentage of practice comprised of their most common operation were calculated. Correlation was measured between general surgeons’ case volume and the number of other specialists in a health service area. Results There were 1,075 general surgeons who performed 240,510 operations in 2008. The mean operative volume for each surgeon was 224 annual procedures. General surgeons performed an average of 23 different types of operations. For the majority of general surgeons, their most common procedure comprised no more than 30% of total practice. The most common operations, ranked by the frequency that they appeared as general surgeons’ top procedure, included: cholecystectomy, colonoscopy, endoscopy, and skin excision. The proportion of general surgery practice comprised of endoscopic procedures inversely correlated with the number of gastroenterologists in the health service area (Rho = - 0.50, p = 0.005). Conclusions Despite trends toward specialization, the current practices of general surgeons remain heterogeneous. This indicates a continued demand for broad-based surgical education to allow future surgeons to tailor their practices to their environment. PMID:24210145

  1. Undergraduate teaching in UK general practice: a geographical snapshot

    PubMed Central

    Derbyshire, Helen; Rees, Eliot; Gay, Simon P; McKinley, Robert K

    2014-01-01

    Background Learning in general practice is an essential component of undergraduate medical education; currently, on average, 13% of clinical placements in the UK are in general practice. However, whether general practice can sustainably deliver more undergraduate placements is uncertain. Aim To identify the geographical distribution of undergraduate teaching practices and their distance from the host medical school. Design and setting National survey of all medical schools in the UK. Method All 33 UK medical schools were invited to provide the postcodes of their undergraduate teaching practices. These were collated, de-duplicated, and mapped. The distance in kilometres and journey times by car and public transport between each medical school and its teaching practices was estimated using Transport Direct (www.transportdirect.info). The postcodes of every practice in the UK were obtained from the UK’s health departments. Results All 33 UK medical schools responded; 4392 practices contributed to teaching, with a median (minimum–maximum) of 142 (17–385) practices per school. The median (minimum–maximum) distance between a school and a teaching practice was 28 km (0–1421 km), 41 (0:00–23:26) minutes’ travel by car and 1 hour 12 (0:00–17:29) minutes’ travel by public transport. All teaching practices were accessible by public transport in one school and 90–99% were in a further four schools; 24 schools had >20% of practices that were inaccessible by public transport. Conclusion The 4392 undergraduate teaching general practices are widely distributed and potentially any practice, no matter how isolated, could contribute to undergraduate education. However, this is, at the price of a considerable travel burden. PMID:24868071

  2. P-12 Engineering Education Research and Practice

    ERIC Educational Resources Information Center

    Moore, Tamara; Richards, Larry G.

    2012-01-01

    This special issue of "Advances in Engineering Education" explores recent developments in P-12 Engineering Education. It includes papers devoted to research and practice, and reports some of the most exciting work in the field today. In our Call of Papers, we solicited two types of papers: Research papers and Practice papers. The former…

  3. From Research to Practice: Lessons Learned

    ERIC Educational Resources Information Center

    Toth, Sheree L.; Manly, Jody Todd; Nilsen, Wendy J.

    2008-01-01

    Research has informed practice since the origins of developmental psychology, but only recently has basic science and practice begun to be consistently integrated with one another. In addition, considerable research documents the utility of empirically-supported interventions, yet it has been difficult to implement such interventions outside of…

  4. Assessment of general education teachers' Tier 1 classroom practices: contemporary science, practice, and policy.

    PubMed

    Reddy, Linda A; Fabiano, Gregory A; Jimerson, Shane R

    2013-12-01

    Progress monitoring is a type of formative assessment. Most work on progress monitoring in elementary school settings has been focused on students. However, teachers also can benefit from frequent evaluations. Research addressing teacher progress monitoring is critically important given the recent national focus on teacher evaluation and effectiveness. This special topic section of School Psychology Quarterly is the first to showcase the current research on measuring Tier 1 instructional and behavioral management practices used by prekindergarten and elementary school teachers in general education settings. The three studies included in the special section describe the development and validation efforts of several teacher observational and self-report measures of instruction and/or behavioral management. These studies provide evidence for the utility of such assessments for documenting the use of classroom practices, and these assessment results may be leveraged in innovative coaching models to promote best practice. These articles also offer insight and ideas for the next generation of teacher practice assessment for the field. Finally, the special topic is capped by a commentary synthesizing the current work and offers "big ideas" for future measurement development, policy, and professional development initiatives. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  5. Readiness for organisational change among general practice staff.

    PubMed

    Christl, B; Harris, M F; Jayasinghe, U W; Proudfoot, J; Taggart, J; Tan, J

    2010-10-01

    Increasing demands on general practice to manage chronic disease may warrant organisational change at the practice level. Staff's readiness for organisational change can act as a facilitator or barrier to implementing interventions aimed at organisational change. To explore general practice staff readiness for organisational change and its association with staff and practices characteristics. This is a cross-sectional study of practices in three Australian states involved in a randomised control trial on the effectiveness of an intervention to enhance the role of non-general practitioner staff in chronic disease management. Readiness for organisational change, job satisfaction and practice characteristics were assessed using questionnaires. 502 staff from 58 practices completed questionnaires. Practice characteristics were not associated with staff readiness for change. A multilevel regression analysis showed statistically significant associations between staff readiness for organisational change (range 1 to 5) and having a non-clinical staff role (vs general practitioner; B=-0.315; 95% CI -0.47 to -0.16; p<0.001), full-time employment (vs part-time; B=0.175, 95% CI 0.06 to 0.29; p<0.01) and lower job satisfaction (B=-0.277, 95% CI -0.40 to -0.15; p<0.001). The results suggest that different approaches are needed to facilitate change which addresses the mix of practice staff. Moderately low job satisfaction may be an opportunity for organisational change.

  6. Adolescent Literacy Research and Practice

    ERIC Educational Resources Information Center

    Jetton, Tamara L., Ed.; Dole, Janice A., Ed.

    2004-01-01

    This book addresses the role of literacy instruction in enhancing content area learning and fostering student motivation and success well beyond the primary grades. The unique literacy needs of middle school and secondary students are thoroughly examined and effective practices and interventions identified. Reviewing the breadth of current…

  7. Adolescent Literacy Research and Practice

    ERIC Educational Resources Information Center

    Jetton, Tamara L., Ed.; Dole, Janice A., Ed.

    2004-01-01

    This book addresses the role of literacy instruction in enhancing content area learning and fostering student motivation and success well beyond the primary grades. The unique literacy needs of middle school and secondary students are thoroughly examined and effective practices and interventions identified. Reviewing the breadth of current…

  8. Perspectives on Writing: Research, Theory, and Practice.

    ERIC Educational Resources Information Center

    Indrisano, Roselmina, Ed.; Squire, James R., Ed.

    Providing a foundation in which researchers may build future research and theory and in which teachers may design more effective classroom practice, this book presents 12 essays that bring together the contributions of researchers and teacher-scholars to present the significant theory and research related to the writing process. The book is…

  9. Practices, patients and (im)perfect data - feasibility of a randomised controlled clinical drug trial in German general practices

    PubMed Central

    2011-01-01

    Background Randomised controlled clinical (drug) trials supply high quality evidence for therapeutic strategies in primary care. Until now, experience with drug trials in German general practice has been sparse. In 2007/2008, the authors conducted an investigator-initiated, non-commercial, double-blind, randomised controlled pilot trial (HWI-01) to assess the clinical equivalence of ibuprofen and ciprofloxacin in the treatment of uncomplicated urinary tract infection (UTI). Here, we report the feasibility of this trial in German general practices and the implementation of Good Clinical Practice (GCP) standards as defined by the International Conference on Harmonisation (ICH) in mainly inexperienced general practices. Methods This report is based on the experience of the HWI-01 study conducted in 29 German general practices. Feasibility was defined by 1) successful practice recruitment, 2) sufficient patient recruitment, 3) complete and accurate data collection and 4) appropriate protection of patient safety. Results The final practice recruitment rate was 18%. In these practices, 79 of 195 screened UTI patients were enrolled. Recruitment differed strongly between practices (range 0-12, mean 2.8 patients per practice) and was below the recruitment goal of approximately 100 patients. As anticipated, practice nurses became the key figures in the screening und recruitment of patients. Clinical trial demands, in particular for completing symptom questionnaires, documentation of source data and reporting of adverse events, did not agree well with GPs' documentation habits and required support from study nurses. In many cases, GPs and practice staff seemed to be overwhelmed by the amount of information and regulations. No sudden unexpected serious adverse reactions (SUSARs) were observed during the trial. Conclusions To enable drug trials in general practice, it is necessary to adapt the setup of clinical research infrastructure to the needs of GPs and their practice

  10. Impact of robotic general surgery course on participants' surgical practice.

    PubMed

    Buchs, Nicolas C; Pugin, François; Volonté, Francesco; Hagen, Monika E; Morel, Philippe

    2013-06-01

    Courses, including lectures, live surgery, and hands-on session, are part of the recommended curriculum for robotic surgery. However, for general surgery, this approach is poorly reported. The study purpose was to evaluate the impact of robotic general surgery course on the practice of participants. Between 2007 and 2011, 101 participants attended the Geneva International Robotic Surgery Course, held at the University Hospital of Geneva, Switzerland. This 2-day course included theory lectures, dry lab, live surgery, and hands-on session on cadavers. After a mean of 30.1 months (range, 2-48), a retrospective review of the participants' surgical practice was performed using online research and surveys. Among the 101 participants, there was a majority of general (58.4 %) and colorectal surgeons (10.9 %). Other specialties included urologists (7.9 %), gynecologists (6.9 %), pediatric surgeons (2 %), surgical oncologists (1 %), engineers (6.9 %), and others (5.9 %). Data were fully recorded in 99 % of cases; 46 % of participants started to perform robotic procedures after the course, whereas only 6.9 % were already familiar with the system before the course. In addition, 53 % of the attendees worked at an institution where a robotic system was already available. All (100 %) of participants who started a robotic program after the course had an available robotic system at their institution. A course that includes lectures, live surgery, and hands-on session with cadavers is an effective educational method for spreading robotic skills. However, this is especially true for participants whose institution already has a robotic system available.

  11. Does the computerisation of a general practice increase doctor's fees?

    PubMed

    Thomson, A N

    1988-12-14

    While few Auckland general practitioners had inpractice computers before 1981-2, many installed computers after 1981-2. In order to assess some of the determinants of the computerisation of practices and the outcomes of computerisation, data was collected on a random sample of Auckland urban area general practitioners for the financial years 1981-2 and 1984-5. The characteristics of those installing computers and the effect of computerisation on practice costs, fees and workloads was explored. No significant difference in fees was seen between computerised and noncomputerised general practitioners, but differences were observed in practice costs and practice workstyles. The cost of the purchase of a computer by a practice does not appear to be directly passed on to the consumer in higher patient fees.

  12. Principles of practice for academic/practice/community research partnerships.

    PubMed

    Baker, E A; Homan, S; Schonhoff, R; Kreuter, M

    1999-04-01

    Researchers and practitioners are increasingly realizing that improvements in public health require changes in individual, social, and economic factors. Concurrent with this renewed awareness there has been a growing interest in working with communities to create healthful changes through academic/practice/community research partnerships. However, this type of research presents different challenges and requires different skills than traditional research projects. The development of a set of principles of practice for these types of research projects can assist researchers in developing, implementing, and evaluating their partnerships and their project activities. This paper describes the different ways in which academics and community groups may work together, including academic/practice/community partnerships. Several principles of practice for engaging in these research partnerships are presented followed by a description of how these principles have been put into operation in a family violence prevention program. The principles presented are: (1) identify the best processes/model to be used based on the nature of the issue and the intended outcome; (2) acknowledge the difference between community input and active community involvement; (3) develop relationships based on mutual trust and respect; (4) acknowledge and honor different partner's "agendas"; (5) consider multi-disciplinary approaches; (6) use evaluation strategies that are consistent with the overall approach taken in the academic/practice/community partnership; and (7) be aware of partnership maturation and associated transition periods. The limitations of these principles and their application in various settings are discussed.

  13. Supervision--growing and building a sustainable general practice supervisor system.

    PubMed

    Thomson, Jennifer S; Anderson, Katrina J; Mara, Paul R; Stevenson, Alexander D

    2011-06-06

    This article explores various models and ideas for future sustainable general practice vocational training supervision in Australia. The general practitioner supervisor in the clinical practice setting is currently central to training the future general practice workforce. Finding ways to recruit, retain and motivate both new and experienced GP teachers is discussed, as is the creation of career paths for such teachers. Some of the newer methods of practice-based teaching are considered for further development, including vertically integrated teaching, e-learning, wave consulting and teaching on the run, teaching teams and remote teaching. Approaches to supporting and resourcing teaching and the required infrastructure are also considered. Further research into sustaining the practice-based general practice supervision model will be required.

  14. Research, Practice, and Managed Care.

    ERIC Educational Resources Information Center

    Strupp, Hans H.

    Few questions in psychotherapy are of greater importance than the relationship among practitioners, researchers, and managed care. The present and future roles of psychotherapy are covered here. Despite ample evidence that psychotherapy does work, its effectiveness continues to be questioned. When psychotherapy research emerged some 50 years ago,…

  15. Position Paper: Dental General Practice Residency Programs: Financing and Operations.

    ERIC Educational Resources Information Center

    Hanson, Paul W.

    1983-01-01

    A discussion of changeable economic issues that can affect dental general practice residency program planning includes costs and resource allocation, maximizing efficiency and productivity, ambulatory and inpatient revenue sources, management functions, faculty as practitioners, faculty appointments, and marketing. (MSE)

  16. Australian and overseas models of general practice training.

    PubMed

    Hays, Richard B; Morgan, Simon

    2011-06-06

    General practice training in Australia continues to evolve. It is now the responsibility of an independent organisation, is delivered by regional training providers, and comprises a structured training program. Overseas, general practice varies in its importance to health care systems, and training models differ considerably. In some cases training is mandatory, in others voluntary, but the aim is always similar--to improve the quality of care delivered to the large majority of populations that access health care through primary care. We review the current status of vocational general practice training in Australia, compare it with selected training programs in international contexts, and describe how the local model is well placed to address future challenges. Challenges include changes in population demographics, increasing comorbidity, increasing costs of technology-based health care, increasing globalisation of health, and workforce shortages. Although general practice training in Australia is strong, it can improve further by learning from other training programs to meet these challengers.

  17. Case stories in general practice: a focus group study

    PubMed Central

    Abildsnes, Eirik; Flottorp, Signe; Stensland, Per

    2012-01-01

    Objectives To explore the interactive process of sharing case stories in small-group activity in general practice. Design Qualitative focus group study. Setting Peer-group meetings of doctors attending specialist training or continuous medical education in general practice. Participants Twenty female and 30 male doctors working in general practice in Norway. Results The storyline of case presentations included detailed stories with emotional engagement, co-authored by other group members. The stories initiated discussions and reflections concerning patients’ and doctors’ perspectives, medical ethics as well as clinical problems. The safe atmosphere allowed testing out boundaries of socially shared knowledge. Conclusions Sharing case stories in small groups in general practice initiated interaction that facilitated meaning-making, reflection and peer support. PMID:22874630

  18. Position Paper: Dental General Practice Residency Programs: Financing and Operations.

    ERIC Educational Resources Information Center

    Hanson, Paul W.

    1983-01-01

    A discussion of changeable economic issues that can affect dental general practice residency program planning includes costs and resource allocation, maximizing efficiency and productivity, ambulatory and inpatient revenue sources, management functions, faculty as practitioners, faculty appointments, and marketing. (MSE)

  19. Clinical Factual Recall and Patient Management Skill in General Practice

    ERIC Educational Resources Information Center

    Freeman, J.; Byrne, P. S.

    1977-01-01

    A battery of assessment measures, including MCQ measures of factual recall, MEQ measures of problem-solving skills, measures of attitudes, intelligence and ability, and personality factors was administered to trainee intakes of several postgraduate training courses for general practice.

  20. [MODERN EDUCATIONAL TECHNOLOGY MASTERING PRACTICAL SKILLS OF GENERAL PRACTITIONERS].

    PubMed

    Kovalchuk, L I; Prokopchuk, Y V; Naydyonova, O V

    2015-01-01

    The article presents the experience of postgraduate training of general practitioners--family medicine. Identified current trends, forms and methods of pedagogical innovations that enhance the quality of learning and mastering the practical skills of primary professionals providing care.

  1. A framework for developing rural academic general practices: a qualitative case study in rural Victoria.

    PubMed

    Brown, J B; Morrison, Tracy; Bryant, Melanie; Kassell, Lisa; Nestel, Debra

    2015-01-01

    There is increasing pressure for Australian rural general practices to engage in educational delivery as a means of addressing workforce issues and accommodating substantial increases in learners. For practices that have now developed a strong focus on education, there is the challenge to complement this by engaging in research activity. This study develops a rural academic general practice framework to assist rural practices in developing both comprehensive educational activity and a strong research focus thus moving towards functioning as mature academic units. A case study research design was used with the unit of analysis at the level of the rural general practice. Purposively sampled practices were recruited and individual interviews conducted with staff (supervisors, practice managers, nurses), learners (medical students, interns and registrars) and patients. Three practices hosted 'multi-level learners', two practices hosted one learner group and one had no learners. Forty-four individual interviews were conducted with staff, learners and patients. Audio recordings were transcribed for thematic analysis. After initial inductive coding, deductive analysis was undertaken with reference to recent literature and the expertise of the research team resulting in the rural academic general practice framework. Three key themes emerged with embedded subthemes. For the first theme, organisational considerations, subthemes were values/vision/culture, patient population and clinical services, staffing, physical infrastructure/equipment, funding streams and governance. For the second theme, educational considerations, subthemes were processes, clinical supervision, educational networks and learner presence. Third, for research considerations, there were the subthemes of attitude to research and research activity. The framework maps the development of a rural academic practice across these themes in four progressive stages: beginning, emerging, consolidating and

  2. Action research: changing nursing practice.

    PubMed

    Hegney, Desley Gail; Francis, Karen

    2015-06-03

    This article describes action research as a methodology and gives two examples of its application to nursing and health services research. Action research is cyclical in nature and involves the development, evaluation and redefining of an action plan using four basic steps: planning, action, observation and reflection. These cycles of action continue until the research group is satisfied that its objectives have been met. Data generation and analysis are iterative processes that occur continuously throughout the project, which is usually time-limited. Factors that should be taken into account to ensure success include: engaging the community, consideration of 'insider' versus 'outsider' perspectives, competing agendas, expectations not being met and the integrity of the research methodology.

  3. Translating research findings to clinical nursing practice.

    PubMed

    Curtis, Kate; Fry, Margaret; Shaban, Ramon Z; Considine, Julie

    2017-03-01

    To describe the importance of, and methods for, successfully conducting and translating research into clinical practice. There is universal acknowledgement that the clinical care provided to individuals should be informed on the best available evidence. Knowledge and evidence derived from robust scholarly methods should drive our clinical practice, decisions and change to improve the way we deliver care. Translating research evidence to clinical practice is essential to safe, transparent, effective and efficient healthcare provision and meeting the expectations of patients, families and society. Despite its importance, translating research into clinical practice is challenging. There are more nurses in the frontline of health care than any other healthcare profession. As such, nurse-led research is increasingly recognised as a critical pathway to practical and effective ways of improving patient outcomes. However, there are well-established barriers to the conduct and translation of research evidence into practice. This clinical practice discussion paper interprets the knowledge translation literature for clinicians interested in translating research into practice. This paper is informed by the scientific literature around knowledge translation, implementation science and clinician behaviour change, and presented from the nurse clinician perspective. We provide practical, evidence-informed suggestions to overcome the barriers and facilitate enablers of knowledge translation. Examples of nurse-led research incorporating the principles of knowledge translation in their study design that have resulted in improvements in patient outcomes are presented in conjunction with supporting evidence. Translation should be considered in research design, including the end users and an evaluation of the research implementation. The success of research implementation in health care is dependent on clinician/consumer behaviour change and it is critical that implementation strategy

  4. Process analysis in general practice--a new perspective?

    PubMed

    Boaden, R J; Zolkiewski, J M

    1998-01-01

    This paper reports the initial findings from a study of the application of process analysis into a general practice. It discusses the issues surrounding the relationships between clinical and managerial tasks. A new model of primary care is proposed which takes into account management issues and separates out non-patient contact activities. Evidence is presented and conclusions and drawn about front/back office activities, general practice as a small business, patient care and suggestions are made for future work.

  5. Locum doctors in general practice: motivation and experiences.

    PubMed Central

    McKevitt, C; Morgan, M; Hudson, M

    1999-01-01

    BACKGROUND: There is evidence of dissatisfaction with locum doctors' performance, but little is known about doctors who work as locums in general practice or about their experiences of this work. AIM: To describe the motivations and experiences of doctors providing locum cover in general practices. METHOD: A postal questionnaire survey distributed to locums through organizations such as locum groups, commercial agencies, and general practices. RESULTS: Questionnaires were returned by 111 doctors currently working as locums in general practice. Four main reasons for working as a locum GP were: as a short-term option while between posts, to gain experience of different practices before commitment to one practice, to balance work and family or other commitments, to continue part-time work after retirement. One-quarter of responders intended to continue working as a locum indefinitely. The drawbacks of locum work included frustration with low status, lack of security, and difficulty accessing structured training and education. CONCLUSION: Locum doctors in general practice are a heterogeneous group that includes those who have chosen this type of work. The doctors who intend to continue as locums indefinitely represent a useful resource in primary care whose ability to provide short-term cover could be maximized. The need to control the quality of 'freelance' doctors should not overshadow the need to control the quality of their working environments. PMID:10621983

  6. General practice ethics: Continuing medical education and the pharmaceutical industry.

    PubMed

    Mintzker, Yishai; Braunack-Mayer, Annette; Rogers, Wendy

    2015-01-01

    This is the fifth in a six-part series on general practice ethics. Cases from practice are used to trigger reflection on common ethical issues where the best course of action may not be immediately apparent. The case presented in the article is an illustrative compilation and not based on specific individuals.

  7. General practice-based clinical trials in Germany - a problem analysis.

    PubMed

    Hummers-Pradier, Eva; Bleidorn, Jutta; Schmiemann, Guido; Joos, Stefanie; Becker, Annette; Altiner, Attila; Chenot, Jean-François; Scherer, Martin

    2012-11-08

    In Germany, clinical trials and comparative effectiveness studies in primary care are still very rare, while their usefulness has been recognised in many other countries. A network of researchers from German academic general practice has explored the reasons for this discrepancy. Based on a comprehensive literature review and expert group discussions, problem analyses as well as structural and procedural prerequisites for a better implementation of clinical trials in German primary care are presented. In Germany, basic biomedical science and technology is more reputed than clinical or health services research. Clinical trials are funded by industry or a single national programme, which is highly competitive, specialist-dominated, exclusive of pilot studies, and usually favours innovation rather than comparative effectiveness studies. Academic general practice is still not fully implemented, and existing departments are small. Most general practitioners (GPs) work in a market-based, competitive setting of small private practices, with a high case load. They have no protected time or funding for research, and mostly no research training or experience. Good Clinical Practice (GCP) training is compulsory for participation in clinical trials. The group defined three work packages to be addressed regarding clinical trials in German general practice: (1) problem analysis, and definition of (2) structural prerequisites and (3) procedural prerequisites. Structural prerequisites comprise specific support facilities for general practice-based research networks that could provide practices with a point of contact. Procedural prerequisites consist, for example, of a summary of specific relevant key measures, for example on a web platform. The platform should contain standard operating procedures (SOPs), templates, checklists and other supporting materials for researchers. All in all, our problem analyses revealed that a substantial number of barriers contribute to the low

  8. An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice.

    PubMed

    McInnes, Susan; Peters, Kath; Bonney, Andrew; Halcomb, Elizabeth

    2015-09-01

    To identify facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general (family) practice. Internationally, a shortage of doctors entering and remaining in general practice and an increasing burden of chronic disease has diversified the nurse's role in this setting. Despite a well-established general practice nursing workforce, little attention has been paid to the ways doctors and nurses collaborate in this setting. Integrative literature review. CINAHL, Scopus, Web of Life, Cochrane Library, Joanna Briggs Institute Library of Systematic Reviews and Trove (dissertation and theses) were searched for papers published between 2000 and May 2014. This review was informed by the approach of Whittemore and Knafl (2005). All included papers were assessed for methodological quality. Findings were extracted, critically examined and grouped into themes. Eleven papers met the inclusion criteria. Thematic analysis revealed three themes common to the facilitators of and barriers to collaboration and teamwork between GPs in general practice: (1) roles and responsibilities; (2) respect, trust and communication; and (3) hierarchy, education and liability. This integrative review has provided insight into issues around role definition, communication and organizational constraints which influence the way nurses and general practitioners collaborate in a team environment. Future research should investigate in more detail the ways doctors and nurses work together in general practice and the impact of collaboration on nursing leadership and staff retention. © 2015 John Wiley & Sons Ltd.

  9. NASA general aviation research overview - 1976

    NASA Technical Reports Server (NTRS)

    Winblade, R. L.; Westfall, J. A.

    1976-01-01

    Recent accomplishments in the field of general aviation are reviewed which resulted from NASA's steadily improving communication with the industry and user community, both on a formal level and through more direct involvement in the research activities. Several NASA programs are examined whose aim is to provide new technologies across the board for improvements in safety, efficiency, and reduction of the impact of general aviation on the environment. The use of the results of some NASA programs in designing new aircraft is demonstrated. A list of technical reports generated by the NASA program is given in an appendix.

  10. Intervention Research and Bridging the Gap between Research and Practice

    ERIC Educational Resources Information Center

    Deshler, Donald D.

    2003-01-01

    Getting research-based instructional practices into the hands of professionals who teach students with learning disabilities is one of the most significant challenges for educators. This paper describes some of the major factors accounting for the gaps that exist between the special education research and classroom practice and presents four major…

  11. Supporting families of parents with mental illness in general practice.

    PubMed

    Baulderstone, Michaela J; Morgan, Bradley S; Fudge, Elizabeth A

    2013-08-05

    The general-practice setting provides a unique opportunity to positively influence the impact of mental illness on individuals and families. Intervention can begin from the moment an individual seeks professional help. Using a family-focused approach, and supporting parents to develop practical strategies to promote resilience in their children, can aid parents' recovery and promote the optimal emotional wellbeing of their children. We suggest a family-orientated therapeutic approach relevant to the general-practice setting, with particular consideration of the value of communicating with children according to the child's stage of emotional development.

  12. Implant Dentistry in General Practice. Part 1: Introduction.

    PubMed

    Nicholson, Ken

    2016-06-01

    This paper, the first of two, provides an introduction to implant dentistry for the general dental practitioner. CPD/Clinical Relevance: Implant placement and restoration is becoming more common place in general dental practice to the point where it may already be considered a routine treatment option.

  13. A survey of acupuncture treatments in general practice.

    PubMed

    Joseph, Peter

    2002-08-01

    This paper represents a retrospective survey of the effectiveness of acupuncture in an urban General Practice setting. Patients were treated within normal surgeries and records kept of treatments and outcomes. The paper reveals that when acupuncture is offered by a General Practitioner in the course of his normal working day, a significant number of patients can benefit without an excessive rise in workload.

  14. [Development of a pharmacological curriculum for general practice: Identifying and prescribing orally administered pharmacological substances with relevance for general practice].

    PubMed

    Straßner, Cornelia; Kaufmann-Kolle, Petra; Flum, Elisabeth; Schwill, Simon; Brandt, Bettina; Steinhäuser, Jost

    2017-05-01

    General practitioners (GPs) are among the specialists who prescribe the highest number of medication. Therefore the improvement of pharmacological competencies is an important part of the GP specialist training. The self-concept of general practice stating that GPs are the first contact persons for all health problems makes it challenging to define and acquire competencies for specialist training. While the "Competence-based Curriculum" developed by the German College of General Practitioners and Family Physicians defines diagnoses, reasons for counselling and competencies which are essential for general practice, a similar orientation guide is lacking for the pharmacological field. The aim of this study is to define and characterize pharmacological substances which every GP should know so well that he or she is able to conduct counselling and monitoring. We analysed private and public health insurance prescriptions of all general practices participating in the CONTENT project in the period from 2009 to 2014. The analysis was limited to substances with oral application which were prescribed at least once by at least 25 % (n = 11) of the practices. While the 100 most frequent prescriptions were included due to their frequency, less frequently prescribed substances were assessed concerning their relevance for general practice in a rating procedure. The substances included were classified by diagnoses and reasons for counselling. We analysed 1,912,896 prescriptions from 44 practices and 112,535 patients on the basis of the Anatomical Therapeutic Chemical (ATC) classification system. After applying the inclusion criteria, 453 substances were left, 302 of which were considered relevant for general practice and could be assigned to 45 diagnoses / reasons for counselling. The result of this study could be considered a working draft for a pharmacological curriculum for general practice, which may complement the "Competence-based Curriculum" in the medium term. Copyright

  15. Teaching Reading: Research into Practice

    ERIC Educational Resources Information Center

    Macalister, John

    2014-01-01

    In pre-service and in-service language teacher education, and in curriculum-related projects in second and foreign language settings, a recurrent issue is the failure to relate the teaching of reading to reading as a meaning-making activity. In this paper, I will consider what current research on second language (L2) reading has actually succeeded…

  16. Norfolk general practice: a comparison of rural and urban doctors

    PubMed Central

    Fearn, Richard M.G.

    1988-01-01

    A postal questionnaire was sent to all Norfolk practitioners, allowing a comparison to be made between rural general practice and urban practice in Norwich and Great Yarmouth. However, when Norfolk town and country doctors were compared, little difference was found in their personal or practice characteristics. In respect of their workload rural doctors, as expected, carried out more procedures overall but, somewhat surprisingly, did not make more home visits. Both sets of doctors had similar views on their present and future role in general practice. When Norfolk doctors collectively were compared with general practitioners nationally their service appeared to be of a high standard. The only uncertainty surrounded the effects of the greater clustering of Norfolk surgeries, together with the levels of home visiting and their attendant effects on patient accessibility. PMID:3255815

  17. THE IMPENDING RESEARCH EXPLOSION AND EDUCATIONAL PRACTICE.

    ERIC Educational Resources Information Center

    GUBA, EGON G.

    THE RAPID EXPANSION OF EDUCATIONAL RESEARCH HAS BEEN ACCOMPANIED BY THE FEELING THAT A CONNECTIVE LINK MUST BE ESTABLISHED BETWEEN THE AREAS OF RESEARCH AND EDUCATIONAL PRACTICE. THE INCREASED AVAILABILITY OF RESEARCH FUNDS NECESSITATES REFORMULATION AND CONCEPTUALIZATION OF SUITABLE MECHANISMS AND AGENCIES CAPABLE OF BRIDGING THE GAP BETWEEN…

  18. Research and Practice: We Can Integrate Them.

    ERIC Educational Resources Information Center

    Casanova, Ursula

    1989-01-01

    The teacher-researcher split must be overcome to help improve schools and instruction. Research and practice integration will involve attitudinal changes accomplished through specific activities to increase teacher reflection, familiarity with the knowledge base, inquiry, and collegiality. Researchers, teacher-training institutions, and school…

  19. Seeding Literacy: Adult Educators Research Their Practice.

    ERIC Educational Resources Information Center

    Davis, Janelle; Searle, Jean

    This publication presents five reports that represent research conducted by adult educators. "Supporting Adult Educators in Researching Their Practice" (Janelle Davis, Jean Searle) presents results of four action research projects related to developing literacies for disadvantaged groups or groups with special needs. "Towards Mutual…

  20. Relationships Between the Survey of Organizational Research Climate (SORC) and Self-Reported Research Practices

    PubMed Central

    Crain, A. Lauren; Martinson, Brian C.; Thrush, Carol R.

    2012-01-01

    Background The Survey of Organizational Research Climate (SORC) is a validated tool to facilitate promotion of research integrity and research best practices. This work uses the SORC to assess shared and individual perceptions of the research climate in universities and academic departments and relate these perceptions to desirable and undesirable research practices. Methods An anonymous web- and mail-based survey was administered to randomly selected biomedical and social science faculty and postdoctoral fellows in the United States. Respondents reported their perceptions of the research climates at their universities and primary departments, and the frequency with which they engaged in desirable and undesirable research practices. Results More positive individual perceptions of the research climate in one’s university or department were associated with higher likelihoods of desirable, and lower likelihoods of undesirable, research practices. Shared perceptions of the research climate tended to be similarly predictive of both desirable and undesirable research practices as individuals’ deviations from these shared perceptions. Conclusions Study results supported the central prediction that more positive SORC-measured perceptions of the research climate were associated with more positive reports of research practices. There were differences with respect to whether shared or individual climate perceptions were related to desirable or undesirable practices but the general pattern of results provide empirical evidence that the SORC is predictive of self-reported research behavior. PMID:23096774

  1. Relationships between the Survey of Organizational Research Climate (SORC) and self-reported research practices.

    PubMed

    Crain, A Lauren; Martinson, Brian C; Thrush, Carol R

    2013-09-01

    The Survey of Organizational Research Climate (SORC) is a validated tool to facilitate promotion of research integrity and research best practices. This work uses the SORC to assess shared and individual perceptions of the research climate in universities and academic departments and relate these perceptions to desirable and undesirable research practices. An anonymous web- and mail-based survey was administered to randomly selected biomedical and social science faculty and postdoctoral fellows in the United States. Respondents reported their perceptions of the research climates at their universities and primary departments, and the frequency with which they engaged in desirable and undesirable research practices. More positive individual perceptions of the research climate in one's university or department were associated with higher likelihoods of desirable, and lower likelihoods of undesirable, research practices. Shared perceptions of the research climate tended to be similarly predictive of both desirable and undesirable research practices as individuals' deviations from these shared perceptions. Study results supported the central prediction that more positive SORC-measured perceptions of the research climate were associated with more positive reports of research practices. There were differences with respect to whether shared or individual climate perceptions were related to desirable or undesirable practices but the general pattern of results provide empirical evidence that the SORC is predictive of self-reported research behavior.

  2. NASA Research on General Aviation Power Plants

    NASA Technical Reports Server (NTRS)

    Stewart, W. L.; Weber, R. J.; Willis, E. A.; Sievers, G. K.

    1978-01-01

    Propulsion systems are key factors in the design and performance of general aviation airplanes. NASA research programs that are intended to support improvements in these engines are described. Reciprocating engines are by far the most numerous powerplants in the aviation fleet; near-term efforts are being made to lower their fuel consumption and emissions. Longer-term work includes advanced alternatives, such as rotary and lightweight diesel engines. Work is underway on improved turbofans and turboprops.

  3. Does indirect consultation lead to overprescribing in general practice?

    PubMed

    Haaijer-Ruskamp, F M; Stewart, R; Wesseling, H

    1987-01-01

    Indirect consultations (by telephone or receptionist) are of increasing importance in general practice and may result in more prescribing than during direct (face to face)-consultations. We analysed prescribing data for 14,660 disorders, presented in one week in 52 general practices. In general, a significant, but hardly relevant increase in prescribing during indirect consultations was observed. The effect varies strongly for different disorders and was especially relevant for repeat-prescriptions for the following conditions: musculoskeletal- and connective tissue diseases, endocrine, nutritional and metabolic disorders and disorders of the female genital tract.

  4. Effectiveness of empathy in general practice: a systematic review.

    PubMed

    Derksen, Frans; Bensing, Jozien; Lagro-Janssen, Antoine

    2013-01-01

    Empathy as a characteristic of patient-physician communication in both general practice and clinical care is considered to be the backbone of the patient-physician relationship. Although the value of empathy is seldom debated, its effectiveness is little discussed in general practice. This literature review explores the effectiveness of empathy in general practice. Effects that are discussed are: patient satisfaction and adherence, feelings of anxiety and stress, patient enablement, diagnostics related to information exchange, and clinical outcomes. To review the existing literature concerning all studies published in the last 15 years on the effectiveness of physician empathy in general practice. Systematic literature search. Searches of PubMed, EMBASE, and PsychINFO databases were undertaken, with citation searches of key studies and papers. Original studies published in English between July 1995 and July 2011, containing empirical data about patient experience of GPs' empathy, were included. Qualitative assessment was applied using Giacomini and Cook's criteria. After screening the literature using specified selection criteria, 964 original studies were selected; of these, seven were included in this review after applying quality assessment. There is a good correlation between physician empathy and patient satisfaction and a direct positive relationship with strengthening patient enablement. Empathy lowers patients' anxiety and distress and delivers significantly better clinical outcomes. Although only a small number of studies could be used in this search, the general outcome seems to be that empathy in the patient-physician communication in general practice is of unquestionable importance.

  5. How to choose a new partner in general practice.

    PubMed Central

    King, J; Whitfield, M

    1990-01-01

    OBJECTIVE--To provide a guide to choosing a new partner in general practice by using psychometric assessments. DESIGN--A descriptive account of the experience of one practice. SETTING--A general practice in Bristol. RESULTS--The partners found that using a psychologist to assess both themselves and the candidates facilitated the selection process. During the pre-interview stage the partners learnt about the dynamics of the practice and their own personalities. The examination of the candidates by an outside assessor as well as the partners gave a sense of security and a certainty that mistakes were unlikely to be made. CONCLUSION--More practices should consider adopting a selection process using psychometric assessments when appointing a new partner. PMID:2271828

  6. Phynx: an open source software solution supporting data management and web-based patient-level data review for drug safety studies in the general practice research database and other health care databases.

    PubMed

    Egbring, Marco; Kullak-Ublick, Gerd A; Russmann, Stefan

    2010-01-01

    To develop a software solution that supports management and clinical review of patient data from electronic medical records databases or claims databases for pharmacoepidemiological drug safety studies. We used open source software to build a data management system and an internet application with a Flex client on a Java application server with a MySQL database backend. The application is hosted on Amazon Elastic Compute Cloud. This solution named Phynx supports data management, Web-based display of electronic patient information, and interactive review of patient-level information in the individual clinical context. This system was applied to a dataset from the UK General Practice Research Database (GPRD). Our solution can be setup and customized with limited programming resources, and there is almost no extra cost for software. Access times are short, the displayed information is structured in chronological order and visually attractive, and selected information such as drug exposure can be blinded. External experts can review patient profiles and save evaluations and comments via a common Web browser. Phynx provides a flexible and economical solution for patient-level review of electronic medical information from databases considering the individual clinical context. It can therefore make an important contribution to an efficient validation of outcome assessment in drug safety database studies.

  7. Video-assisted feedback in general practice internships using German general practitioner's guidelines.

    PubMed

    Bölter, Regine; Freund, Tobias; Ledig, Thomas; Boll, Bernhard; Szecsenyi, Joachim; Roos, Marco

    2012-01-01

    The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the possibility to spend one quarter of the internship, in the last year of their academic studies, in a practice of family medicine. The demonstrated teaching method aims at giving feedback to the student based on video recordings of patient consultations (student-patient) with the help of a checklist. Video-feedback is already successful used in medical teaching in Germany and abroad. This feasibility study aims at assessing the practicability of video-assisted feedback as a teaching method during internship in general practice. First of all, the general practice chooses a guideline as the learning objective. Secondly, a subsequent patient - student - consultation is recorded on video. Afterwards, a video-assisted formative feedback is given by the physician. A checklist with learning objectives (communication, medical examination, a structured case report according to the guideline) is used to structure the feedback content. The feasibility was assessed by a semi structured interview in order to gain insight into barriers and challenges for future implementation. The teaching method was performed in one general practice. Afterwards the teaching physician and the trainee intern were interviewed. The Following four main categories were identified: feasibility, performance, implementation in daily routine, challenges of the teaching concept.The results of the feasibility study show general practicability of this approach. Installing a video camera in one examination room may solve technical problems. The trainee intern mentioned theoretical and practical benefits using the guideline. The teaching physician noted the challenge to reflect on his daily routines in the light of evidence

  8. Video-assisted feedback in general practice internships using German general practitioner's guidelines

    PubMed Central

    Bölter, Regine; Freund, Tobias; Ledig, Thomas; Boll, Bernhard; Szecsenyi, Joachim; Roos, Marco

    2012-01-01

    Introduction: The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the possibility to spend one quarter of the internship, in the last year of their academic studies, in a practice of family medicine. The demonstrated teaching method aims at giving feedback to the student based on video recordings of patient consultations (student-patient) with the help of a checklist. Video-feedback is already successful used in medical teaching in Germany and abroad. This feasibility study aims at assessing the practicability of video-assisted feedback as a teaching method during internship in general practice. Teaching method: First of all, the general practice chooses a guideline as the learning objective. Secondly, a subsequent patient – student – consultation is recorded on video. Afterwards, a video-assisted formative feedback is given by the physician. A checklist with learning objectives (communication, medical examination, a structured case report according to the guideline) is used to structure the feedback content. Feasibility: The feasibility was assessed by a semi structured interview in order to gain insight into barriers and challenges for future implementation. The teaching method was performed in one general practice. Afterwards the teaching physician and the trainee intern were interviewed. The following four main categories were identified: feasibility, performance, implementation in daily routine, challenges of the teaching concept. The results of the feasibility study show general practicability of this approach. Installing a video camera in one examination room may solve technical problems. The trainee intern mentioned theoretical and practical benefits using the guideline. The teaching physician noted the challenge to reflect on his daily

  9. Medically unexplained conditions considered by patients in general practice.

    PubMed

    Tschudi-Madsen, Hedda; Kjeldsberg, Mona; Natvig, Bård; Ihlebaek, Camilla; Straand, Jørund; Bruusgaard, Dag

    2014-04-01

    Patients frequently present with multiple and 'unexplained' symptoms, often resulting in complex consultations. To better understand these patients is a challenge to health care professionals, in general, and GPs, in particular. In our research on symptom reporting, we wanted to explore whether patients consider that they may suffer from conditions commonly regarded as unexplained, and we explored associations between these concerns and symptom load, life stressors and socio-demographic factors. Consecutive, unselected patients in general practice completed questionnaires addressing eight conditions commonly regarded as unexplained (amalgam poisoning, Candida syndrome, fibromyalgia, food intolerance, electromagnetic hypersensitivity, burnout syndrome, chronic fatigue syndrome and irritable bowel syndrome). With logistic regression, we analysed associations with symptom load, burden of life stressors with negative impact on present health and socio-demographic variables. Out of the 909 respondents (response rate = 88.8%), 863 had complete data. In total, 39.6% of patients had considered that they may suffer from one or more unexplained conditions (UCs). These concerns were strongly and positively associated with recent symptom load and number of life stressors. If we excluded burnout and food intolerance, corresponding associations were found. Patients frequently considered that they may suffer from UCs. The likelihood of such concerns strongly increased with an increasing symptom load and with the number of life stressors with negative impact on present health. Hence, the number of symptoms may be a strong indicator of whether patients consider their symptoms part of such often controversial multisymptom conditions.

  10. Auditing palliative care in one general practice over eight years.

    PubMed

    Holden, J D

    1996-09-01

    To document the delivery and outcome of palliative care in one practice. All appropriate deaths were documented over the period of the study. One general practice of four doctors caring for 8000 patients in the North-West of England. All patients dying of malignant disease which had included a palliative phase of at least one week. Place of death; continuity of care; general practitioners' assessment of symptom relief; follow-up of bereaved relatives. 118 deaths from terminal malignant disease were recorded over eight years in my practice. 75% were being cared for by us (GPs) at the time of death. More detailed information was recorded on 64 of these patients showing generally "satisfactory" care. A simple audit can help maintain high standards of palliative care. General practitioners are encouraged to maintain registers of the care received by terminally-ill patients as an aid to quality assurance in this area.

  11. Academic research: policies and practice.

    PubMed

    Bertha, S L

    1996-04-01

    The Bayh-Dole Act of 1980 allowed universities in the US to own and manage inventions obtained using federal funds. This Act laid the foundation for university technology transfer activities in most major research universities of the country. Consequently, the interaction between universities and industry has increased, and so has the sophistication in university intellectual property management. UIC's model for managing its intellectual property is efficient and successful, and is the one increasingly used by university technology transfer offices. The model deals with all aspects of UIC's intellectual property: disclosure, protection, marketing, negotiating and licensing, as well as intellectual property provisions in UIC's research agreements, material transfer agreements, option agreements, licensing agreements and others. In a pioneer effort, UIC has developed a policy on contracts for collecting natural product samples for drug discovery which includes royalty sharing and other important provisions. Accompanying this policy we have also drafted a standard contractual agreement for collectors.

  12. Public Health Practice Is Not Research

    PubMed Central

    Holodniy, Mark; DeFraites, Robert F.

    2014-01-01

    Scientific and clinical activities undertaken by public health agencies may be misconstrued as medical research. Most discussions of regulatory and legal oversight of medical research focus on activities involving either patients in clinical practice or volunteers in clinical trials. These discussions often exclude similar activities that constitute or support core functions of public health practice. As a result, public health agencies and practitioners may be held to inappropriate regulatory standards regarding research. Through the lens of the Departments of Defense and Veterans Affairs, and using several case studies from these departments, we offer a framework for the adjudication of activities common to research and public health practice that could assist public health practitioners, research oversight authorities, and scientific journals in determining whether such activities require regulatory review and approval as research. PMID:24524499

  13. Public health practice is not research.

    PubMed

    Otto, Jean Lin; Holodniy, Mark; DeFraites, Robert F

    2014-04-01

    Scientific and clinical activities undertaken by public health agencies may be misconstrued as medical research. Most discussions of regulatory and legal oversight of medical research focus on activities involving either patients in clinical practice or volunteers in clinical trials. These discussions often exclude similar activities that constitute or support core functions of public health practice. As a result, public health agencies and practitioners may be held to inappropriate regulatory standards regarding research. Through the lens of the Departments of Defense and Veterans Affairs, and using several case studies from these departments, we offer a framework for the adjudication of activities common to research and public health practice that could assist public health practitioners, research oversight authorities, and scientific journals in determining whether such activities require regulatory review and approval as research.

  14. Feasibility study of hernia surgery in a general practice setting

    PubMed Central

    Dhumale, Raj

    2004-01-01

    Background: In the early 1990s, waiting times for some surgical procedures and opinions for such routine problems as groin hernia repair were unacceptably long. General practitioners with a special interest (GPwSIs) in general surgery may improve this, but little evidence exists as to whether such service developments may improve efficiency and effectiveness of care. Aims: To reduce the waiting time by offering a surgical service from a general practice setting without compromising on quality and safety of patient care. Design of study: Feasibility study. Setting: One general practice and the patient population of northwest Norfolk. Methods: A GPwSI whose special interest was in general surgery started offering a surgical service, including open hernia repair, from a purpose-built operating theatre within general practice premises. Results: Four thousand, nine hundred and sixty-five surgical procedures, including 286 inguinal hernia repairs, were performed. Quality and safety of patient care were not compromised and the waiting time was reduced from 18 months to 4 months. Conclusion: It is feasible to perform open inguinal hernia repairs in a general practice setting. PMID:15296560

  15. Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management.

    PubMed

    Halcomb, Elizabeth J; Davidson, Patricia M; Yallop, Julie; Griffiths, Rhonda; Daly, John

    2007-08-01

    Practice nursing is an integral component of British and New Zealand primary care, but in Australia it remains an emerging specialty. Despite an increased focus on the Australian practice nurse role, there has been limited strategic role development, particularly relating to national health priority areas. This paper reports the third stage of a Project exploring the Australian practice nurse role in the management of cardiovascular disease (CVD). This stage involved a consensus development conference, undertaken to identify strategic, priority recommendations for practice nurse role development. 1. Practice nurses have an important role in developing systems and processes for CVD management; 2. A change in the culture of general practice is necessary to promote acceptance of nurse-led CVD management; 3. Future research needs to evaluate specific models of care, incorporating outcome measures sensitive to nursing interventions; 4. Considerable challenges exist in conducting research in general practice; and 5. Changes in funding models are necessary for widespread practice nurse role development. The shifting of funding models provides evidence to support interdisciplinary practice in Australian general practice. The time is ripe, therefore, to engage in prospective and strategic planning to inform development of the practice nurse role.

  16. Children's Emergent Literacy: From Research to Practice.

    ERIC Educational Resources Information Center

    Lancy, David F., Ed.

    Noting that renaming common folk practices as "emergent literacy" practices legitimizes these unacknowledged ways of learning to read and write, this book highlights the importance of out-of-school literacy experiences and the value of real literature and real writing. It stresses a reciprocal relationship between basic research on the…

  17. Bringing Research into Educational Practice: Lessons Learned

    ERIC Educational Resources Information Center

    Hille, Katrin

    2011-01-01

    Bringing research into educational practice is necessary but does not happen automatically. The Transfercenter for Neuroscience and Learning, at the University of Ulm in Germany, is set up to transfer (neuro)scientific knowledge into educational practice. In doing so we have learned why this does not happen automatically, and have tried to make…

  18. Bringing Research into Educational Practice: Lessons Learned

    ERIC Educational Resources Information Center

    Hille, Katrin

    2011-01-01

    Bringing research into educational practice is necessary but does not happen automatically. The Transfercenter for Neuroscience and Learning, at the University of Ulm in Germany, is set up to transfer (neuro)scientific knowledge into educational practice. In doing so we have learned why this does not happen automatically, and have tried to make…

  19. Practical Wisdom and the Workplace Researcher

    ERIC Educational Resources Information Center

    Gibbs, Paul

    2007-01-01

    This paper addresses the form of enquiry appropriate for the workplace researcher. The first part of the paper is used to introduce the main themes of "phronesis" and relies heavily on Aristotle and Heidegger. It is argued that practical wisdom developed through experience of practical judgements offers a form of enquiry appropriate for…

  20. Research Review: Magazine Editors and Editing Practices.

    ERIC Educational Resources Information Center

    Jolliffe, Lee

    1994-01-01

    Reviews and critiques literature in the subfield of magazine editing research, chiefly biographical studies of individual editors and various types of studies of editorial practices, including surveys, magazine content analyses, and close qualitative examinations of editors' relationships with others. (SR)

  1. Research Review: Magazine Editors and Editing Practices.

    ERIC Educational Resources Information Center

    Jolliffe, Lee

    1994-01-01

    Reviews and critiques literature in the subfield of magazine editing research, chiefly biographical studies of individual editors and various types of studies of editorial practices, including surveys, magazine content analyses, and close qualitative examinations of editors' relationships with others. (SR)

  2. Transition of Research into Medical Practice

    NASA Technical Reports Server (NTRS)

    Polk, James D.; Johnson-Throop, Kathy A.

    2010-01-01

    This slide presentation reviews the process of transforming medical research into practical medicine for astronauts and for every day people. Several examples of medical practices that started in space medical research and then were proved useful in other settings: Actigraphy, bone density scanning, the use of Potassium Citrate as a countermeasure used to lessen the risk of kidney stone formation, and ultrasound uses in remote and telemedicine,

  3. Training Research: Practical Recommendations for Maximum Impact

    PubMed Central

    Beidas, Rinad S.; Koerner, Kelly; Weingardt, Kenneth R.; Kendall, Philip C.

    2011-01-01

    This review offers practical recommendations regarding research on training in evidence-based practices for mental health and substance abuse treatment. When designing training research, we recommend: (a) aligning with the larger dissemination and implementation literature to consider contextual variables and clearly defining terminology, (b) critically examining the implicit assumptions underlying the stage model of psychotherapy development, (c) incorporating research methods from other disciplines that embrace the principles of formative evaluation and iterative review, and (d) thinking about how technology can be used to take training to scale throughout all stages of a training research project. An example demonstrates the implementation of these recommendations. PMID:21380792

  4. Analysis of 1263 deaths in four general practices.

    PubMed

    Holden, J; O'Donnell, S; Brindley, J; Miles, L

    1998-07-01

    The death of a patient is a significant event that occurs often enough in general practice for it to have the potential to tell us much about the care we provide. There are few large series in the literature and we still know little about the collaborative use of this outcome measure. To determine the pattern of deaths and potentially preventable factors in our practices. We completed a standard data collection form after each death in four general practices over a 40-month period. The results were discussed at quarterly meetings. A total of 1263 deaths occurred among our registered patients during the period of the audit. Preventable factors contributing to deaths were considered to be attributable to: patients (40%): mainly cigarette smoking, poor compliance, and alcohol problems; general practice teams (5%): mainly delayed referral, diagnosis and treatment, and failure to prescribe aspirin to patients with vascular disease; hospitals (6%): mainly delayed diagnosis and perceived treatment problems; the environment (3%): mainly falls, principally resulting in fractured neck of femur. A simple audit of deaths along the lines that we describe gives important information about the care provided by general practice teams and those in hospital practice. It has both educational value and is a source of ideas for service improvement and further study, particularly when carried out over several years.

  5. A survey of audit activity in general practice.

    PubMed Central

    Hearnshaw, H; Baker, R; Cooper, A

    1998-01-01

    BACKGROUND: Since 1991, all general practices have been encouraged to undertake clinical audit. Audit groups report that participation is high, and some local surveys have been undertaken, but no detailed national survey has been reported. AIM: To determine audit activities in general practices and the perceptions of general practitioners (GPs) regarding the future of clinical audit in primary care. METHOD: A questionnaire on audit activities was sent to 707 practices from 18 medical audit advisory group areas. The audit groups had been ranked by annual funding from 1992 to 1995. Six groups were selected at random from the top, middle, and lowest thirds of this rank order. RESULTS: A total of 428 (60.5%) usable responses were received. Overall, 346 (85%) responders reported 125.7 audits from the previous year with a median of three audits per practice. There was no correlation between the number of audits reported and the funding per GP for the medical audit advisory group. Of 997 audits described in detail, changes were reported as 'not needed' in 220 (22%), 'not made' in 142 (14%), 'made' in 439 (44%), and 'made and remeasured' in 196 (20%). Thus, 635 (64%) audits were reported to have led to changes. Some 853 (81%) of the topics identified were on clinical care. Responders made 242 (42%) positive comments on the future of clinical audit in primary care, and 152 (26%) negative views were recorded. CONCLUSION: The level of audit activity in general practice is reasonably high, and most of the audits result in change. The number of audits per practice seems to be independent of the level of funding that the medical audit advisory group has received. Although there is room for improvement in the levels of effective audit activity in general practice, continued support by the professionally led audit groups could enable all practices to undertake effective audit that leads to improvement in patient care. PMID:9624769

  6. Systems and Complexity Thinking in the General Practice Literature: An Integrative, Historical Narrative Review

    PubMed Central

    Sturmberg, Joachim P.; Martin, Carmel M.; Katerndahl, David A.

    2014-01-01

    PURPOSE Over the past 7 decades, theories in the systems and complexity sciences have had a major influence on academic thinking and research. We assessed the impact of complexity science on general practice/family medicine. METHODS We performed a historical integrative review using the following systematic search strategy: medical subject heading [humans] combined in turn with the terms complex adaptive systems, nonlinear dynamics, systems biology, and systems theory, limited to general practice/family medicine and published before December 2010. A total of 16,242 articles were retrieved, of which 49 were published in general practice/family medicine journals. Hand searches and snowballing retrieved another 35. After a full-text review, we included 56 articles dealing specifically with systems sciences and general/family practice. RESULTS General practice/family medicine engaged with the emerging systems and complexity theories in 4 stages. Before 1995, articles tended to explore common phenomenologic general practice/family medicine experiences. Between 1995 and 2000, articles described the complex adaptive nature of this discipline. Those published between 2000 and 2005 focused on describing the system dynamics of medical practice. After 2005, articles increasingly applied the breadth of complex science theories to health care, health care reform, and the future of medicine. CONCLUSIONS This historical review describes the development of general practice/family medicine in relation to complex adaptive systems theories, and shows how systems sciences more accurately reflect the discipline’s philosophy and identity. Analysis suggests that general practice/family medicine first embraced systems theories through conscious reorganization of its boundaries and scope, before applying empirical tools. Future research should concentrate on applying nonlinear dynamics and empirical modeling to patient care, and to organizing and developing local practices, engaging in

  7. Systems and complexity thinking in the general practice literature: an integrative, historical narrative review.

    PubMed

    Sturmberg, Joachim P; Martin, Carmel M; Katerndahl, David A

    2014-01-01

    Over the past 7 decades, theories in the systems and complexity sciences have had a major influence on academic thinking and research. We assessed the impact of complexity science on general practice/family medicine. We performed a historical integrative review using the following systematic search strategy: medical subject heading [humans] combined in turn with the terms complex adaptive systems, nonlinear dynamics, systems biology, and systems theory, limited to general practice/family medicine and published before December 2010. A total of 16,242 articles were retrieved, of which 49 were published in general practice/family medicine journals. Hand searches and snowballing retrieved another 35. After a full-text review, we included 56 articles dealing specifically with systems sciences and general/family practice. General practice/family medicine engaged with the emerging systems and complexity theories in 4 stages. Before 1995, articles tended to explore common phenomenologic general practice/family medicine experiences. Between 1995 and 2000, articles described the complex adaptive nature of this discipline. Those published between 2000 and 2005 focused on describing the system dynamics of medical practice. After 2005, articles increasingly applied the breadth of complex science theories to health care, health care reform, and the future of medicine. This historical review describes the development of general practice/family medicine in relation to complex adaptive systems theories, and shows how systems sciences more accurately reflect the discipline's philosophy and identity. Analysis suggests that general practice/family medicine first embraced systems theories through conscious reorganization of its boundaries and scope, before applying empirical tools. Future research should concentrate on applying nonlinear dynamics and empirical modeling to patient care, and to organizing and developing local practices, engaging in community development, and influencing

  8. Spot-checks to measure general hygiene practice.

    PubMed

    Sonego, Ina L; Mosler, Hans-Joachim

    2016-01-01

    A variety of hygiene behaviors are fundamental to the prevention of diarrhea. We used spot-checks in a survey of 761 households in Burundi to examine whether something we could call general hygiene practice is responsible for more specific hygiene behaviors, ranging from handwashing to sweeping the floor. Using structural equation modeling, we showed that clusters of hygiene behavior, such as primary caregivers' cleanliness and household cleanliness, explained the spot-check findings well. Within our model, general hygiene practice as overall concept explained the more specific clusters of hygiene behavior well. Furthermore, the higher general hygiene practice, the more likely children were to be categorized healthy (r = 0.46). General hygiene practice was correlated with commitment to hygiene (r = 0.52), indicating a strong association to psychosocial determinants. The results show that different hygiene behaviors co-occur regularly. Using spot-checks, the general hygiene practice of a household can be rated quickly and easily.

  9. Remuneration and organization in general practice: do GPs prefer private practice or salaried positions?

    PubMed

    Halvorsen, Peder A; Steinert, Svein; Aaraas, Ivar J

    2012-12-01

    In Norway the default payment option for general practice is a patient list system based on private practice, but other options exist. This study aimed to explore whether general practitioners (GPs) prefer private practice or salaried positions. Cross-sectional online survey (QuestBack). General practice in Norway. Participants were asked whether their current practice was based on (1) private practice in which the GP holds office space, equipment, and employs the staff, (2) private practice in which the GPs hire office space, equipment, or staff from the municipality, (3) salary with bonus arrangements, or (4) salary without bonus arrangement. Furthermore, they were asked which of these options they would prefer if they could choose. GPs in Norway (n = 3270). Proportion of GPs who preferred private practice. Responses were obtained from 1304 GPs (40%). Among these, 75% were currently in private practice, 18% in private practice with some services provided by the municipality, 4% had a fixed salary plus a proportion of service fees, whereas 3% had salary only. Corresponding figures for the preferred option were 52%, 26%, 16%, and 6%, respectively. In multivariate logistic regression analysis, size of municipality, specialty attainment, and number of patients listed were associated with preference for private practice. The majority of Norwegian GPs had and preferred private practice, but a significant minority would prefer a salaried position. The current private practice based system in Norway seems best suited to the preferences of experienced GPs in urban communities.

  10. Social Work Research in Practice: Lessons Learned.

    PubMed

    Trowbridge, Kelly; Mische Lawson, Lisa

    2017-01-01

    Using data and research to drive and evaluate clinical decision-making continues to slowly gain prominence across social work settings. This article shares insights and recommendations from a novice social work investigator to encourage other social workers to consider the value of researching while in practice. Practitioners new to research need encouragement and support. This article provides ideas for easing the first steps towards research to avoid potentially discouraging pitfalls.

  11. Impact of social prescribing on general practice workload and polypharmacy.

    PubMed

    Loftus, A M; McCauley, F; McCarron, M O

    2017-07-01

    Social prescribing has emerged as a useful tool for helping patients overcome some of the social and behavioural determinants of poor health. There has been little research on the impact of social prescribing on use of primary healthcare resources. This study sought to determine whether social prescribing activities influenced patient-general practitioner (GP) contacts and polypharmacy. Quality-improvement design with social prescribing activity interventions from an urban general practice in Northern Ireland. Patients over 65 years of age with a chronic condition who attended their GP frequently or had multiple medications were offered a social prescribing activity. Participants' contacts with GP and the new repeat prescriptions before and during the social prescribing activity were measured. The total number of repeat prescriptions per patient was compared at the time of referral and 6-12 months later. Indications for referral, primary diagnoses and reasons for declining participation in a social prescribing activity after referral were prospectively recorded. Sixty-eight patients agreed to participate but only 28 (41%) engaged in a prescribed social activity. There was no statistically significant difference in GP contacts (visits to GP, home visits or telephone calls) or number of new repeat prescriptions between referral and completion of 12 weeks of social prescribing activity. Similarly there was no statistically significant difference in the total number of repeat prescriptions between referral and 6-12 months after social prescribing activity in either intention to treat or per protocol analyses. Social prescribing participants had similar demographic factors. Mental health issues (anxiety and/or depression) were more common among participants than those who were referred but declined participation in a social prescribing activity (P = 0.022). While social prescribing may help patients' self-esteem and well-being, it may not decrease GP workload. Further

  12. Future methods in pharmacy practice research.

    PubMed

    Almarsdottir, A B; Babar, Z U D

    2016-06-01

    This article describes the current and future practice of pharmacy scenario underpinning and guiding this research and then suggests future directions and strategies for such research. First, it sets the scene by discussing the key drivers which could influence the change in pharmacy practice research. These are demographics, technology and professional standards. Second, deriving from this, it seeks to predict and forecast the future shifts in use of methodologies. Third, new research areas and availability of data impacting on future methods are discussed. These include the impact of aging information technology users on healthcare, understanding and responding to cultural and social disparities, implementing multidisciplinary initiatives to improve health care, medicines optimization and predictive risk analysis, and pharmacy as business and health care institution. Finally, implications of the trends for pharmacy practice research methods are discussed.

  13. Childbirth across cultures: research and practice.

    PubMed

    Chalmers, Beverley

    2012-12-01

    Countries and cultures differ in their approach to childbirth, as well as in their research practices. This paper examines 10 surveys of women's reports of their labor and birth in seven countries spanning North America and Western Europe and Eastern Europe. Similarities and differences in practice are highlighted, and the methodological difficulties of conducting research in cross-cultural settings are examined. This paper discusses innovative and culturally unique perinatal practices that are not revealed by such surveys and stresses the importance of sharing such ideas globally.

  14. Theory and interpretation in qualitative studies from general practice: Why and how?

    PubMed

    Malterud, Kirsti

    2016-03-01

    In this article, I want to promote theoretical awareness and commitment among qualitative researchers in general practice and suggest adequate and feasible theoretical approaches. I discuss different theoretical aspects of qualitative research and present the basic foundations of the interpretative paradigm. Associations between paradigms, philosophies, methodologies and methods are examined and different strategies for theoretical commitment presented. Finally, I discuss the impact of theory for interpretation and the development of general practice knowledge. A scientific theory is a consistent and soundly based set of assumptions about a specific aspect of the world, predicting or explaining a phenomenon. Qualitative research is situated in an interpretative paradigm where notions about particular human experiences in context are recognized from different subject positions. Basic theoretical features from the philosophy of science explain why and how this is different from positivism. Reflexivity, including theoretical awareness and consistency, demonstrates interpretative assumptions, accounting for situated knowledge. Different types of theoretical commitment in qualitative analysis are presented, emphasizing substantive theories to sharpen the interpretative focus. Such approaches are clearly within reach for a general practice researcher contributing to clinical practice by doing more than summarizing what the participants talked about, without trying to become a philosopher. Qualitative studies from general practice deserve stronger theoretical awareness and commitment than what is currently established. Persistent attention to and respect for the distinctive domain of knowledge and practice where the research deliveries are targeted is necessary to choose adequate theoretical endeavours. © 2015 the Nordic Societies of Public Health.

  15. Paying research participants: a study of current practices in Australia

    PubMed Central

    Fry, C; Ritter, A; Baldwin, S; Bowen, K; Gardiner, P; Holt, T; Jenkinson, R; Johnston, J

    2005-01-01

    Objective: To examine current research payment practices and to inform development of clearer guidelines for researchers and ethics committees. Design: Exploratory email based questionnaire study of current research participant reimbursement practices. A diverse sample of organisations and individuals were targeted. Setting: Australia. Participants: Contacts in 84 key research organisations and select electronic listservers across Australia. A total of 100 completed questionnaires were received with representations from a variety of research areas (for example, market, alcohol and drug, medical, pharmaceutical and social research). Main measurements: Open-ended and fixed alternative questions about type of research agency; type of research; type of population under study; whether payment is standard; amounts and mechanisms of payment; factors taken into account when deciding on payment practices; and whether payment policies exist. Results: Reimbursement practice is highly variable. Where it occurs (most commonly for drug dependent rather than health professional or general population samples) it is largely monetary and is for time and out-of-pocket expenses. Ethics committees were reported to be often involved in decision making around reimbursement. Conclusions: Research subject payment practices vary in Australia. Researchers who do provide payments to research participants generally do so without written policy and procedures. Ethics committees have an important role in developing guidelines in this area. Specific guidelines are needed considering existing local policies and procedures; payment models and their application in diverse settings; case study examples of types and levels of reimbursement; applied definitions of incentive and inducement; and the rationale for diverse payment practices in different settings. PMID:16131558

  16. M.D. by thesis from general practice *

    PubMed Central

    Williams, W. O.

    1974-01-01

    The results of an enquiry into M.D.s from general practice in the five-year period 1968-1972 are given and compared with another survey covering the previous ten years. The total number of M.D. theses from all the universities of the British Isles in the five-year period of study was 723 and only 18 (2·5 per cent) were from general practice. The upward trend seen in the latter half of the first survey was not maintained in this study period, although there were eight in the last year compared with only one in the first year. The reasons for the small number from general practice, and methods for improving the situation are discussed.

  17. General practice and ethnicity: an experimental study of doctoring

    PubMed Central

    2014-01-01

    when working within a demanding environment. In general practice, the quality of the relationship between doctor and patient is an essential component of the effective management of chronic illness. Our research highlights the complexity of ethnic discrimination in general practice, and the need for further studies. PMID:24884670

  18. Practical Guidelines for Qualitative Research Using Online Forums

    PubMed Central

    Im, Eun-Ok; Chee, Wonshik

    2012-01-01

    With an increasing number of Internet research in general, the number of qualitative Internet studies has recently increased. Online forums are one of the most frequently used qualitative Internet research methods. Despite an increasing number of online forum studies, very few articles have been written to provide practical guidelines to conduct an online forum as a qualitative research method. In this paper, practical guidelines in using an online forum as a qualitative research method are proposed based on three previous online forum studies. First, the three studies are concisely described. Practical guidelines are proposed based on nine idea categories related to issues in the three studies: (a) a fit with research purpose and questions; (b) logistics; (c) electronic versus conventional informed consent process; (d) structure and functionality of online forums; (e) interdisciplinary team; (f) screening methods; (g) languages; (h) data analysis methods; and (i) getting participants’ feedback. PMID:22918135

  19. Investigators’ Perspectives on Translating Human Microbiome Research into Clinical Practice

    PubMed Central

    Slashinski, Melody J.; Whitney, Simon N.; Achenbaum, Laura S.; Keitel, Wendy A.; McCurdy, Sheryl A.; McGuire, Amy L.

    2013-01-01

    Background Human microbiome research has the potential to transform the practice of medicine, fundamentally shifting the ways in which we think not only about human health, illness, and disease, but also about clinical practice and public health interventions. Drawing from a larger qualitative study on ethical, legal, and social dimensions of human microbiome research, in this article we document perspectives related to the translation of human microbiome research into clinical practice, focusing particularly on implications for health, illness, and disease. Methods We conducted 60 in-depth, semi-structured interviews (2009–2010) with 63 researchers and National Institutes of Health project leaders (“investigators”) involved with human microbiome research. Interviews explored a range of ethical, legal, and social implications of human microbiome research, including investigators’ perspectives on potential strategies for translating findings to clinical practice. Using thematic content analysis, we identified and analyzed emergent themes and patterns. Results We identified three themes: (1) Investigators’ general perspectives on the clinical utility of human microbiome research, (2) Investigators’ perspectives on antibiotic use, overuse, and misuse, and (3) Investigators’ perspectives concerning future challenges of translating data to clinical practice. Conclusion The issues discussed by investigators concerning the clinical significance of human microbiome research, including embracing a new paradigm of health and disease, the importance of microbial communities, and clinical utility, will be of critical importance as this research moves forward. PMID:23615375

  20. Understanding general practice: a conceptual framework developed from case studies in the UK NHS.

    PubMed

    Checkland, Kath

    2007-01-01

    General practice in the UK is undergoing a period of rapid and profound change. Traditionally, research into the effects of change on general practice has tended to regard GPs as individuals or as members of a professional group. To understand the impact of change, general practices should also be considered as organisations. To use the organisational studies literature to build a conceptual framework of general practice organisations, and to test and develop this empirically using case studies of change in practice. This study used the implementation of National Service Frameworks (NSFs) and the new General Medical Services (GMS) contract as incidents of change. In-depth, qualitative case studies. The design was iterative: each case study was followed by a review of the theoretical ideas. The final conceptual framework was the result of the dynamic interplay between theory and empirical evidence. Five general practices in England, selected using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and nonparticipant observation, and examination of documents. A conceptual framework was developed that can be used to understand how and why practices respond to change. This framework enabled understanding of observed reactions to the introduction of NSFs and the new GMS contract. Important factors for generating responses to change included the story that the practice members told about their practice, beliefs about what counted as legitimate work, the role played by the manager, and previous experiences of change. Viewing general practices as small organisations has generated insights into factors that influence responses to change. Change tends to occur from the bottom up and is determined by beliefs about organisational reality. The conceptual framework suggests some questions that can be asked of practices to explain this internal reality.

  1. General Practice and Pandemic Influenza: A Framework for Planning and Comparison of Plans in Five Countries

    PubMed Central

    Patel, Mahomed S.; Phillips, Christine B.; Pearce, Christopher; Kljakovic, Marjan; Dugdale, Paul; Glasgow, Nicholas

    2008-01-01

    Background Although primary health care, and in particular, general practice will be at the frontline in the response to pandemic influenza, there are no frameworks to guide systematic planning for this task or to appraise available plans for their relevance to general practice. We aimed to develop a framework that will facilitate planning for general practice, and used it to appraise pandemic plans from Australia, England, USA, New Zealand and Canada. Methodology/Principal Findings We adapted the Haddon matrix to develop the framework, populating its cells through a multi-method study that incorporated the peer-reviewed and grey literature, interviews with general practitioners, practice nurses and senior decision-makers, and desktop simulation exercises. We used the framework to analyse 89 publicly-available jurisdictional plans at similar managerial levels in the five countries. The framework identifies four functional domains: clinical care for influenza and other needs, public health responsibilities, the internal environment and the macro-environment of general practice. No plan addressed all four domains. Most plans either ignored or were sketchy about non-influenza clinical needs, and about the contribution of general practice to public health beyond surveillance. Collaborations between general practices were addressed in few plans, and inter-relationships with the broader health system, even less frequently. Conclusions This is the first study to provide a framework to guide general practice planning for pandemic influenza. The framework helped identify critical shortcomings in available plans. Engaging general practice effectively in planning is challenging, particularly where governance structures for primary health care are weak. We identify implications for practice and for research. PMID:18509538

  2. Promoting Mental Health and Preventing Mental Illness in General Practice.

    PubMed

    Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona

    2016-01-01

    This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert 'Think Tank' convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your 'cluster' of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development.

  3. Promoting Mental Health and Preventing Mental Illness in General Practice

    PubMed Central

    Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona

    2016-01-01

    Abstract This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert ‘Think Tank’ convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your ‘cluster’ of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development. PMID:28250821

  4. General aviation energy-conservation research programs

    NASA Technical Reports Server (NTRS)

    Willis, E. A.

    1978-01-01

    A review is presented of nonturbine general aviation engine programs underway at the NASA-Lewis Research Center. The program encompasses conventional, lightweight diesel, and rotary engines. Its three major thrusts are: (1) reduced SFC's; (2) improved fuels tolerance; and (3) reducing emissions. Current and planned future programs in such areas as lean operation, improved fuel management, advanced cooling techniques, and advanced engine concepts, are described. These are expected to lay the technology base, by the mid to latter 1980's, for engines whose total fuel costs are as much as 30% lower than today's conventional engines.

  5. General aviation energy-conservation research programs

    NASA Technical Reports Server (NTRS)

    Willis, E. A.

    1978-01-01

    A review is presented of nonturbine general aviation engine programs underway at the NASA-Lewis Research Center. The program encompasses conventional, lightweight diesel, and rotary engines. Its three major thrusts are: (1) reduced SFC's; (2) improved fuels tolerance; and (3) reducing emissions. Current and planned future programs in such areas as lean operation, improved fuel management, advanced cooling techniques, and advanced engine concepts, are described. These are expected to lay the technology base, by the mid to latter 1980's, for engines whose total fuel costs are as much as 30% lower than today's conventional engines.

  6. Building chronic disease management capacity in General Practice: The South Australian GP Plus Practice Nurse Initiative.

    PubMed

    Fuller, Jeffrey; Koehne, Kristy; Verrall, Claire C; Szabo, Natalie; Bollen, Chris; Parker, Sharon

    2015-01-01

    This paper draws on the implementation experience of the South Australian GP Plus Practice Nurse Initiative in order to establish what is needed to support the development of the chronic disease management role of practice nurses. The Initiative was delivered between 2007 and 2010 to recruit, train and place 157 nurses across 147 General Practices in Adelaide. The purpose was to improve chronic disease management in General Practice, by equipping nurses to work as practice nurses who would coordinate care and establish chronic disease management systems. Secondary analysis of qualitative data contained in the Initiative evaluation report, specifically drawing on quarterly project records and four focus groups conducted with practice nurses, practice nurse coordinators and practice nurse mentors. As evidenced by the need to increase the amount of support provided during the implementation of the Initiative, nurses new to General Practice faced challenges in their new role. Nurses described a big learning curve as they dealt with role transition to a new work environment and learning a range of new skills while developing chronic disease management systems. Informants valued the skills development and support offered by the Initiative, however the ongoing difficulties in implementing the role suggested that change is also needed at the level of the Practice. While just over a half of the placement positions were retained, practice nurses expressed concern with having to negotiate the conditions of their employment. In order to advance the role of practice nurses as managers of chronic disease support is needed at two levels. At one level support is needed to assist practice nurses to build their own skills. At the level of the Practice, and in the wider health workforce system, support is also needed to ensure that Practices are organisationally ready to include the practice nurse within the practice team.

  7. Rethinking registrar attributes for Australian rural general practice training.

    PubMed

    Eley, Diann S; Laurence, Caroline; David, Michael; Cloninger, C Robert; Walters, Lucie

    2017-08-01

    Despite increases in Commonwealth funded general practice (GP) Registrar training positions, workforce trends continue to show geographical maldistribution. This study aimed to identify Registrar attributes which describe a cohort choosing to work in rural practice. Cross-sectional self-report questionnaire for socio-demographics, prior training, current training pathway, measures of personality and resilience. GP Registrars (N = 452) training in either the general or rural pathways of three Registered Training Providers in three states, or training through the Australian College of Rural and Remote Medicine's independent pathway. Ordinal logistic regression tested the impact of key variables on the likelihood that Registrars would settle in rural practice. Univariate analysis explored differences between groups and effects of variables. A significantly increased interest in rural practice was to found to exist among registrars who were male, identified themselves as being rural, had a partner who identified as being rural, were enrolled in a rural training pathway and had high levels of Cooperativeness. We present a discriminating model combining socio-demographics, prior training and personality variables which challenges Australia to rethink Registrar attributes when training for rural general practice. With significant changes about to occur to GP training in Australia, this paper highlights the need for a more holistic approach which considers personal attributes such as Cooperativeness, rural identity and provision of geographically focused rural training pipelines to encourage Registrars to bond to individual rural communities and further develop their personal connectedness to country life and rural medical practice. © 2016 National Rural Health Alliance Inc.

  8. Private or salaried practice: how do young general practitioners make their career choice? A qualitative study.

    PubMed

    Kinouani, Shérazade; Boukhors, Gary; Luaces, Baptiste; Durieux, William; Cadwallader, Jean-Sébastien; Aubin-Auger, Isabelle; Gay, Bernard

    2016-09-01

    Young French postgraduates in general practice increasingly prefer salaried practice to private practice in spite of the financial incentives offered by the French government or local communities to encourage the latter. This study aimed to explore the determinants of choice between private or salaried practice among young general practitioners. A qualitative study was conducted in the South West of France. Semi-structured interviews of young general practitioners were audio-recorded until data saturation. Recordings were transcribed and then analyzed according to Grounded Theory by three researchers working independently. Sixteen general practitioners participated in this study. For salaried and private doctors, the main factors governing their choice were occupational factors: working conditions, need of varied scope of practice, quality of the doctor-patient relationship or career flexibility. Other factors such as postgraduate training, having worked as a locum or self-interest were also determining. Young general practitioners all expected a work-life balance. The fee-for-service scheme or home visits may have discouraged young general practitioners from choosing private practice. National health policies should increase the attractiveness of ambulatory general practice by promoting the diversification of modes of remuneration and encouraging the organization of group exercises in multidisciplinary medical homes and community health centers.

  9. Practice-based research: the role of HUSK in knowledge development.

    PubMed

    Julkunen, Ilse

    2015-01-01

    Practice research involves curiosity about practice. It is about challenging complex practices through a critical and co-productive examination of concrete practices and how ideas are created, adopted, and spread. By involving the relational complexities within practice and by strengthening the relational and organizational linkage between research and practice, the relevance of research may transcend the process of generalizing and disseminating research findings. In this analysis, the author uses the theoretical approach of actor relations to analyze the HUSK projects in their efforts to develop new forms of collaboration between research, practice, education, and service users to build knowledge about improving the quality of social services.

  10. Acute illness in infants: a general practice study

    PubMed Central

    Wilson, A. D.; Downham, M. A. P. S.; Forster, D. P.

    1984-01-01

    The character and frequency of acute illness in infants presenting to a general practice over a 16-week period was studied. Symptoms were classified as 'major' or 'minor' in accordance with the definitions used in a multicentre study in infant mortality. Of the 126 consultations reviewed, 106 (84 per cent) included at least one major symptom. None of the illnesses resulted in hospital admission or had a fatal outcome. It was concluded that this classification of symptoms into `major' and `minor' categories is not sufficiently discriminating to use in general practice. More specific definitions are required. PMID:6708005

  11. Educational Research as a Practical Science

    ERIC Educational Resources Information Center

    Carr, Wilfred

    2007-01-01

    This article offers a philosophical contribution to recent debates about the assessment of quality in educational research. It shows how criticisms of the quality of educational research--pointing to its failure to meet epistemic criteria of rigour and practical criteria of relevance--are an inevitable manifestation of the flawed assumption that…

  12. Educational Research and Evidence-Based Practice

    ERIC Educational Resources Information Center

    Hammersley, Martyn, Ed.

    2007-01-01

    Combining classic articles that have been key markers in recent debates with new and influential material, this book addresses the problems involved in educational research and the issues surrounding its contribution to policymaking and practice. The authors examine the diverse approaches within qualitative research and address some of the key…

  13. Educational Research as a Practical Science

    ERIC Educational Resources Information Center

    Carr, Wilfred

    2007-01-01

    This article offers a philosophical contribution to recent debates about the assessment of quality in educational research. It shows how criticisms of the quality of educational research--pointing to its failure to meet epistemic criteria of rigour and practical criteria of relevance--are an inevitable manifestation of the flawed assumption that…

  14. Efficiency in mental health practice and research.

    PubMed

    Lagomasino, Isabel T; Zatzick, Douglas F; Chambers, David A

    2010-01-01

    Limited financial resources, escalating mental health-related costs and opportunities for capitalizing on advances in health information technologies have brought the theme of efficiency to the forefront of mental health services research and clinical practice. In this introductory article to the journal series stemming from the 20th NIMH Mental Health Services Research Conference, we first delineate the need for a new focus on efficiency in both research and clinical practice. Second, we provide preliminary definitions of efficiency for the field and discuss issues related to measurement. Finally, we explore the interface between efficiency in mental health services research and practice and the NIMH strategic objectives of developing improved interventions for diverse populations and enhancing the public health impact of research. Case examples illustrate how perspectives from dissemination and implementation research may be used to maximize efficiencies in the development and implementation of new service delivery models. Allowing findings from the dissemination and implementation field to permeate and inform clinical practice and research may facilitate more efficient development of interventions and enhance the public health impact of research.

  15. STS: Adding Value To Research and Practice.

    ERIC Educational Resources Information Center

    Kumar, David D.; Chubin, Daryl E.

    2000-01-01

    Introduces the Kumar and Chubin-edited collection, "Science, Technology, and Society: A Sourcebook on Research and Practice". Presents an outline of the 12 chapters that examine STS trends, curriculum, teaching, learning, mentoring, advocacy, public policy, and issues for further research. (Author/WRM)

  16. Doing Developmental Research: A Practical Guide

    ERIC Educational Resources Information Center

    Striano, Tricia

    2016-01-01

    Addressing practical issues rarely covered in methods texts, this user-friendly, jargon-free book helps students and beginning researchers plan infant and child development studies and get them done. The author provides step-by-step guidance for getting involved in a developmental laboratory and crafting effective research questions and proposals.…

  17. Doing Developmental Research: A Practical Guide

    ERIC Educational Resources Information Center

    Striano, Tricia

    2016-01-01

    Addressing practical issues rarely covered in methods texts, this user-friendly, jargon-free book helps students and beginning researchers plan infant and child development studies and get them done. The author provides step-by-step guidance for getting involved in a developmental laboratory and crafting effective research questions and proposals.…

  18. Practical Research: Planning and Design. Seventh Edition.

    ERIC Educational Resources Information Center

    Leedy, Paul D.; Ormrod, Jeanne Ellis

    This book is a broad-spectrum guide, suitable for all courses in basic research. It guides the student from problem selection to completed research report with practical suggestions based on a solid theoretical framework and learning procedure. As a do-it-yourself guide, it is useful for students who are left to their own resources in executing…

  19. Practical Research: Planning and Design. Seventh Edition.

    ERIC Educational Resources Information Center

    Leedy, Paul D.; Ormrod, Jeanne Ellis

    This book is a broad-spectrum guide, suitable for all courses in basic research. It guides the student from problem selection to completed research report with practical suggestions based on a solid theoretical framework and learning procedure. As a do-it-yourself guide, it is useful for students who are left to their own resources in executing…

  20. A Practical School Public Relations Research Primer

    ERIC Educational Resources Information Center

    Moore, Edward H.

    2010-01-01

    Advances in communication technology have created many new tools for school communicators--as well as increasing complexities for their programs. As a result, solid school communication research programs offering practical research insights for planning, tracking, and assessing school communication efforts are more important than ever. Still, many…

  1. STS: Adding Value To Research and Practice.

    ERIC Educational Resources Information Center

    Kumar, David D.; Chubin, Daryl E.

    2000-01-01

    Introduces the Kumar and Chubin-edited collection, "Science, Technology, and Society: A Sourcebook on Research and Practice". Presents an outline of the 12 chapters that examine STS trends, curriculum, teaching, learning, mentoring, advocacy, public policy, and issues for further research. (Author/WRM)

  2. A Practical School Public Relations Research Primer

    ERIC Educational Resources Information Center

    Moore, Edward H.

    2010-01-01

    Advances in communication technology have created many new tools for school communicators--as well as increasing complexities for their programs. As a result, solid school communication research programs offering practical research insights for planning, tracking, and assessing school communication efforts are more important than ever. Still, many…

  3. NASA research on general aviation power plants

    NASA Technical Reports Server (NTRS)

    Stewart, W. L.; Weber, R. J.; Willis, E. A.; Sievers, G. K.

    1979-01-01

    Research activities within NASA to support general aviation industry in improving propulsion engines are described. Near-term objectives include improvements of gasoline piston engines to achieve fuel savings and reduce emissions well below EPA levels. To meet the longer term goals, advanced combustion research has been considered as essential in obtaining further improvements in BSFC (break specific fuel consumption). Modifications of an aircraft rotary engine were tested and it was found that by increasing the compression ratio and other refinements the BSFC was improved by 15%. The applicability of available large turbofan engine technology to small engines in order to obtain significant reductions in noise and pollutant emissions is being tested. Studies have been conducted at exploring the possibility of achieving high improvements in cost and performance for turboprop engines of less than 1000 horsepower.

  4. Conducting medication safety research projects in a primary care physician practice-based research network.

    PubMed

    Kuo, Grace M; Steinbauer, Jeffrey R; Spann, Stephen J

    2008-01-01

    To describe a roadmap for developing a practice-based research network (PBRN) through the experience of conducting medication safety research projects in a primary care physician PBRN. Southern Primary-care Urban Research Network (SPUR-Net) in Houston, Tex., from 2000 to 2007. SPUR-Net is a partnership of six health care organizations in Houston and includes 32 clinics with 313 primary care clinicians (50% family physicians, 25% general internists, and 25% pediatricians) who provide care for approximately 1 million patient encounters annually. The pharmacist principal investigator collaborates with physicians and researchers in primary care clinics to investigate medication safety practice in SPUR-Net. (1) A roadmap for PBRN research and (2) initiation of a research program focusing on medication safety through the PBRN. A roadmap with 10 steps for conducting practice-based research is recommended: (1) form collaborative partnership, (2) develop research infrastructure, (3) formulate research questions, (4) design study methods, (5) obtain funding support, (6) develop study instruments, (7) implement the study, (8) manage and analyze data, (9) disseminate results, and (10) translate research into practice. Four research projects focusing on medication safety were conducted in SPUR-Net from 2002 to 2007. Medication outcomes include improved medication use, increased awareness for medication counseling, decreased medication errors, and identification of best practices for medication reconciliation. Practice-based research conducted in primary care settings identifies, studies, and evaluates common problems encountered in busy clinic practice. With feedback from stakeholders, best practices and improved practice can be identified and "translated" back to practice. Grant funding for research projects helps sustain PBRNs. The implementation of medication safety research projects has helped primary care clinics, clinicians, and patients increase appropriate medication

  5. Professional Practices in Undergraduate Research Programs.

    PubMed

    Seeling, Joni M; Choudhary, Madhusudan

    2016-05-01

    The undergraduate research experience (URE) is an important avenue within a college trajectory in which students enhance their critical thinking, learn about the scientific process, and develop the knowledge and values that will guide their future scientific and professional careers. Individual institutions, programs, departments, and faculty administer undergraduate research differently, but each should adhere to a common set of guidelines which govern the research mentoring process. Adherence to standard practices will enhance the research experience for both students and mentors. This article examines standards and guidelines for professional practices involving undergraduate research and scholarship, and will discuss lapses and limitations that students and faculty frequently confront. The growth, support, and proper management of undergraduate research programs (URPs) at primarily undergraduate institutions (PUIs) is important for maintaining a talented pool of young scientists, as students benefit greatly from direct interactions with faculty mentors that predominate at PUIs.

  6. Professional Practices in Undergraduate Research Programs

    PubMed Central

    Seeling, Joni M.; Choudhary, Madhusudan

    2016-01-01

    The undergraduate research experience (URE) is an important avenue within a college trajectory in which students enhance their critical thinking, learn about the scientific process, and develop the knowledge and values that will guide their future scientific and professional careers. Individual institutions, programs, departments, and faculty administer undergraduate research differently, but each should adhere to a common set of guidelines which govern the research mentoring process. Adherence to standard practices will enhance the research experience for both students and mentors. This article examines standards and guidelines for professional practices involving undergraduate research and scholarship, and will discuss lapses and limitations that students and faculty frequently confront. The growth, support, and proper management of undergraduate research programs (URPs) at primarily undergraduate institutions (PUIs) is important for maintaining a talented pool of young scientists, as students benefit greatly from direct interactions with faculty mentors that predominate at PUIs. PMID:27158305

  7. Generalized Chernoff Fusion Approximation for Practical Distributed Data Fusion

    DTIC Science & Technology

    2009-07-01

    Generalized Chernoff Fusion Approximation for Practical Distributed Data Fusion William J. Farrell III R&D Department Adaptive Methods , Inc...independence or modify legacy systems with pedigree tagging techniques . Leveraging the well- known Covariance Intersection algorithm, its generalization...Adaptive Methods , Inc.,Centreville, VA , , 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR

  8. Discourse analysis in general practice: a sociolinguistic approach.

    PubMed

    Nessa, J; Malterud, K

    1990-06-01

    It is a simple but important fact that as general practitioners we talk to our patients. The quality of the conversation is of vital importance for the outcome of the consultation. The purpose of this article is to discuss a methodological tool borrowed from sociolinguistics--discourse analysis. To assess the suitability of this method for analysis of general practice consultations, the authors have performed a discourse analysis of one single consultation. Our experiences are presented here.

  9. [The Dutch College of General Practitioners' practice guidelines, "Examination of the neonate": response from the perspective of general practice medicine].

    PubMed

    Springer, M P

    2002-11-09

    With the publication of the Dutch College of General Practitioners' practice guideline 'Examination of the neonate', a discussion which has lasted several decades has been brought to an end. Up to now a second neonatal examination by the general practitioner on the third, fourth or fifth day after a midwife-assisted birth was recommended. The arguments in support of this recommendation were based on the following: (a) the limited expertise of midwives in the past, (b) the experience that general practitioners had in examining children, although this experience was not specifically related to the defects for which neonates should be checked, and (c) the government bodies' wish to restrict the number of hospital deliveries by giving greater structure to the organisation of midwife care, which in practice, did not lead to large changes. Based on three studies, the practice guideline recommends that a second examination is of no added value.

  10. Barriers to recruitment of professionals into a general practice childhood obesity program.

    PubMed

    Jones, Kay M; Dixon, Maureen E; Falkingham, Leah; Piteman, Leon; Dixon, John B

    2011-01-01

    Recruiting general practitioners to take part in research in primary care is important and challenging. This paper describes the process, barriers and achievements experienced by a research team whilst recruiting Divisions and general practitioners (GPs)/practices into a project related to management of obesity in children, which used Breakthrough Series methodology in the intervention arm. The research team chose to recruit GPs through Divisions of General Practice, because of the existing positive relationship between the research team and the Divisions, and the Divisions' positive relationships with the GPs/practices in their area. The project aimed to recruit four Divisions of General Practice, who in turn would recruit a total of 24 GPs/practices. Four Divisions (two rural, two metropolitan) were recruited initially, but the two rural Divisions withdrew before the project commenced and were replaced by two metropolitan Divisions. As Divisions were unable to recruit sufficient GPs/practices, two additional strategies were used, but despite all efforts, only 17 practices were recruited. Reflection on recruitment failure focussed on reasons from the perspective of Divisions, GPs, other projects using the Breakthrough Series methodology with a chronic disease focus and other projects conducted in Australia where the focus was childhood obesity. The results showed that even Divisions who were enthusiastic about joining a project may be unable to recruit sufficient GPs and practices, for reasons including staff changeover and GP reluctance. Caution is suggested when setting recruitment targets where the condition is sensitive, is not the presenting problem, is not routinely tackled in general practice, involves minors, where treatment is perceived to be of doubtful effectiveness, or where major government policies may need to be considered.

  11. Is the cold chain for vaccines maintained in general practice?

    PubMed Central

    Haworth, E A; Booy, R; Stirzaker, L; Wilkes, S; Battersby, A

    1993-01-01

    OBJECTIVE--To investigate the cold chain for vaccines and compliance with the local code of practice for storage. DESIGN--In a random sample of general practices orders for live vaccines (oral polio and measles, mumps, and rubella) were accompanied by a cold chain monitor which was activated on leaving the supplying pharmacy. The monitors were read at specified intervals and when all vaccines in the order had been used. Structured interview was used to check compliance with the local code of practice on storage. SETTING--West Berkshire and Aylesbury Vale district health authorities. SUBJECTS--16 (25%) general practices in West Berkshire, and 13 (50%) in Aylesbury Vale. MAIN OUTCOME MEASURES--Compliance with code of practice. Changes in the cold chain monitor. RESULTS--For six key requirements within the code of practice compliance varied from 70% to 0%. Only 16 of 29 practices had a named person responsible for vaccine storage and only four were aware of the local code of practice. Vaccine was stored for longer and more breaks in the cold chain occurred in West Berkshire than in Aylesbury Vale. The potency of some vaccines in 10 of 26 orders became suspect before use. CONCLUSIONS--Knowledge of appropriate management of the cold chain in two districts was poor. Breaks in the chain were more frequent and compromised potency more likely when vaccine had been stored for more than eight weeks. Problems in maintaining the cold chain indicate the need for continuing audit, which should become a prerequisite for payments to general practitioners for immunisation. PMID:8369691

  12. Effectiveness of empathy in general practice: a systematic review

    PubMed Central

    Derksen, Frans; Bensing, Jozien; Lagro-Janssen, Antoine

    2012-01-01

    Background Empathy as a characteristic of patient–physician communication in both general practice and clinical care is considered to be the backbone of the patient–physician relationship. Although the value of empathy is seldom debated, its effectiveness is little discussed in general practice. This literature review explores the effectiveness of empathy in general practice. Effects that are discussed are: patient satisfaction and adherence, feelings of anxiety and stress, patient enablement, diagnostics related to information exchange, and clinical outcomes. Aim To review the existing literature concerning all studies published in the last 15 years on the effectiveness of physician empathy in general practice. Design and setting Systematic literature search. Method Searches of PubMed, EMBASE, and PsychINFO databases were undertaken, with citation searches of key studies and papers. Original studies published in English between July 1995 and July 2011, containing empirical data about patient experience of GPs’ empathy, were included. Qualitative assessment was applied using Giacomini and Cook’s criteria. Results After screening the literature using specified selection criteria, 964 original studies were selected; of these, seven were included in this review after applying quality assessment. There is a good correlation between physician empathy and patient satisfaction and a direct positive relationship with strengthening patient enablement. Empathy lowers patients’ anxiety and distress and delivers significantly better clinical outcomes. Conclusion Although only a small number of studies could be used in this search, the general outcome seems to be that empathy in the patient–physician communication in general practice is of unquestionable importance. PMID:23336477

  13. The expression of aversion to medicines in general practice consultations.

    PubMed

    Britten, Nicky; Stevenson, Fiona; Gafaranga, Joseph; Barry, Christine; Bradley, Colin

    2004-10-01

    Although the relevance of patients' views about medicines for their medicine taking behaviour is now well established, little is known about the ways in which these views are discussed in primary care consultations. In particular, many studies have demonstrated patients' aversion to medicines. This paper examines the form that aversion talk takes in the consultation and how doctors respond to patients' expression of aversion to medicines. It is based on a dataset of 35 case studies of general practice consultations in England. In interviews with researchers, aversion to medicines was expressed in 34 of the 35 cases. In consultations with doctors, aversion was expressed in 10 cases. The interactional dimension of aversion talk in consultations was analysed using Conversation Analysis, and two general patterns were identified. Aversion could be used as an interactional resource, or it could be a topic in its own right. If used as an interactional resource, no real discussion of patients' views of medicines took place. When aversion was a conversational topic in its own right, two situations were observed. Firstly, the doctor elicited patients' views directly. Secondly, patients initiated aversive talk using a range of indirect strategies to do so. Even when patients managed to express their aversion to medicines, doctors did not engage them in any real discussion of their views. A scheme of interpretation is suggested to explain these findings. In this scheme patients perceive medicines to be an extension of the doctor and to be beneficial. In this view it is right for doctors to prescribe medicines and for patients to take medicines. The results of this paper suggest that using aversion as an interactional resource might be the only safe way for patients to express their aversion without seeming to breach the social contract.

  14. Prevalence of anal symptoms in general practice: a prospective study.

    PubMed

    Tournu, Géraldine; Abramowitz, Laurent; Couffignal, Camille; Juguet, Frédéric; Sénéjoux, Agnès; Berger, Stéphane; Wiart, Anne-Laure; Bernard, Marc; Provost, Françoise; Pillant-Le Moult, Hélène; Bouchard, Dominique; Aubert, Jean-Pierre

    2017-08-03

    Anal disorders are largely underestimated in general practice. Studies have shown patients conceal anal symptoms leading to late diagnosis and treatment. Management by general practitioners is poorly described. The aim of this study is to assess the prevalence of anal symptoms and their management in general practice. In this prospective, observational, national study set in France, all adult patients consulting their general practitioner during 2 days of consultation were included. Anal symptoms, whether spontaneously revealed or not, were systematically collected and assessed. For symptomatic patients, the obstacles to anal examination were evaluated. The general practitioner's diagnosis was collected and a proctologist visit was systematically proposed in case of anal symptoms. If the proctologist was consulted, his or her diagnosis was collected. From October 2014 to April 2015, 1061 patients were included by 57 general practitioners. The prevalence of anal symptoms was 15.6% (95% CI: 14-18). However, 85% of these patients did not spontaneously share their symptoms with their doctors, despite a discomfort rating of 3 out of 10 (range 1-5). Although 65% of patients agreed to an anal examination, it was not proposed in 45% of cases with anal symptoms. Performing the examination was associated with a significantly higher diagnosis rate of 76% versus 20% (p < 0.001). Proctologist and general practitioner diagnoses were consistent in 14 out of 17 cases. Patients' concealed anal symptoms are significant in general practice despite the impact on quality of life. Anal examination is seldom done. Improved training of general practitioners is required to break the taboo.

  15. Soviet Psycho-educational Research on Learning Disabilities: Implications for American Research and Practice.

    ERIC Educational Resources Information Center

    Wozniak, Robert H.

    The implications of Soviet psychoeducational research on learning disabilities (LD) and its relevance to American research and practice are discussed. The first section provides an overview of the general perspective of Soviet special education, with particular reference to LD and its relationship to Soviet psychology and philosophy. The second…

  16. Teaching Composition: Research on Effective Practices. Topical Synthesis No. 2. School Improvement Research Series II.

    ERIC Educational Resources Information Center

    Cotton, Kathleen

    A synthesis of research on teaching composition and on effective schooling, this report reviewed 36 documents to present findings on: writing as a process; instructional practices; instructional modes; and teacher training. As the major general finding from the research the report identifies, higher student achievement when the teaching approach…

  17. Soviet Psycho-educational Research on Learning Disabilities: Implications for American Research and Practice.

    ERIC Educational Resources Information Center

    Wozniak, Robert H.

    The implications of Soviet psychoeducational research on learning disabilities (LD) and its relevance to American research and practice are discussed. The first section provides an overview of the general perspective of Soviet special education, with particular reference to LD and its relationship to Soviet psychology and philosophy. The second…

  18. STORMWATER BEST MANAGEMENT PRACTICES DESIGN GUIDE VOLUME 1 - GENERAL CONSIDERATIONS

    EPA Science Inventory

    This document is Volume 1 of a three volume series that provides guidance on the selection and design of stormwater management Best Management Practices (BMPs). This first volume provides general considerations associated with the selection and design of BMPs.
    Volume I provi...

  19. STORMWATER BEST MANAGEMENT PRACTICES DESIGN GUIDE VOLUME 1 - GENERAL CONSIDERATIONS

    EPA Science Inventory

    This document is Volume 1 of a three volume series that provides guidance on the selection and design of stormwater management Best Management Practices (BMPs). This first volume provides general considerations associated with the selection and design of BMPs.
    Volume I provi...

  20. A joint course for general practitioner and practice nurse trainers.

    PubMed Central

    Bolden, K J; Lewis, A P

    1990-01-01

    An experimental multidisciplinary course for prospective general practitioner and practice nurse trainers is described. Factual knowledge and attitudes were measured before and after the course and some of the changes measured emphasized the importance of multidisciplinary training. The ideas generated by the group of nurse trainers in terms of their future professional development were identified. PMID:2265007

  1. Chemical Aspects of General Anesthesia: Part II. Current Practices

    ERIC Educational Resources Information Center

    Brunsvold, Robert; Ostercamp, Daryl L.

    2006-01-01

    The basics of balanced general anesthesia developed since 1956 and the update on existing practices of intravenous induction anesthetics and inhalational anesthetics are discussed. Some of the progressive anesthetics discussed are propofol instead of barbiturate such as thiopental or methohexital, inhalational anesthetic halothane,…

  2. Student Guide for Documenting Experiential Learning: General Office Practice.

    ERIC Educational Resources Information Center

    Coastline Community Coll., Fountain Valley, CA.

    Coastline Community College has developed a series of guides to assist adults who wish to obtain college credit or advanced standing in evaluating and verifying their non-college learning experiences. This guide lists the competency requirements of four courses within the General Office Practice program: Filing, Business Correspondence,…

  3. The British Telecom radiopaging service in general practice

    PubMed Central

    Cole, F. H.

    1981-01-01

    This paper reports a new radiopaging service supplied by British Telecom that will eventually cover the whole United Kingdom. The use of this service by a three-man practice is described. The service is considered to be a major development in communications that will be of interest to most general practitioners. PMID:7328548

  4. Practice Characteristics of Graduates of Postdoctoral General Dentistry Programs.

    ERIC Educational Resources Information Center

    Gatlin, Lonny J.; And Others

    1993-01-01

    A survey of 391 dentists completing a postdoctoral general dentistry program and 369 not participating in such a program revealed 75% of program participants were trained in civilian programs and the remainder in either military or Veterans Administration training programs. Employment patterns, treatment settings, and patterns of practice or…

  5. Chemical Aspects of General Anesthesia: Part II. Current Practices

    ERIC Educational Resources Information Center

    Brunsvold, Robert; Ostercamp, Daryl L.

    2006-01-01

    The basics of balanced general anesthesia developed since 1956 and the update on existing practices of intravenous induction anesthetics and inhalational anesthetics are discussed. Some of the progressive anesthetics discussed are propofol instead of barbiturate such as thiopental or methohexital, inhalational anesthetic halothane,…

  6. Nurses in Australian general practice: implications for chronic disease management.

    PubMed

    Halcomb, Elizabeth J; Davidson, Patricia M; Salamonson, Yenna; Ollerton, Richard; Griffiths, Rhonda

    2008-03-01

    The purpose of this study was to describe the demographic and employment characteristics of Australian practice nurses and explore the relationship between these characteristics and the nurses' role. Nursing in general practice is an integral component of primary care and chronic disease management in the United Kingdom and New Zealand, but in Australia it is an emerging specialty and there is limited data on the workforce and role. National postal survey embedded in a sequential mixed method design. 284 practice nurses completed a postal survey during 2003-2004. Descriptive statistics and factor analysis were utilized to analyse the data. Most participants were female (99%), Registered Nurses (86%), employed part-time in a group practice, with a mean age of 45.8 years, and had a hospital nursing certificate as their highest qualification (63%). The tasks currently undertaken by participants and those requiring further education were inversely related (R2 = -0.779). Conversely, tasks perceived to be appropriate for a practice nurse and those currently undertaken by participants were positively related (R2 = 0.8996). There was a mismatch between the number of participants who perceived that a particular task was appropriate and those who undertook the task. This disparity was not completely explained by demographic or employment characteristics. Extrinsic factors such as legal and funding issues, lack of space and general practitioner attitudes were identified as barriers to role expansion. Practice nurses are a clinically experienced workforce whose skills are not optimally harnessed to improve the care of the growing number of people with chronic and complex conditions. Relevance to clinical practice. Study data reveal a need to overcome the funding, regulatory and interprofessional barriers that currently constrain the practice nurse role. Expansion of the practice nurse role is clearly a useful adjunct to specialist management of chronic and complex disease

  7. Complications of regional and general anaesthesia in obstetric practice.

    PubMed

    Jadon, Ashok

    2010-09-01

    Any anaesthetic technique, either regional or general, has potential for complications. Moreover, it has been seen that in obstetric patients, the complications are potentiated due to pregnancy-related changes in physiology and due to various other factors. Increasing trend of caesarean section in the setting of increasing maternal age, obesity and other concomitant diseases will continue to challenge the obstetric anaesthetist in his/her task of providing safe regional and general anaesthesia. This review has highlighted the possible complications of regional and general anaesthesia encountered during the obstetric anaesthesia practice.

  8. Complications of regional and general anaesthesia in obstetric practice

    PubMed Central

    Jadon, Ashok

    2010-01-01

    Any anaesthetic technique, either regional or general, has potential for complications. Moreover, it has been seen that in obstetric patients, the complications are potentiated due to pregnancy-related changes in physiology and due to various other factors. Increasing trend of caesarean section in the setting of increasing maternal age, obesity and other concomitant diseases will continue to challenge the obstetric anaesthetist in his/her task of providing safe regional and general anaesthesia. This review has highlighted the possible complications of regional and general anaesthesia encountered during the obstetric anaesthesia practice. PMID:21189879

  9. Pure tone audiometry: comparison of general practice and hospital services

    PubMed Central

    Smith, Michael C.F.; Cable, Hugh R.; Wilmot, John F.

    1988-01-01

    Pure tone audiometry was obtained for both ears of 32 children by a general practitioner using a simple audiometer in his surgery, and by audiometricians in a hospital department on the same day. Comparing the worst hearing threshold at any of the three tested frequencies, the general practitioner did not find any ears to hear more than 10 dB better than the hospital (no false negatives). However, there were six false positives (9%) where the general practitioner identified an apparent hearing loss of greater than 15 dB. It is concluded that pure tone audiometry could be carried out accurately in the practice. PMID:3267745

  10. Cluster randomized trials for pharmacy practice research.

    PubMed

    Gums, Tyler; Carter, Barry; Foster, Eric

    2016-06-01

    Introduction Cluster randomized trials (CRTs) are now the gold standard in health services research, including pharmacy-based interventions. Studies of behaviour, epidemiology, lifestyle modifications, educational programs, and health care models are utilizing the strengths of cluster randomized analyses. Methodology The key property of CRTs is the unit of randomization (clusters), which may be different from the unit of analysis (individual). Subject sample size and, ideally, the number of clusters is determined by the relationship of between-cluster and within-cluster variability. The correlation among participants recruited from the same cluster is known as the intraclass correlation coefficient (ICC). Generally, having more clusters with smaller ICC values will lead to smaller sample sizes. When selecting clusters, stratification before randomization may be useful in decreasing imbalances between study arms. Participant recruitment methods can differ from other types of randomized trials, as blinding a behavioural intervention cannot always be done. When to use CRTs can yield results that are relevant for making "real world" decisions. CRTs are often used in non-therapeutic intervention studies (e.g. change in practice guidelines). The advantages of CRT design in pharmacy research have been avoiding contamination and the generalizability of the results. A large CRT that studied physician-pharmacist collaborative management of hypertension is used in this manuscript as a CRT example. The trial, entitled Collaboration Among Pharmacists and physicians To Improve Outcomes Now (CAPTION), was implemented in primary care offices in the United States for hypertensive patients. Limitations CRT design limitations include the need for a large number of clusters, high costs, increased training, increased monitoring, and statistical complexity.

  11. Patients' assessment of out of hours care in general practice

    PubMed Central

    Bollam, Mary J; McCarthy, Mark; Modell, Michael

    1988-01-01

    A sample of 177 patients drawn from 13 north London practices were interviewed shortly after they had sought help from their practice outside normal surgery hours. Patients were asked to describe the process and outcome of their out of hours call, to comment on specific aspects of the consultation, and to access their overall satisfaction with the encounter. Parents seeking consultations for children were least satisfied with the consultation; those aged over 60 responded most positively. Visits from general practitioners were more acceptable than visits from deputising doctors for patients aged under 60, but for patients aged over 60 visits from general practitioners and deputising doctors were equally acceptable. Monitoring of patients' views of out of hours consultations is feasible, and the findings of this study suggest that practices should regularly review the organisation of their out of hours care and discuss strategies for minimising conflict in out of hours calls—particularly those concerning children. PMID:3130934

  12. The value of marginality in a medical school: general practice and curriculum change.

    PubMed

    Mowat, H; Mowat, D

    2001-02-01

    To report the process of introduction, development and sustenance of a curriculum for a department of general practice in the context of changing curricula required by the General Medical Council. Tayside Centre for General Practice, the Department of General Practice within Dundee University Medical School. Use of action research methodology common in educational and sociological research. Action research utilizes a range of data collection techniques which allow the participants in the research full opportunities to reflect on the data as it emerges and make developments accordingly. This took place as part of the process of the 5-year project. The analysis used as its starting point the sociological theory of the social construction of power within institutions. It offers the thesis that marginality seems to be a prerequisite in confronting institutional conservatism. Use of an action research model facilitated more effective change by providing a supportive atmosphere in which to tackle changes. The marginal status of the general practice group in relation to the medical school allowed creative negotiation of alliances within the medical school. Other groups within the medical school who are introducing new curricula can learn from this report.

  13. Health promotion and disease prevention in general practice and primary care: a scoping study.

    PubMed

    Peckham, Stephen; Hann, Alison; Kendall, Sally; Gillam, Steve

    2017-08-11

    This paper reports the findings of a scoping review on the organisation and delivery of health improvement activities in general practice and the primary healthcare team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices and how individual practices and the primary healthcare team organise such public health activities and how these contribute to health improvement. Our focus was on health promotion and prevention activities and aimed to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary healthcare team. Many of the research studies reviewed had some details about the type, process, location or who provided the intervention. Little attention is paid in the literature to examining the impact of the organisational context on the way services are delivered or how this affects the effectiveness of health improvement interventions in general practice. We found that the focus of attention is mainly on individual prevention approaches with practices engaging in both primary and secondary prevention. Although many GPs do not take a population approach and focus on individual patients some do see health promotion as an integral part of practice - whether as individual approaches to primary or secondary health improvement or as a practice-based approach to improving the health of their patients. Based on our analysis we conclude that there is insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care.

  14. [Research and professional practice in speech therapy].

    PubMed

    Monfort, Isabelle; Monfort, Marc; Juárez-Sánchez, Adoración

    2014-02-24

    The relationship between research and clinical practice is discussed based on the request of this last on new therapeutic perspectives and empirical confirmations of their decisions. Two examples of a clear and justified relation between theoretical research data and the later development of an intervention program illustrate the achievements and disappointments of these relationships. From this analysis, the proposal of evidence-based practice is discussed, the requirements involved and the difficulties in its practical application, especially in the intervention in aspects such as semantics and pragmatics. It finally points out the lack of research on an item that is considered crucial to the effectiveness of therapy: the characteristics and skills of the therapist.

  15. Reframing placebo in research and practice

    PubMed Central

    Jonas, Wayne B.

    2011-01-01

    The terms ‘placebo’ and ‘placebo effects’ cause confusion among patients, practitioners and scientists. This confusion results in both the adoption of practices that have no evidence of specificity yet considerable risk (such as surgery for low back pain) or the elimination of clinical practices proven to facilitate healing because they are not ‘better than placebo’ (such as acupuncture for low back pain). In this article, I discuss these issues and introduce the concept of optimal healing environment as a framework for disentangling what is useful from placebo research for adopting into clinical practice in a manner that is ethical and evidence-based. PMID:21576147

  16. Participatory design of a preliminary safety checklist for general practice.

    PubMed

    Bowie, Paul; Ferguson, Julie; MacLeod, Marion; Kennedy, Susan; de Wet, Carl; McNab, Duncan; Kelly, Moya; McKay, John; Atkinson, Sarah

    2015-05-01

    The use of checklists to minimise errors is well established in high reliability, safety-critical industries. In health care there is growing interest in checklists to standardise checking processes and ensure task completion, and so provide further systemic defences against error and patient harm. However, in UK general practice there is limited experience of safety checklist use. To identify workplace hazards that impact on safety, health and wellbeing, and performance, and codesign a standardised checklist process. Application of mixed methods to identify system hazards in Scottish general practices and develop a safety checklist based on human factors design principles. A multiprofessional 'expert' group (n = 7) and experienced front-line GPs, nurses, and practice managers (n = 18) identified system hazards and developed and validated a preliminary checklist using a combination of literature review, documentation review, consensus building workshops using a mini-Delphi process, and completion of content validity index exercise. A prototype safety checklist was developed and validated consisting of six safety domains (for example, medicines management), 22 sub-categories (for example, emergency drug supplies) and 78 related items (for example, stock balancing, secure drug storage, and cold chain temperature recording). Hazards in the general practice work system were prioritised that can potentially impact on the safety, health and wellbeing of patients, GP team members, and practice performance, and a necessary safety checklist prototype was designed. However, checklist efficacy in improving safety processes and outcomes is dependent on user commitment, and support from leaders and promotional champions. Although further usability development and testing is necessary, the concept should be of interest in the UK and internationally. © British Journal of General Practice 2015.

  17. Toward ethical research practice with deaf participants.

    PubMed

    Singleton, Jenny L; Jones, Gabrielle; Hanumantha, Shilpa

    2014-07-01

    In recent years, scholars have been critical of what they consider unethical conduct by researchers whose studies focus on members of the Deaf or signing communities. This is the first empirical study that investigates ethical concerns and recommendations from the perspective of three stakeholder groups (Deaf research participants, researchers, and Deaf studies experts). We analyzed focus group discussions using strategies from grounded theory and community-based participatory research. The themes we identified highlight the need for the broader scientific research community to include linguistically and culturally sensitive research procedures that more adequately protect the rights of Deaf research participants, as well as other marginalized groups. We address the need to increase the number of Deaf scientists and reconsider collaboration practices between Deaf and hearing researchers.

  18. Mild hypertension: a clinical trial conducted in hospital general practice.

    PubMed

    Joesbury, H E; Phillips, C A; Garrett, R T; Wilkes, E; Smith, A J

    1976-12-18

    To compare findings in a hospital trial of hypotensive drugs with those in a general practice trial several patients with mild hypertension were studied at the same time in hospital and in general practice. They received bendrofluazide and potassium chloride or bendrofluazide, potassium chloride, and reserpine according to a double-blind crossover protocol, and blood biochemical values were studied over eight weeks and six months. When reserpine was withdrawn from nine women they followed a modified protocol comparing bendrofluazide and potassium chloride with potassium chloride alone. The blood pressure values measured by the general practitioners were similar to those measured in hospital. Both the diuretic alone and the diuretic with reserpine produced significant falls in blood pressures. Although plasma renin activity increased on diuretic treatment, continued treatment did not produce a further increase, and levels gradually declined towards normal.

  19. Mild hypertension: a clinical trial conducted in hospital general practice.

    PubMed Central

    Joesbury, H E; Phillips, C A; Garrett, R T; Wilkes, E; Smith, A J

    1976-01-01

    To compare findings in a hospital trial of hypotensive drugs with those in a general practice trial several patients with mild hypertension were studied at the same time in hospital and in general practice. They received bendrofluazide and potassium chloride or bendrofluazide, potassium chloride, and reserpine according to a double-blind crossover protocol, and blood biochemical values were studied over eight weeks and six months. When reserpine was withdrawn from nine women they followed a modified protocol comparing bendrofluazide and potassium chloride with potassium chloride alone. The blood pressure values measured by the general practitioners were similar to those measured in hospital. Both the diuretic alone and the diuretic with reserpine produced significant falls in blood pressures. Although plasma renin activity increased on diuretic treatment, continued treatment did not produce a further increase, and levels gradually declined towards normal. PMID:793680

  20. Independent learning among general practice trainees: an initial survey.

    PubMed

    Bligh, J G

    1992-11-01

    Self-directed learning is a natural way for adults to learn. Vocational training for general practice is a preparation for unsupervised clinical work that will be supported, in the main, by continuing medical education. This study uses the Self-Directed Learning Readiness Scale to investigate factors influencing readiness for such learning among a sample of general practice trainees. Three principal factors emerged from analysis: enjoyment and enthusiasm for learning; a positive self-concept as a learner and a factor suggesting the possibility of a 'reproducing' orientation to learning. These factors may reflect approaches to learning in general rather than these adopted for professional learning, but offer helpful pointers for the development of both vocational training and of continuing medical education.

  1. Problem solving therapy - use and effectiveness in general practice.

    PubMed

    Pierce, David

    2012-09-01

    Problem solving therapy (PST) is one of the focused psychological strategies supported by Medicare for use by appropriately trained general practitioners. This article reviews the evidence base for PST and its use in the general practice setting. Problem solving therapy involves patients learning or reactivating problem solving skills. These skills can then be applied to specific life problems associated with psychological and somatic symptoms. Problem solving therapy is suitable for use in general practice for patients experiencing common mental health conditions and has been shown to be as effective in the treatment of depression as antidepressants. Problem solving therapy involves a series of sequential stages. The clinician assists the patient to develop new empowering skills, and then supports them to work through the stages of therapy to determine and implement the solution selected by the patient. Many experienced GPs will identify their own existing problem solving skills. Learning about PST may involve refining and focusing these skills.

  2. Gainsharing in a general practice residency: report of an experience.

    PubMed

    Durham, Timothy M; Lange, Brian; Carroll, Kathy; Brown, David

    2004-01-01

    Postgraduate general dentistry programs are facing critical problems with funding, resident recruitment and viability. Recent federal actions reduced and eliminated graduate medical education (GME) support for some programs, and rising student debt and increasingly lucrative private practice opportunities reduce the value of postgraduate general dentistry experiences. Faced with these complex and interlinked challenges, the University of Nebraska Medical Center College of Dentistry General Practice Residency implemented a gainshare plan. The first 12 months of the plan produced a 44% increase in production and a concomitant 42% increase in actual collections resulting in enough funds to provide remuneration over base salary for residents, staff and faculty. The plan also compensated the Dean, the host department and the College of Dentistry while also funding the development of a reserve account for program enhancement and future stipend support. Gainshare concepts, rationale and details of the pilot plan are presented along with a discussion of key outcomes and experiences.

  3. [Modular training in practical medicine: electronic evaluation of student education in general practice].

    PubMed

    Himmel, W; Kühne, I; Chenot, J-F; Scheer, N; Primas, I; Sigle, J

    2004-07-01

    Effective from spring 2004, new regulations for undergraduate medical education in Germany require a two-week practical training in general practice. Similar to other forms of medical education, this practical training should be regularly evaluated by students. With regard to special conditions of the training, we preferred a web based evaluation. Since adequate models were not available, we designed, implemented and tested an electronic way of evaluation. The following aspects turned out to be of special importance: teamwork, time, data protection and cost. Meanwhile, the evaluation is established and still accessible as demo-version for visitors of the home page. This electronic evaluation of medical training in general practice is highly appropriate for a timely evaluation allowing us to obtain a comparison between students' expectations and actual experience as well as a continuous supervision and to provide feedback to the participating practices. This is an important step for quality assurance of medical education in practices inside and outside the university.

  4. Installing a Practical Research Project and Interpreting Research Results

    Treesearch

    Kasten R. Dumroese; David L. Wenny

    2003-01-01

    The basic concepts of the scientific method and research process are reviewed. An example from a bareroot nursery demonstrates how a practical research project can be done at any type of nursery, meshing sound statistical principles with the limitations of busy nursery managers.

  5. Installing a practical research project and interpreting research results

    Treesearch

    R. Kasten Dumroese; David L. Weny

    2002-01-01

    We review the basic concepts of science and research and the scientific process. Using an example from a bareroot nursery, we show how a practical research project can be done at any type of nursery, meshing sound statistical principles with limitations of busy nursery managers.

  6. The use of kiosk technology in general practice.

    PubMed

    Lowe, Charles; Cummin, Debbie

    2010-01-01

    We have attempted to quantify the benefit to both patients and professional users from introducing 'self-service' kiosks into the waiting rooms of general practitioners (GPs). We conducted a series of interviews with practice managers, GPs and patients in practices where kiosks had been used. We then estimated the time savings and other benefits. There were significant time savings both for nursing and GP staff, and similar time savings for patients. We estimate that the total time savings would be equivalent to one health-care assistant for a practice size of 10-12,000. Practice income was enhanced as a result of the improved information gathering made possible by the kiosks. These effects resulted in improved patient outcomes. The key to successful implementation appears to be strong support, particularly from reception staff to encourage and facilitate the use of kiosks. To maximise the benefits, GPs and nurses must be prepared to change their ways of working.

  7. Ethics, Practice, and Research in Public Health

    PubMed Central

    MacQueen, Kathleen M.; Buehler, James W.

    2004-01-01

    Ethical issues that can arise in distinguishing public health research from practice are highlighted in 2 case studies—an investigation of a tuberculosis outbreak in a prison and an evaluation of a program for improving HIV prevention services. Regardless of whether such public health investigations represent research or practice, we see a need for ethics oversight procedures that reflect actual risks and enable timely responses to crises. Such oversight should accommodate the perspectives of persons and communities affected by public health threats and by governmental responses to those threats; it should further recognize that public health ethics is a distinct field combining bioethics, political philosophy, human rights, and law. PMID:15249291

  8. Advancing general practice nursing in Australia: roles and responsibilities of primary healthcare organisations.

    PubMed

    Lane, Riki; Halcomb, Elizabeth; McKenna, Lisa; Zwar, Nicholas; Naccarella, Lucio; Davies, Gawaine Powell; Russell, Grant

    2016-04-21

    Objectives Given increased numbers and enhanced responsibilities of Australian general practice nurses, we aimed to delineate appropriate roles for primary health care organisations (PHCOs) to support this workforce.Methods A two-round online Delphi consensus process was undertaken between January and June 2012, informed by literature review and key informant interviews. Participants were purposively selected and included decision makers from government and professional organisations, educators, researchers and clinicians from five Australian states and territoriesResults Of 56 invited respondents, 35 (62%) and 31 (55%) responded to the first and second invitation respectively. Participants reached consensus on five key roles for PHCOs in optimising nursing in general practice: (1) matching workforce size and skills to population needs; (2) facilitating leadership opportunities; (3) providing education and educational access; (4) facilitating integration of general practice with other primary care services to support interdisciplinary care; and (5) promoting advanced nursing roles. National concerns, such as limited opportunities for postgraduate education and career progression, were deemed best addressed by national nursing organisations, universities and peak bodies.Conclusions Advancement of nursing in general practice requires system-level support from a range of organisations. PHCOs play a significant role in education and leadership development for nurses and linking national nursing organisations with general practices.What is known about the topic? The role of nurses in Australian general practice has grown in the last decade, yet they face limited career pathways and opportunities for career advancement. Some nations have forged interprofessional primary care teams that use nurses' skills to the full extent of their scope of practice. PHCOs have played important roles in the development of general practice nursing in Australia and internationally

  9. [Forest degradation/decline: research and practice].

    PubMed

    Zhu, Jiao-Jun; Li, Feng-Qin

    2007-07-01

    As one of the most critical environmental problems in the 21st century, forest degradation has been facing worldwide. There are many definitions about forest degradation, but its common features are the permanent loss of forests, stand structure destructed, forest quality decreased, and forest functions lowered. Forest decline or tree decline in fact is one of the causes of forest degradation, which includes the general reduction of trees in vigor, low level growth of trees in productivity, death of trees, and even, decline of soil fertility. Many researches indicated that deforestation is the permanent loss of forests in area, which is shifted to other land uses. Deforestation is the product of the interactions between environmental, social, economic, cultural, and political forces at work in any given country/region, and thus, more and more attention is focused on the negative socioeconomic and environmental effects after forest degradation, especially on the reduction of forest area induced by deforestation. The effects of any decisions or policies in national and international levels on forest degradation induced by deforestation have been paid attention as well. How to make efforts and strengthen the worldwide cooperation to combat the forest degradation induced by deforestation must be challenged to find appropriate solutions. There are many researches on forest decline, because of its complexity and uncertainties. The major causes of forest decline include: 1) pollution from both industry and agriculture, 2) stress factors, e.g., desiccation, 3) changes in stand dynamics, 4) decline disease of forest or diseases of complex etiology, 5) degradation of productivity and/or soil fertility in pure plantation forests. Forest degradation in China is similar to that all over the world, but with the characteristics in forest components, i.e., 1) secondary forests are the major forest resources, 2) China has the most plantation forests in the world, some of which have

  10. Communications with research participants and communities: foundations for best practices.

    PubMed

    Parkin, Rebecca T

    2004-11-01

    Communities and research participants increasingly feel that they have rights to be equal partners with researchers and to have access to the results of studies to which they have contributed. Concurrently, research sponsors have become aware of legal liabilities, societal repercussions, and credibility impacts of ignoring research communication responsibilities. However, issues related to research communications are rarely discussed at professional meetings or taught in academic programs. As a result, individual investigators may not be clear about their duties to communicate the results of their research. It is important to address this gap between expectations and abilities, because researchers' lack of communication fosters a climate of distrust in science and implies disinterest or disrespect for participants and communities. Ethical, legal, and professional frameworks and practices were reviewed to develop insights about principles, guidelines, and means that can be used to promote best practices. A review of general research guidance and specific requests for proposals revealed sponsors' communication priorities. While there are barriers to research communication, there is an increasing awareness among sponsors and investigators that effective and responsive communication is not a cheap or uniform add-on to a project or proposal. Communications must be tailored to the project considering all potential stakeholders, and resources need to be allocated specifically for communication activities within projects. Researchers, sponsors, professional societies and academia all have opportunities to improve principles, policies, frameworks, guidelines and strategies to foster "best practice" communication of research results.

  11. Fieldwork in nursing research: positionality, practicalities and predicaments.

    PubMed

    Borbasi, Sally; Jackson, Debra; Wilkes, Lesley

    2005-09-01

    This paper draws on the literature to explore some of the issues of concern to nurses undertaking fieldwork in contemporary healthcare settings. The emergence of poststructuralist and postmodern perspectives has raised questions about ethnographic approaches, and problematized the role of researchers in the construction of plausible and credible ethnographic accounts. As a practice discipline, nursing needs to negotiate a thorny path between methodological purity and practical application, with nurse researchers required to take account of both philosophical and pragmatic concerns. There is general agreement that researching with an individual or group rather than researching on an individual or group is the more effective way to approach fieldwork. Feminist writers appear to have dealt with this issue best, advocating intimacy, self-disclosure, and reciprocity in encounters with research participants. The duality of the nurse researcher role; power and politics and the moral implications of fieldwork are acknowledged as factors influencing nurses in the planning and conduct of fieldwork. Nurses as researchers may be better equipped than other social researchers to deal with contingencies in the field. Laying the epistemological ground for the participant observer role during fieldwork and understanding its impact on the resultant ethnographic account is essential to methodological rigour in field research. Consideration of some of the practicalities and predicaments experienced by nurses as researchers when conducting fieldwork prior to going out into the field is an important research strategy and will facilitate methodological potency.

  12. Transforming practices: a primer on action research.

    PubMed

    Acosta, Sandra; Goltz, Heather Honoré

    2014-07-01

    Action research (AR) is a powerful tool for health education and promotion practitioners who want to focus on improving the quality of their programs and services. In this Tool, we describe the characteristics and controversial aspects of AR, differentiate between traditional and action research, present the benefits of applying AR methods/techniques for investigating problems related to professional practice, and offer a four-phase methodological framework for conducting AR studies. Unlike traditional research, AR is a methodology that links theory, research, and practice; advances new knowledge and understandings via iterative action cycles; employs frontline health practitioners as researchers; and promotes collaborative practitioner-community partnerships. Egalitarian in its approach, AR offers an "insider's perspective" centered on context-specific problems and issues related to health promotion. AR falls into two categories: large-scale community-based research and small-scale practice-based research. Each cycle of the AR framework includes four phases: (a) preplanning/needs assessment, (b) planning/study organization, (c) action and observation/study implementation, and (d) reflection and planning/data analysis and interpretation. Using the AR primer in this Tool has the potential to empower health education/promotion practitioners, encourage collaborative partnerships, enhance practitioners' knowledge base, and promote social change. © 2014 Society for Public Health Education.

  13. Receptionists' experiences of occupational violence in general practice: a qualitative study

    PubMed Central

    Magin, Parker; Joyce, Terry; Adams, Jon; Goode, Susan; Cotter, Georgina

    2009-01-01

    Background The significance of occupational violence in general practice is well established, but research has focused almost exclusively on the experiences of GPs. Only limited research has examined the role of general practice receptionists despite their acknowledged vulnerability to violent patient behaviour. No qualitative research has explored this problem. Aim To explore the experiences of general practice receptionists regarding occupational violence and the effects of violence on their psychological and emotional wellbeing and on their work satisfaction and performance. Design of study Qualitative study. Setting Constituent practices of an Australian network of research general practices. Practices were located in a range of socioeconomic settings. Method Semi-structured interviews were conducted with practice receptionists. The interviews were audiotaped, transcribed, and subjected to thematic analysis employing a process of constant comparison in which data collection and analysis were cumulative and concurrent. Qualitative written responses from a cross-sectional questionnaire-based study performed concurrently with the qualitative study were similarly analysed. Results Nineteen interviews were conducted and 12 written responses were received. Violence was found to be a common, sometimes pervasive, experience of many receptionists. Verbal abuse, both ‘across the counter’ and telephone abuse, was the most prominent form of violence, although other violence, including assault and threats with guns, was reported. Experiences of violence could have marked emotional and psychological effects and could adversely affect job satisfaction, performance, and commitment. Conclusion It is apparent that occupational violence is a whole-of-practice problem and strategies for GP and staff safety will need to take a whole-of-practice approach. PMID:22751233

  14. Population-based prevention of influenza in Dutch general practice.

    PubMed Central

    Hak, E; Hermens, R P; van Essen, G A; Kuyvenhoven, M M; de Melker, R A

    1997-01-01

    BACKGROUND: Although the effectiveness of influenza vaccination in high-risk groups has been proven, vaccine coverage continues to be less than 50% in The Netherlands. To improve vaccination rates, data on the organizational factors, which should be targeted in population-based prevention of influenza, is essential. AIM: To assess the organizational factors in Dutch general practice, which were associated with the influenza vaccination rate in 1994. METHOD: A retrospective questionnaire study was undertaken in 1586 of the 4758 Dutch general practices, which were randomly selected. A total of 1251 (79%) practices returned a questionnaire. The items verified were practice profile, urbanization, delegation index, use of computer-based patient records, influenza vaccination characteristics and influenza vaccination rate. RESULTS: No differences were found with regard to the percentage of single-handed practices (65%), practices situated in urban area (38%), practices with a pharmacy (12%), patients insured by the National Health Service (59%) and use of computer-based patient records (57%) when compared with national statistics. The mean overall influenza vaccination rate was 9.0% (SD 4.0%). Using a logistic regression analysis, a high vaccination rate (> or = 9%) was associated with the use of personal reminders (odds ratio (OR) 1.7, 1.3-2.2), monitoring patient compliance (OR 1.8, 1.3-2.4), marking risk patients in computer-based patient records (OR 1.3, 1.0-1.6), a small number of patients per full-time practice assistant (OR 1.5, 1.1-1.9), urban areas (OR 1.6, 1.3-2.1) and single-handed practices (OR 1.5, 1.1-1.9). CONCLUSION: Improvement of vaccination rates in high-risk patients may be achievable by promoting the use of personal reminders and computer-based patient records, as well as monitoring patient compliance. In addition, the role of practice assistants with regard to preventive activities should be developed further. Practices situated in rural areas and

  15. Evidence-Based Practice in Autism Educational Research: Can We Bridge the Research and Practice Gap?

    ERIC Educational Resources Information Center

    Guldberg, Karen

    2017-01-01

    In order to develop deeper and better understandings of what constitutes effective educational practices, and to bridge the gap between research and practice, there is a need for a paradigm shift in autism educational research. The contribution of this paper is to examine the key methodological challenges that stand in the way of autism…

  16. Researcher Practice: Embedding Creative Practice within Doctoral Research in Industrial Design

    ERIC Educational Resources Information Center

    Evans, Mark

    2010-01-01

    This article considers the potential for a researcher to use their own creative practice as a method of data collection. Much of the published material in this field focuses on more theoretical positions, with limited use being made of specific PhDs that illustrate the context in which practice was undertaken by the researcher. It explores…

  17. A community of practice: librarians in a biomedical research network.

    PubMed

    De Jager-Loftus, Danielle P; Midyette, J David; Harvey, Barbara

    2014-01-01

    Providing library and reference services within a biomedical research community presents special challenges for librarians, especially those in historically lower-funded states. These challenges can include understanding needs, defining and communicating the library's role, building relationships, and developing and maintaining general and subject specific knowledge. This article describes a biomedical research network and the work of health sciences librarians at the lead intensive research institution with librarians from primarily undergraduate institutions and tribal colleges. Applying the concept of a community of practice to a collaborative effort suggests how librarians can work together to provide effective reference services to researchers in biomedicine.

  18. Whither British general practice after the 2004 GMS contract? Stories and realities of change in four UK general practices.

    PubMed

    Huby, Guro; Guthrie, Bruce; Grant, Suzanne; Watkins, Francis; Checkland, Kath; McDonald, Ruth; Davies, Huw

    2008-01-01

    The purpose of this article is to provide answers to two questions: what has been the impact of nGMS on practice organisation and teamwork; and how do general practice staff perceive the impact? The article is based on comparative in-depth case studies of four UK practices. There was a discrepancy between changes observed and the way practice staff described the impact of the contract. Similar patterns of organisational change were apparent in all practices. Decision-making became concentrated in fewer hands. Formally or informally constituted "elite" multidisciplinary groups monitored and controlled colleagues' behaviour for maximum performance and remuneration. This convergence of organisational form was not reflected in the dominant "story" each practice constructed about its unique ethos and style. The "stories" also failed to detect negative consequences to the practice flowing from its adaptation to the contract. The paper highlights how collective "sensemaking" in practices may fail to detect and address key organisational consequences from the nGMS.

  19. Sex differences among recipients of benzodiazepines in Dutch general practice.

    PubMed Central

    van der Waals, F W; Mohrs, J; Foets, M

    1993-01-01

    OBJECTIVE--To analyse sex differences among recipients of benzodiazepines in Dutch general practice. DESIGN--Study of consultations and associated interventions as recorded in the Dutch national survey of general practice. SETTING--Practices of 45 general practitioners monitored during 1 April to 30 June 1987. SUBJECTS--61,249 patients (29,035 (47.4%) men in the age groups 19-44, 45-64, and 65 years and over. MAIN OUTCOME MEASURES--Symptoms among recipients of repeat as well as new benzodiazepine prescriptions stratified by sex and age. RESULTS--Prescriptions for benzodiazepines were found to be significantly more common among women than among men, (a) after correcting for the sex distribution of the total patient population, and (b) in the two oldest age groups after correcting for the number of consultations. Of all prescriptions for benzodiazepines, 89% (6055/6777) were repeats and 70% (4759/6777) requests. Only 9% (439/4759) of these were authorized by the general practitioner, the rest being issued by the general practitioner's assistant after he or she had referred to the diagnosis in the patient's record. In contrast, only three (1%) of the 492 first time recipients of benzodiazepines had requested a prescription and were not seen by the general practitioner. Women (43/96; 45%) aged 45-64 years received their first prescription for benzodiazepines almost twice as often as men (15/63; 24%) without symptoms or a diagnosis being an indication (female to male relative risk 1.88 (95% confidence interval 1.15 to 3.08)). CONCLUSIONS--The sex difference among first time recipients of benzodiazepines seems to be due to general practitioners being less stringent when prescribing this drug for women. The difference continues in repeat prescriptions, physicians failing to check adequately the need for these. PMID:8104066

  20. Continuous quality improvement in small general medical practices: the attitudes of general practitioners and other practice staff.

    PubMed

    Geboers, H; Mokkink, H; van Montfort, P; van den Hoogen, H; van den Bosch, W; Grol, R

    2001-10-01

    Continuous quality improvement (CQI) offers opportunities to improve care in small-scale office-based practice. Little is yet known about the implementation of CQI in small primary care practices. We studied the attitudes of physicians and staff in small family practices to a model of CQI tailored to office-based practice setting. PRACTICES AND DESIGN: An exploratory study in 20 family practices in The Netherlands. Practices were stimulated to adopt the model for continuous quality improvement. The use of the model at the end of the study period, the perception of the physicians and staff of their success with adopting the model, their view of its usefulness, their willingness to continue and personal and practical obstacles. Measurements were made using written questionnaires. The rate of implementation of the model varied between practices. Participants rated their success in performing improvement projects, holding regular quality meetings and setting targets and priorities. They were positive about the usefulness of the model and they were generally willing to continue to use it. Barriers included the size of workload and the tendency to postpone actions until external support by an outreach visitor was provided. Physician and staff attitudes were homogeneous at a practice level. Our findings stress the importance of starting CQI with small, easy-to-handle projects. Workload reduction might be an important issue to focus on. Personal obstacles should be addressed throughout the introduction. We found attitudes in small-scale practices to be homogeneous, so that it was important to pay explicit attention to commitment to CQI from the start of the introduction.

  1. Algorithm linking patients and general practices in Denmark using the Danish National Health Service Register

    PubMed Central

    Kjaersgaard, Maiken Ina Siegismund; Vedsted, Peter; Parner, Erik Thorlund; Bech, Bodil Hammer; Vestergaard, Mogens; Flarup, Kaare Rud; Fenger-Grøn, Morten

    2016-01-01

    Background The patient list system in Denmark assigns virtually all residents to a general practice. Nevertheless, historical information on this link between patient and general practice is not readily available for research purposes. Objectives To develop, implement, and evaluate the performance of an algorithm linking individual patients to their general practice by using information from the Danish National Health Service Register and the Danish Civil Registration System. Materials and methods The National Health Service Register contains information on all services provided by general practitioners from 1990 and onward. On the basis of these data and information on migration history and death obtained from the Civil Registration System, we developed an algorithm that allocated patients to a general practice on a monthly basis. We evaluated the performance of the algorithm between 2002 and 2007. During this time period, we had access to information on the link between patients and general practices. Agreement was assessed by the proportion of months for which the algorithm allocated patients to the correct general practice. We also assessed the proportion of all patients in the patient list system for which the algorithm was able to suggest an allocation. Results The overall agreement between algorithm and patient lists was 98.6%. We found slightly higher agreement for women (98.8%) than for men (98.4%) and lower agreement in the age group 18–34 years (97.1%) compared to all other age groups (≥98.6%). The algorithm had assigned 83% of all patients in the patient list system after 1 year of follow-up, 91% after 2 years of follow-up, and peaked at 94% during the fourth year. Conclusion We developed an algorithm that enables valid and nearly complete linkage between patients and general practices. The algorithm performs better in subgroups of patients with high health care needs. The algorithm constitutes a valuable tool for primary health care research. PMID

  2. Algorithm linking patients and general practices in Denmark using the Danish National Health Service Register.

    PubMed

    Kjaersgaard, Maiken Ina Siegismund; Vedsted, Peter; Parner, Erik Thorlund; Bech, Bodil Hammer; Vestergaard, Mogens; Flarup, Kaare Rud; Fenger-Grøn, Morten

    2016-01-01

    The patient list system in Denmark assigns virtually all residents to a general practice. Nevertheless, historical information on this link between patient and general practice is not readily available for research purposes. To develop, implement, and evaluate the performance of an algorithm linking individual patients to their general practice by using information from the Danish National Health Service Register and the Danish Civil Registration System. The National Health Service Register contains information on all services provided by general practitioners from 1990 and onward. On the basis of these data and information on migration history and death obtained from the Civil Registration System, we developed an algorithm that allocated patients to a general practice on a monthly basis. We evaluated the performance of the algorithm between 2002 and 2007. During this time period, we had access to information on the link between patients and general practices. Agreement was assessed by the proportion of months for which the algorithm allocated patients to the correct general practice. We also assessed the proportion of all patients in the patient list system for which the algorithm was able to suggest an allocation. The overall agreement between algorithm and patient lists was 98.6%. We found slightly higher agreement for women (98.8%) than for men (98.4%) and lower agreement in the age group 18-34 years (97.1%) compared to all other age groups (≥98.6%). The algorithm had assigned 83% of all patients in the patient list system after 1 year of follow-up, 91% after 2 years of follow-up, and peaked at 94% during the fourth year. We developed an algorithm that enables valid and nearly complete linkage between patients and general practices. The algorithm performs better in subgroups of patients with high health care needs. The algorithm constitutes a valuable tool for primary health care research.

  3. Preventing sexually transmissible infections in Australian general practice.

    PubMed

    Khan, Asaduzzaman; Plummer, David; Hussain, Rafat; Minichiello, Victor

    2008-07-01

    The aims of the present study were to explore aspects of sexually transmissible infections (STI) prevention in general practice and to examine general practitioners' (GPs) perceived barriers to sexual-health promotion. The data from a postal survey of 409 GPs practising in New South Wales, Australia (response rate 45.4%) are analysed to explore the prevention of STI in general practice and to examine practitioners' perceived barriers to sexual-health promotion. About 49% of GPs reported having STI leaflets/pamphlets for patients in their clinic, while 21% had posters on STI displayed in their waiting room. Two-third (67%) of GPs provided STI-specific printed materials/leaflets to patients with STI. Female GPs were more likely to be proactive in STI prevention. Time and funding appear to be the major barriers to sexual-health promotion, followed by inadequate access to counselling. One-fifth (22%) of GPs felt that they had little influence in changing patients' risk behaviour, while about 28% emphasized the need for further preventive care training. The present study identifies inconsistencies in STI-prevention activities in general practice along with barriers to undertake sexual-health promotion. This area warrants further attention if GPs are to contribute fully to the control of STI.

  4. Newer antidepressants: a comparison of tolerability in general practice.

    PubMed Central

    Mackay, F R; Dunn, N R; Martin, R M; Pearce, G L; Freemantle, S N; Mann, R D

    1999-01-01

    BACKGROUND: An increasing number of antidepressants have been released on the United Kingdom market in recent years, and these are being prescribed more frequently in general practice. Clinical trials suggest that such agents have similar efficacy and the choice of drug is probably based on tolerability, toxicity in overdose, and cost. AIM: To compare the tolerability and safety profile of six, newly marketed antidepressants used in general practice. METHOD: Studies have been conducted for six antidepressants: fluoxetine, sertraline, paroxetine, moclobemide, venlafaxine, and nefazodone, using the technique of prescription-event monitoring. Patients were identified using incident dispensed prescription data. Questionnaires were sent to patients' general practitioners six months after the date of first prescription. Questionnaires asked for date of birth, sex, indication for prescribing each drug, and all events entered in the patients' records after the date of first prescription. RESULTS: Each cohort exceeded 10,000 patients. Nausea/vomiting was the most frequently reported event for all drugs. The difference in incidence rates for drowsiness/sedation, male sexual dysfunction, and hypertension is shown. Mortality data are also reported. CONCLUSION: Frequently reported events were similar for all six drugs but there were clinically and statistically significant differences for less frequently reported events. The adjusted mortality rate was identical between the six drugs. This study provides valuable comparative data for six, widely used antidepressants in general practice. PMID:10818655

  5. Intimate partner violence - identification and response in general practice.

    PubMed

    Hegarty, Kelsey; O'Doherty, Lorna

    2011-11-01

    Intimate partner violence is a common problem among women attending general practice, with around one in 10 women currently experiencing physical, sexual or emotional abuse by a partner. Abused women frequently present with physical and psychosocial issues. Yet intimate partner violence often remains concealed and addressing it poses challenges for the clinician and patient alike. Although some of the general recommendations in this review may also apply to same-sex relationships and to women who abuse men, this article discusses identifying intimate partner violence in women who present to general practice. Identifying intimate partner violence is important in clinical practice as it underlies many common physical and mental health presentations. Facilitating disclosure and responding effectively requires good communication skills. Safety assessment of women and their families, pinpointing level of readiness to contemplate action, and providing appropriate referral options and ongoing nonjudgmental support are elements of an effective response. General practitioners have the potential to identify women and support them safely on a pathway to recovery, thereby avoiding the long term impacts of intimate partner violence.

  6. Re-visioning practice through action research.

    PubMed

    Reed, Kirk; Hocking, Clare

    2013-06-01

    Ongoing knowledge development calls on health professionals to explore strategies to disseminate new or updated theoretical frameworks to practitioners. To date few researchers have explored effective means to do this or how the dissemination of professional ideas impacts on effective service delivery. The study described in this article aimed to identify strategies senior occupational therapists adopted to disseminate new concepts that have the potential to re-vision and transform practice. Six occupational therapists were recruited as co-researchers to become part of a collaborative community of practice. Over a 9-month period they engaged in a project based on action research cycles where they had access to a newly revised theoretical framework. During each cycle the co-researchers participated in a teleconference which was audio-recorded where they reflected on concepts in relation to their own practice. As understanding of the theoretical framework increased, they discussed which aspects of their practice could change, particularly in relation to processes they used to disseminate knowledge to the staff they supervised or managed. The co-researchers described a range of ideas for dissemination which included individual and group strategies. In addition, they became aware of the transformative potential of their new knowledge as a way to better understand and create change within their organisations. The co-researchers also described a sense of increased confidence, not only in terms of conceptualising practice but in terms of supervising staff and challenging service delivery. © 2013 The Authors Australian Occupational Therapy Journal © 2013 Occupational Therapy Australia.

  7. [Association between productivity, list size, patient and practice characteristics in general practice].

    PubMed

    Olsen, Kim Rose; Sørensen, Torben Højmark; Gyrd-Hansen, Dorte

    2010-04-19

    Due to shortage of general practitioners, it may be necessary to improve productivity. We assess the association between productivity, list size and patient- and practice characteristics. A regression approach is used to perform productivity analysis based on national register data and survey data for 1,758 practices. Practices are divided into four groups according to list size and productivity. Statistical tests are used to assess differences in patient- and practice characteristics. There is a significant, positive correlation between list size and productivity (p < 0.01). Nevertheless, 19% of the practices have a list size below and a productivity above mean sample values. These practices have relatively demanding patients (older, low socioeconomic status, high use of pharmaceuticals) and they are frequently located in areas with limited access to specialized care and have a low use of assisting personnel. 13% of the practices have a list size above and a productivity below mean sample values. These practices have relatively less demanding patients, are located in areas with good access to specialized care, and have a high use of assisting personnel. Lists and practice characteristics have substantial influence on both productivity and list size. Adjusting list size to external factors seems to be an effective tool to increase productivity in general practice.

  8. Improving patient safety culture in general practice: an interview study

    PubMed Central

    Verbakel, Natasha J; de Bont, Antoinette A; Verheij, Theo JM; Wagner, Cordula; Zwart, Dorien LM

    2015-01-01

    Background When improving patient safety a positive safety culture is key. As little is known about improving patient safety culture in primary care, this study examined whether administering a culture questionnaire with or without a complementary workshop could be used as an intervention for improving safety culture. Aim To gain insight into how two interventions affected patient safety culture in everyday practice. Design and setting After conducting a randomised control trial of two interventions, this was a qualitative study conducted in 30 general practices to aid interpretation of the previous quantitative findings. Method Interviews were conducted at practice locations (n = 27) with 24 GPs and 24 practice nurses. The theory of communities of practice — in particular, its concepts of a domain, a community, and a practice — was used to interpret the findings by examining which elements were or were not present in the participating practices. Results Communal awareness of the problem was only raised after getting together and discussing patient safety. The combination of a questionnaire and workshop enhanced the interaction of team members and nourished team feelings. This shared experience also helped them to understand and develop tools and language for daily practice. Conclusion In order for patient safety culture to improve, the safety culture questionnaire was more successful when accompanied by a practice workshop. Initial discussion and negotiation of shared goals during the workshop fuelled feelings of coherence and belonging to a community wishing to learn about enhancing patient safety. Team meetings and day-to-day interactions enhanced further liaison and sharing, making patient safety a common and conscious goal. PMID:26622035

  9. Cultural Reflexivity in Health Research and Practice

    PubMed Central

    Aronowitz, Robert; Deener, Andrew; Keene, Danya; Schnittker, Jason

    2015-01-01

    Recent public health movements have invoked cultural change to improve health and reduce health disparities. We argue that these cultural discourses have sometimes justified and maintained health inequalities when those with power and authority designated their own social practices as legitimate and healthy while labeling the practices of marginalized groups as illegitimate or unhealthy. This “misrecognition,” which creates seemingly objective knowledge without understanding historical and social conditions, sustains unequal power dynamics and obscures the fact that what is deemed legitimate and healthy can be temporally, geographically, and socially relative. We use examples from research across multiple disciplines to illustrate the potential consequences of cultural misrecognition, highlight instances in which culture was invoked in ways that overcame misrecognition, and discuss how cultural reflexivity can be used to improve health research and practice. PMID:25905833

  10. Quality aspects of Dutch general practice-based data: a conceptual approach.

    PubMed

    van den Dungen, Catharina; Hoeymans, Nancy; Schellevis, François G; van Oers, Hans J A M

    2013-06-01

    General practice-based data, collected within general practice registration networks (GPRNs), are widely used in research. The quality of the data is important but the recording criteria about what type of information is collected and how this information should be recorded differ between GPRNs. We aim to identify aspects that describe the quality of general practice-based data in the Netherlands. To investigate the quality aspects, we used the method of concept mapping, a structured conceptualization process for a complex multi-dimensional topic. We explored the ideas of representatives from 10 Dutch GPRNs on the quality of general practice-based data in five steps: preparation, generation of statements, structuring, representation and interpretation. In a brainstorm session, 10 experts generated statements about good data quality from general practice, which we completed with information from the literature. In total, 18 experts participated in the ranking and clustering of the statements. These results were analysed using ARIADNE software, using a combination of principal component analysis and cluster analysis techniques. Finally, the clusters were labelled based on their content. A total of 72 statements were analysed, which resulted in a two-dimensional picture with six clusters, 'complete health record', 'coding of information', 'episode oriented recording', 'diagnostic validity', 'recording agreements' and 'residual category'. The quality of general practice-based data can be considered on five content-based aspects. These aspects determine the quality of recording.

  11. Practical Assessment, Research and Evaluation, 2000.

    ERIC Educational Resources Information Center

    Rudner, Lawrence M., Ed.; Schafer, William D., Ed.

    2000-01-01

    This document consists of articles 1 through 14 of volume 6 of "Practical Assessment, Research & Evaluation": (1) "Seven Myths about Literacy in the United States" (Jeff McQuillan); (2) "Implementing Performance Assessment in the Classroom" (Amy Brualdi); (3) "Some Evaluation Questions" (William Shadish); (4) "Item Banking" (Lawrence Rudner); (5)…

  12. Just in Time Research: Privacy Practices

    ERIC Educational Resources Information Center

    Grama, Joanna Lyn

    2014-01-01

    The January 2014 edition of the ECAR Update subscriber newsletter included an informal poll on information privacy practices. The poll was intended to collect a quick snapshot of the higher education community's thoughts on this important topic during Data Privacy Month. Results of the poll will be used to inform EDUCAUSE research, programs,…

  13. Flipped Instruction: Breakthroughs in Research and Practice

    ERIC Educational Resources Information Center

    IGI Global, 2017

    2017-01-01

    The integration of technology into modern classrooms has enhanced learning opportunities for students. With increased access to educational content, students gain a better understanding of the concepts being taught. "Flipped Instruction: Breakthroughs in Research and Practice" is a comprehensive reference source for the latest scholarly…

  14. Practical Assessment, Research & Evaluation, 2000-2001.

    ERIC Educational Resources Information Center

    Rudner, Lawrence M., Ed.; Schafer, William D., Ed.

    2001-01-01

    This document consists of papers published in the electronic journal "Practical Assessment, Research & Evaluation" during 2000-2001: (1) "Advantages of Hierarchical Linear Modeling" (Jason W. Osborne); (2) "Prediction in Multiple Regression" (Jason W. Osborne); (3) Scoring Rubrics: What, When, and How?"…

  15. Kindergarten Education: Theory, Research, and Practice, 1999.

    ERIC Educational Resources Information Center

    Robinson, Violet B., Ed.

    1999-01-01

    This document is comprised of the two 1999 issues of a biannually-published journal featuring research studies, theoretical essays, and classroom practice articles about the development and education of kindergarten children as well as occasional articles concerning preschool and the early primary grades. The spring 1999 issue contains the…

  16. Kindergarten Education: Theory, Research, and Practice, 2000.

    ERIC Educational Resources Information Center

    Robinson, Violet B., Ed.

    2000-01-01

    This document is comprised of the two 2000 issues of a biannually-published journal featuring research studies, theoretical essays, and classroom practice articles about the development and education of kindergarten children as well as occasional articles concerning preschool and the early primary grades. The spring 2000 issue contains the…

  17. Practical Assessment, Research and Evaluation, 2001.

    ERIC Educational Resources Information Center

    Rudner, Lawrence M., Ed.; Schafer, William D., Ed.

    2001-01-01

    This document consists of articles 23 through 26 published in the electronic journal "Practical Assessment, Research & Evaluation" in 2001: (23) "Effects of Removing the Time Limit on First and Second Language Intelligence Test Performance" (Jennifer Mullane and Stuart J. McKelvie); (24) "Consequences of (Mis)use of the Texas Assessment of…

  18. Contemporary Play Therapy: Theory, Research, and Practice

    ERIC Educational Resources Information Center

    Schaefer, Charles E., Ed.; Gerard Kaduson, Heidi, Ed.

    2006-01-01

    This highly practical book presents current developments in play therapy, including innovative applications for particular problems and populations. Contributors first discuss the latest ideas and techniques emerging from object-relations, experiential, dynamic, and narrative perspectives. Next, research evaluating the effectiveness of play…

  19. CALL Environments: Research, Practice, and Critical Issues.

    ERIC Educational Resources Information Center

    Egbert, Joy, Ed.; Hanson-Smith, Elizabeth, Ed.

    Essays on computer-assisted language learning (CALL) include: "Computer-Enhanced Language Learning Environments" (Joy Egbert, Chin-chi Chao, Elizabeth Hanson-Smith); "Theory and Research Interaction via Computers" (Joy Kreeft Peyton); "Classroom Practice: Creating Interactive CALL Activities" (Joy Egbert); "CALL…

  20. Encouraging Gender Analysis in Research Practice

    ERIC Educational Resources Information Center

    Thien, Deborah

    2009-01-01

    Few resources for practical teaching or fieldwork exercises exist which address gender in geographical contexts. This paper adds to teaching and fieldwork resources by describing an experience with designing and implementing a "gender intervention" for a large-scale, multi-university, bilingual research project that brought together a group of…

  1. Practical Engagements and Co-Created Research

    ERIC Educational Resources Information Center

    Simpson, Jennifer Lyn; Seibold, David R.

    2008-01-01

    In this essay we foreground the value of engaging meaningfully with practitioners in our work. We review research by scholars whose work cuts across topics and contexts to gain insight into the power and practice of human communication as it shapes the world in which we live-highlighting work that is at its best because of its co-creation with…

  2. Making Connections between Research and Practice

    ERIC Educational Resources Information Center

    Porter, Andrew; McMaken, Jennifer

    2009-01-01

    Strengthening connections between research and practice is an important goal in education. Making the connection has both a supply side and a demand side but the demand is often ignored in education. The authors offer six hypotheses about why this situation occurs.

  3. Embodied Experience in Educational Practice and Research

    ERIC Educational Resources Information Center

    Bengtsson, Jan

    2013-01-01

    The intention of this article is to make an educational analysis of Merleau-Ponty's theory of experience in order to see what it implicates for educational practice as well as educational research. In this way, we can attain an understanding what embodied experience might mean both in schools and other educational settings and in researching…

  4. Kindergarten Education: Theory, Research, and Practice, 1999.

    ERIC Educational Resources Information Center

    Robinson, Violet B., Ed.

    1999-01-01

    This document is comprised of the two 1999 issues of a biannually-published journal featuring research studies, theoretical essays, and classroom practice articles about the development and education of kindergarten children as well as occasional articles concerning preschool and the early primary grades. The spring 1999 issue contains the…

  5. Talking the Talk: Translating Research to Practice

    ERIC Educational Resources Information Center

    Grifenhagen, Jill F.; Barnes, Erica M.; Collins, Molly F.; Dickinson, David K.

    2017-01-01

    Decades of research have identified features of classrooms and teachers' talk that are associated with children's language growth. Unfortunately, much of this work has not yet translated to widespread practice in early childhood classrooms. Given the important contributions that early language development makes to later academic achievement,…

  6. The Gap between Research and Practice Revisited

    ERIC Educational Resources Information Center

    Korthagen, Fred A. J.

    2007-01-01

    Increasingly, teachers--but also parents and politicians--voice dissatisfaction with the divide they experience between research and practice and the resulting minimal impact of teacher education (Ashton, 1996; Barone, Berliner, Blanchard, Casanova, & McGowan, 1996). The problem seems to be perennial. More than a century ago, John Dewey pointed…

  7. Contemporary Play Therapy: Theory, Research, and Practice

    ERIC Educational Resources Information Center

    Schaefer, Charles E., Ed.; Gerard Kaduson, Heidi, Ed.

    2006-01-01

    This highly practical book presents current developments in play therapy, including innovative applications for particular problems and populations. Contributors first discuss the latest ideas and techniques emerging from object-relations, experiential, dynamic, and narrative perspectives. Next, research evaluating the effectiveness of play…

  8. Just in Time Research: Privacy Practices

    ERIC Educational Resources Information Center

    Grama, Joanna Lyn

    2014-01-01

    The January 2014 edition of the ECAR Update subscriber newsletter included an informal poll on information privacy practices. The poll was intended to collect a quick snapshot of the higher education community's thoughts on this important topic during Data Privacy Month. Results of the poll will be used to inform EDUCAUSE research, programs,…

  9. Leadership Practices and School Choice. Research Brief

    ERIC Educational Resources Information Center

    Cravens, Xiu; Goldring, Ellen; Penaloza, Roberto V.

    2011-01-01

    As part of a larger study on school choice, researchers at the National Center on School Choice examined variation in leadership practices across school types, relying on a convenience matched sample of schools that included charter, magnet, private, and traditional public schools. A total of 284 schools agreed to participate in the study--116…

  10. Making Connections between Research and Practice

    ERIC Educational Resources Information Center

    Porter, Andrew; McMaken, Jennifer

    2009-01-01

    Strengthening connections between research and practice is an important goal in education. Making the connection has both a supply side and a demand side but the demand is often ignored in education. The authors offer six hypotheses about why this situation occurs.

  11. Implications of Brain Research for Educational Practices.

    ERIC Educational Resources Information Center

    Guckes, Lucille; Elkins, Robert

    Recent brain research demonstrates that the left hemisphere of the brain processes information in a linear, organized way. The right hemisphere processes the same information as a whole, with a focus on nonverbal, spatial components. Current educational practice is inordinately skewed to develop only the left hemisphere of the brain. Data from…

  12. Representativeness of the dabigatran, apixaban and rivaroxaban clinical trial populations to real-world atrial fibrillation patients in the United Kingdom: a cross-sectional analysis using the General Practice Research Database

    PubMed Central

    Lee, Sally; Monz, Brigitta U; Clemens, Andreas; Brueckmann, Martina; Lip, Gregory Y H

    2012-01-01

    Objective Three oral anticoagulants have reported study results for stroke prevention in patients with atrial fibrillation (AF) (dabigatran etexilate, rivaroxaban and apixaban); all demonstrated superiority or non-inferiority compared with warfarin (RE-LY, ARISTOTLE and ROCKET-AF). This study aimed to assess the representativeness for the real-world AF population, particularly the population eligible for anticoagulants. Design A cross-sectional database analysis. Setting Dataset derived from the General Practice Research Database (GPRD). Primary and secondary outcomes measure The proportion of real-world patients with AF who met the inclusion/exclusion criteria for RE-LY, ARISTOTLE and ROCKET-AF were compared. The results were then stratified by risk of stroke using CHADS2 and CHA2DS2-VASc. Results 83 898 patients with AF were identified in the GPRD. For the population at intermediate or high risk of stroke and eligible for anticoagulant treatment (CHA2DS2-VASc ≥1; n=78 783 (94%)), the proportion eligible for inclusion into RE-LY (dabigatran etexilate) was 68% (95% CI 67.7% to 68.3%; n=53 640), compared with 65% (95% CI 64.7% to 65.3%; n=51 163) eligible for ARISTOTLE (apixaban) and 51% (95% CI 50.7% to 51.4%; n=39 892) eligible for ROCKET-AF (rivaroxaban). Using the CHADS2 method of risk stratification, for the population at intermediate or high risk of stroke and eligible for anticoagulation treatment (CHADS2 ≥1; n=71 493 (85%)), the proportion eligible for inclusion into RE-LY was 74% (95% CI 73.7% to 74.3%; n=52 783), compared with 72% (95% CI 71.7% to 72.3%; n=51 415) for ARISTOTLE and 56% (95% CI 55.6% to 56.4%; n=39 892) for ROCKET-AF. Conclusions Patients enrolled within RE-LY and ARISTOTLE were more reflective of the ‘real-world’ AF population in the UK, in contrast with patients enrolled within ROCKET-AF who were a more narrowly defined group of patients at higher risk of stroke. Differences between trials should be taken into

  13. Laparoscopic entry: a review of Canadian general surgical practice

    PubMed Central

    Compeau, Christopher; McLeod, Natalie T.; Ternamian, Artin

    2011-01-01

    Background Laparoscopic surgery has gained popularity over open conventional surgery as it offers benefits to both patients and health care practitioners. Although the overall risk of complications during laparoscopic surgery is recognized to be lower than during laparotomy, inadvertent serious complications still occur. Creation of the pneumoperitoneum and placement of laparoscopic ports remain a critical first step during endoscopic surgery. It is estimated that up to 50% of laparoscopic complications are entry-related, and most injury-related litigations are trocar-related. We sought to evaluate the current practice of laparoscopic entry among Canadian general surgeons. Methods We conducted a national survey to identify general surgeon preferences for laparoscopic entry. Specifically, we sought to survey surgeons using the membership database from the Canadian Association of General Surgeons (CAGS) with regards to entry methods, access instruments, port insertion sites and patient safety profiles. Laparoscopic cholecystectomy was used as a representative general surgical procedure. Results The survey was completed by 248 of 1000 (24.8%) registered members of CAGS. Respondents included both community and academic surgeons, with and without formal laparoscopic fellowship training. The demographic profile of respondents was consistent nationally. A substantial proportion of general surgeons (> 80%) prefer the open primary entry technique, use the Hasson trocar and cannula and favour the periumbilical port site, irrespective of patient weight or history of peritoneal adhesions. One-third of surgeons surveyed use Veress needle insufflation in their surgical practices. More than 50% of respondents witnessed complications related to primary laparoscopic trocar insertion. Conclusion General surgeons in Canada use the open primary entry technique, with the Hasson trocar and cannula applied periumbilically to establish a pneumoperitoneum for laparoscopic surgery. This

  14. Practical issues in multi-lingual research.

    PubMed

    Im, Eun-Ok; Kim, Sangmi; Tsai, Hsiu-Min; Nishigaki, Masakazu; Yeo, Seon Ae; Chee, Wonshik; Chee, Eunice; Mao, Jun James

    2016-02-01

    With an increasing number of ethnic minority populations, the use of multiple languages in one research study has increased in recent years. The use of multiple languages helps increase comprehensiveness of educational materials and/or survey questionnaires, and promote ethnic minorities' participation in research. However, little has been clearly known about practical issues in using multiple languages in one research study. The purpose of this paper is to explore practical issues in using multiple languages in a study among diverse sub-ethnic groups of Asian American breast cancer survivors in order to propose future directions for the use of multiple languages in research projects. Throughout the research process, research team made written records of practical issues and possible reasons for the issues as they arose. Weekly group discussions among research team members were administered, and the written records of these discussions were reviewed and analyzed using the content analysis. The unit of analysis was individual words. The words in the data (memos and written records) were classified into idea categories that emerged from the coding process. The idea categories included issues in: (a) collaborators from various sub-ethnic groups; (b) IRB protocol submissions; (c) consistencies in translation process, (d) conceptual equivalence; (e) cultural differences; (f) existing translated versions; and (g) authorship issues. Based on the issues, we made the following suggestions for multi-lingual research: (a) networking and setting multiple communication channels with potential collaborators; (b) checking the institution's IRB policies related to the use of multiple languages; (c) setting the rules and procedures for translation process; (d) checking existing different language versions of instruments; and (e) setting the rules for authorship in advance. The suggestions made in this study would help the researchers be prepared in advance to deal with the

  15. Data Resource Profile: Clinical Practice Research Datalink (CPRD)

    PubMed Central

    Herrett, Emily; Gallagher, Arlene M; Bhaskaran, Krishnan; Forbes, Harriet; Mathur, Rohini; van Staa, Tjeerd; Smeeth, Liam

    2015-01-01

    The Clinical Practice Research Datalink (CPRD) is an ongoing primary care database of anonymised medical records from general practitioners, with coverage of over 11.3 million patients from 674 practices in the UK. With 4.4 million active (alive, currently registered) patients meeting quality criteria, approximately 6.9% of the UK population are included and patients are broadly representative of the UK general population in terms of age, sex and ethnicity. General practitioners are the gatekeepers of primary care and specialist referrals in the UK. The CPRD primary care database is therefore a rich source of health data for research, including data on demographics, symptoms, tests, diagnoses, therapies, health-related behaviours and referrals to secondary care. For over half of patients, linkage with datasets from secondary care, disease-specific cohorts and mortality records enhance the range of data available for research. The CPRD is very widely used internationally for epidemiological research and has been used to produce over 1000 research studies, published in peer-reviewed journals across a broad range of health outcomes. However, researchers must be aware of the complexity of routinely collected electronic health records, including ways to manage variable completeness, misclassification and development of disease definitions for research. PMID:26050254

  16. Welfare to work: the role of general practice.

    PubMed Central

    Ford, F M; Ford, J; Dowrick, C

    2000-01-01

    This paper considers the potential effects of the government's Welfare to Work policy on general practitioner (GP) working patterns, and aims to explore the relationship between unemployment, ill health, and GP sickness certification. Social security and employment policy initiatives are discussed in relation to the literature on the relationship between unemployment and ill health, sociological and psychological perspectives on work and unemployment, medicalisation of unemployment, adjudication of fitness for work, re-employment and health, and treatment of barriers to employment. The authors postulate that Welfare to Work policy may depend for its success on the crucial role of general practice in sickness certification. PMID:10962795

  17. The growing challenge of party drugs in general practice.

    PubMed

    Khong, Eric; Wain, Toni

    2004-09-01

    'Party drugs' are commonly used by young people to enhance feelings of sociability, mood and sexual arousal. Recent studies suggest the prevalence of party drug use is increasing with more than 1 million Australians using party drugs. The potential for morbidity is high with increasing polydrug use. This article aims to provide practical information for the general practitioner in the assessment and management of patients presenting with party drug related problems. People that use party drugs can present in general practice with a variety of symptoms and signs depending on the drug used. Importance is often placed on identifying the drug, but it is more important to engage the user and explore the drug using behaviour. While cessation of party drug use may be influenced by many things including GP advice, the natural history is eventual cessation, and GPs have a key role in promoting harm minimisation strategies and ongoing health care in the meantime.

  18. General practice--a post-modern specialty?

    PubMed Central

    Mathers, N; Rowland, S

    1997-01-01

    The 'modern' view of the world is based on the premise that we can discover the essential truth of the world using scientific method. The assumption is made that knowledge so acquired has been 'uncontaminated' by the mind of the investigator. Post-modern theory, however, is concerned with the process of knowing and how our minds are part of the process, i.e. our perceptions of reality and the relationships between different concepts are important influences on our ways of knowing. The values of post-modern theory are those of uncertainty, many different voices and experiences of reality and multifaceted descriptions of truth. These values are closer to our experience of general practice than the 'modern' values of scientific rationalism and should be reflected in a new curriculum for general practice. PMID:9167325

  19. The advent of mental health nurses in Australian general practice.

    PubMed

    Olasoji, Michael; Maude, Phil

    2010-01-01

    The remarkable progress that has been witnessed in the physical and material wellbeing for most Australians over the 20th century has not been paralleled by gains in the mental and subjective wellbeing of the population. General practice plays a strategic role in Australia's primary health care, which has been recognised as an essential health system that is able to deliver health to the population in a timely and equitable manner (World Health Organisation [WHO], 2008). General Practitioners are unable to provide adequate care to people experiencing a severe mental illness without support from specialist mental health professional such as a mental health nurse in the practice. The mental health nurse incentive program (MHNIP) offers opportunity for mental health nurses to work collaboratively with GPs in primary health care in the delivery of care to people with a severe mental illness.

  20. The epidemiology of prescribing in an urban general practice

    PubMed Central

    Murdoch, J. C.

    1980-01-01

    The total prescribing in an urban general practice was recorded over a six-month period and classified according to the length of time that drugs were continued. The number of patients receiving any prescription rose with age, as did the total number of items per patient prescribed for; while the continued items rose with age, the number of items prescribed once only per patient remained constant in all age groups. The bulk of the total prescribing was for the elderly and this was mainly for continued items. The classification also shows that certain drug groups are liable to be continued whereas others are virtually always prescribed once only. The implications of these findings for self-audit of prescribing and the care of the elderly in general practice are discussed. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6. PMID:7452600

  1. Value of written health information in the general practice setting.

    PubMed Central

    Collings, L H; Pike, L C; Binder, A I; McClymont, M E; Knight, S T

    1991-01-01

    The value of a library for patients as a way of providing written health information in the general practice setting has been investigated using a questionnaire. In 15 months, 243 books were borrowed from one library. Each book contained a questionnaire and 163 questionnaires were returned (67%). It was found that 106 respondents (65%) would not have sought the information elsewhere and 159 respondents (98%) found the books they had read to be very useful or of some use. The perceived level of anxiety after reading was raised in nine respondents (6%) but reduced in 71 (44%). Patients read books on 53 separate topics overall, although 73 respondents (45%) read on 10 recurring topics. A patients' library thus enables most patients to gain useful information from their general practice without increasing their anxiety. PMID:1807307

  2. The epidemiology of teaching and training General Practices in England.

    PubMed

    Rees, Eliot L; Gay, Simon P; McKinley, Robert K

    2016-11-01

    There is no national picture of teaching and training practices or the communities they serve. We aimed to describe the association between general practices' engagement with education and their characteristics, locality and patients' health-status and satisfaction. This data linkage study of all English practices calculated odds ratios for teaching and training status and practice, locality and patient variables. Teaching and training practices are larger than practices which do neither (mean list size (SD) 7074 (3736), 10112 (4934), and 5327 (3368) respectively, p < 0.001 and have fewer patients per GP (1932 (951), 1838 (544), and 2117 (1585) respectively, p < 0.001). Their localities have a higher proportion of White British residents (77.99% (24.17), 81.66% (20.81), 73.07% (26.91), p < 0.001). Practices with more GPs (OR 1.21 (95%CI 1.18-1.20)), fewer male GPs (0.45 (0.36-0.55)) and a higher proportion of White British people in their locality (1.30 (1.06-1.60)) were more likely to teach. Practices in rural areas (1.68 (1.43-1.98)), with more GPs (1.22 (1.27-1.39)), more full time equivalent GPs (2.68 (1.64-4.40)), fewer male GPs (0.17 (0.13-0.22)) and a higher proportion of White British people in their locality (1.34 (1.02-1.75)) were more likely to train. Teaching and training practices had higher patient satisfaction (0.293 (0.190, 0.397) and (0.563 (0.442, 0.685)) respectively and quality and outcomes framework scores (0.507 (0.211, 0.804)) and (0.996 (0.650, 1.342)) respectively than those which did not. Educationally engaged practices are unrepresentative in serving less ethnically diverse and (for training practices) less urban environments. Investment is needed to increase the proportion of educational practices in diverse urban localities.

  3. [The practice guideline 'Anemia' from the Dutch College of General Practitioners; a response from the perspective of general practice medicine].

    PubMed

    van den Bosch, W J

    2003-10-04

    The practice guideline 'Anaemia' from the Dutch College of General Practitioners will certainly be a support for the Dutch general practitioner. The inclusion of an algorithm to make a more precise diagnosis is an experiment that needs to be evaluated in the near future. However, many general practitioners will regard it as too complex for use in daily practice and specialists will find it to be of limited use, as it does not cover all cases. Consultation between the general practitioner and the specialist will give the best answer in complicated cases. Patients who complain about tiredness or dizziness will expect their general practitioner to take a blood sample for a haemoglobin test. The general practitioner will consider the risk of false-positive test results in interpreting the patient's haemoglobin level. A few concrete remarks: the guideline does not mention that vegetarianism and a low meat intake can increase the risk of vitamin B12 deficiency, and iron suppletion is advised in premenopausal women with profuse vaginal blood loss, whereas there are several treatable disorders that may cause menorrhagia.

  4. Dental therapists in general dental practices: an economic evaluation.

    PubMed

    Beazoglou, Tryfon J; Lazar, Vickie F; Guay, Albert H; Heffley, Dennis R; Bailit, Howard L

    2012-08-01

    Dental access disparities are well documented and have been recognized as a national problem. Their major cause is the lack of reasonable Medicaid reimbursement rates for the underserved. Specifically, Medicaid reimbursement rates for children average 40 percent below market rates. In addition, most state Medicaid programs do not cover adults. To address these issues, advocates of better oral health for the underserved are considering support for a new allied provider--a dental therapist--capable of providing services at a lower cost per service and in low-income and rural areas. Using a standard economic analysis, this study estimated the potential cost, price, utilization, and dentist's income effects of dental therapists employed in general dental practices. The analysis is based on national general dental practice data and the broadest scope of responsibility for dental therapists that their advocates have advanced, including the ability to provide restorations and extractions to adults and children, training for three years, and minimum supervision. Assuming dental therapists provide restorative, extraction, and pulpal services to patients of all ages and dental hygienists continue to deliver all hygiene services, the mean reduction in a general practice costs ranges between 1.57 and 2.36 percent. For dental therapists treating children only, the range is 0.31 to 0.47 percent. The effects on price and utilization are even smaller. In addition, the effects on most dentists' gross income, hours of work, and net income are negative. The estimated economic impact of dental therapists in the United States on private dental practice is very limited; therefore, the demand for dental therapists by private practices also would probably be very limited.

  5. Participatory design of a preliminary safety checklist for general practice

    PubMed Central

    Bowie, Paul; Ferguson, Julie; MacLeod, Marion; Kennedy, Susan; de Wet, Carl; McNab, Duncan; Kelly, Moya; McKay, John; Atkinson, Sarah

    2015-01-01

    Background The use of checklists to minimise errors is well established in high reliability, safety-critical industries. In health care there is growing interest in checklists to standardise checking processes and ensure task completion, and so provide further systemic defences against error and patient harm. However, in UK general practice there is limited experience of safety checklist use. Aim To identify workplace hazards that impact on safety, health and wellbeing, and performance, and codesign a standardised checklist process. Design and setting Application of mixed methods to identify system hazards in Scottish general practices and develop a safety checklist based on human factors design principles. Method A multiprofessional ‘expert’ group (n = 7) and experienced front-line GPs, nurses, and practice managers (n = 18) identified system hazards and developed and validated a preliminary checklist using a combination of literature review, documentation review, consensus building workshops using a mini-Delphi process, and completion of content validity index exercise. Results A prototype safety checklist was developed and validated consisting of six safety domains (for example, medicines management), 22 sub-categories (for example, emergency drug supplies) and 78 related items (for example, stock balancing, secure drug storage, and cold chain temperature recording). Conclusion Hazards in the general practice work system were prioritised that can potentially impact on the safety, health and wellbeing of patients, GP team members, and practice performance, and a necessary safety checklist prototype was designed. However, checklist efficacy in improving safety processes and outcomes is dependent on user commitment, and support from leaders and promotional champions. Although further usability development and testing is necessary, the concept should be of interest in the UK and internationally. PMID:25918338

  6. Editorial: A Note on Good Research Practice

    SciTech Connect

    Dooley, James J.

    2013-07-01

    Good scientific practice and research misconduct have been concerns of mine for more than a decade (Dooley and Kerch, 2000) and in my role as an editor of the International Journal of Greenhouse Gas Control, I feel it is time to speak up and at the very least share my concerns and suggestions as they relate to the integrity of the research published in this journal. Rather than wait to write an editorial on good research practices in response to a major incident, I thought it might be best to be proactive and address some of the trends we see in submissions to this peer reviewed journal and to offer some suggestions for improvement improving the level of scholarship in some – but by no means all – of the papers submitted.

  7. Prosthodontics in a general practice program of advanced dental education.

    PubMed

    Plekavich, E J

    1976-01-01

    The problems involved in teaching prosthodontics in a general practice program outwardly appear to be due to the lack of sufficient basic prosthodontic training dispensed by the dental schools. This lack of sufficient training is not the fault of dental school faculties. The students are not learning what they are taught. What they need is more repetition, which means more time. The problems are not insurmountable. We just must find the route.

  8. Prescribing psychotropic drugs in general practice: three year study.

    PubMed Central

    Jones, L; Simpson, D; Brown, A C; Bainton, D; McDonald, H

    1984-01-01

    A three year longitudinal study of psychotropic drug prescribing in one inner city general practice showed that there was a greater use of such drugs among women and elderly men and women. Repeat prescriptions without consultation accounted for 44% of prescriptions written. We think that any attempt to reduce the volume of prescriptions for psychotropic drugs should take into account the prescribing habits and attitudes of doctors as well as the problems and needs of patients. PMID:6435768

  9. Impact of an audiology clinic in one general practice.

    PubMed Central

    Khunti, K; Carr, M

    1997-01-01

    There is a large demand for the provision of hearing aids. However, there are lengthy delays involved between referral and fitment of National Health Service (NHS) hearing aids. This report shows that a general practice based audiology clinic can lead to an increase in the number of patients referred and fitted with a hearing aid. The introduction of the clinic also led to reduced waiting times for patients to be fitted with hearing aids. PMID:9474829

  10. Patients' knowledge of heart disease in general practice

    PubMed Central

    Moore, Philip; Garraway, Michael

    1977-01-01

    Interviews with 400 consecutive patients attending a general practice sought their knowledge of the signs and symptoms of an acute heart attack, what action they would take for such an event, and their understanding of the predisposing factors contributing to heart disease. The survey revealed poor recognition of the relevant signs and symptoms of an acute heart attack and lack of knowledge of some of the main predisposing factors associated with heart disease. PMID:618352

  11. Homoeopathic and herbal prescribing in general practice in Scotland

    PubMed Central

    Ross, Sarah; Simpson, Colin R; McLay, James S

    2006-01-01

    What is already known about this subject Homoeopathy and herbalism are increasingly popular among the public and prescribed by general practitioners in the NHS. Doctors and regulatory authorities have expressed concerns about their efficacy and safety. Studies from the 1990s suggest that between 5.9 and 7.5% of English NHS general practitioners have prescribed homoeopathy, while less than 1% have prescribed herbal remedies. Current levels of prescribing are unknown but are thought to have increased. What this study adds Sixty percent of Scottish general practices now prescribe homoeopathic or herbal remedies. The prevalence of homoeopathic prescribing in those under 16 years has doubled since 2000 and is maximal in children < 1 year old, of whom 1% are prescribed a homoeopathic remedy. Recognized drug–herb interactions were identified in 4% of patients prescribed oral herbal remedies. Aims To investigate the current levels of homoeopathic and herbal prescribing in Scottish general practice. Methods Prescribing of homoeopathic and herbal remedies in primary care was assessed in 1891 669 patients for the year 2003–2004, using computerized prescribing data retrieved from 323 general practices in Scotland. Results Forty-nine percent of practices prescribed homoeopathic and 32% herbal remedies. A total of 193 homoeopathic and 17 herbal remedies were prescribed, with 5% of practices accounting for 46% of patients and 50% of remedies. Four thousand one hundred and sixty patients (2.2/1000 registered patients) were prescribed at least one homoeopathic remedy during the study period, with the highest prevalence to children under 12 months of age (9.5/1000 children of that age). Children under the age of 16 made up 16% of the population prescribed homoeopathic remedies (2.2/1000 registered patients of that age). Three hundred and sixty-one patients (0.2/1000 registered patients) were prescribed at least one herbal remedy during the study period, 44 of whom were children

  12. [Strategies for productive collaboration between science and general practice].

    PubMed

    Trojan, A

    1996-05-01

    My contribution is a systematic account of strategies for cooperation and feedback between public health sciences and research. A feature both areas have in common is their commitment to empirically based knowledge. "Rational" models of cooperation (or rather, models based on belief in rationality) presume simple linear links between research and its application. Diffusion models, however, seem to be far more adequate for translating public health research into reality. The best model is the "Discourse Model" based on continuous communication and feedback between science and practice. It seems to promote the diffusion of public health innovations most effectively. In the second part I give examples of how to translate the Discourse Model into practical reality. Summing up, its strategic elements are: 1. responsive project shaping, 2. interactive running of projects, 3. shared processing of results, 4. active diffusion of results.

  13. Patients’ Views Concerning Research on Medical Practices: Implications for Consent

    PubMed Central

    Weinfurt, Kevin P.; Bollinger, Juli M.; Brelsford, Kathleen M.; Crayton, Travis J.; Topazian, Rachel J.; Kass, Nancy E.; Beskow, Laura M.; Sugarman, Jeremy

    2016-01-01

    Background Comparative effectiveness research (CER) and pragmatic clinical trials commonly test interventions that are in routine use and pose minimal incremental risk or burdens to patients who participate in this research. The objective of this study was to elicit the range of patients’ views and opinions regarding a variety of different types of research on usual medical practices, especially notification and authorization for them. Methods We conducted twelve focus groups with adults in five U.S. cities—six focus groups addressing CER (“CER groups”) and six groups addressing research involving hospital operations and clinician interventions (“Operations groups”). Participants discussed hypothetical research studies and potential methods of notifying patients and obtaining their authorization to participate. Group discussions were recorded, transcribed, and coded to identify patients’ views related to research on standard medical practice. Results A total of ninety six people participated. Twelve key themes emerged from participants’ discussions of the hypothetical research studies; these themes were then grouped into four general categories: clinical care; notification and authorization; communication; and conduct and design of research. The desire to be actively notified and asked was more prominent with regard to CER studies than with regard to Operations studies. Conclusions Our data suggest that effective policy and guidance will involve balancing different patients’ interests and potentially different sets of interests for different types of research studies on usual medical practices. PMID:27800531

  14. Dollars, debts and duties: lessons from funding Australian general practice.

    PubMed

    Rogers, Wendy A.; Veale, Bronwyn

    2000-09-01

    This study investigated changes in resource allocation and activities of Australian Divisions of General Practice associated with new funding procedures which link monies to nominated outcomes. The study involved analysis of annual reports and strategic plans, and semistructured telephone interviews with key personnel from 27 divisions of general practice. The main outcome measures were: number of activities in various nominated health areas; total and median expenditure per activity in each area; and methods of resource allocation. Despite a modest increase in funding to the total general practice divisions program over the two year period, expenditure decreased in the National Health Priority Areas of mental health, diabetes, cardiovascular disease, injuries and cancer. There was increased expenditure in the priority area of immunisation, which received dedicated funding. There was greatly increased expenditure in the areas of information technology and services to GPs (including continuing medical education, professional development and workforce issues). The ease of defining and measuring outcomes influenced the choice of activities. In 1996, activities were linked to formal needs analyses in approximately 20 per cent of cases. The most frequent driving force for projects was enthusiastic GPs. In 1998, resource allocation decisions were more explicitly linked to formal needs analyses; however, the standard of the needs analyses varied widely between divisions. Changes in funding procedures which use nominated outcomes as the major accountability mechanism may produce unexpected, and unintended results, including significantly decreased expenditure in areas with outcomes which are hard to define and measure but which are important for health improvement.

  15. Research to Practice: Implementing Physical Activity Recommendations

    PubMed Central

    Davis, Sally M.; Cruz, Theresa H.; Kozoll, Richard

    2016-01-01

    Introduction Dissemination and implementation (D&I) science focuses on bridging the gap between research and practice. The Community Preventive Services Task Force (CPSTF) published recommendations for increasing physical activity based on scientific review and consensus. Little research on the D&I of these recommendations has been conducted in under-represented populations at high risk for inactivity and chronic disease. Methods Partnering with one rural community (beta site), the University of New Mexico Prevention Research Center studied the translation of CPSTF recommendations to practice. Strategies for increasing physical activity were selected, implemented, and analyzed in 2009 to 2013. Participant observations; content analysis of meeting minutes, field notes, and other documents; and in-depth interviews were conducted over the 5-year period to identify factors important for carrying out the CPSTF recommendations for physical activity in a rural New Mexico community. Results Included among the implementation outcomes were new sidewalks and trails, a community-wide campaign, social support of walking, and park improvements. The following factors were identified as important to the implementation process: an active community-academic partnership; multiple partners; culturally appropriate strategies; and approaches that fit local context and place characteristics (topography, land ownership, population clusters, existing roadways). Conclusions This study illustrates how evidence can be translated to practice and identifies key factors in that process. The successful beta model provides a practical blueprint for D&I in rural, under-represented populations. This model is currently being disseminated (scaled up) to other rural New Mexico communities. PMID:28215385

  16. The conduct of practice-based research in community clinics compared to private practices: similarities, differences, and challenges

    PubMed Central

    Gillette, Jane; Cunha-Cruz, Joana; Gilbert, Ann; Speed-McIntyre, Pollene; Zhou, Lingmei; DeRouen, Timothy

    2013-01-01

    Practice-based research should be performed in all practice settings if the results are to be applied to all settings. However, some practice settings, such as community clinics, have unique features that may make the conduct of such research more challenging. The purpose of this article is to describe and compare the similarities and unique challenges related to conducting research in community clinics compared to private practices within the Northwest Practice-Based REsearch Collaborative in Evidence-Based DENTistry (PRECEDENT) network. Information was obtained from meetings with general dentists, a survey of general dentists (N = 253), and a clinical examination and record review of a systemic random sample of patients visiting community clinics and private practices. (N = 1903)—all part of a dental practice-based research network. The processes of conducting research, the dentist and patient sociodemographic characteristics, the prevalence of oral diseases, and the dental treatments received in community clinics and private practices were compared. Both community clinics and private practices have the clinical treatment of the patients as their priority and have time constraints on research. The processes of research training, obtaining informed consent, and collecting, transmitting, and securely maintaining research data are also similar. The patient populations and treatment needs differ substantially between community clinics and private practices, with a higher prevalence of dental caries and higher restorative treatment needs in the community clinic patients. The process of study participant selection and follow-up for research and the dentist and staff work arrangements also vary between the two practice settings. Although community clinic patients and their dental healthcare providers have different research needs and challenges than their counterparts in private practice, practice-based research can be successfully PMID:25429251

  17. Managing patient demand: a qualitative study of appointment making in general practice.

    PubMed

    Gallagher, M; Pearson, P; Drinkwater, C; Guy, J

    2001-04-01

    Managing patients' requests for appointments is an important general practice activity. No previous research has systematically observed how patients and receptionists negotiate appointments. To observe appointment making and investigate patients' and professionals' experiences of appointment negotiations. A qualitative study using participant observation. Three general practices on Tyneside; a single-handed practice, a practice comprising three doctors, and a seven-doctor practice. Participant observation sessions, consisting of 35 activity recordings and 34 periods of observation and 38 patient and 15 professional interviews, were set up. Seven groups of patients were selected for interview. These included patients attending an 'open access' surgery, patients who complained about making an appointment, and patients who complimented the receptionists. Appointment making is a complex social process. Outcomes are dependent on the process of negotiation and factors, such as patients' expectations and appointment availability. Receptionists felt that patients in employment, patients allocated to the practice by the Health Authority, and patients who did not comply with practice appointment rules were most demanding. Appointment requests are legitimised by receptionists enforcing practice rules and requesting clinical information. Patients volunteer information to provide evidence that their complaint is appropriate and employ strategies, such as persistence, assertiveness, and threats, to try and persuade receptionists to grant appointments. Appointment making is a complex social process where outcomes are negotiated. Receptionists have an important role in managing patient demand. Practices should be explicit about how appointments are allocated, including publishing practice criteria.

  18. Role of research in best practices.

    PubMed

    Revell, Maria A

    2015-03-01

    Evidence based care (EBP) is imperative to the promotion of best practices. EBP forms the foundation for safe, efficient, and cost-effective patient management. It gives nurses the ability to implement care activities with proved outcomes and validate interventions from a database of sources. EBP not only has an impact on nursing practice but also affects theoretic models and care frameworks. It forms a foundation for professional care activities that use grounded protocols and guidelines and nursing education. This article includes resources to promote continued use of research evidence to guide in patient care areas. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Authorizing psychiatric research: principles, practices and problems.

    PubMed

    Chong, Siow Ann; Huxtable, Richard; Campbell, Alastair

    2011-01-01

    Psychiatric research is advancing rapidly, with studies revealing new investigative tools and technologies that are aimed at improving the treatment and care of patients with psychiatric disorders. However, the ethical framework in which such research is conducted is not as well developed as we might expect. In this paper we argue that more thought needs to be given to the principles that underpin research in psychiatry and to the problems associated with putting those principles into practice. In particular, we comment on some of the difficulties posed by the twin imperatives of ensuring that we respect the autonomy and interests of the research subject and, at the same time, enable potentially beneficial psychiatric research to flourish. We do not purport to offer a blueprint for the future; we do, however, seek to advance the debate by identifying some of the key questions to which better answers are required.

  20. Research Informing Practice--Practice Informing Research: Innovative Teaching Methologies for World Language Teachers. Research in Second Language Learning

    ERIC Educational Resources Information Center

    Schwarzer, David, Ed.; Petron, Mary, Ed.; Luke, Christopher, Ed.

    2011-01-01

    "Research Informing Practice--Practice Informing Research: Innovative Teaching Methodologies for World Language Educators" is an edited volume that focuses on innovative, nontraditional methods of teaching and learning world languages. Using teacher-research projects, each author in the volume guides readers through their own personal…

  1. Research Informing Practice--Practice Informing Research: Innovative Teaching Methologies for World Language Teachers. Research in Second Language Learning

    ERIC Educational Resources Information Center

    Schwarzer, David, Ed.; Petron, Mary, Ed.; Luke, Christopher, Ed.

    2011-01-01

    "Research Informing Practice--Practice Informing Research: Innovative Teaching Methodologies for World Language Educators" is an edited volume that focuses on innovative, nontraditional methods of teaching and learning world languages. Using teacher-research projects, each author in the volume guides readers through their own personal…

  2. Pre-registration house officer rotations incorporating general practice: does the order of rotation matter?

    PubMed

    Williams, C; Cantillon, P; Cochrane, M

    2001-06-01

    In relation to pre-registration house officer (PRHO) rotations incorporating general practice, previous research has recommended that where possible, no PRHO should undertake general practice as the first placement, because of the difficulties encountered. It was recognized that logistically, this could make such schemes almost unworkable. Within the context of a larger qualitative evaluation comparing how 24 PRHOs learned in hospital and general practice settings, the issue of rotation order was explored. In-depth semistructured interviews were conducted with the 12 PRHOs who were involved in general practice rotations. They were interviewed at the beginning and end of the PRHO year, and following their return to hospital work after the general practice placement. Each rotation order had both advantages and disadvantages, with no particular rotation order being obviously better or worse for the PRHOs involved. This small qualitative evaluation has highlighted a number of advantages and disadvantages specific to each rotation order, and makes some practical recommendations to help alleviate the problems encountered. It is important that future evaluations of similar schemes consider this issue, as there are conflicting reports about the significance of the rotation order.

  3. An ethnographic exploration of influences on prescribing in general practice: why is there variation in prescribing practices?

    PubMed Central

    2013-01-01

    Background Prescribing is a core activity for general practitioners, yet significant variation in the quality of prescribing has been reported. This suggests there may be room for improvement in the application of the current best research evidence. There has been substantial investment in technologies and interventions to address this issue, but effect sizes so far have been small to moderate. This suggests that prescribing is a decision-making process that is not sufficiently understood. By understanding more about prescribing processes and the implementation of research evidence, variation may more easily be understood and more effective interventions proposed. Methods An ethnographic study in three Scottish general practices with diverse organizational characteristics. Practices were ranked by their performance against Audit Scotland prescribing quality indicators, incorporating established best research evidence. Two practices of high prescribing quality and one practice of low prescribing quality were recruited. Participant observation, formal and informal interviews, and a review of practice documentation were employed. Results Practices ranked as high prescribing quality consistently made and applied macro and micro prescribing decisions, whereas the low-ranking practice only made micro prescribing decisions. Macro prescribing decisions were collective, policy decisions made considering research evidence in light of the average patient, one disease, condition, or drug. Micro prescribing decisions were made in consultation with the patient considering their views, preferences, circumstances and other conditions (if necessary). Although micro prescribing can operate independently, the implementation of evidence-based, quality prescribing was attributable to an interdependent relationship. Macro prescribing policy enabled prescribing decisions to be based on scientific evidence and applied consistently where possible. Ultimately, this influenced prescribing

  4. Epidemiology of Patient Harms in New Zealand: Protocol of a General Practice Records Review Study

    PubMed Central

    Leitch, Sharon; Wallis, Katharine A; Eggleton, Kyle S; Cunningham, Wayne K; Williamson, Martyn I; Lillis, Steven; McMenamin, Andrew W; Tilyard, Murray W; Reith, David M; Samaranayaka, Ari; Hall, Jason E

    2017-01-01

    Background Knowing where and why harm occurs in general practice will assist patients, doctors, and others in making informed decisions about the risks and benefits of treatment options. Research to date has been unable to verify the safety of primary health care and epidemiological research about patient harms in general practice is now a top priority for advancing health systems safety. Objective We aim to study the incidence, distribution, severity, and preventability of the harms patients experience due to their health care, from the whole-of-health-system lens afforded by electronic general practice patient records. Methods “Harm” is defined as disease, injury, disability, suffering, and death, arising from the health system. The study design is a stratified, 2-level cluster, retrospective records review study. Both general practices and patients will be randomly selected so that the study’s results will apply nationally, after weighting. Stratification by practice size and rurality will allow comparisons between 6 study groups (large, medium-sized, small; urban and rural practices). Records of equal numbers of patients from each study group will be included in the study because there may be systematic differences in patient harms in different types of practices. Eight general practitioner investigators will review 3 years of electronic general practice health records (consultation notes, prescriptions, investigations, referrals, and summaries of hospital care) from 9000 patients registered in 60 general practices. Double-blinded reviews will check the concordance of reviewers’ assessments. Study data will comprise demographic data of all 9000 patients and reviewers’ assessments of whether patients experienced harm arising from health care. Where patient harm is identified, their types, preventability, severity, and outcomes will be coded using the Medical Dictionary for Regulatory Activities (MedDRA) 18.0. Results We have recruited practices and

  5. Moving research knowledge into dental hygiene practice.

    PubMed

    Cobban, Sandra J; Edgington, Eunice M; Clovis, Joanne B

    2008-01-01

    Dental hygiene, as an emerging profession, needs to increase the number of intervention studies that identify improvements in oral health outcomes for clients. Historically, dental hygiene studies have typically been atheoretical, but the use of theoretical frameworks to guide these studies will increase their meaningfulness. Rogers' theory of diffusion of innovations has been used to study research utilization across many disciplines, and may offer insights to the study of research use in dental hygiene. Research use is an important component of evidence-based practice (EBP), and diffusion of research knowledge is an important process in implementing EBP. The purpose of this paper is to use diffusion of innovations theory to examine knowledge movement in dental hygiene, specifically through the example of the preventive practice of oral cancer screening by dental hygienists, considered as an innovation. Diffusion is considered to be the process by which an innovation moves through communication channels over time among a social network. We suggest diffusion theory holds promise for the study of knowledge movement in dental hygiene, but there are limitations including access to and understanding research studies as innovations. Nevertheless, using a theoretical framework such as Rogers' diffusion of innovations will strengthen the quality of intervention research in dental hygiene, and subsequently, health outcomes for clients.

  6. Developing a general practice medical workstation: the integration aspect.

    PubMed Central

    Frassine, R.; Bertelli, S.; Innocenti, E. B.

    1993-01-01

    ISAAC (Integrated System Architecture for Advanced Primary Care) is a project aiming at developing information technology and telematic support in the specific field of General Practice--and more broadly in the Primary Health Care sector--within the health care systems of different European Countries. The project aims at improving the work of the General Practitioners through the development of a useful and usable medical workstation for day-to-day patient care. Moreover ISAAC has the goal of prototyping an integration architecture for the improvement of the communications between the ISAAC workstation and heterogeneous application environments, namely other components of the health care system. This paper deals with a general description of the design along with a discussion of the adopted approach to fulfill the integration requirements. PMID:8130469

  7. The general practice formulary — its role in rational therapeutics

    PubMed Central

    Green, Philip E.

    1985-01-01

    This paper describes a project in which a voluntary preferred prescribing list (general practice formulary), analogous to those already in use in some hospitals, was created, implemented and monitored. Cooperation between a pharmacist with knowledge of drug information, access to specialist advice and back-up in the form of evaluated information from drug information centres and a group of five general practitioners and their trainees was necessary. The formulary was well accepted with between 68.2% and 89.6% compliance in therapeutic classes corresponding to the recent National Health Service restricted groups. This method enhances the critical appraisal of prescribing rationale, takes into account the needs of doctors and patients, and reduces costs. Such work highlights the value and scope of interdisciplinary liaison between pharmacists, general practitioners and clinical pharmacologists and it could prove beneficial on a national scale. PMID:4093901

  8. Tooth wear: prevalence and associated factors in general practice patients

    PubMed Central

    Cunha-Cruz, Joana; Pashova, Hristina; Packard, J.D.; Zhou, Lingmei; Hilton, Thomas J.

    2011-01-01

    Objectives To estimate the prevalence of tooth wear and to investigate factors associated with tooth wear in patients from general practices in the Northwest United States. Methods Data on the diagnosis and treatment of oral diseases during the previous year were collected in a survey with a systematic random sample of patients (n = 1530) visiting general dentists from the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT) (n = 80). Prevalence ratios (PRs) of moderate to severe occlusal and incisal tooth wear by patient characteristics were estimated using cluster-adjusted multiple binomial regression for adults (18+ years) and children/adolescents (3–17 years). Results For adults, the mean number of teeth with wear facets was 5.4 [95% confidence interval (CI) = 4.6–6.2] and 51% of the adults had four or more teeth with wear. Participants 45–64 and 65+ years old were 1.3 (95% CI = 1.1–1.6) and 1.4 (95% CI = 1.1–1.8) times as likely to have 4+ teeth with moderate to severe wear facets as participants 18–44 years old. Adult males had a 20% (PR = 1.2; 95% CI = 1.1–1.4) higher prevalence of wear than adult females. Adults who were using, or had ever used occlusal splints had higher prevalence of tooth wear compared to those who never used such appliances (PR = 1.3; 95% CI = 1.0–1.5). Adults with any periodontal bone loss also had a 20% higher prevalence of wear than adults without periodontal disease (PR = 1.2; 95% CI = 1.0–1.4). For children/adolescents, the mean number of teeth with moderate to severe wear facets was 1.6 (95% CI = 0.9–2.6) and 31% of the children had one or more teeth with wear facets. The adjusted prevalence ratio of tooth wear (1+ teeth with wear facets) for boys was 1.6 times as high (95% CI = 1.1–2.4) as compared with girls. The prevalence of wear for children 12+ years old was 50% (PR = 0.5; 95% CI = 0.3–0.8) lower than that of children <12 years old. Angle’s class II was associated

  9. Medical students' attitudes towards general practice and factors affecting career choice: a questionnaire study

    PubMed Central

    Garnham, Laura

    2014-01-01

    Background The current issue of general practice recruitment is a significant challenge and concern. In order to address this, it is vital to understand medical students' attitudes towards general practice and what influences their choice of intended career. Method We used a questionnaire study to examine these attitudes across all years at Imperial College Medical School and to understand what a group of London medical students' current intended career choices were. Results We found that only 13% of students ranked general practice as their first choice career despite having a generally realistic and positive attitude towards the speciality. They highlighted that the main influence on future career choice was interest in the specific speciality and that lifestyle factors did not seem to be so important. Conclusion Exposure to general practice, primary care research and student GP societies might play some part in increasing interest, but more work is needed to understand why students are rejecting general practice and what we can do collectively to attract students into choosing a career in primary care. PMID:25949732

  10. [Practice relevant research in biological psychiatry].

    PubMed

    Meyer-Lindenberg, A

    2015-11-01

    The practice of psychiatry would be unthinkable without modern psychopharmacology. Drug treatment, especially of severe psychiatric disorders, is often a precondition of community participation, societal reintegration and recovery. Seen in this context it is understandable that biological psychiatry has long been primarily defined by its close interconnection with psychopharmacology and has been perceived this way by practicing physicians. In recent years, however, the concept of what is "biological" has markedly expanded and so has the outreach of this approach into the practice of psychiatry. This article discusses examples showing that biological research methods provide new impulses for individualized medicine, psychotherapy and understanding environmental risks and therefore provide the basis for a preemptive and preventive approach that will be the key to master the challenges posed by the severe burden of mental illness.

  11. Learning about general practice through qualitative interviews: lessons from a seminar course with medical students.

    PubMed

    von Unger, Hella; Werwick, Katrin; Lichte, Thomas; Herrmann, Markus

    2010-01-01

    A seminar course was developed in order to train medical students in qualitative research methods, while providing an introduction to the field of General Practice. Students were enabled to conduct semi-structured interviews with general practitioners (GPs), during which they learned about the prevention, diagnosis, and treatment of frequently encountered medical problems. The course was carried out four times at two universities in Germany. The study explores the students' learning experiences focusing on their research experience. Data were collected in four focus groups and analyzed. The students perceived the course as very different from their usual medical education. This was appreciated, but also caused some difficulties. Three themes emerged: (1) Missing 'facts', (2) New horizons: 'Thinking outside the box', and (3) The challenge of interpretation: 'Reading between the lines'. Learning qualitative research methods can be particularly challenging for medical students as the tasks and epistemology of qualitative research run counter to the usual learning formats and research paradigms in medical education. When teaching qualitative research, special care should be taken to address the cognitive dissonance experienced by students and to explain the unique contribution of qualitative research to medical practice and the field of General Practice especially.

  12. Teachers' General and Contextualised Research Conceptions

    ERIC Educational Resources Information Center

    Schouteden, Wendy; Verburgh, An; Elen, Jan

    2016-01-01

    The integration of research into teaching is a new and important focus in teaching-intensive institutions in higher education. Given the paucity of empirical insight into the research--teaching relationship in teaching-intensive institutions, teachers' research conceptions are studied as a first step in understanding the research--teaching…

  13. Teachers' General and Contextualised Research Conceptions

    ERIC Educational Resources Information Center

    Schouteden, Wendy; Verburgh, An; Elen, Jan

    2016-01-01

    The integration of research into teaching is a new and important focus in teaching-intensive institutions in higher education. Given the paucity of empirical insight into the research--teaching relationship in teaching-intensive institutions, teachers' research conceptions are studied as a first step in understanding the research--teaching…

  14. Audit and feedback by medical students to improve the preventive care practices of general practice supervisors.

    PubMed

    Gilkes, Lucy A; Liira, Helena; Emery, Jon

    Medical students benefit from their contact with clinicians and patients in the clinical setting. However, little is known about whether patients and clinicians also benefit from medical students. We developed an audit and feedback intervention activity to be delivered by medical students to their general practice supervisors. We tested whether the repeated cycle of audit had an effect on the preventive care practices of general practitioners (GPs). The students performed an audit on topics of preventive medicine and gave feedback to their supervisors. Each supervisor in the study had more than one student performing the audit over the academic year. After repetitive cycles of audit and feedback, the recording of social history items by GPs improved. For example, recording alcohol history increased from 24% to 36%. This study shows that medical students can be effective auditors, and their repeated audits may improve their general practice supervisors' recording of some aspects of social history.

  15. Data Management Practices for Collaborative Research

    PubMed Central

    Schmitt, Charles P.; Burchinal, Margaret

    2011-01-01

    The success of research in the field of maternal–infant health, or in any scientific field, relies on the adoption of best practices for data and knowledge management. Prior work by our group and others has identified evidence-based solutions to many of the data management challenges that exist, including cost–effective practices for ensuring high-quality data entry and proper construction and maintenance of data standards and ontologies. Quality assurance practices for data entry and processing are necessary to ensure that data are not denigrated during processing, but the use of these practices has not been widely adopted in the fields of psychology and biology. Furthermore, collaborative research is becoming more common. Collaborative research often involves multiple laboratories, different scientific disciplines, numerous data sources, large data sets, and data sets from public and commercial sources. These factors present new challenges for data and knowledge management. Data security and privacy concerns are increased as data may be accessed by investigators affiliated with different institutions. Collaborative groups must address the challenges associated with federating data access between the data-collecting sites and a centralized data management site. The merging of ontologies between different data sets can become formidable, especially in fields with evolving ontologies. The increased use of automated data acquisition can yield more data, but it can also increase the risk of introducing error or systematic biases into data. In addition, the integration of data collected from different assay types often requires the development of new tools to analyze the data. All of these challenges act to increase the costs and time spent on data management for a given project, and they increase the likelihood of decreasing the quality of the data. In this paper, we review these issues and discuss theoretical and practical approaches for addressing these issues

  16. Methadone maintenance in general practice: patients, workload, and outcomes.

    PubMed Central

    Wilson, P.; Watson, R.; Ralston, G. E.

    1994-01-01

    OBJECTIVE--To assess recruitment to and work-load associated with methadone maintenance clinics in general practice; to investigate the characteristics of patients and outcomes associated with treatment. DESIGN--Study of case notes. SETTING--Methadone maintenance clinics run jointly by general practitioners and drug counsellors in two practices in Glasgow. PARTICIPANTS--46 injecting drug users receiving methadone maintenance during an 18 month period, 31 of whom were recruited to clinic based methadone maintenance treatment and 15 of whom were already receiving methadone maintenance treatment from the general practitioners. Mean (SD) age of patients entering treatment was 29.6 (5.5) years; 29 were male. They had been injecting opiates for a mean 9.9 (5.1) years, and most had a concurrent history of benzodiazepine misuse. Average reported daily intake of heroin was approximately 0.75 g. Participants in treatment had high levels of preexisting morbidity, and most stated that they committed crime daily. RESULTS--2232 patient weeks of treatment were studied. Mean duration of treatment during the study period was 50.7 (21.1) weeks and retention in treatment at 26 weeks was 83%. No evidence of illicit opiate use was obtained at an average of 78% of patients' consultations where methadone had been prescribed in the previous week; for opiate injection the corresponding figure was 86%. CONCLUSIONS--Providing methadone maintenance in general practice is feasible. Although costs are considerable, the reduction in drug use, especially of intravenous opiates, is encouraging. Attending clinics also allows this population, in which morbidity is considerable, to receive other health care. PMID:8086989

  17. Medical education practice-based research networks: Facilitating collaborative research

    PubMed Central

    Schwartz, Alan; Young, Robin; Hicks, Patricia J.; APPD LEARN, For

    2016-01-01

    Abstract Background: Research networks formalize and institutionalize multi-site collaborations by establishing an infrastructure that enables network members to participate in research, propose new studies, and exploit study data to move the field forward. Although practice-based clinical research networks are now widespread, medical education research networks are rapidly emerging. Aims: In this article, we offer a definition of the medical education practice-based research network, a brief description of networks in existence in July 2014 and their features, and a more detailed case study of the emergence and early growth of one such network, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN). Methods: We searched for extant networks through peer-reviewed literature and the world-wide web. Results: We identified 15 research networks in medical education founded since 2002 with membership ranging from 8 to 120 programs. Most focus on graduate medical education in primary care or emergency medicine specialties. Conclusions: We offer four recommendations for the further development and spread of medical education research networks: increasing faculty development, obtaining central resources, studying networks themselves, and developing networks of networks. PMID:25319404

  18. Medical education practice-based research networks: Facilitating collaborative research.

    PubMed

    Schwartz, Alan; Young, Robin; Hicks, Patricia J

    2016-01-01

    Research networks formalize and institutionalize multi-site collaborations by establishing an infrastructure that enables network members to participate in research, propose new studies, and exploit study data to move the field forward. Although practice-based clinical research networks are now widespread, medical education research networks are rapidly emerging. In this article, we offer a definition of the medical education practice-based research network, a brief description of networks in existence in July 2014 and their features, and a more detailed case study of the emergence and early growth of one such network, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN). We searched for extant networks through peer-reviewed literature and the world-wide web. We identified 15 research networks in medical education founded since 2002 with membership ranging from 8 to 120 programs. Most focus on graduate medical education in primary care or emergency medicine specialties. We offer four recommendations for the further development and spread of medical education research networks: increasing faculty development, obtaining central resources, studying networks themselves, and developing networks of networks.

  19. Improving communication: a practical programme for teaching trainees about communication issues in the general practice consultation.

    PubMed

    Boulton, M; Griffiths, J; Hall, D; McIntyre, M; Oliver, B; Woodward, J

    1984-07-01

    This paper describes a teaching programme, for use in general practice vocational training, which provides a theoretical and practical framework for exploring key aspects of the consultation with trainees. A particular emphasis is on the educational or 'cognitive' outcomes of the consultation and skills for improving them. The five stages of the programme are described and an example of experience of each stage is given. The paper concludes with an evaluation of the programme by the trainers, trainees and social scientist involved.

  20. Instructional Simulation Integrates Research, Education, and Practice.

    PubMed

    Teasdale, Thomas A; Mapes, Sheryl A; Henley, Omolara; Lindsey, Jeanene; Dillard, Della

    2016-01-01

    Instructional simulation is widely used in clinical education. Examples include the use of inanimate models meant to imitate humans, standardized patients who are actors portraying patients with certain conditions, and role-play where learners experience the disease through props and circumstances. These modalities are briefly described, and then case examples are provided of simulation curricula in use that integrate research findings and clinical practice expertise to guide development and implementation steps. The cases illustrate how formative and summative feedback from two legs of the "three-legged stool" can be potent integrating forces in development of simulation curricula. In these examples, the educational outputs benefit from purposeful inclusion of research and practice inputs. Costs are outlined for instructor and learner time commitments, space considerations, and expendables. The authors' data and experience suggest that instructional simulation that is supported by a solid scientific base and clinical expertise is appreciated by teachers and learners.