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Types of treatment collaboration between conventional and alternative practitioners – results from a research project at a Danish MS hospital
Lasse Skovgaard,Niels Haahr,Liv Bjerre,Laila Launs?
International Journal of Integrated Care , 2010,
Abstract: Introduction: More than 50% of the People with Multiple Sclerosis (PwMS) in Denmark use alternative treatment. Most of them combine alternative and conventional treatment, but PwMS often find that there is no dialogue, coordination or synergy between the parallel courses of treatment offered. For this reason the Danish Multiple Sclerosis Society conducted a research project to develop and examine different models for collaboration between conventional and alternative treatment providers. Materials and methods: Empirical material consist of individual interviews with practitioners, a group interview with practitioners, a group interview with professional staff at the Danish MS hospital that provided the organisational framework for the project, interviews with patients as well as written responses from participating treatment providers in connection with practitioner-researcher seminars held. Results: Collaboration between researchers and the treatment team resulted in the development examination of several models which describe the strengths and weaknesses of various types of collaboration. The models also show that the various types of collaboration place different requirements on the degree of 1) mutual acknowledgement and understanding among practitioners, 2) flexibility and resources in the organizational framework, and 3) patients' activities and own efforts, respectively. Perspectives: The relationship between integration and pluralism can contribute to a fruitful discussion in regards to the value of treatment collaboration. In addition to the many positive perspectives the characterise integration of different treatment modalities the project points to the importance of not overlooking the opportunities, values and potential inherent in a pluralistic ideal in the form of patients' own active efforts and the dynamism that can arise when the patient becomes a co-informant, co-coordinator and/or co-integrator.
Does race really matter? Career goals, perceptions of criminal justice practitioners and competence among criminal justice undergraduates  [cached]
Youngyol Y. Schanz
Journal of Arts and Humanities , 2013,
Abstract: This study examines whether race or ethnicity affects student decision-making pertaining to career goals and choices. The career goals and choices of undergraduates in criminal justice (CJ) were surveyed in early spring of 2006. The research also investigates students’ perceptions of their own perceived competence as future CJ practitioners. Data were collected from CJ undergraduates from an urban university in the upper Midwestern part of the U.S. The results indicate that racial or ethnic minority students have significantly different career goals and choices than those of non-minority students. Some future research implications and policy implications are discussed.
The Importance of Gender of Patients and General Practitioners in Relation to Treatment Practices for Overweight  [PDF]
Jeanett Friis Rohde, Marie Vik Hessner, J?rgen Lous, Pia Müller, Ulla H?lund, Berit Lilienthal Heitmann
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0095706
Abstract: Background Several studies suggest that men and women are treated differently for similar disease including diabetes and cardiovascular disease. Differences in attitudes and treatment practices towards men and women with obesity are not well recognized. Objective To investigate the attitudes and treatment practices among Danish general practitioners (GPs), in relation to treatment of overweight, while taking gender of both the patients and practitioners into account. Design Questionnaire inventory covertly examining attitudes and practices among Danish general practitioners towards treatment of overweight. All 3.637 general practitioners from the Danish Medical Association register were invited to participate in the survey. In total 1.136 participated. Results The GPs found weight loss to be more important for overweight male than overweight female patients. They also treated complications to overweight more rigorously among male than female patients, and recommended lipid lowering medicine more often to male than female overweight patients. In addition, the younger female GPs and older male GPs more often said that they would treat an overweight patient with lipid lowering medicine. Conclusion Among general practitioners in Denmark, treatment for weight loss is more often practiced for overweight male than overweight female patients presenting with same symptoms. In addition, hyperlipidemia among overweight males is also more often treated with lipid lowering medicine than hyperlipidemia among overweight females.
Primary Care Nurse Practitioners: Do Not Blend the Colors in the Rainbow of Advanced Practice Nursing.
Brown, M. A
Online Journal of Issues in Nursing , 1996,
Abstract: On June 11, 1996, Governor George V. Voinovich signed Sub SB 154, The Advanced Practice Nursing Bill, into law. This event followed six legislative attempts in the past decade to grant legal authority for Advanced Practice Nurses (APNs) in Ohio (Pearson, 1996). Title protection, scope of practice, collaboration/supervision arrangements with physicians, Board of Nursing regulation and education/certification requirements for nurse practitioners (NPs), nurse midwives (NMs), nurse anesthetists (NAs), and clinical nurse specialists (CNSs) have been tenaciously negotiated by nurses, physicians, hospitals, pharmacists, insurers and legislators. (Stir & Savino, 1996). However, the celebration of this monumental achievement may be overshadowed by an even greater controversy within the nursing profession -- to merge or not to merge the roles of the NP and the CNS. That is the question! The position taken in this paper is that we must merge the roles to create an Advanced Practice Nurse (APN) role.
Treatment of acute ischemic stroke: Awareness among general practitioners  [cached]
Aaron S,Alexander M,Maya T,Mathew V
Neurology India , 2010,
Abstract: For promptly referral of a patient with acute ischemic stroke (AIS) for possible thrombolysis, general practitioners (GPs) need to equipped with the advanced knowledge of AIS treatment. We assessed the knowledge regarding treatment of AIS among GPs practicing in and around a quaternary care teaching hospital in south India. A total of 109 GPs who attend to medical emergencies were interviewed using a standard questionnaire. Of the 109 GPs interviewed, 54% felt that tissue plasminogen activator (tPA) can be used in the treating AIS, but only 24% had chosen tPA as the best treatment option and 22% opted for other agents like citicholine or edavarone. Only 17% were aware that tPA should be given within 3 h. and 35% felt that intra-arterial thrombolysis as a treatment option.. Only 30% felt the need for good sugar control and 37% wanted aggressive lowering of blood pressure. Majority of GPs are not clear about beneficial effects of thrombolysis and are not updated regarding BP and sugar control in the setting of AIS.
Dental practitioners' attitudes, subjective norms and intentions to practice atraumatic restorative treatment (ART) in Tanzania
Kikwilu, Emil N.;Frencken, Jo E.;Mulder, Jan;Masalu, Joyce R.;
Journal of Applied Oral Science , 2009, DOI: 10.1590/S1678-77572009000200005
Abstract: the aim of this study was to describe the attitude and subjective norm of dental practitioners towards practicing the atraumatic restorative treatment (art) in tanzania. a pre-tested questionnaire on attitudes and subjective norms to practice art was mailed to all 147 dental practitioners working in the regional and district government clinics. the independent variables were: gender, working experience, qualification and ever heard of art. the dependent variables were: attitude, subjective norm and intention to practice art. chi-square tests and multiple regression analysis were used to test for effects between independent and dependent variables. significance level was set at 5%. a total of 138 practitioners returned completed questionnaires. more experienced dental practitioners encountered moderate social pressure than less experienced dental practitioners, who met strong social pressure (p=0.045). a total of 73.2% of dental practitioners felt that art was worth introducing in tanzania, 92.8% recommended art training for all dental practitioners and 97.8% recommended inclusion of art in dental curricula. positive attitude, strong subjective norm and high intention to practice art were recorded in 76.3%, 28.1% and 90.6% of the practitioners, respectively. only subjective norm had a statistically significant influence on the intention to practice art (p<0.0001). the results indicated that dental practitioners were willing to have art introduced in tanzania and had positive attitudes towards practicing this technique. nevertheless, their intention to perform art was strongly influenced by social pressures. therefore, in order to have a successful introduction of art in tanzania, people who matter in the daily practice of dental practitioners need to accept and appraise the art approach positively.
An Approach to the Diagnosis, Treatment and Referral of Tuberculosis Patients: The Family Practitioners\' Role
NO Ndjeka, R Matji, GA Ogunbanjo
South African Family Practice , 2008,
Abstract: The family practitioner in private practice is a key role player within the primary health care system and should play a bigger role in national tuberculosis (TB) control. TB training at medical undergraduate level is often not adequate and continuous medical education is necessary to develop capacity among private family practitioners. The Department of Health should also encourage the involvement of especially the private family practitioners in district TB control, which is a long overdue public-private interaction. This article discusses the role of the family practitioner to better diagnose, treat and refer tuberculosis patients. South African Journal of Family Practice Vol. 50 (4) 2008: pp.44-50
General practitioners' opinions on how to improve treatment of mental disorders in primary health care. Interviews with one hundred Norwegian general practitioners
Arnstein Mykletun, Ann Knudsen, Tone Tangen, Simon ?verland
BMC Health Services Research , 2010, DOI: 10.1186/1472-6963-10-35
Abstract: Among GPs affiliated within the Norwegian reimbursement system, we approached 353, and made contact with 246 GP's. One-hundred of these agreed to participate in our study, and 95 of them expressed opinions on how to improve treatment of mental disorders. The telephone interviews were based on open-ended questions, responses were transcribed continuously, and content analysis was applied. Results are presented both as frequency tables of common responses, and as qualitative descriptions and quotations of opinions.Nearly all (95%) of the GPs had suggestions on how to improve treatment of mental disorders in primary health care. Increased capacity in secondary health care was suggested by 59% of GPs. Suggestions of improved collaboration with secondary health care were also common (57%), as were improvements of GPs' skills and knowledge relevant for diagnosing and treating mental disorders (40%) and more time for patients with mental disorders in GP contexts (40%).The GPs' suggestions are in line with international research and debate. It is thought-provoking that the majority of GPs call for increased capacity in secondary care, and also better collaboration with secondary care. Some GPs made comparisons to the health care system for physical disorders, which is described as better-functioning. Our study identified no simple short-term cost-effective interventions likely to improve treatment for mental disorders within primary health care. Under-treatment of mental disorders is, however, also associated with significant financial burdens.Most patients who suffer from severe mental disorders are treated in specialized health care services [1]. Such conditions are however far less frequent than common mental disorders, like anxiety and depression, which increasingly are described as major public health challenges [2,3]. In the present health care system, most patients with a common mental disorder are offered treatment in a general practice setting. In Norway, this is o
The Delivery and Quality of Sexually Transmitted Infections Treatment by Private General Practitioners in Windhoek Namibia
Scholastika N Iipinge,Louise Pretorius
Global Journal of Health Science , 2012, DOI: 10.5539/gjhs.v4n5p156
Abstract: Introduction: The main objective for this study was to investigate the quality of Sexually Transmitted Infections (STI) treatment and control by the private sector in Namibia. Method: This was a cross-sectional study employing quantitative methodology using different methods of data collection. A self-administered questionnaire exploring General Practitioners (GPs) perceptions of factors that influence the way they manage Sexually Transmitted Infections (STI) which was then concluded with the face to face interviews and the checklist that was used while doing observations in the consulting rooms Results: A total of 50 private general practitioners in the area of Windhoek were interviewed, 48 self-administered questionnaires plus all checklists were received back from the private general practitioners. None of the private general practitioners interviewed had specific training in the syndromic management of the STIs. The 86% of all patients were seen by these private general practitioners on a medical aid, while 14 % pay cash for service provided. With regard to Urethral Discharge, an average of 56.5% of GPs could treat urethral discharge correctly as per the Namibian syndromic approach guidelines. None of the GPs could demonstrate the correct treatment of genital ulcer (whether they received medical aid or not) as recommended in the syndromic approach guidelines in Namibia (GRN, 1999; 2000). Only 28% of the GPs could demonstrate the correct treatment of Pelvic Inflammatory Disease (PID) as per the syndromic management of the STIs. For patients without medical aid the drugs prescribed and their dosages for PID are correct but the frequencies are not in line with the guidelines as for patients with medical aid. Discussion: In general, patients presenting with STIs to the GPs in private practices are not given quality of care because not all private general practitioners have time to do investigations, counseling, give condoms and to notify the partners of those with urethral discharge, genital ulcers and PID looking for treatment.
Survey of attitudes, materials and methods employed in endodontic treatment by general dental practitioners in North Jordan
Wael M Al-Omari
BMC Oral Health , 2004, DOI: 10.1186/1472-6831-4-1
Abstract: A questionnaire was posted to all registered general dental practitioners working in private practice in Irbid Governate in North Jordan (n = 181). The questionnaire included information on methods, materials and techniques used in endodontic treatment.Reply rate was 72% (n = 131). The results demonstrated that only five dentists used rubber dam occasionally and not routinely. The majority used cotton rolls for isolation solely or in combination with a high volume saliva ejector (n = 116). The most widely used irrigants were sodium hypochlorite and hydrogen peroxide, which were used by 32.9% (n = 43) and 33.6% (n = 44) of the respondents, respectively. Forty eight percent of the respondents (n = 61) used the cold lateral condensation technique for canal obturation, 31.3% (n = 41) used single cone, 9.9% (n = 13) used vertical condensation and 12.2% (n = 16) used paste or cement only for the obturation. The majority used zinc oxide eugenol as a sealer (72.5%). All, but one, respondents used hand instruments for canal preparation and the technique of choice was step back (52.7%). More than 50% (n = 70) of the dentists took one radiograph for determining the working length, whilst 22.9% (n = 30) did not take any radiograph at all. Most practitioners performed treatment in three visits for teeth with two or more root canals, and in two visits for teeth with a single root canal.This study indicates that dentists practicing in North Jordan do not comply with international quality standards and do not use recently introduced techniques. Many clinicians never take a radiograph for determining the working length and never used rubber dam or intra-canal medicaments.Root canal treatment is considered an essential element in the dental services provided to the population in developed countries. Various investigations were, therefore, carried out to explore the standard of root canal treatment carried out by general dental practitioners in Europe [1-3].It is the responsibility of
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