What Professional Activities Do General Practitioners Find Most Meaningful? Cross Sectional Survey of Norwegian General Practitioners.

What professional activities do general practitioners find most meaningful? cross sectional survey of Norwegian general practitioners.

BMC Fam Pract. 2013 Mar 23; 14(1): 41
Halvorsen PA, Edwards A, Aaraas IJ, Aasland OG, Kristiansen IS

BACKGROUND: Health reforms in many countries affect the scope and nature of primary care. General Practitioners (GPs) are expected to spend more time developing public health, preventive health care, coordination of care and teamwork. We aimed to explore which professional activities GPs consider to be meaningful and how they would like to prioritise tasks. METHODS: In a cross sectional online survey 3,270 GPs were invited to consider twenty different activities in general practice. They were asked to rate each of them on a Likert scale anchored from 1 (not meaningful) to 5 (very meaningful). They then selected three activities from the item list on which they would like to spend more time and three activities on which they would like to spend less time. We used multinomial logistic regression to explore associations between the GPs’ preferences for time spent on preventive health care activities and age, gender and practice characteristics. RESULTS: Approximately 40% (n=1,308) responded. The most meaningful activities were handling common symptoms and complaints (94% scored 4 or 5), chronic somatic diseases (93%), terminal care (80%), chronic psychiatric diseases (77%), risk conditions (76%) and on call emergency services (70%). In terms of priority the same items prevailed except that GPs would like to spend less time on emergency services. Items with low priority were health certificates, practice administration, meetings with local health authorities, medically unexplained symptoms, addiction medicine, follow up of people certified unfit for work, psychosocial problems, preventive health clinics for children and school health services. In multivariate regression models physician and practice characteristics explained no more than 10% of the variability in the GPs’ preferences for time spent on preventive health care services. CONCLUSIONS: The GPs found diagnosis and treatment of diseases most meaningful. Their priorities were partly at odds with those of the health authorities and policy makers. HubMed – addiction

Neurocognitive features in subgroups of bipolar disorder.

Bipolar Disord. 2013 Mar 25;
Aminoff SR, Hellvin T, Lagerberg TV, Berg AO, Andreassen OA, Melle I

OBJECTIVE: To examine which subgroups of DSM-IV bipolar disorder (BD) [BD type I (BD-I) or BD type II (BD-II), and subgroups based on history of psychosis, presenting polarity, and age at onset] differentiate best regarding neurocognitive measures. METHODS: A total of 199 patients with BD were characterized by clinical and neurocognitive features. The distribution of subgroups in this sample was: BD-I, 64% and BD-II, 36%; 60% had a history of psychosis; 57% had depression as the presenting polarity; 61% had an early onset of BD, 25% had a mid onset, and 14% had a late onset. We used multivariate regression analyses to assess relationships between neurocognitive variables and clinical subgroups. RESULTS: Both BD-I diagnosis and elevated presenting polarity were related to impairments in verbal memory, with elevated presenting polarity explaining more of the variance in this cognitive domain (22.5%). History of psychosis and BD-I diagnosis were both related to impairment in semantic fluency, with history of psychosis explaining more of the variance (11.6%). CONCLUSION: Poor performance in verbal memory appears to be associated with an elevated presenting polarity, and poor performance in semantic fluency appears to be associated with a lifetime history of psychosis. HubMed – addiction

Pattern of psychiatric illnesses among long-stay patients at Mental Health Hospital, Taif, Saudi Arabia: a 10-year retrospective study.

East Mediterr Health J. 2013 Jan; 19(1): 37-44
Al-Zahrani H, Al-Qarni A, Abdel-Fattah M

To identify the pattern and determinants of psychiatric illness and the predictors of long stay among long-stay patients at the Mental Health Hospital, Taif, Saudi Arabia, we examined a total of 430 records of patients who had been admitted during the period January 1999-January 2009 and had stayed for > 9 months. More than half these patients had a history of drug addiction (60.7%). The majority were diagnosed with schizophrenia (88.8%) and mental retardation was reported in 17.7%. Personality disorders and epilepsy were diagnosed in 3.7% and 1.9% of the participants respectively. The mean duration of hospital stay was 6.16 (standard deviation 2.32; range 1-10) years. Multivariate logistic regression analysis showed that patients diagnosed with schizophrenia accompanied by mental retardation, those with lower education levels, and those with a history of co-morbid chronic diseases stayed for more than 2 years. HubMed – addiction

Perceived danger and offending: exploring the links between violent victimization and street crime.

Violence Vict. 2013; 28(1): 16-35
Frederick TJ, McCarthy B, Hagan J

Perceptions of the danger of crime are typically discussed in the context of people’s fear that they will be harmed by offenders. We shift the focus and examine the association between perceived danger and offending and the contribution of these perceptions to the well-established relationship between violent victimization and crime. We hypothesize that violence may embolden some victims and contribute to their perception that offending is not dangerous. We examine the mediating effects of these perceptions alongside two other potential links between violent victimization and crime: deviant definitions and risk seeking. Our analyses of data from a sample of homeless youth find that violent victimization is strongly associated with four types of offending–theft, drug use, drug selling, and prostitution–and that perceived danger significantly mediates several of these relationships. Our results suggest that perceived danger may be an important mechanism connecting victimization and crime. HubMed – addiction