scholarly journals A taboo topic? How General Practitioners talk about overweight and obesity in New Zealand

2018 ◽  
Vol 10 (2) ◽  
pp. 150 ◽  
Author(s):  
Lesley Gray ◽  
Maria Stubbe ◽  
Lindsay Macdonald ◽  
Rachel Tester ◽  
Jo Hilder ◽  
...  
Keyword(s):  
New Zealand ◽  
Weight Management ◽  
General Practitioners ◽  
Health Professionals ◽  
Secondary Analysis ◽  
Overweight And Obesity ◽  
Full Potential ◽  
Naturally Occurring ◽  
Interactional Analysis ◽  
General Practices

ABSTRACT INTRODUCTION Obesity is overtaking tobacco smoking in New Zealand as the leading potentially modifiable risk to health. International obesity guidelines recommend that health professionals opportunistically encourage weight management with their patients. However, research shows consistently low rates of weight management discussion, suggesting that health professionals may not be realising their full potential to address obesity. AIM To identify communication strategies used by General Practitioners (GPs) to open the topic of weight and weight management in routine consultations. METHODS A secondary analysis was conducted of 36 video-recorded consultations in general practices, selected for relevance from a database of 205 consultations. Content and interactional analysis was conducted in the context of the entire consultation. RESULTS The topic of weight was initiated more often by GPs than patients and was raised mostly once or twice in a consultation and occasionally as many as six times. GPs employed opportunistic strategies twice as often as they used structured strategies. DISCUSSION This study of naturally occurring consultations confirmed GPs do engage in opportunistic discussions about weight. However, such discussions are challenging and interactionally delicate. Highlighting the clinical relevance of weight appears to be effective. The high frequency of patient contact with GPs provides opportunity to reach and work with people at risk of chronic conditions associated with excess weight. Further research is required to identify suitable training and brief intervention tools for use in routine consultations that may be beneficial for both GPs and patients.

scholarly journals Repeat prescribing policy in New Zealand general practice: making it better

2020 ◽  
Vol 12 (4) ◽  
pp. 373
Author(s):  
Steven Lillis ◽  
Liza Lack
Keyword(s):  
General Practice ◽  
New Zealand ◽  
General Practitioners ◽  
Local Development ◽  
Policy Research ◽  
Practice Research ◽  
Annual Conference ◽  
Protected Time ◽  
Repeat Prescribing ◽  
General Practices

ABSTRACT INTRODUCTIONRepeat prescribing is common in New Zealand general practice. Research also suggests that repeat prescribing is a process prone to error. All New Zealand general practices have to comply with requirements to have a repeat prescribing policy, with the details of the policy to be designed by the practice. AIMTo inform the development of practice policy, research was undertaken with experienced general practitioners to identify and mitigate risk in the process. METHODSAt the 2019 annual conference of the Royal New Zealand College of General Practitioners, a workshop was held with 58 experienced general practitioner participants. The group was divided into six small groups, each with the task of discussing one aspect of the repeat prescribing process. The results were then discussed with the whole group and key discussion points were transcribed and analysed. RESULTSIssues identified included: improving patient education on appropriateness of repeat prescribing; having protected time for medicine reconciliation and the task of repeat prescribing; reducing the number of personnel and steps in the process; and clarity over responsibility for repeat prescribing. DISCUSSIONThis research can inform the local development of a repeat prescribing policy at the practice level or be used to critique existing practice policies. Attention was also drawn to the increasing administrative burden that repeat prescribing contributes to in general practice.

scholarly journals The anatomical placement of body organs by Australian and New Zealand patients and health professionals in general practice

2012 ◽  
Vol 4 (3) ◽  
pp. 239 ◽  
Author(s):  
Marjan Kljakovic ◽  
Jo Risk
Keyword(s):  
General Practice ◽  
New Zealand ◽  
Health Professionals ◽  
Health Knowledge ◽  
Doctor Patient Communication ◽  
Correct Placement ◽  
General Practices ◽  
Gp Visits ◽  
Health Administrators ◽  
Better Than

INTRODUCTION: Understanding patients’ awareness of the anatomical placement of their body organs is important for doctor–patient communication. AIM: To measure the correct anatomical placement of body organs by people from Australian and New Zealand general practices METHOD: A questionnaire survey containing drawings of 11 organs placed in different locations within each drawing. RESULTS: Among 1156 participants, there was no difference in the proportion of correct placement of 11 organs between Australian (51.7%) and New Zealand (49.6%) general practices. There was a positive correlation between the proportion of correctly placed organs and the age participants left school (p=0.012) and a negative correlation with the number of GP visits in the previous year (p=0.040). Participants from rural Australia were more likely to correctly place organs than urban participants (p=0.018). The mean proportion of organs correctly placed for doctors was 80.5%, nurses 66.5%, allied health 61.5%, health administrators 50.6% and the remaining consulting patients 51.3%. DISCUSSION: Patients from Australian and New Zealand general practice were poorly aware of the correct placement of organs. Health professionals were moderately better than patients at correct placement. KEYWORDS: Health knowledge; attitudes; practice; anatomy; general practice

scholarly journals Current nut recommendation practices differ between health professionals in New Zealand

2017 ◽  
Vol 21 (6) ◽  
pp. 1065-1074 ◽  
Author(s):  
Rachel C Brown ◽  
Andrew R Gray ◽  
Lee Ching Yong ◽  
Alex Chisholm ◽  
Sook Ling Leong ◽  
...  
Keyword(s):  
New Zealand ◽  
Chronic Disease ◽  
General Practitioners ◽  
Health Professionals ◽  
Disease Risk ◽  
Population Level ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Practice Nurses ◽  
Study Participants

AbstractObjectiveDespite evidence linking regular nut consumption with reduced chronic disease risk, population-level intakes remain low. Research suggests nut-promoting advice from doctors facilitates regular nut consumption. However, there is no information on current nut recommendation practices of health professionals. The aim of the present study was to examine the advice provided by health professionals regarding nut consumption.DesignIn this cross-sectional study, participants were invited to complete a survey including questions about their nut recommendation practices.SettingNew Zealand (NZ).SubjectsThe NZ Electoral Roll was used to identify dietitians, general practitioners and practice nurses.ResultsIn total 318 dietitians, 292 general practitioners and 149 practice nurses responded. Dietitians were more likely (82·7 %) to recommend patients increase consumption of nuts than general practitioners (55·5 %) and practice nurses (63·1 %; both P<0·001). The most popular nuts recommended were almonds, Brazil nuts and walnuts, with most health professionals recommending raw nuts. The most common recommendation for frequency of consumption by dietitians and practice nurses was to eat nuts every day, while general practitioners most frequently recommended 2–4 times weekly, although not statistically significantly different between professions. Dietitians recommended a significantly greater amount of nuts (median 30 g/d) than both general practitioners and practice nurses (20 g/d; both P<0·001).ConclusionsDietitians were most likely to recommend consumption of nuts in accordance with current guidelines, but there are opportunities to improve the adoption of nut consumption recommendations for all professions. This may be a viable strategy for increasing population-level nut intakes to reduce chronic disease.

scholarly journals Employment of counsellors and mental health professionals by fundholding general practices

1995 ◽  
Vol 19 (10) ◽  
pp. 627-630 ◽  
Author(s):  
T. I. R. Mutale
Keyword(s):  
Mental Health ◽  
Health Services ◽  
General Practitioners ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
General Practices ◽  
Recent Establishment

Recent surveys have shown that general practitioners have begun to employ practice counsellors. The recent establishment of fundholding practices has made it possible for general practitioners (GPs) to be direct purchasers of health services. The number and nature of counsellors and specialist mental health professionals directly employed by fundholding practices is reported.

Isolation and identification of plant growth-promoting bacteria associated with tall fescue

2009 ◽  
pp. 211-216 ◽  
Author(s):  
J. Monk ◽  
E. Gerard ◽  
S. Young ◽  
K. Widdup ◽  
M. O'Callaghan
Keyword(s):  
New Zealand ◽  
Plant Growth ◽  
Tall Fescue ◽  
Festuca Arundinacea ◽  
Plant Growth Promoting Bacteria ◽  
Beneficial Bacteria ◽  
Isolation And Identification ◽  
Naturally Occurring ◽  
Plant Growth Promoting ◽  
Growth Promoting

Tall fescue (Festuca arundinacea) is a useful alternative to ryegrass in New Zealand pasture but it is slow to establish. Naturally occurring beneficial bacteria in the rhizosphere can improve plant growth and health through a variety of direct and indirect mechanisms. Keywords: rhizosphere, endorhiza, auxin, siderophore, P-solubilisation

scholarly journals ‘Motivational work’: a qualitative study of preventive health dialogues in general practice

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Marie Broholm-Jørgensen ◽  
Siff Monrad Langkilde ◽  
Tine Tjørnhøj-Thomsen ◽  
Pia Vivian Pedersen
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Support System ◽  
Preventive Intervention ◽  
Digital Health ◽  
Clinical Encounter ◽  
Preventive Health ◽  
Structured Interviews ◽  
General Practices ◽  
Municipal Health

Abstract Background The aim of this article is to explore preventive health dialogues in general practice in the context of a pilot study of a Danish primary preventive intervention ‘TOF’ (a Danish acronym for ‘Early Detection and Prevention’) carried out in 2016. The intervention consisted of 1) a stratification of patients into one of four groups, 2) a digital support system for both general practitioners and patients, 3) an individual digital health profile for each patient, and 4) targeted preventive services in either general practice or a municipal health center. Methods The empirical material in this study was obtained through 10 observations of preventive health dialogues conducted in general practices and 18 semi-structured interviews with patients and general practitioners. We used the concept of ‘motivational work’ as an analytical lens for understanding preventive health dialogues in general practice from the perspectives of both general practitioners and patients. Results While the health dialogues in TOF sought to reveal patients’ motivations, understandings, and priorities related to health behavior, we find that the dialogues were treatment-oriented and structured around biomedical facts, numeric standards, and risk factor guidance. Overall, we find that numeric standards and quantification of motivation lessens the dialogue and interaction between General Practitioner and patient and that contextual factors relating to the intervention framework, such as a digital support system, the general practitioners’ perceptions of their professional position as well as the patients’ understanding of prevention —in an interplay—diminished the motivational work carried out in the health dialogues. Conclusion The findings show that the influence of different kinds of context adds to the complexity of prevention in the clinical encounter which help to explain why motivational work is difficult in general practice.

scholarly journals Influence of serum iron test results on the diagnosis of iron deficiency in children: a retrospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046865
Author(s):  
Gorkem Sezgin ◽  
Ling Li ◽  
Johanna Westbrook ◽  
Elisabeth Wearne ◽  
Denise Azar ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Observational Study ◽  
General Practitioners ◽  
Serum Ferritin ◽  
Serum Iron ◽  
Estimating Equation ◽  
Normal Serum ◽  
Retrospective Observational Study ◽  
Test Results ◽  
General Practices

Background and objectiveSerum iron results are not indicative of iron deficiency yet may be incorrectly used to diagnose iron deficiency instead of serum ferritin results. Our objective was to determine the association between serum iron test results and iron-deficiency diagnosis in children by general practitioners.Design, setting, patients and main outcome measuresA retrospective observational study of 14 187 children aged 1–18 years with serum ferritin and serum iron test results from 137 general practices in Victoria, Australia, between 2008 and 2018. Generalised estimating equation models calculating ORs were used to determine the association between serum iron test results (main exposure measure) and iron-deficiency diagnosis (outcome measure) in the following two population groups: (1) iron-deplete population, defined as having a serum ferritin <12 µg/L if aged <5 years and <15 µg/L if aged ≥5 years and (2) iron-replete population, defined as having a serum ferritin >30 µg/L.Results3484 tests were iron deplete and 15 528 were iron replete. Iron-deplete children were less likely to be diagnosed with iron deficiency if they had normal serum iron levels (adjusted OR (AOR): 0.73; 95% CI 0.57 to 0.96). Iron-replete children had greater odds of an iron-deficiency diagnosis if they had low serum iron results (AOR: 2.59; 95% CI 1.72 to 3.89). Other contributors to an iron-deficiency diagnosis were female sex and having anaemia.ConclusionSerum ferritin alone remains the best means of diagnosing iron deficiency. Reliance on serum iron test results by general practitioners is leading to significant overdiagnosis and underdiagnosis of iron deficiency in children.

scholarly journals Modes of Interaction in Naturally Occurring Medical Encounters With General Practitioners: The “One in a Million” Study

2021 ◽  
pp. 104973232199379
Author(s):  
Olaug S. Lian ◽  
Sarah Nettleton ◽  
Åge Wifstad ◽  
Christopher Dowrick
Keyword(s):  
General Practitioners ◽  
Narrative Analysis ◽  
Mode Competition ◽  
General Applicability ◽  
Naturally Occurring ◽  
Wide Range ◽  
The One ◽  
Narrative Mode ◽  
Modes Of Interaction

In this article, we qualitatively explore the manner and style in which medical encounters between patients and general practitioners (GPs) are mutually conducted, as exhibited in situ in 10 consultations sourced from the One in a Million: Primary Care Consultations Archive in England. Our main objectives are to identify interactional modes, to develop a classification of these modes, and to uncover how modes emerge and shift both within and between consultations. Deploying an interactional perspective and a thematic and narrative analysis of consultation transcripts, we identified five distinctive interactional modes: question and answer (Q&A) mode, lecture mode, probabilistic mode, competition mode, and narrative mode. Most modes are GP-led. Mode shifts within consultations generally map on to the chronology of the medical encounter. Patient-led narrative modes are initiated by patients themselves, which demonstrates agency. Our classification of modes derives from complete naturally occurring consultations, covering a wide range of symptoms, and may have general applicability.

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