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Biomedical subjects

R B Hays

Publications and source records attributed to R B Hays.

At least 55 records · Page 3Linked to original sources
PubMed1994

Training for rural general practice.

OBJECTIVE: To identify requirements for vocational training and continuing education programs in rural general practice. DESIGN: A questionnaire was sent to all 487 rural doctors and 140 metropolitan and 140 provincial city general practitioners (GPs) in Queensland. A sample of medical educators, health professional and consumer representatives and rural doctors was also interviewed. Responses were compared by geographical area, practice characteristics and level of postgraduate training. RESULTS: There are significant differences between rural and urban practice profiles. Rural doctors have to practise a range of clinical skills in an environment with restricted access to health professional support, although the need for advanced training in procedural or other skills depends on the type of rural practice. Rural and urban doctors want more influence in determining continuing medical education (CME) programs. Interactive learning methods were rated as the most effective education methods by both rural and urban GPs. Rural doctors were less likely to consider that they spent enough time on CME. CONCLUSION: Vocational training programs should accommodate various rural career objectives, including those requiring advanced levels of procedural work. There is a significant unmet demand for CME tailored to the needs of individual doctors, both rural and urban, but distance and isolation may make this more critical in rural practice. These issues need to be addressed as training opportunities can contribute to improved retention of the rural medical workforce.

Australia↗
PubMed1994

Identifying helpful and unhelpful behaviours of loved ones: the PWA's perspective.

Twenty-five gay men with AIDS were interviewed about their social support networks and asked to describe specific interpersonal exchanges with network members which they perceived to be helpful and unhelpful. Content-analysis of responses revealed 12 main categories of helpful behaviours (providing encouragement, companionship, information, practical assistance, material aid, philosophical perspective, support for other network members, expressing concern, sharing feelings, acting as role model, allowing reciprocity, interacting naturally) and 11 categories of unhelpful behaviours (pessimism, physical avoidance, criticizing one's response to AIDS or medical treatment, making unreasonable demands, patronizing attitude, rude comments, insincerity, breaking confidentiality, acting judgmental or ashamed). The perceived helpfulness of particular behaviours varied depending on which network member performed them and the timing of the support attempt. Implications for increasing the effectiveness of support attempts by network members are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1994

A sampling framework for rural and remote doctors.

A pilot survey by telephone interview, followed by a questionnaire of all rural doctors identified in Queensland, was used develop both a definition of rural practice that distinguishes it from urban general practice and a classification of rural and remote practice which assists in sampling of rural doctors. Questionnaire responses in specific geographic areas were compared using chi-square and Mantel-Haenszel chi-square tests. Several factors were found to differentiate rural from urban general practice consistently, thereby enabling a functional definition of rural practice to be developed. Within the broad group of rural doctors, gradients in practice characteristics were found to differentiate doctors in larger rural centres from those in smaller, more remote communities. These gradients were related to the distance and time of travel from support services. They formed the basis of a complex classification of rural and remote general practice. This functional definition of rural and remote medical practice should be considered by researchers of rural medicine issues when sampling rural and remote doctors. The strategies used in this study could be adapted for use in considering practice characteristics of other rural health professions.

Humans↗
PubMed1994

Training by helicopter. Extracts from a rural medical educator's notebook.

This paper reports the experience of one visiting clinical teacher on a teaching visit to a trainee rural doctor in the remote tropical north. Such teaching visits are interesting, may be adventurous and are always welcomed by trainees as they may have limited opportunities to discuss challenging clinical issues with other doctors.

Family Practice↗
PubMed1993

Teaching ethics in the context of general practice.

This paper describes the teaching in medical ethics provided by the Department of General Practice during the fifth year of the undergraduate medical course at the University of Sydney. The objectives of the sessions are to raise awareness of the complex nature of decision-making, to encourage students to determine their own moral viewpoints on common controversial issues, and to provide a framework for managing common ethical dilemmas. This framework is considered in the light of ethical problems which may have arisen during the two-week general practice attachment experienced by students prior to the ethics session. Feedback from students on the sessions is largely positive, although a number complain that simple answers to common problems are not provided.

Education, Medical, Undergraduate↗
PubMed1993

Antibiotics in acute respiratory infections.

In the absence of clear research-based guidelines, this paper gives practical empirical directions for deciding when to prescribe antibiotics in acute respiratory infections, and how not to prescribe them when their use is inappropriate. Antibiotics probably have no effect on the outcome of most respiratory infections, viral or bacterial. When even the small chance of benefit seems to outweigh the risks and disadvantages, penicillin remains the best first-line agent for most respiratory infections, owing to the range of pathogenic bacteria likely to be encountered and its low side effect profile. Convincing some patients that antibiotics are not necessary is a sometimes difficult, but worthwhile task.

Acute Disease↗
PubMed1993

Disclosing HIV seropositivity to significant others.

OBJECTIVES: To examine gay men's patterns of self-disclosure of HIV seropositivity to friends, lovers, relatives and colleagues; to assess the effects of disclosure; and to identify reasons for not disclosing to particular individuals. DESIGN: Longitudinal questionnaire survey of gay men. METHODS: A total of 163 HIV-positive men participating in the AIDS Behavioral Research Project, a longitudinal study of San Francisco gay men, completed questionnaires about their self-disclosure patterns, health status, and psychological well-being. RESULTS: HIV-positive men were most likely to disclose their status to lovers and closest gay friends. Asymptomatic men were less likely to disclose to relatives and colleagues than symptomatic men. Friends and lovers were rated as responding more helpfully than relatives and colleagues. Men who perceived their significant others as responding more helpfully were less depressed and anxious currently and 1 year later. A variety of reasons were given for not disclosing, including not wanting to worry others, fear of discrimination, fear of disrupting relationships, and emotional self-protection. CONCLUSION: While disclosure can have advantages for both HIV-positive individuals and their significant others, HIV-positive individuals must be assured that the benefits of doing so will outweigh the potential costs.

Adult↗
PubMed1993

Quality assurance in general practice.

The Royal Australian College of General Practitioners has been a leader in quality assurance in Australia, requiring members to participate in its Quality Assurance Programme since 1987. This paper presents the underlying philosophy and requirements of the programme, the results of the first 1987-89 triennium, and the likely future development based on an evaluation of the problems and successes of the first triennium.

Australia↗
PubMed1993

Choosing a career in general practice: the influence of medical schools.

This paper reviews the literature on career choice to investigate the undergraduate influences on the preference of Australian graduates for a career in general practice. Although isolation of influencing factors is difficult, admission criteria and undergraduate curricula may influence career preference. As the institutional environment of medical schools is weighted towards scientific research and specialized medicine, medical students may be socialized into choosing non-generalist careers. Medical schools should consider broadening selection criteria and curriculum exposure to produce graduates with a broad range of career interests.

Attitude of Health Personnel↗
PubMed1993

Rural obstetrics in NSW.

Rural general practitioners are responsible for providing obstetric services to the majority of women living in rural communities. This paper reports a comparison of 5,950 deliveries conducted by rural GPs in NSW during 1990-1991 with all 88,275 deliveries during the same period in NSW. No evidence that obstetric care in accredited rural GP obstetric units is of less than acceptable standards could be found. There is scope to increase the use of rural obstetric units for the training of future rural GP obstetricians.

Adolescent↗
PubMed1993

Determinants of social support among gay men: the context of AIDS.

In this study, the determinants of social support are examined among a probability sample of gay men residing in San Francisco. Using two waves of data (collected in 1985 and 1987), cross-sectional and longitudinal analyses focused on the effects of five sets of factors (demographic, community integration/network, AIDS-related loss, individual, and health) on satisfaction with three types of support (emotional, informational, and practical). Personal acceptance of one's gay identity and talking to family members about AIDS showed the strongest positive associations with concurrent measures of support and changes in support satisfaction over the two-year period. Conversely, depression and number of HIV symptoms were negatively associated with cross-sectional support and support changes. Family knowledge of respondents' homosexuality interacted with HIV symptoms, such that knowledge was negatively associated with support among those experiencing greater numbers of HIV symptoms. Findings suggest that those most in need of support may be the least satisfied with the support they receive. Family appear to have the potential to be particularly helpful or especially harmful to gay men trying to cope with the AIDS crisis.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Social support, AIDS-related symptoms, and depression among gay men.

This study examined the impact of social support and HIV-related conditions on depression among 508 gay men participating in the San Francisco Men's Health Study, a population-based prospective study of single men aged 25-54 years. The number of HIV-related symptoms experienced significantly predicted depression cross-sectionally and 1 year later. Satisfaction with each of three types of social support (emotional, practical, informational) was inversely correlated with depression. Men who were more satisfied with the social support they received were less likely to show increased depression 1 year later. Degree of satisfaction with informational support appeared especially critical in buffering the stress associated with experiencing HIV symptoms. These findings offer valuable insight in understanding the psychological needs of gay men confronting the AIDS crisis and have important practical implications for designing mental health services to meet those needs.

Acquired Immunodeficiency Syndrome↗