Does primary medical practitioner involvement with a specialist team improve patient outcomes? A systematic review.

Patients with chronic or complex medical or psychiatric conditions are treated by many practitioners, including general practitioners (GPs). Formal liaison between primary and specialist is often assumed to offer benefits to patients The aim of this study was to assess the efficacy of formal liaison of GPs with specialist service providers on patient health outcomes, by conducting a systematic review of the published literature in MEDLINE, EMBASE, PsychINFO, CINAHL and Cochrane Library databases using the following search terms family physicians': synonyms of 'patient care planning', 'patient discharge' and 'patient care team'; and synonyms of 'randomised controlled trials'. Seven studies were identified, involving 963 subjects and 899 controls. most health outcomes were unchanged, although some physical and functional health outcomes were improved by formal liaison between GPs and specialist services, particularly among chronic mental illness patients. Some health outcomes worsened during the intervention. Patient retention rates within treatment programmes improved with GP involvement, as did patient satisfaction. Doctor (GP and specialist) behaviour changed, with reports of more rational use of resources and diagnostic tests, improved clinical skills, more frequent use of appropriate treatment strategies, and more frequent clinical behaviours designed to detect disease complications Cost effectiveness could not be determined. In conclusion, formal liaison between GPs and specialist services leaves most physical health outcomes unchanged, but improves functional outcomes in chronically mentally ill patients. It may confer modest long-term health benefits through improvements in patient concordance with treatment programmes and more effective clinical practice.

Estimation of total body water from bioelectrical impedance analysis in patients with pancreatic cancer - agreement between three methods of prediction

Introduction Bioelectrical impedance analysis (BIA) is a useful field measure to estimate total body water (TBW). No prediction formulae have been developed or validated against a reference method in patients with pancreatic cancer. The aim of this study was to assess the agreement between three prediction equations for the estimation of TBW in cachectic patients with pancreatic cancer. Methods Resistance was measured at frequencies of 50 and 200 kHz in 18 outpatients (10 males and eight females, age 70.2 +/- 11.8 years) with pancreatic cancer from two tertiary Australian hospitals. Three published prediction formulae were used to calculate TBW - TBWs developed in surgical patients, TBWca-uw and TBWca-nw developed in underweight and normal weight patients with end-stage cancer. Results There was no significant difference in the TBW estimated by the three prediction equations - TBWs 32.9 +/- 8.3 L, TBWca-nw 36.3 +/- 7.4 L, TBWca-uw 34.6 +/- 7.6 L. At a population level, there is agreement between prediction of TBW in patients with pancreatic cancer estimated from the three equations. The best combination of low bias and narrow limits of agreement was observed when TBW was estimated from the equation developed in the underweight cancer patients relative to the normal weight cancer patients. When no established BIA prediction equation exists, practitioners should utilize an equation developed in a population with similar critical characteristics such as diagnosis, weight loss, body mass index and/or age. Conclusions Further research is required to determine the accuracy of the BIA prediction technique against a reference method in patients with pancreatic cancer.

Managing new product development in the Chinese steel industry: An empirical investigation

This study explores several important aspects of the management of new product development (NPD) in the Chinese steel industry. Specifically it explores NPD success factors, the importance of management functions to new product success and measures of new product success from the perspective of the industry's practitioners. Based on a sample of 190 industrial practitioners from 18 Chinese steel companies, the study provides a mixed picture as China makes the transition from a centrally-controlled to market-based economy. On one hand, respondents ranked understanding users' needs as the most important factor influencing the performance of the new products. Further, formulating new product strategy and strengthening market research are perceived as the most important managerial functions in NPD. However, technical performance measures are regarded as more important and are more widely used in industry than market-based or financial measures of success.

"Owned by...". Country of origin's new cue

This study identifies and explores a new country of origin (COO) cue, “owned by….” The importance of three extrinsic cues “owned by …,” “made in …” and price was examined using conjoint analysis. Data were collected from a sample of 268 undergraduate students familiar with color televisions. Segments were formed using cluster analysis and analyzed using multiple discriminant analysis. “Owned by …” was found to be important and distinct from the “made in …” cue. Segments based on the two COO cues were identified using importance weights and individual utilities. When segments were formed using individual utilities the individual difference construct, economic nationalism, provided discriminatory power while consumer ethnocentrism did not, supporting the hypothesis that economic nationalism and consumer ethnocentrism differ. Practitioners can now use “owned by …” knowing that it forms an important and distinct marketing tool. Limitations and future research are discussed.

Sexual dysfunction in the Australian population

AIM: To describe the prevalence and forms of sexual dysfunction experienced by Australians, and compare these with people in the United States. METHODS: A cross sectional, telephone interview survey of a randomly selected sample of men (n = 876) and women (n = 908) aged between 18 and 59 years on the electoral roll in all states and territories of Australia (response rate = 61%) was conducted between November 1999 and April 2000. RESULTS: Large proportions of Australian men (55.0%) and women (60.5%) reported at least one sexual problem within the preceding year. More serious sexual dysfunction (> 3 symptoms) was observed in 13.2% of men and 19.7% of women. DISCUSSION: Australia and the USA are similar with regard to the high rate of symptoms of sexual dysfunction observed in the population. The low rate of treatment points to both patient and doctor reluctance to discuss sexual performance and practices.

Editorial

The year 2003 marks the 30th anniversary of The Australian Journal of Indigenous Education (AJIE) and coincides with the re-launching of the journal as a peer reviewed research journal.Beginning life in 1973 as The Aboriginal Child at School, AJIE has played a vital role in raising awareness of educational issues for Aboriginal and Torres Strait Islander peoples; fostering debate amongst researchers, government representatives and community groups; and sharing stories of success between both Indigenous and non- Indigenous practitioners positioned in the broad area of Aboriginal and Torres Strait Islander education. The dialogue which has taken place in AJIE over the past 30 years maps out the social, political and cultural history of Indigenous education in Australia, and draws attention to the shifting paradigms,problems and practical outcomes.