Australian veterinarians who work with horses: views of the future

Objective To give an account of the views held by Australian veterinarians who work with horses on the future of their professional field. Method Questionnaires were mailed to 866 veterinarians who had been identified as working with horses, and 87% were completed and returned. Data were entered onto an Excel spreadsheet, and analysed using the SAS System for Windows. Results Their future prospects were believed to be very good or excellent by >60% of equine veterinarians but by only 30% of mixed practitioners seeing < 10% horses. The main factors believed likely to affect these prospects were the strength of the equine industries and the economic climate affecting horse owners, followed by the encroachment of cities into areas used for horses, competition from other veterinarians including specialist centres and from non-veterinary operators, and their ability to recruit and retain veterinarians with interest, experience and skill with horses. Urban encroachment, competition and recruitment were especially important for those seeing few horses. Concerns were also expressed about the competence and ethical behaviour of other veterinarians, the physical demands and dangers of horse work, the costs of providing equine veterinary services and of being paid for them, the regulatory restrictions imposed by governments and statutory bodies, the potential effects of litigation, and insurance issues. For many veterinarians in mixed practice these factors have reduced and are likely to reduce further the number of horses seen, to the extent that they have scant optimism about the future of horse work in their practices. Conclusion Economic and local factors will result in an increasing proportion of equine veterinary work being done in specialised equine centres, and the future of horse work in many mixed practices is, at best, precarious. A key factor influencing future prospects will be the availability of competent veterinarians committed to working with horses.

General practitioners' role in preventive medicine: scenario analysis using alcohol as a case study

The purpose of this analysis is threefold: first, to extract from the literature, current levels of GP detection of at-risk drinking by their patients, rates at which general practitioners (GPs) offer an intervention; and the effectiveness of these interventions; secondly, to develop a model based on this literature to be used in conjunction with scenario analysis; and thirdly, to consider the cost implications of current efforts and various scenarios. This study deals specifically with Australian general practice. A two-step procedure is used in the scenario analysis, which involves identifying opportunities for detection, intervention, effectiveness and assigning probabilities to outcomes. The results suggest that increasing rates of GP intervention achieves greatest benefit and return on resource use. For every 5% point increase in the rate of GP intervention, an additional 26 754 at-risk drinkers modify their drinking behaviour at a cost of $231.45 per patient. This compares with a cost per patient modifying drinking behaviour of $232.60 and $208.31 for every 5% point increase in the rates of detection and effectiveness, respectively. The knowledge, skill and attitude of practitioners toward drinking are significant, and they can be the prime motivators in persuading their patients to modify drinking behaviour.

A comparison of the responses of first and second year veterinary science students to group project work

A change in curriculum permitted a direct and simultaneous comparison between first and second year responses to group project work while assuming similar prior experience with this method of learning. Responses were obtained by a survey form and by meetings with individual groups. Overall, there were no differences between first and second year responses, although analyses of gender responses suggested trends whereby males indicated they had developed greater creativity and felt they had contributed more to the group. The majority of students responded that group project work was a positive experience and a useful learning experience.

Educating Practitioners for Integrative Rural Practice

Arguably, living and working in rural communities can pose significant challenges for human service practitioners - challenges that are different from those encountered by their urban counterparts. Human services employers, like many other employers in rural areas, have difficulty in recruiting and retaining staff. There is now considerable evidence to support the notion that rural and remote practice constitutes a different and distinct form of practice and has undergone significant changes over the past decade. Living and working in rural communities means that practitioners are not only influenced by the rural and remote context of practice, they are also part of that context. Given the difficulty encountered in attracting and retaining rural practitioners and the changes in this area, an important question which emerges is: How can practitioners best be prepared for this work through largely urban based social work and human service education? The multifaceted and multilayered complexities in rural practice requires creativity, improvisation and a capacity for 'integrative thinking' (Martinez-Brawley 2002). This paper discusses six elements of newer forms of rural and remote practice and how they might be most effectively addressed through social work and human service curricula. An education model which integrates these elements and other principles for rural practice is proposed.

Referral to rehabilitation following traumatic brain injury: practitioners and the process of decision-making

The study aimed to examine the factors influencing referral to rehabilitation following traumatic brain injury (TBI) by using social problems theory as a conceptual model to focus on practitioners and the process of decision-making in two Australian hospitals. The research design involved semi-structured interviews with 18 practitioners and observations of 10 team meetings, and was part of a larger study on factors influencing referral to rehabilitation in the same settings. Analysis revealed that referral decisions were influenced primarily by practitioners' selection and their interpretation of clinical and non-clinical patient factors. Further, practitioners generally considered patient factors concurrently during an ongoing process of decision-making, with the combinations and interactions of these factors forming the basis for interpretations of problems and referral justifications. Key patient factors considered in referral decisions included functional and tracheostomy status, time since injury, age, family, place of residence and Indigenous status. However, rate and extent of progress, recovery potential, safety and burden of care, potential for independence and capacity to cope were five interpretative themes, which emerged as the justifications for referral decisions. The subsequent negotiation of referral based on patient factors was in turn shaped by the involvement of practitioners. While multi-disciplinary processes of decision-making were the norm, allied health professionals occupied a central role in referral to rehabilitation, and involvement of medical, nursing and allied health practitioners varied. Finally, the organizational pressures and resource constraints, combined with practitioners' assimilation of the broader efficiency agenda were central factors shaping referral. (C) 2004 Elsevier Ltd. All rights reserved.

Factors influencing the number needed to excise: excision rates of pigmented lesions by general practitioners

Objective: To identify doctor and patient characteristics associated with excision of benign versus malignant pigmented skin lesions. Design, setting and participants: Retrospective audit of data on 4741 pigmented skin lesions excised from November 1998 to February 2000 by 468 general practitioners (39% response rate) from 223 practices in Perth, WA. (The data used were from the baseline period of a randomised controlled trial of a diagnostic aid for pigmented skin lesions.) Main outcome measure: The number needed to treat (NNT), defined as the number of pigmented lesions needed to be excised to identify one melanoma, in relation to demographic characteristics of GPs and patients. Results: Relatively more benign lesions were excised per melanoma (NNT = 83) in the youngest patients (aged 10-19 years) compared with the oldest (aged greater than or equal to 70) (NNT = 11) (P [trend]