General Practitioners' willingness to pay for continuing medical education in a fee-for-service universal coverage health care system

Background: Sponsoring of physicians meetings by life science companies has led to reduced participation fees but might influence physician's prescription practices. A ban on such sponsoring may increase participation fees. We aimed to evaluate factors associated with physicians' willingness to pay for medical meetings, their position on the sponsoring of medical meetings and their opinion on alternative financing options. Methods: An anonymous web-based questionnaire was sent to 447 general practitioners in one state in Switzerland, identified through their affiliation to a medical association. The questionnaire evaluated physicians' willingness to pay for medical meetings, their perception of a bias in prescription practices induced by commercial support, their opinion on the introduction of a binding legislation and alternative financing options, their frequency of exchange with sales representatives and other relevant socioeconomic factors. We built a multivariate predictor logistic regression model to identify determinants of willingness to pay. Results: Of the 115 physicians who responded (response rate 26%), 48% were willing to pay more than what they currently pay for congresses, 79% disagreed that commercial support introduced a bias in their prescription practices and 61% disagreed that it introduced a bias in their colleagues' prescription practices. Based on the multivariate logistic regression, perception of a bias in peers prescription practices (OR=7.47, 95% CI 1.65-38.18) and group practice structure (OR=4.62, 95% CI 1.34-22.29) were significantly associated with an increase in willingness to pay. Two thirds (76%) of physicians did not support the introduction of a binding legislation and 53% were in favour of creating a general fund administered by an independent body. Conclusion: Our results suggest that almost half of physicians surveyed are willing to pay more than what they currently pay for congresses. Predictors of an increase in physicians' willingness to pay were perception of the influence of bias in peers prescription practices and group practice structure. Most responders did not agree that sponsoring introduced prescribing bias nor did they support the 2 introduction of a binding legislation prohibiting sponsoring but a majority did agree to an independent body that would centrally administer a general fund.

Parental education and family characteristics: educational opportunities across cohorts in Italy and Spain

Drawing on data contained in the 2005 EU-SILC, this paper investigates the disparities in educational opportunities in Italy and Spain. Its main objective is to analyse the predicted probabilities of successfully completing upper-secondary and tertiary education for individuals with different parental backgrounds, and the changes in these probabilities across birth cohorts extending from 1940 to 1980. The results suggest that the disparities in tertiary education opportunities in Italy tend to increase over time. By contrast, the gap in educational opportunity in Spain shows a marked decrease across the cohorts. Moreover, by using an intuitive decomposition strategy, the paper shows that a large part of the educational gap between individuals of different backgrounds is “composed” of the difference in the endowment of family characteristics. Specifically, it seems that more highly educated parents are more able to endow their children with a better composition of family characteristics, which accounts for a significant proportion of the disparities in educational opportunity.

Aprender investigando. Una experiencia formativa en el ámbito de la enfermería = Research teaching processes used as a methodological strategy in the education of healthcare professionals

Este trabajo tiene como propósito presentar y valorar, desde la perspectiva del alumnado participante, un proyecto de investigación-formación puesto en marcha durante el curso 2003-2004 en la elaboración del trabajo de tesina, fin de carrera, en la Escuela de Enfermería de Vitoria, dentro del programa de Licenciatura Europea de Enfermería. Constituye el punto de partida de un proyecto a largo plazo, iniciado con la intención de desarrollar principios teóricos y procedimientos prácticos que nos permitan sistematizar procesos formativos que, centrados en la investigación, articulen la teoría y la práctica e integren una perspectiva comunicativa y cooperativa.

Health education, public information, and communication in schistosomiasis control in Brazil: a brief retrospective and perspectives

In recent years, the strategy for the control of schistosomiasis has placed increased emphasis on the role of health education, public information, and communication. This should, not only bring about specific changes in behavior aiming at disease prevention, but also stimulate participation of the community in health programs. Beyond this, it is desirable that both community members and researchers should seek better life conditions through a transformative social action. The present paper addresses these concerns; first, by critically reviewing some health education programs that were developed in Brazil, and, secondly, by analyzing and suggesting ways to improve this area.

Partir de soi, rencontrer l'autre--quelques réflexions sur la formation de psychiatre [The self and the other: a few comments on psychiatric education].

This manuscript has served for an oral presentation in honour of Professor Pierre Bovet who retired from his position as head physician at the Department of Psychiatry of the Lausanne University Hospital, Switzerland. Pierre Bovet has focused his clinical and scientific interest and his teaching activities on the schizophrenic spectrum disorders. The author tries to describe the essential elements of a clinical attitude which allows to really encounter the patient.

The Security Council and the Legitimacy of the Use of Force: Legal, Normative, and Social Aspects.

Tal i com estableix la Carta de les Nacions Unides, el Consell de Seguretat determina l’existència d’una amenaça a la pau, un trencament de la pau o un acte d’agressió i decideix les mesures que han de fer-se servir per restaurar la pau i seguretat internacionals, també l’ús de la força. L’objectiu d’aquest article és explorar la legitimitat d’aquest ús de la força. Amb aquest objectiu, el text parteix d’una definició centrada en les seves dimensions legal, normativa i social. En segon lloc, s’analitzarà com aquestes dimensions estan representades als debats del Consell de Seguretat de la guerra d’Irak de 2003, un dels usos de la força més controvertits i que més debat ha generat als darrers anys. Finalment, l’anàlisi proposat permet treure algunes conclusions sobre les bases canviants de la legitimitat de l’ús de la força.

Institucions polítiques de Catalunya : creació de materials docents en suport digital que fomentin la interacció amb l'estudiant a partir de la visualització de conceptes

Amb una plantilla, hem elaborat uns materials docents -l'objecte d'estudi dels quals és l’Estatut d'Autonomia de Catalunya de 2006, des d'una perspectiva jurídica -, que corresponen fonamentalment a l’assignatura “Institucions Polítiques de Catalunya” de 4rt. curs de la llicenciatura de Dret de la UAB. Els materials s’han penjat al web http://www.institucionspolitiques.com. L' objectiu de l’acció docent ha estat consolidar una eina interactiva, que fomenti la creativitat i el treball cooperatiu de l’estudiant, que permeti un rol més actiu del professorat, i finalment, es faciliti l’adaptació docent a l’espai europeu d’educació superior. L’experiència s'ha completat amb l’ús del mètode bimodal -campus virtual de la UAB -, amb visites a institucions públiques i amb l’assistència periòdica com a públic a programes de televisió de continguts relacionats amb la matèria. La plantilla per a desenvolupar els diversos temes del programa ha estat la següent: 1.- Redacció del tema; 2.- Visualització de conceptes: quadres sinòptics, esquemes, gràfics; 3.-Bibliografia bàsica. 4.-Legislació i jurisprudència. 5.-Text reproduït. 6.-Qüestions.7.-Temes per al debat. 8.-Test. 9.-Materials complementaris audiovisuals. 10.-Enllaços útils a la xarxa. L'experiència s’ha desenvolupat els dos darrers cursos acadèmics: 2006/07 i 2007/08, i ha girat entorn de l'elaboració i aplicació dels materials elaborats. Ha estat teòrica i pràctica a la vegada. S'ha prestat especial atenció a la feina de l'alumnat fora de l'aula, amb el conseqüent estudi previ i col·laboració en l’elaboració de materials. Cal destacar també que hem aconseguit augmentar la participació de l'alumnat a l’aula, i d'aquesta manera el rol del professor ha esdevingut més dinàmic. Els materials han permès un fàcil i ràpid accés dels estudiants, amb l’objectiu de gaudir d’unes sessions presencials més interactives, i s'ha connectat la Universitat amb la societat, a més de desenvolupar actituds cíviques o de consciència de país en una matèria tan sensible com és l'estudi del dret públic de Catalunya.

A Preliminary Analysis of Insects of Medico-legal Importance in Curitiba, State of Paraná

A survey of the carrion fauna was made at two sites in Curitiba, State of Paraná, with the objective of describing the insects associated with carrion and setting up a preliminary data-base for medico-legal purposes in south Brazil. Vertebrate exclusion experiments were carried out in each season between 1994 and 1995 with a 250 g laboratory-bred rat (Rattus norvegicus). Five stages of decomposition were identified: fresh, bloated, decaying, dry and adipocere-like. Some species showed seasonal and site preference and so could be used to identify the probable place and season where death took place. Sarconesia chlorogaster (Diptera, Calliphoridae) was restricted to an open field site and to cooler months. Hemilucilia semidiaphana (Diptera, Calliphoridae) and Pattonella resona (Diptera, Sarcophagidae) were restricted to the forest site and warmer months. Phaenicia eximia (Diptera, Calliphoridae) and Oxyletrum discicolle (Coleoptera, Silphidae) were present at both sites throughout the year and could be useful for population level analysis. Dissochaetus murray (Coleoptera, Cholevidae) was present throughout the year at the forest site and was associated with the adipocere-like stage. Ants played an important role producing post-mortem injuries to the carcasses. Insects of 32 species are reported as being useful in community level approaches