28 research outputs found

    New Prospectors: The Formation and Early Years of the Scottish Australian Mining Company in Newcastle, NSW, 1850-70

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    Following the end of the Australian Agricultural Company’s monopoly in the coal-mining region of Newcastle, NSW, in the late 1840s, the Scottish Australian Investment Company (SAIC), headquartered in London, was amongst the first of several firms to seek mining opportunities in the Hunter region of NSW. As part of a broader project evaluating social and economic influences of the Northumberland/Durham coal mining regions on the early development of the Newcastle coalfields, this paper presents an overview of the role of individuals in the events and decisions surrounding formation and early successes of the Scottish Australian Mining Company which went on to become one of the leading coal producers in the region in the second half of the nineteenth century.The symposium is organised on behalf of AAHANZBS by the Business and Labour History Group, The University of Sydney, with the financial support of the University’s Faculty of Economics and Business

    Explanation and relations. How do general practitioners deal with patients with persistent medically unexplained symptoms: a focus group study

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    Contains fulltext : 80758.pdf (publisher's version ) (Open Access)BACKGROUND: Persistent presentation of medically unexplained symptoms (MUS) is troublesome for general practitioners (GPs) and causes pressure on the doctor-patient relationship. As a consequence, GPs face the problem of establishing an ongoing, preferably effective relationship with these patients. This study aims at exploring GPs' perceptions about explaining MUS to patients and about how relationships with these patients evolve over time in daily practice. METHODS: A qualitative approach, interviewing a purposive sample of twenty-two Dutch GPs within five focus groups. Data were analyzed according to the principles of constant comparative analysis. RESULTS: GPs recognise the importance of an adequate explanation of the diagnosis of MUS but often feel incapable of being able to explain it clearly to their patients. GPs therefore indicate that they try to reassure patients in non-specific ways, for example by telling patients that there is no disease, by using metaphors and by normalizing the symptoms. When patients keep returning with MUS, GPs report the importance of maintaining the doctor-patient relationship. GPs describe three different models to do this; mutual alliance characterized by ritual care (e.g. regular physical examination, regular doctor visits) with approval of the patient and the doctor, ambivalent alliance characterized by ritual care without approval of the doctor and non-alliance characterized by cutting off all reasons for encounter in which symptoms are not of somatic origin. CONCLUSION: GPs feel difficulties in explaining the symptoms. GPs report that, when patients keep presenting with MUS, they focus on maintaining the doctor-patient relationship by using ritual care. In this care they meticulously balance between maintaining a good doctor-patient relationship and the prevention of unintended consequences of unnecessary interventions

    The CIPRUS study, a nurse-led psychological treatment for patients with undifferentiated somatoform disorder in primary care: study protocol for a randomised controlled trial

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    Background: Up to a third of patients presenting medically unexplained physical symptoms in primary care may have a somatoform disorder, of which undifferentiated somatoform disorder (USD) is the most common type. Psychological interventions can reduce symptoms associated with USD and improve functioning. Previous research has either been conducted in secondary care or interventions have been provided by general practitioners (GPs) or psychologists in primary care. As efficiency and cost-effectiveness are imperative in primary care, it is important to investigate whether nurse-led interventions are effective as well. The aim of this study is to examine the effectiveness and cost-effectiveness of a short cognitive behavioural therapy (CBT)-based treatment for patients with USD provided by mental health nurse practitioners (MHNPs), compared to usual care. Methods: In a cluster randomised controlled trial, 212 adult patients with USD will be assigned to the intervention or care as usual. The intervention group will be offered a short, individual CBT-based treatment by the MHNP in addition to usual GP care. The main goal of the intervention is that patients become less impaired by their physical symptoms and cope with symptoms in a more effective way. In six sessions patients will receive problem-solving treatment. The primary outcome is improvement in physical functioning, measured by the physical component summary score of the RAND-36. Secondary outcomes include health-related quality of life measured by the separate subscales of the RAND-36, somatization (PHQ-15) and symptoms of depression and anxiety (HADS). Problem-solving skills, health anxiety, illness perceptions, coping, mastery and working alliance will be assessed as potential mediators. Assessments will be done at 0, 2, 4, 8 and 12 months. An economic evaluation will be conducted from a societal perspective with quality of life as the primary outcome measure assessed by the EQ-5D-5L. Health care, patient and lost productivity costs will be assessed with the Tic-P. Discussion: We expect that the intervention will improve physical functioning and is cost-effective compared to usual care. If so, more patients might successfully be treated in general practice, decreasing the number of referrals to specialist care. Trial registration: Dutch Trial Registry, identifier: NTR4686, Registered on 14 July 2014. © 2017 The Author(s)

    Greep op psychische klachten.

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    Problem-solving treatment during general practice residency: feasibility, and effectiveness for patients with emotional symptoms in primary care.

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    Contains fulltext : 82618.pdf (publisher's version ) (Open Access)Radboud Universiteit Nijmegen, 12 oktober 2010Promotor : Weel, C. van Co-promotores : Weel-Baumgarten, E.M. van, Lucassen, P.L.B.J., Beek, M.M.L.176 p

    Motivational interviewing bij type 2 diabeten.

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    [High time for a total ban on smoking in the hotel, restaurant and catering industry: the arguments are mounting],Hoogste tijd voor een rookvrije horeca: de argumenten stapelen zich op.

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    Item does not contain fulltextActive and passive smoking are well-known causes of disease, including respiratory and cardiovascular disease and cancer. In 2004 the Dutch government introduced new legislation to regulate smoking in the workplace. However, smoking is still allowed in hotels, bars and restaurants, despite the fact that two-thirds of the Dutch population support a total ban on smoking in public places. Several other European countries and American states have banned smoking in public places. Studies performed in these regions show that the new smoking regulations have had no negative economic effects. Moreover, various studies have shown that smoking bans have a positive impact on public health, even in the short-term, including a significant decrease in respiratory and cardiovascular disease. There is therefore no reason to continue to exclude hotels, bars and restaurants from the smoking ban in all public places in The Netherlands

    Blood pressure measurement in hemiparetic patients: which arm?

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    Contains fulltext : 70289.pdf (publisher's version ) (Closed access

    Vrije toegang tot CT-scans bij chronische hoofdpijn

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    Paniekaanval

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