The readiness of German GPs to recommend and conduct cancer screening is associated with patient–physician gender concordance. Results of a survey

<p><b>Background:</b> Cancer screening participation rates in Germany differ depending on patients’ gender. International studies have found that patient–physician gender concordance fosters recommendation and conducting of cancer screening, and especially cancer screening for women.</p> <p><b>Objectives:</b> We aimed to ascertain whether gender concordance influences general practitioners' (GPs’) rating of the usefulness of cancer screening, as well as their recommendations and readiness to conduct cancer screening in general practice in Germany.</p> <p><b>Methods:</b> For an exploratory cross-sectional survey, 500 randomly selected GPs from all over Germany were asked to fill in a questionnaire on cancer screening in general practice between March and June 2015. We asked them to rate the usefulness of each cancer screening examination, how frequently they recommended and conducted them and whether they viewed GPs or specialists as responsible for carrying them out. We used multiple logistic regression to analyse gender effect size by calculating odds ratios.</p> <p><b>Results:</b> Our study sample consisted of 139 GPs of which 65% were male. Male and female GPs did not differ significantly in their rating of the general usefulness of any of the specified cancer screening examinations. Male GPs were 2.9 to 6.8 times as likely to consider GPs responsible for recommending and conducting PSA testing and digital rectal examinations and were 3.7 to 7.9 times as likely to recommend and conduct these examinations on a regular basis.</p> <p><b>Conclusion:</b> Patient–physician gender concordance made it more likely that male-specific cancer screenings would be recommended and conducted, but not female-specific screenings.</p> <p>KEY MESSAGES </p><p>Male GPs are more likely than female GPs to view GPs as responsible for recommending and conducting male-specific cancer screening.</p><p>Men consult urologists less frequently than women consult gynaecologists, so male GPs seem to take on the role of ‘doctor for men’.</p><p></p> <p>Male GPs are more likely than female GPs to view GPs as responsible for recommending and conducting male-specific cancer screening.</p> <p>Men consult urologists less frequently than women consult gynaecologists, so male GPs seem to take on the role of ‘doctor for men’.</p

Leadership decision making at a time of rapid reform: An English Case Study

This paper explores the decision making process of a school leadership team at a time of rapid educational reform using Bourdieu’s thinking tools of field, capital and habitus. The context of educational policy making is viewed as a field, a site in which schools in England struggle for symbolic capital from within the policy arena. Initial findings of this historically successful case study school is that the perceptions of school leaders indicate a) the field of educational policy is in flux and the decision making reveals the habitus of the head teacher to seize the pragmatic opportunity to increase symbolic capital within the field by converting into an academy, b) that whilst there is an element of risk taking involved in this decision to become an autonomous institution operating outside of local authority of control this is outweighed by the promises autonomy will bring to develop a new model for delivery of education provision. As such the school leaders c) recognise the hierarchy of power in the field and base their decision making upon the desire to protect their school’s interests and to increase their capital and position within the field by gaining official recognition from the policy actors within the field. Thus the on-going policy codification of ‘new practices and old hierarchies in the field’ is a powerful way to understand how school leaders interpret policy and position themselves and the school in relation to current educational reform. The case study illustrates that the on-going struggle within and across the symbolic economy of educational reform is encouraging school leaders to respond and behave in certain ways, to second-guess in the wake of centralised decentralisation. However that drive to conform is motivated by their knowledge of the specific context in which the school operates and thus decisions are made which first and foremost respond to the local need, interest and intake of their students. Thus the study shows that the school leaders are engaged with viewing the positive possibilities made available through reform processes and that the potential for remodelling school structures through the academies programme in England offers an opportunity for school leaders to innovate within a centrally recognised and endorsed framework

Sociodemographics characteristics and morbidity.

a<p>n = 3,188;</p>b<p>n = 2,793;</p>c<p>n = 3,178.</p

Multiple linear regression model of the effect of individual conditions on overall HRQL measured by EQ-VAS.

<p>n = 3189; Adj. R²: 0.14; Significant results are printed bold.</p

Regression model of the effect of multimorbidity (weighted count score) on overall HRQL measured by the EQ VAS.

<p>n = 3,189; Adj. R² = 0.14; Significant results are printed bold.</p

Distribution of responses in the EQ-5D dimensions in the study sample.

a<p>n = 3,185;</p>b<p>n = 3,188;</p>c<p>n = 3,187.</p

Logistic regression models of the effect of individual conditions on separate EQ-5D dimensions.

*<p>p<0.01;</p>**<p>p<0.001; Significant results are printed bold. All variables included in the second model are presented.</p

Prevalence of diagnosis groups and rank order in the sample, overall and by gender.

*<p>Not part of the GP questionnaire. Assessed using responses to open questions.</p