Factors predicting trust between GPs and OPs

PURPOSE: To study possible differences in trust between general practitioners (GPs) and occupational physicians (OPs) and the explanatory factors for trust. Insight into the factors predicting trust can improve programmes for stimulating the co-operation of GPs and OPs. THEORY: On the basis of theories of trust and of social identity theory we expected, (1) in both professions a higher level of knowledge-based trust than of identification-based trust, (2) a relationship between higher levels of identification-based trust and higher frequency of contact, (3) OPs to have a higher level of identification-based trust than GPs. We hypothesised (4) that OPs perceiving an equal status have higher levels of trust and (5) GPs perceiving a higher status have lower levels of trust. METHODS: A mail survey sent to 2297 doctors (1728 GPs and 569 OPs) of which we used 547 questionnaires. RESULTS: Hypotheses 1 and 2 were supported. Hypothesis 3 was not supported. Hypotheses 4 and 5 were supported for knowledge-based trust. On the basis of these findings it is possible that co-operation between the two groups is still in its early stages. CONCLUSIONS: Programmes to improve the co-operation of GPs and OPs should focus on equalising status and stimulating contacts to build (identification-based) trust

Cooperation of general practitioners and occupational physicians: Identity, trust and responsibility

Our study shows that different social psychological mechanisms have a profound effect on the quality of the cooperation of GPs and OPs. Especially we found significant differences between the two professions in professional identity, relative position, dependency, trust and responsibility. There is a significant correlation between the number of contacts and the evaluation of the contacts and between the number of contacts and trust in the communication. Apparently trust in the quality of the work is not the problem. Our results suggest ways of improving education and training. On base of our findings we suggest the following interventions: 1. OPs should improve their own professional identity. They should work on internal contacts and create a more cohesive group. The professional group should present itself more clearly. The professional association of OPs could play a prominent role in this. This association is already active in producing standards and composing a declaration of intent. These are useful steps in this view. 2. GPs need to be better informed about what an OP does. It will then be clearer in which respects the well-being of the patient will gain quality when they use the expertise of OPs. Accepting and using the mutual dependency of GP and OP is beneficial for the patient. 3. More possibilities for contacts between GPs and OPs. They could for instance talk about the division of tasks and responsibilities; also about communication. Talking as equal colleagues is the most important factor, having a communal problem: the patient

Phylogeographic Analysis Elucidates the Influence of the Ice Ages on the Disjunct Distribution of Relict Dragonflies in Asia

Unusual biogeographic patterns of closely related groups reflect events in the past, and molecular analyses can help to elucidate these events. While ample research on the origin of disjunct distributions of different organism groups in the Western Paleartic has been conducted, such studies are rare for Eastern Palearctic organisms. In this paper we present a phylogeographic analysis of the disjunct distribution pattern of the extant species of the strongly cool-adapted Epiophlebia dragonflies from Asia. We investigated sequences of the usually more conserved 18 S rDNA and 28 S rDNA genes and the more variable sequences of ITS1, ITS2 and CO2 of all three currently recognised Epiophlebia species and of a sample of other odonatan species. In all genes investigated the degrees of similarity between species of Epiophlebia are very high and resemble those otherwise found between different populations of the same species in Odonata. This indicates that substantial gene transfer between these populations occurred in the comparatively recent past. Our analyses imply a wide distribution of the ancestor of extant Epiophlebia in Southeast Asia during the last ice age, when suitable habitats were more common. During the following warming phase, its range contracted, resulting in the current disjunct distribution. Given the strong sensitivity of these species to climatic parameters, the current trend to increasing global temperatures will further reduce acceptable habitats and seriously threaten the existences of these last representatives of an ancient group of Odonata