Turning the winter of doctor discontent to summer : tackling GP needs in state primary care

Introduction: A study on job satisfaction among state General Practitioners (GPs) in Malta addressed the problem of the inadequate number of doctors within the government GP service. It investigated the hypothesis that this is due to poor job satisfaction, and allowed GPs to suggest other reasons and propose solutions. Method: A mixed methodology was used, with both quantitative (the Spector `Job Satisfaction Survey') and qualitative methods (3 open questions) in a questionnaire sent to current and former government GPs, followed by focus group/elite interviews. Results: 71 out of 136 questionnaires were returned, giving a 52% response rate. (a) Quantitative analysis: Job dissatisfaction was confirmed among health-centre doctors during 1998-2003. Taking significance as p<0.05, regression analysis revealed that doctors formerly working in health centres were significantly more dissatisfied than present ones (univariate p=0.033), and working part-time is significantly more satisfying than working full-time (univariate p=0.007, multiple p=0.039). (b) Qualitative analysis: 41% of GPs felt unappreciated, neglected and disrespected; 39% experienced job dissatisfaction, stress and depression; while 31% felt verbally and physically used, misused and abused. The top causes cited for the lack of government GPs were poor pay and ancillary benefits (70%), poor training prospects/ career progression (54%) and poor working conditions (46%). Discussion: As former state GPs during 1998-2002 were significantly more dissatisfied than those in employment in 2003, this corroborates the hypothesis that job dissatisfaction is associated with the shortage of government GPs. Direct solutions (enhanced remuneration/conditions and professional development) and indirect measures (organisational, management and educational initiatives to improve working arrangements) were proposed and discussed

Awareness, Use, and Perceptions of Low-Carbohydrate Diets

Introduction Low-carbohydrate diets (LCDs) have regained popularity in recent years, but public awareness and perceived healthfulness of LCDs have not been explored. We describe population awareness, use, and perceptions of the healthfulness of LCDs and examine differences by socio-demographic and communication variables. Methods Nationally representative data from the Health Information National Trends Survey (HINTS 2005) were analyzed by using multivariate logistic regression to examine independent correlates of awareness, use, and perceptions of the healthfulness of LCDs. Results Awareness of LCDs in the United States was high (86.6%). Independent correlates of awareness included being a college graduate, being non-Hispanic white, and having a high body mass index (BMI). Among respondents who were aware of LCDs, approximately 17% had tried LCDs during the last year. Independent correlates of LCD use included being a woman and having a high BMI. One-third of respondents who were aware of LCDs agreed that they are a healthy way to lose weight. Independent correlates of perceived LCD healthfulness included not being a high school graduate and being likely to change behavior in response to new nutrition recommendations. Conclusion This study is among the first to explore correlates of awareness, use, and perceptions of LCDs in a nationally representative sample. Despite high levels of awareness of LCDs, these diets are not used frequently and are not perceived as being healthy

Diffusing a Research-based Physical Activity Promotion Program for Seniors Into Diverse Communities: CHAMPS III

INTRODUCTION: Increasing the physical activity levels of older adults through diffusion of successful research-based programs into community settings is challenging because of differences between research and real-world settings. This project diffused the Community Healthy Activities Model Program for Seniors (CHAMPS) II, an individual-level research-based physical activity promotion program, through three community organizations to reach lower-income and minority (primarily Hispanic or Latino and African American) seniors. METHODS: Through an academic–community partnership, university staff worked with each organization to adapt the program to be appealing and effective, enable their staff and volunteers to provide the program, increase participants' physical activity, and leave sustainable programs in place. Evaluation was based on methods recommended by the Centers for Disease Control and Prevention. RESULTS: The adapted programs, referred to as CHAMPS III, differed from the original program and among organizations. Group-based components and resource guides were included and new features were added; however, individualized components were not offered because of limited resources. A total of 321 people enrolled among three organizations; there was a trend toward increased physical activity at two organizations (an estimated increase of 481 kcal/week [P = .08] and 437 kcal/week [P = .06] expended in physical activity). Evaluation revealed challenges and unexpected community-level benefits. All organizations are continuing efforts to promote physical activity for older adults. CONCLUSION: This project enabled community organizations to implement physical activity promotion programs. The overarching challenge was to retain original program features within each organization's resources yet be sustainable. Although the programs differed from the original research program, they were a catalyst for numerous community-level changes. Our findings can guide similar projects to reach underserved older adults

Impact of Periodic Follow-Up Testing Among Urban American Indian Women With Impaired Fasting Glucose

of periodic follow-up testing among urban American Indian women with impaired fasting glucose. Prev Chronic Di