Biomedical subjects

Julian Davis

Publications and source records attributed to Julian Davis.

7 recordsLinked to original sources

PubMed2006

Rural suicide--people or place effects?

OBJECTIVE: To examine factors that may contribute to elevated rates of suicide among rural communities in Australia. METHOD: A wide-ranging literature search reviewed possible factors that may contribute to the geographical variation in suicide. Literature was organized to enable examination of compositional and contextual explanations, as well as collective social functioning and social practices. RESULTS: A variety of factors may contribute to elevated rates of suicide in rural compared with urban areas. Collective and contextual (place) factors seem to be of particular importance as possible contributors to the elevated rate of suicide among rural males. These include rural socioeconomic decline; facilitators and barriers to service utilization such as service availability and accessibility, rural culture, community attitudes to mental illness and help seeking; and exposure to firearms. CONCLUSIONS: Compositional, contextual and collective factors are hypothesized to influence the elevated rate of suicide in rural compared with urban areas. These factors need to be tested in empirical studies that consider both individual and community-based risk factors, and are designed to enable exploration of likely within-rural differences.

Australia↗

PubMed2004

Rural Integrated Primary Care Psychiatry Programme: a systems approach to education, training and service integration.

OBJECTIVE: To describe the development of a rural primary care psychiatry programme, within a stepped collaborative care model. CONCLUSION: Development of a system-wide approach to the provision of mental health services offers the opportunity to increase the proportion of people with mental health problems who receive effective treatment. In addition, it enables allocation of resources and matching of interventions to patient preference and clinical need. This is particularly important in rural areas where there is a shortage of specialist mental health services and practitioners.

Community Health Workers↗

PubMed2004

Implementation strategies for a Scottish national epilepsy guideline in primary care: results of the Tayside Implementation of Guidelines in Epilepsy Randomized (TIGER) trial.

PURPOSE: To determine the effectiveness of two dissemination and implementation strategies to implement a national guideline for epilepsy management in primary care settings. METHODS: Three-arm cluster-randomized controlled trial. The participants were general practitioners from 68 practices in Tayside, Scotland, and 1,133 of their patients with self-reported epilepsy treated with antiepileptic medications (AEDs). Practices were randomized blind to a control, intermediate, or intensive intervention. CONTROL: Postal dissemination of a nationally developed clinical guideline. Intermediate intervention: Postal dissemination of the guideline supported by interactive, accredited workshops, and dedicated, structured protocol documents. Intensive intervention: Intermediate intervention plus a nurse specialist who supported and educated practices in the establishment of epilepsy review clinics. The primary outcome was the SF-36 health-related quality-of-life instrument. Secondary measures were a battery of prevalidated epilepsy-specific quality-of-life instruments. These were administered at baseline and after the intervention phase. Process of care was assessed by case-note review on number of review meetings and counseling sessions for epilepsy before and after the interventions. RESULTS: None of the intervention groups showed any change in the primary or secondary outcome measures or process-of-care measures. CONCLUSIONS: None of the intervention strategies led to improvements in patient quality of life or quality of epilepsy care. Further research is needed to discover why the interventions failed, to identify barriers to adoption of guidelines, and to develop strategies that might improve implementation and uptake in the future.

Adult↗

PubMed2004

Interpersonal counselling in general practice.

BACKGROUND: Interpersonal counselling (IPC) derives from interpersonal psycho-therapy (IPT) but is briefer in the number and duration of sessions and is particularly suited to the primary care setting. While depression and other psychological symptoms are not necessarily 'caused' by interpersonal problems, they do occur in a social and interpersonal context. Problem areas commonly associated with the onset of depression are unresolved grief, interpersonal disputes, role transition and interpersonal deficits such as social isolation. OBJECTIVE: This article discusses IPC and how it can be used in the general practice setting. DISCUSSION: The structure of IPC is of a brief treatment of six sessions, each with an explicit focus: assessment, education about the interaction between interpersonal relationships and psychological symptoms, identifying current stress areas and helping the patient deal with these more positively and termination of the IPC relationship. Interpersonal counselling can be utilised general practice to reduce psychological symptoms, restore morale, improve self esteem and the quality of the patient's social adjustment and interpersonal relationships.

Adult↗

PubMed2003

First year of practice visits for the Rural Depression Anxiety Research and Treatment General Practice program.

OBJECTIVE: To describe the first 12 months activities of a key component of a General Practice Psychiatry program - the GP practice visit. DESIGN: Questionnaire to evaluate effects on participating general practitioners practice. SETTING: Rural group general practices. SUBJECTS: Thirty-two general practitioners in the Loddon Campaspe Southern Mallee region in Victoria. INTERVENTIONS: Practice visits involved a combination of each of three key activities: primary consultation, secondary consultation and/or case discussion and formal teaching. RESULTS: General practitioners reported a variety of changes in their practice as a result of the visits. CONCLUSION: Practice visits appear to be a useful means of influencing GP's practice. Further work is required to determine whether such changes are accompanied by demonstrable benefits in patient outcome. WHAT IS ALREADY KNOWN: Several models to assist GPs effectively manage mental health problems have been described. These models require regular contact and so have had limited utility in rural settings. WHAT THIS STUDY ADDS: This study suggests that infrequent contact or input, based on well established models, can alter GP's clinical behaviour.

Anxiety↗

PubMed2002

Synthesis and biolocalization of water-soluble sapphyrins.

The synthesis, characterization, and biolocalization properties of new, fully water-soluble sapphyrins is reported. These systems, which display light absorbing features that make them of potential interest as photodynamic therapy (PDT) sensitizers, were found to localize selectively in pancreatic carcinoma tissue in a xenographic murine model. In this model, the concentration ratios for malignant tissue to surrounding muscle tissue were found to be as high as 280 in the most favorable case. The concentrations of the water-soluble sapphyrins reported here, as well as a porphyrin control system, were determined as a function of time and tissue type.

Animals↗

PubMed2002

A Graduate Certificate and Master in General Practice Psychiatry by distance education--1998-2001.

BACKGROUND: The General Practice Psychiatry Program is a collaborative initiative between two universities and two professional colleges. Since 1998 it has offered general practitioners a one year part time Graduate Certificate, and a two year Master of General Practice Psychiatry. The learning is by distance education and multimode, including text packages sent out, tapes, teleconferences and two annual residential weekends with role plays and didactic teaching. OBJECTIVE: To describe the development of a Graduate Certificate and Master in General Practice Psychiatry. DISCUSSION: The program has been well supported with 141 general practitioners enrolling in the Graduate Certificate and 48 in the Masters during 1998-2001. General practitioners have been enrolling from around Australia, with rural, female and more experienced GPs predominating.

Adult↗