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Biomedical subjects

Peter M Walker

Publications and source records attributed to Peter M Walker.

2 recordsLinked to original sources

Family physician views about primary care reform in Ontario: a postal questionnaire.

BACKGROUND: Primary care reform initiatives in Ontario are proceeding with little information about the views of practicing family physicians. METHODS: A postal questionnaire was sent to 1200 randomly selected family physicians in Ontario five months after the initial invitation to join the Ontario Family Health Network. It sought information about their practice characteristics, their intention to participate in the Network and their views about the organization and financing of primary care. RESULTS: The response rate was 50.3%. While many family physicians recognize the need for change in the delivery of primary care, the majority (72%) did not expect to join the Ontario Family Health Network by 2004, or by some later date (60%). Nor did they favour capitation or rostering, 2 key elements of the proposed reforms. Physicians who favour capitation were 5.5 times more likely to report that they expected to join the Network by 2004, although these practices comprise 5% of the sample. CONCLUSIONS: The results of this survey, conducted five months after the initial offering of primary care reform agreements to all Ontario physicians, suggest that an 80% enrollment target is unrealistic.

Adult↗

Radiation exposure using laser aiming guide in orthopaedic procedures.

BACKGROUND: Ionizing radiation from intraoperative fluoroscopy presents a serious occupational health and safety concern to orthopaedic surgeons.The long-term effects of ionizing radiation are well known; they include damage to the eyes, increased risk of haematological malignancy and carcinomas throughout the body. We studied the effect of using an attachable laser aiming guide on radiation exposure during intraoperative fluoroscopy. METHODS: A prospective, randomized controlled trial was performed at a single institution. Eight hundred and eighty consecutive orthopaedic procedures involving fluoroscopy were randomized into two groups. One group had fluoroscopy without an aiming guide, the other group had fluoroscopy with the aiming guide. Total exposure time, number of exposures and the body region examined were recorded. RESULTS: For most regions studied, no significant difference in exposure time or number of exposures was found. For hip fractures, use of the laser aiming device was associated with an increase in the number of exposures (P = 0.035), but there was no significant difference in average exposure time (P = 0.31). Use of the aiming device was associated with an increased number of exposures (P = 0.0025) and an increased exposure time (P = 0.0016)for examination of the wrist, but this may represent selection bias. CONCLUSION: Use of a laser aiming device during intraoperative fluoroscopy was not associated with decreased exposure to radiation.

Fluoroscopy↗