A study of 35 nonprofessional helpers, identified as community "guides," focused on the contribution each made to helping marginalized individuals and families become a part of their communities. The lessons learned through these lay helpers can inform a postmodern social work practice that promotes the use of indigenous practice principles appropriate for work with and in culturally distinct communities. The practice wisdom of these guides demonstrates a need for professionals to reposition themselves in the associational life of a community, and to make their practice less visible. It is shown that an effective community-building practice that respects community solutions to individual and community problems requires permeable boundaries on the part of intervening professionals.
The CMA believes that prescribing data that identify individual physicians should be used in a manner that does not breach the privacy of patients or of physicians in their personal or professional lives. To address this concern, the CMA has developed the following set of principles for the compilation, sale and other commercial use of data on individual physician prescribers.
Drug therapy is an integral component of modern medical care, and practising physicians are faced with the difficult task of keeping up with rapid changes in pharmacologic treatments. Recent evidence indicates that prescribing practice is often inconsistent with criteria for safety and effectiveness. Surveys indicate that community-based physicians are not satisfied with current sources of information on prescription drugs. The dissemination of printed material alone does not lead to improved prescribing practice, but specific education and feedback strategies can. To improve prescribing practice in Canada we need to systematically evaluate strategies to change prescribing behaviour, to design quality assurance programs based on proven strategies and to develop collaboration and cooperation among providers, manufacturers, governments and the public.
The use of culture of vaginal secretions by physicians and their use of microscopy of vaginal secretions were assessed.
The study was conducted partly as a registration of all microbiological requests and reports from the Department of Clinical Microbiology in a selected period, and partly as a questionnaire sent to all general practitioners (GPs) and specialists in obstetrics and gynaecology in the county of Arhus.
In only 19% of 1,354 vaginal swabs received in a month could the findings lead to a specific antimicrobial treatment; 48% of these cases could be diagnosed by microscopy of vaginal secretions alone. Sixty-four per cent of the physicians returned the questionnaire. Half of the specialists and 60% of the GPs performed microscopy. Twenty-five per cent of the physicians treated patients solely on the basis of clinical symptoms.
General culture of vaginal secretions has a limited clinical value. The diagnosis in patients complaining of vaginal discharge can often be made by microscopy. There is, however, a need for training GPs in microscopy, as well as specialists.