Showing papers by "General Medical Council published in 2010"

Low genetic diversity in a snail intermediate host (Biomphalaria pfeifferi Krass, 1848) and schistosomiasis transmission in the Senegal River Basin.

Abstract: Population genetic perturbations of intermediate hosts, often a consequence of human pressure on environmental resources, can precipitate unexpectedly severe disease outbreaks. Such disturbances are set to become increasingly common following range changes concomitant with climate shifts, dwindling natural resources and major infrastructure changes such as hydroprojects. Construction of the Diama dam in the Senegal River Basin (SRB) reduced river salinity, enabling the freshwater snail intermediate host Biomphalaria pfeifferi to rapidly expand its distribution. A serious public health problem ensued, with an epidemic of intestinal schistosomiasis occurring in the previously schistosome-free Richard-Toll region within 2 years. The current study aimed to assess the population variability of B. pfeifferi in the SRB, and speculate upon its subsequent impact on host-parasite interactions following such engineered ecological change. Genetic variation at nine polymorphic microsatellite loci revealed little population differentiation in SRB snails compared with those from natural habitats in Zimbabwe, where Schistosoma mansoni transmission is much lower. 'Open' SRB habitats are associated with greater water contact, smaller population sizes and less genetic diversity, with sites downstream of Richard-Toll showing greater inter- and intrapopulation variation, concomitant with less frequent human contact. These observations may be explained by rapid expansion into pristine habitat selecting for high fecundity genotypes at the expense of schistosome resistance, presenting S. mansoni with genetically homogenous highly fecund susceptible populations around the focal point, promoting development of a highly compatible host-parasite relationship. Longitudinal study of such systems may prove important in predicting public health risks engendered by future environmental engineering projects.

Comparison of Attitude of Primary Health Care Physicians and Nurses Towards Domestic Violence Against Women

Abstract: Background: Domestic violence (DV) against women has increased during the past few years and became an important public health problem. Personal values and beliefs of primary health care workers can affect both diagnostic and management procedures adopted to deal with battered women. Objectives: The current study was formulated to compare attitude of physicians and nurses towards DV against women. Methods: All physicians and nurses currently working in the primary health care centers in Kuwait (2516) were asked to answer a self-administered questionnaire. Out of them, 1553 completed the questionnaire with an overall response rate of 61.7%. Results: Physicians tended to have a higher positive overall attitude score towards violence against women than nurses (60.75 + 13.16% compared with 58.3 + 13.82%, P <0.001), with a mean percent score of 75.73 + 21.80% compared with 69.7 + 21.3% for good reasons to hit women domain. No significant differences were revealed between the two groups for either the relationship between partners domain (42.36 + 15.37% compared with 42.9 + 15.99%, P = 0.679) or the management domain (58.39 + 17.11% compared with 58.7 + 20.59%, P = 0.104). Conclusion: Relatively low positive attitude scores were recorded by primary care physicians and nurses Yet, physicians tended to have higher scores than nurses. There is a great need to improve attitude of health care workers, especially nurses, about DV against women through properly planned training programs.

Revalidation: a General Medical Council perspective

Abstract: Most doctors in the UK are very good doctors who keep themselves up to date because they are highly motivated and committed to doing their best for their patients. In the past this was accepted on trust, but the world has changed. Revalidation is the process by which doctors in the future will confirm that they are up to date and fit to practise. A BMJ editorial accurately foreshadowed a tumultuous decade for doctors: ‘All changed, changed utterly. British medicine will be transformed by the Bristol case’. 1 Until the highly publicised events in children’s heart surgery in Bristol, it had been assumed that doctors would maintain high standards in their profession by self-regulation. However, in Bristol some doctors had been harming patients by working outside their competence while others knew but had remained silent. Self-regulation had been found wanting and the General Medicine Council (GMC) proposed revalidation as a consequence. The idea that evolved within the GMC at that time envisaged a four-layer model of revalidation: the professionalism of the individual; constructive self-assessment within the clinical team; effective clinical governance and quality improvement within the organisation; and, at a national level, the regulator. These principles still stand today. Revalidation has been a long time coming. The challenge has been to develop a system that is fit for purpose, while being usable by the 218,000 doctors with a licence to practise: revalidation has to work at the front line. The main pillars will be appraisal and multisource feedback (MSF).

The Stoke CNEP saga--a view from the General Medical Council.

Abstract: The General Medical Council’s (GMC) purpose is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine. To support that purpose, the GMC has four main regulatory functions: registration (which, in future, will include revalidation); education and training; standards and ethics; and the fitness-to-practise procedures (sometimes misleadingly labelled disciplinary procedures). The fitness-to-practise procedures seem guaranteed to polarize opinions; over the years, there have been criticisms from both sides of the yawning divide that separates those who believe the GMC is too lenient and those who believe it is too harsh. Neither caricature is accurate, as evidenced by the outcomes of appeals and other referrals to the High Court. As with all activities based on human judgements, errors are made but the numbers are very small and they do not reflect systemic bias. The GMC is committed to having processes and procedures that are fair, objective, transparent and free from discrimination. Nevertheless, some criticisms of the fitness-topractise procedures have been justified. The procedures that operated in the 1990s and in the early part of the 2000s were no longer fit for purpose. That is why the GMC launched a programme of fundamental review in 2000 and introduced reformed procedures in November 2004. It is also why, at the Shipman Inquiry in November 2003, the GMC frankly recognized past deficiencies in three areas – operational effectiveness; consistency and quality of decision-making; and the architecture of the procedures. Other criticisms are not justified. Some reflect a historical rather than a current perspective; some are based on misunderstanding; and some are partisan. They include that the GMC bears down

Locum staff. Responsibilities of individual doctors.

Abstract: Chris Isles’ disturbing account (doi:10.1136/bmj.c1412) highlights both the continuing shortage of doctors in some parts of the country and the apparent failure of some agencies and doctors to provide reliable information about their skills and competence. Of course, the onus is on employers to ensure that the doctors they employ are fit to carry out the role expected of them. However, that does not take away the responsibility of individual doctors to ensure that what they say about themselves is accurate in every particular. The experience from this hospital raises serious questions about the role of locum agencies. These are …