Risk reduction in general practice and the role of the receptionist

Medical receptionists play a crucial role in any practice as they are usually the first points of contact for patients and the intermediaries through whom contacts with medical practitioners are made. This article reports the findings of a qualitative study of medical receptionists undertaken to explore their role in general practice, particularly in relation to activities involving direct patient assessment, monitoring, counselling and therapy. The findings highlight a number of significant issues in relation to the potential liability of receptionists, medical practitioners, medical centre owners and insurers.     

Association of Contextual Factors with Drug Use and Binge Drinking among White, Native American, and Mixed-Race Adolescents in the General Population

Large-scale surveys have shown elevated risk for many indicators of substance abuse among Native American and Mixed-Race adolescents compared to other minority groups in the United States. This study examined underlying contextual factors associated with substance abuse among a nationally representative sample of White, Native American, and Mixed-Race adolescents 12–17?years of age, using combined datasets from the National Survey on Drug Use and Health (NSDUH 2006–2009, N?=?46,675, 48.77?% female). Native American adolescents displayed the highest rate of past-month binge drinking and past-year illicit drug use (14.06 and 30.91?%, respectively). Results of a logistic regression that included seven predictors of social bonding, individual views of substance use, and delinquent peer affiliations showed that friendships with delinquent peers and negative views of substance use were associated significantly with both substance abuse outcomes among White and Mixed-Race adolescents and, to a lesser extent, Native American adolescents. The association of parental disapproval with binge drinking was stronger for White than for Native American adolescents. Greater attention to specific measures reflecting racial groups’ contextual and historical differences may be needed to delineate mechanisms that discourage substance abuse among at-risk minority adolescent populations.     

Beyond government? The appeal of public‐private partnerships

Abstract: For the most part, the considerable literature devoted to new public management and its subset, alternative service delivery, is enthusiastic about this dramatic shift in the role of government. The metaphor of governments steering and the private sector rowing is an appealing one that has captured the imagination of many public officials and private‐sector actors. Literature addressing this phenomenon tends to focus on defining the characteristics of various forms of government/private‐sector partnerships rather than on assessing the implications and results of actual examples. This paper attempts to complement the existing literature by examining six cases of public‐private partnerships, of both high and low profile ‐ the Confederation Bridge; the Charleswood Bridge; canarie ; rcmp /Disney; Highway 407; and Chrysler/University of Windsor. The higher profile (and more costly) ventures have placed heavy emphasis on confidentiality, which raises concerns about traditional public‐sector values such as accountability, democracy and neutrality. The conclusions of the article are mixed, but at the very least, they suggest the need for caution, vigilance and scepticism. Sommaire: Pour la plupart, c'est avec beaucoup d'enthousiasme que les nombreaux auteurs d'ouvrages sur la Nouvelle gestion publique et sur son sous‐élément, la Prestation de services de rechange, envisagent cette modification fondamentale du rôle des gouvernements. Le gouvernement au gouvernail et le secteur privé aux avirons, voilà une métaphore qui a fait de nombreux adeptes parmi les hauts fonctionnaires comme chez les intervenants du secteur privé. Plutôt que d'évaluer les répercussions et les résultats d'exemples réels, les ouvrages sur ce sujet ont tendance à focaliser sur la définition des caractéristiques de divers types de partenariats entre le gouvernement et le secteur privé. Dans cet article, nous visons à complémenter ces ouvrages en analysant six partenariats public‐privé entrepris par divers paliers de gouvernement au cours des années 1990. La gamme des cas choisis est assez hétéroclite, certains étant très connus, d'autres moins: les ponts Confédération et Charleswood, CANARIE, GRC/Disney, l'Autoroute 407 et Chrysler/Université de Windsor. Les projets plus connus (et plus coûteux) ont fortement souligné leur caractère confidentiel, ce qui a mis en cause les valeurs traditionnelles du secteur public, telles l'imputabilité, la démocratic et la neutralité. Selon les conclusions de l'article, qui sont variées, il conviendrait pour le moins de procéder avec prudence, vigilance et scepticisme.     

The implications for trustees of the possible EU Savings Directive reforms

The EU is considering making the Savings Directive more effective.One measure could be redefining trustees for the purpose ofthe Savings Directive and adopting the definition used in theThird Eu Money Laundering Directive.