Why do doctors choose a career in geriatric medicine?

Reforms to postgraduate training in the U.K. may affect recruitment to geriatric medicine. In 2005, a questionnaire survey was undertaken to determine the factors favouring geriatric medicine as a career choice and whether these might be used to influence recruitment. In all, 1036 responses to the questionnaire were received (response rate 56.4%); 4% of the respondents decided to specialise in geriatric medicine as students, 3.8% of consultants and 8.6% of registrars decided as pre-registration house officers while 39% of consultants and 7% of registrars chose geriatric medicine while a middle grade in another specialty. The strongest influences on choice were clinical aspects of the specialty (34.1%) and inspirational seniors (26.2%). However, 9.2% of consultants and 10.1% of registrars subsequently regretted their career decision. Geriatric medicine seems to be a career choice for doctors of increasing maturity and including more posts in foundation programmes may not improve recruitment as anticipated. Although a small number of doctors regretted choosing geriatric medicine as a career, this was rarely to do with core aspects of the specialty.     

Why do women choose nursing?

To answer the question, "Why do women choose nursing?", female nursing students were given an opportunity to speak "in their own voices" to reveal their needs, motivations, and expectations. In a study employing grounded theory methodology, 16 female nursing students were interviewed and audiotaped for initial constant comparison analysis. Further analyses employing coding, categorizing, comparing, and contrasting of data made it possible to isolate recurrent words and phrases, and to identify concepts for the purpose of theory building. Reliability was established by both stability analysis and reproducibility analysis. Validity was supported by construct (convergent and discriminant) and representational components. Not surprisingly, the construct of desiring to care for others was readily apparent. However, it was power and empowerment that emerged from the interviews as the most resounding and fully developed construct of the study. Students' references to practical motivations for choosing nursing were so notably scarce that their virtual omission constituted an important theme.     

Why do sales of lipid-lowering drugs vary between counties in Norway? Evidence from the OPPHED Health Study 2000-2001

OBJECTIVE: To study and compare plausible factors that might explain varying sales of lipid-lowering drugs (LLDs) in the two neighbouring counties of Hedmark and Oppland in Norway, with a similar age distribution, socioeconomic structure, and access to healthcare services. DESIGN, SETTING, SUBJECTS: Cross-sectional population study comprising 10 598 attendants aged 40, 45, 60, and 75 years in the OPPHED Health Study, 2000-2001 (attendance rate 61%). MAIN OUTCOME MEASURE: Treatment eligibility (cardiovascular morbidity and risk score), treatment frequency in treatment-eligible subgroups and treatment intensity in terms of achievement of total cholesterol (TC) goal. RESULTS: Proportions eligible for LLD treatment in Hedmark and Oppland were similar. There was no difference in prevalence of LLD use among participants with cardiovascular disease or diabetes (secondary prevention subgroup). However, LLD use among men in the primary prevention subgroup was higher in Hedmark compared with Oppland, 6.3% and 4.1%, respectively (p < 0.05). The same tendency was seen among women. In both sexes, more LLD users in the primary prevention subgroup achieved the TC goal in Hedmark compared with Oppland (p < 0.05). CONCLUSION AND IMPLICATIONS: The proportion of the population eligible for LLD treatment in the two counties should imply similar treatment rates in both. Higher LLD treatment frequency and intensity in the primary prevention subgroup in Hedmark are probably both contributing factors that explain the higher sales of LLDs in Hedmark compared with Oppland. Feasible intervention thresholds for primary prevention with concurrent reimbursement rules should be defined in guidelines to avoid unintentional variation in LLD use in the future.     

Why do nurses choose to work in the perioperative field?

It is important for educators to know why nursing students choose perioperative nursing so that they can help these students become knowledgeable and perceptive professionals. The purpose of this study was to learn why perioperative nurses chose their specialty and why they chose to leave former positions. We used a Likert-type questionnaire with 26 statements and one open-ended question. Ninety of approximately 180 perioperative nursing students in Norway returned the questionnaire. The three most important reasons for choosing perioperative nursing were interest, being able to help patients, and being useful to others, and the three most important reasons for leaving former jobs were wanting more than working on typical patient care units, insufficient staff to provide high-quality care, and being responsible for too many patients.     

Why do patients seek treatment in hospitals of complementary medicine?

OBJECTIVE: This exploratory study evaluated patients' reasons for entering a complementary (alternative) medicine hospital by ranking 15 medical and psychosocial factors that were thought to influence this choice. SUBJECTS AND OUTCOME MEASURES: Two hundred patients (200) from two complementary hospitals, one focusing on Traditional Chinese Medicine and one on the Western type of complementary medicine, completed an extensive questionnaire at the beginning of their inpatient treatment. The questionnaire covered personal background; disease parameters; attitude towards conventional medicine; previous experience with, and knowledge of, complementary therapies; expectations concerning the forthcoming treatment; health-related habits; personality traits; and social support. RESULTS: Optimistic attitudes towards treatment and a positive appraisal of alternative doctors were frequently stated reasons (80%), as was the disease severity (long duration: 86%; acute progression or imminent surgery: 70%). Previous successes with complementary therapies, however, ranked relatively low (53%). Negative opinions concerning conventional therapies and conventional doctors' treatments were mentioned by 68% of the patients. Many patients felt themselves to be under considerable psychologic stress (74%). A majority (73%) was well informed about complementary therapies, and 65% were curious about the forthcoming therapies. Sixty-eight percent (68%) indicated good health behaviors. Fewer patients mentioned contemplative and/or religious attitudes (44%) or lack of social support (25%). Age primarily accounted for variations in the ranking weights of the two subgroups. The specific type of complementary medicine was of minor influence. In 14 out of 21 personality dimensions, the current patient group showed significant deviations from the healthy reference, which is in good agreement with findings from conventionally treated patients.     

CPR in terminally ill patients?

While limiting and foregoing therapy at the end of life is now accepted on medical, ethical, moral and legal grounds, many Americans continue to die with heroic measures being taken to prevent their death. When the patient does eventually die, attempts are frequently made to revive the patient by performing cardiopulmonary resuscitation (CPR). While CPR may result in the establishment of a perfusing pressure, in almost all instances, the patient succumbs despite advanced life support technology. The widespread adoption of do-not-resuscitate (DNR) protocols has not prevented CPR from being performed on patients, who are unlikely to survive. We present two cases, which highlight the modern American way of dying. We submit that poor end-of-life care may result from physicians discomfort with death, their poor communication skills and their failure to fully comprehend the benefits and limitations of advanced life support technology. Furthermore, we maintain that CPR should only be performed on patients, who are likely to derive benefit from this intervention.     

Why do our kidneys get old?

The majority of the human population shows a decline in renal clearance with age and a loss of renal physiologic reserve. Kidneys are increasingly less able to deal with stressful challenges such as a salt or acid load. It is not clear what underlies this aging-related change and whether it is inevitable or can be modified in such a way as to preserve renal function throughout the life span. This is a very brief review of aging biology and how it might impact on renal aging.     

Why do Mindful People Worry Less?

Mindfulness is negatively related to forms of repetitive thought (RT) such as worry. However, the nature of this relationship is unclear because discrete forms of RT are composed of several underlying dimensions, including valence and total amount, either or both of which might be responsible for the negative relationship between worry and mindfulness. Using the Five Facet Mindfulness Questionnaire and multidimensional scaling of a battery of RT measures, the present study found that mindfulness correlated with less total RT and more positively valenced RT (N = 199). Analysis of individual mindfulness facets supported a two-component model of mindfulness consisting of attention regulation and an accepting attitude toward one’s experiences. This attitudinal component of mindfulness was primarily responsible for its association with less total RT and less negative RT.