An analysis was also performed of Regie de l’assurance maladie du Quebec administrative data on medical procedures.\n\nSetting Quebec.\n\nParticipants

Overall, 1415 general practitioners from different practice settings were invited to complete a questionnaire; 970 general practitioners were contacted. A subgroup of 60 general practitioners were contacted to participate in interviews.\n\nMain outcome measures The annual frequency of consultations over MHPs, either common (CMHPs) or serious (SMHPs), clinical practices, collaborative practices, see more factors that either support or interfere with the management of MHPs, and recommendations for improving the health care system.\n\nResults The response rate was 41% (n = 398 general practitioners) for the survey and 63% (n = 60) for the interviews. Approximately 25% of visits to general practitioners are related to MHPs. Nearly all general practitioners manage CMHPs and believed themselves competent to do so; however, the reverse is true for the management of SMHPs. Nearly 20% of patients with CMHPs are referred (mainly to psychosocial professionals), whereas nearly 75% of patients with SMHPs are referred (mostly to psychiatrists and PD98059 mouse emergency departments). More than 50% of general practitioners say that they

do not have any contact with resources in the mental health field. Numerous factors influence the management of MHPs: patients’ profiles (the complexity of the MHP, concomitant disorders); individual characteristics of the general practitioner (informal network, training); the professional culture (working in isolation, formal clinical mechanisms); the institutional setting (multidisciplinarity, staff or consultant); organization of services (resources,

formal coordination); and environment (policies).\n\nConclusion The key role played by general practitioners and their support Batimastat mw of the management of MHPs were evident, especially for CMHPs. For more optimal management of primary mental health care, multicomponent strategies, such as shared care, should be used more often.”
“BACKGROUND: Unstable intertrochanteric fractures remain a challenging problem in elderly individuals due to high failure rates associated with internal fixation. Hemiarthroplasty is one treatment option for intertrochanteric femur fractures in elderly patients. The aim of the present study was to compare the reliability of cementless and cemented hemiarthroplasty for unstable intertrochanteric femur fractures in elderly patients.\n\nMETHODS: Elderly patients with AO type 31-A2 intertrochanteric femur fractures were treated with cemented (n=40) or cementless (n=46) hemiarthroplasty. Duration of surgery, amount of blood loss and blood transfusion, Harris hip scores, rate of loosening of the femoral component, duration of hospital stay after surgery and mortality rates were recorded.