KEY MESSAGE(S):· General practitioners want to play a relatively passive role in the management of obesity · Motivating patients is a key goal of primary care consultations on obesity · Perceived lack of motivation in patients is an important barrier to successful obesity management by general practitioners ABSTRACT Background: Increasing prevalence of obesity worldwide requires providing support for many patients. GPs in particular, as longterm supervisors of patients, are asked to deliver care to those aff ected. Objectives: This qualitative study aimed at identifying GPs ' perspectives on counselling overweight and obese patients. Methods: To that end, semi-structured interviews were conducted in Berlin with GPs regarding their objectives and barriers in overweight care. Fifteen GPs participated; interviews were audio taped, transcribed and analysed using qualitative content analysis. Results : Analysis showed a diff erentiated pattern of medical and psychosocial objectives in obesity treatment. Overall, it was seen that GPs wanted to play a relatively passive role in treatment of obesity. In particular, motivating patients was a key goal of primary care consultations; at the same time patients ' lack of motivation was a main barrier to successful treatment.
Conclusion:Care for obese patients is perceived as ineff ective and frustrating. Recommended solutions include further education to improve GPs ' communication techniques, e.g. to trigger patients ' motivation.
This paper examines the economic and political conditions that influence people's attitudes regarding a municipality break-up. The theoretical model predicts intra-municipal differences in tax bases, political preferences, and population size to affect the expected gain from secession. The predictions of the model are tested using data on local referenda about municipality partitioning in Sweden. The data support one of the three effects; voters in municipality parts that are wealthy compared to other parts of the same municipality are more positive to secession.
The effects of a recent Swedish child-care fee reform are compared with those of an alternative reform, increased child benefits. The fee reform implied considerably decreased fees and was intended to increase both labor supply among parents and their economic well-being. We estimate labor supply effects using a discrete choice labor supply model, and simulate behavioral responses to the changes. We find positive, but small, effects on labor supply from reduced fees, while increased child benefits would make single mothers decrease their labor supply. On the other hand, increased child benefits would make income distribution more equal. We make a social welfare comparison and conclude that for plausible values of inequality aversion, the alternative reform would have been preferred to the implemented fee reform. Copyright Springer Science+Business Media, LLC 2007Labor supply, Redistribution, Reform, Child care, Fees, Child benefit, H31, I38, J22,
Abstract. South Africa waived user fees for primary healthcare in 1994 and, again, in 1996. The first waiver focused on young children, elderly adults, pregnant women and nursing mothers, while the 1996 reform waived fees for the remainder of the population, subject to means tests. We take advantage of household survey information to examine the impact of the policy on a subset of the reform-eligible population. Although it was expected that public healthcare facility usage would have increased post-reform, no statistically significant evidence supported such a claim. Therefore, our results are consistent with some very recent research examining the 1994 reform, but are generally at odds with the general impression in the literature that user fee abolition matters, when it comes to alleviating inequities in access to healthcare.
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