Introduction. Most Australians are dependent on their cars for mobility, thus relinquishing driving licences for medical reasons poses challenges. Aims. To investigate how general practitioners (GPs) recognise and manage patients' fitness to drive, GPs' attitudes and beliefs about their role as assessors, and GPs' experiences in assessing and reporting to driving authorities and identify GPs' educational needs. Methods. Mixed methods: questionnaire mailed to GPs from three rural and two metropolitan Divisons of General Practice in Victoria, Australia. Results. 217/1028 completed questionnaires were returned: 85% recognised a patients' fitness to drive, 54% felt confident in their assessment ability, 21% felt the GP should have primary responsibility for declaring patients' fitness to drive, 79% felt that reporting a patient would negatively impact on the doctor-patient relationship, 74% expressed concern about legal liability, and 74% favoured further education. Discussion. This study provides considerable information including recommendations about GP education, the assessment forms, and legal clarification.

No abstract

1. The tetrabrominated diphenyl ether 3,5-dibromo-2-(2,4-dibromophenoxy)phenol (BPE), a natural marine product isolated from a sponge, was tested for pharmacological activity in guinea-pig ileum. 2. BPE (2 mumol/L) decreased basal force and the frequency of spontaneous contractions of the ileum. It also significantly decreased contractions of the ileum induced by 5 mmol/L barium and to electrical stimulation at parameters which stimulated intrinsic nerves. 3. The slopes of concentration-response curves to acetylcholine (ACh), histamine and 5-hydroxytryptamine (5-HT) were significantly reduced by BPE at concentrations of 2 mumol/L or greater. 4. BPE (2 mumol/L) did not affect calcium-induced contractions of longitudinal muscle fibres from guinea-pig ileum which were stripped of their cellular membrane. It (6 mumol/L) also had no effect on ATP levels in longitudinal muscle fibres. 5. BPE (2 mumol/L) reduced both phasic and tonic components of contractions induced by raising the extracellular concentration of K+ to 15, 30, 45 or 60 mmol/L (in the presence of atropine, propranolol, phentolamine and desensitization to 5-HT to inhibit the effects of nerve transmitter release). 6. BPE (2 mumol/L) reduced carbachol-induced contractions of ileum pre-incubated in 1 mumol/L felodipine, a blocker of L-type voltage-operated calcium channels (VOCC). 7. BPE dose dependently (0.6-6 mumol/L) reduced contractions induced by Ca2+ in both K+ depolarized ileum and in tissue exposed to carbachol (10 mumol/L) in the presence of felodipine (0.1 mumol/L). 8. These results suggest that BPE affects intracellular messenger systems controlling cytosolic calcium and/or blocks entry of calcium into the cell through both VOCC and receptor-operated channels (ROC).

No abstract

No abstract