ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1987.tb133506.x

出版商:Wiley    

年代:1987

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1987.tb133507.x

出版商:Wiley    

年代:1987

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1987.tb133508.x

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

We devised a reliable coding system in order to analyse interactional events between general practitioners and patients that were observed on the videotapes of 201 consultations in which an antibiotic agent was prescribed. Of total consultation events, doctors contributed 14% on the collection of information about the presenting condition for which antibiotic agents were prescribed; 22% on the giving of such information; 17% on social exchanges; and 21% of events were devoted to other problems that emerged during the consultation. Patient questions made up 2% of events and were encouraged specifically by 1% of events. Whereas 75% of patients were told the dose and length of the course, only 46% of patients were told the name of the antibiotic agent, only 10% of patients were told of side‐ effects, and no patient was told what to do if he or she forgot a dose. Not surprisingly, with the exception of the justification of the treatment that was chosen, practitioners seldom used techniques which have been shown to be effective in the improvement of patient compliance or recall of information. Given that antibiotic agents are prescribed commonly, and compliance is frequently poor, our findings have implications for undergraduate, vocational and continuing education.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1987.tb133509.x

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

This study used a randomized clinical control design to test first, whether decreasing the complexity of antibiotic regimens resulted in increased compliance and, secondly, whether the added component of written information and behavioural tailoring increased compliance in patients with twice‐a‐day schedules. Twenty‐eight general practitioners who were selected at random and 232 of their patients took part in the study. Patients were allocated at random to receive either doxycycline (one dose a day); co‐trimoxazole (two doses a day); amoxycillin (three doses a day); or co‐trimoxazole (two doses a day) with a written instruction sheet and advice on how to best fit the tablets into a daily routine. Decreasing complexity of the regimen significantly increased the probability that patients would not miss any doses of the course (absolute compliance: x2 = 25.04; df=2;P<0.001). There was also a significant association between complexity and non‐compliance at a level which might be clinically significant x2= 6.78; df = 2;P=0.03). Written information and behavioural tailoring did not further augment compliance in patients with one‐ or two‐doses‐a‐day schedules. It was also shown that general practitioners predicted potential noncompliance in patients at a rate no better than would be expected by chance.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1987.tb133510.x

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

The initial results from a diagnostic breast clinic in which clinical examination, x‐ray mammography and ultrasound are used to establish a diagnosis during a single patient‐visit are described. In 3461 patient‐visits, 82 histologically‐proven breast cancers were detected. Fifty‐ two per cent of these cancers were 2 cm or less in diameter and 61 % had no axillary lymph‐node métastasés. Fifteen cancers were impalpable lesions which were detected by mammography alone. The over‐all malignant‐to‐ benign biopsy ratio was 1:2.7; for impalpable tumours, this ratio was 1:3.9. The role of such a diagnostic breast clinic is discussed, and attention is drawn to a relatively low attendance of women in the “high‐risk” age group of over 50 years of age.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1987.tb133511.x

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

Information concerning all 435 women who presented with primary breast cancer in Western Australia during 1984 was obtained by a review of the WA Cancer Registry, hospital, histopathological laboratory, and medical practitioner records. The age‐standardized and cumulative incidence rates were 55.7 per 100 000 women and 6.4%, respectively. The probability that a woman would develop breast cancer during her lifetime (to the age of 74 years) was one in 15.6. There was a significant seasonal variation in the incidence of breast cancer, with a peak in spring (November) and a low in winter (July). The highest incidence rates occurred in women who had never had any children, those of professional status and those who lived in better socioeconomic areas. Stage‐1 disease accounted for only 22% of all breast cancers. A younger age was associated with a greater proportion of oestrogen‐receptor‐negative tumours and a longer symptom interval correlated with larger primary tumours. The findings support the concept that the characteristics of Australian women with breast cancer are similar to those that have been described in British and North American women.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1987.tb133512.x

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

A locally‐relevant “market basket” has been devised to help to assess the cost of usual food purchases for Aborigines who live in the Kimberley region. The range of foods in the market basket is relatively restricted, especially for fresh vegetables. In some communities, basic food items cost over 40% more than they would in the Perth metropolitan area. Price differentials and other difficulties encourage unsatisfactory dietary patterns for Aborigines in the region. A food‐voucher system is proposed as one possible way to help to overcome serious nutritional imbalances for pregnant women and their infants and young children who are especially vulnerable to nutritional deficiencies. This proposal is likely to be politically unpopular, so other ways should be sought to help to improve the health of Aboriginal mothers and their children.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1987.tb133513.x

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

Although breast cancer is a rare event in pregnancy, the consequences of a delay in its detection and of late‐stage disease are tragic for the young woman who presents in her childbearing years. Therefore, all pregnant women with breast problems should undergo a careful assessment. Pregnancy is not a contraindication to orthodox investigations for breast cancer, provided that special care is taken to reduce the risk to the developing fetus. Management is also orthodox, and breast cancer in pregnant or lactating women is thought to behave no differently from breast cancer in non‐pregnant women, when age, stage and histological type are similar. For women who have developed early breast cancer during pregnancy, termi‐nation of the pregnancy does not appear to have a beneficial influence on the disease. There is no convincing evidence that a subsequent pregnancy has any effect on the outcome of a breast cancer that has been managed successfully previously. The prevention of subsequent pregnancy is not an indication for a prophylactic oophorectomy. A decision for further pregnancies must be made by the patient and the family after sound advice is given as to the prognosis and consideration of the social, economic and spiritual factors. There is no evidence that the termination of a subsequent pregnancy will affect beneficially or adversely the prognosis of a patient with breast cancer.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1987.tb133514.x

出版商:Wiley    

年代:1987

数据来源: WILEY

摘要:

Education in Australian medical schools is presently under review, including teaching about alcohol and other drugs. In August 1986, the Alcohol and Drug Foundation, Australia (ADFA) presented to the Deans of Australasian medical faculties (including those of Fiji, Papua New Guinea, and New Zealand) a number of options to develop the alcohol and other drugs content of medical courses. It was proposed that a coordinator of education in alcohol and other drugs be appointed in medical faculties; this proposal had been modelled on the US Career Teacher Training Program in Alcohol and Drug Abuse. The Deans expressed interest in ADFA's proposal. This paper discusses the role of undergraduate medical education in alcohol and other drugs, and the background to, and some guide‐lines from, the ADFA proposal.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1987.tb133515.x

出版商:Wiley    

年代:1987

数据来源: WILEY