Family practice
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Review Comparative Study
Frequent attenders of Finnish public primary health care: sociodemographic characteristics and physical morbidity.
In this article results of a Finnish study on frequent attender patients of public primary health care are reported. These patients (n = 96) were compared with other patients (n = 466) attending the same surgeries. ⋯ The results indicate that many frequent attender patients complaints form a complicated network departing from different levels (physical, psychological and social). The implications of the findings are discussed.
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Case note data were obtained for 186 elderly primary care attenders who also completed the 15 item Geriatric Depression Scale (GDS15). The presence or absence in the case notes of a current or past diagnosis of depression, of current treatment of depression, and of a number of clinical features of depression were noted. Case notes were also rated for the presence or absence of contraindications to the use of tricyclic antidepressants (TCAs) and to serotonin-specific reuptake inhibitors (SSRIs). ⋯ The former was significantly associated with GDS caseness (P < 0.05). Twenty-four patients (13%) were currently on antidepressants, 19 of them receiving adequate doses (equivalent to at least 75 mg of amitriptyline). Current antidepressant treatment was not associated with GDS 'caseness'.(ABSTRACT TRUNCATED AT 250 WORDS)
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Review
The role of social support in the pathogenesis of coronary heart disease. A literature review.
A possible effect of social support on the pathogenesis of coronary heart disease (CHD) would have practical implications, especially from a general practitioner's point of view. This paper reviews studies on the relationship between social support and CHD/CHD risk factors. ⋯ This conclusion is supported by several investigations indicating that social support is capable of moderating potentially harmful negative emotions and the potentially harmful cardiovascular response to psychological challenge. However, a lack of control with personality factors in most of the studies makes this conclusion uncertain.
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The 1990 contract for general practitioners in the UK offered incentives for them to organize health promotion clinics and required them to perform 'lifestyle' checkups of their patients every 3 years, despite uncertainty about the impact of such checks on patient health. To address this lack of appropriate evaluation, a follow-up study to assess benefits in terms of patient behaviour and health resulting from the introduction of lifestyle checkups in general practice in a sample of more than 7000 patients aged 30-70 from 18 practices in three FHSA areas (in south London, Surrey and Yorkshire) has been performed. Eighteen per cent of the random sample of patients reported having a health check in the previous year. ⋯ Respondents in less privileged socioeconomic groups were more likely to have had a health check, but less likely to have had a 'full' check. Reactions to the checks were mainly positive; 81% regarded the check as helpful, and only 6% reported it to be worrying and 6% a waste of time. The implications for the new health promotion banding system in the UK are discussed.
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During the 1987 Australian winter, respiratory illness patterns were studied in a population of 454 healthy adults, aged 18-59, over a period of 45 days. These patterns were matched with data obtained from laboratory diagnoses for respiratory viruses, Mycoplasma pneumoniae and bacteria. Influenza B/1/86 was by far the most prevalent pathogen but other viruses including influenza A, paramyxoviruses, respiratory syncytial virus and coronavirus OC-43 were also present, either alone or in combination during the sampling period. ⋯ However, there were only 52 instances of viral or M. pneumoniae infections, of which 37 had a defined aetiology, while the remainder were clinically silent. No bacterial pathogens could be detected from throat swabs taken from 15 of 37 volunteers in whom a viral infection was detected, or from 43 of 70 volunteers who did not experience such infections. The study indicates that major deficiencies in our understanding of the aetiology of respiratory viral illness are probably due to methodological problems in obtaining laboratory diagnoses for many respiratory viruses, and that great difficulties exist in establishing an aetiology for respiratory infections based upon clinical symptoms alone.