Family practice
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The present population-based study comprises 84% of all known diabetics cared for at a rural primary health care centre. Patient education has been given high priority as an integral part of the treatment provided by a specially trained nurse and dietician under the supervision of the general practitioners. Most of the patients were under good metabolic control, as reflected by HbA1 (diet-treated, n = 119, 7.3 +/- 1.3%; oral agent-treated, n = 127, 7.8% +/- 1.3%; insulin-treated, n = 110, 8.0 +/- 1.3%; reference range 5.3-7.3%). Obvious reasons for any high HbA1 values were found.
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Serum total cholesterol and lipoprotein analysis was performed on the same blood samples of 139 asymptomatic Chinese subjects aged 40-60 years. There was a highly significant correlation between serum total cholesterol and low density lipoproteins (correlation coefficient = 0.8376, p less than 0.001) in Chinese, which means that total cholesterol can be used as the initial screening to identify individuals who may need lipoprotein analysis. ⋯ Thirty to forty per cent of the lipoprotein analyses recommended by the ANCEP guidelines were not necessary. There was no significant age or sex influence on the degree of correlation between serum total cholesterol and LDL.
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An analysis is made of the pattern of presenting premenstrual symptoms in randomly selected general practice patients from the Wellington region, New Zealand. Participants, 1826 healthy women 16-54 years old whose characteristics were reasonably representative of the adult female population, were asked about their general, obstetrical and gynaecological health. For the 1456 women who had menstruated within the last month or so, detailed questions were asked about the last menstrual cycle. ⋯ The last group contains a large number of women with miscellaneous symptoms. Characteristics of these groups are outlined. The study highlights the importance of distinguishing among premenstrual syndromes as this can foster more effective clinical management.
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The discussions are led by a psychoanalyst, or someone in touch with the approach fostered by psychoanalysis, and the group is helped to develop an atmosphere of tolerance and safety. Participants are thus able to discuss cases that represent the personal difficulties they are currently experiencing in their daily work. This report is about one group whose members agreed to allow the process of their work to be studied. ⋯ It also describes methods used to assess the quality of learning and the changes in personal attitudes. A Balint group has a safe and defined mode of working but no specific agenda, save that provided by the personal cases presented by those who come regularly to its sessions. This study aims to describe the kind of experience such a group can offer to intending participants.
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In a study in Sweden of 160 consultations, general practitioners and patients separately assessed their satisfaction with the consultation length and the ability of the patient to explain the problem. These assessments were compared with each other and were correlated with the actual length of the consultation. The mean length of the consultations was 21 minutes with a great variation between different doctors. ⋯ The patients were on the whole more satisfied than the doctors. There was no evidence that longer consultations gave more satisfaction for either doctors or patients. The doctors not only registered more psychological problems than the patients but they were more likely to register insufficient time for discussing psychological problems.