Biomedical subjects
Publications and source records attributed to I D Steven.
The fifth edition of the Australian Immunisation Procedures Handbook updates what has become an important reference and practical guide to immunisation practice in Australia. A number of significant changes have been incorporated into this edition. The purpose of this paper is to alert and remind general practitioners of these changes.
A guidelines committee representing 20 professional organisations involved in the management of work related lumbo-sacral injury was convened in South Australia to formulate a consensus plan of management for this complex problem. This paper outlines the development and the content of the agreed guidelines.
Hepatitis C is particularly prevalent among injecting drug users. The infection is asymptomatic over 50% of the time. A significant proportion of those infected ultimately develop cirrhosis or carcinoma of the liver or both. While prevention is the best form of treatment, alpha interferon may benefit up to 30% of those with active infection.
Diabetes mellitus is a chronic disease commonly managed in general practice. This article reviews the findings of a questionnaire survey of 173 randomly chosen South Australian general practitioners and their reported management in the areas of detection, diagnosis, assessment, monitoring and GP knowledge. Substantial differences between respondents were found in all areas, suggesting the need for improved educational methods aimed at all general practitioners.
AIM: This study, carried out in 1989, set out to assess general practitioners' knowledge of asthma management and their reported management practices. METHOD: Of 153 randomly selected South Australian general practitioners 127 (83%) completed a questionnaire designed to explore issues relating to the management of asthma. RESULTS: The survey revealed substantial differences between general practitioners in their knowledge and management practices including the assessment of the severity of asthma, the need for objective monitoring, that is by the use of spirometry and peak flow meters, and the use of medication. Overall, the sampled general practitioners believed that patient-related factors were the main barriers to effective treatment of asthma. CONCLUSION: The findings of this study suggest that ideal asthma management was not being attained. More research is required to ascertain why such variability among practitioners exists and how best to remedy these differences.
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OBJECTIVE: To evaluate the effect of prazosin on the symptoms of benign prostatic hypertrophy for patients of general practitioners. SETTING AND PATIENTS: Eighty-two general practitioner patients from 317 who were identified as being eligible for inclusion in the trial. They were randomly allocated to receive either prazosin or placebo for the first 3 month arm then crossed-over for the second 3 months. RESULTS: Seventy-six patients completed the trial. An analogue scale of patient rating of symptoms showed a statistically significant decrease in symptoms for patients taking prazosin when compared with patients taking placebo, regardless of the order in which they had been administered. A total symptom score and an obstructive symptom score for benign prostatic hypertrophy showed a statistically significant difference between the two treatments at 4 weeks. A difference was still apparent at 8 and 12 weeks but it was not statistically significant. No difference was detected for irritative symptoms. CONCLUSION: Prazosin may have a limited place in the management of benign prostatic hypertrophy.
Some educational, training and politico-economic reasons for the decline in GP obstetrics in Adelaide, South Australia, are described. It is recommended that similar studies be done in other centres in Australia to evaluate the general nature of the findings.
Our results indicate that most demonstration practice grant holders in South Australia and the Northern Territory accept and regularly access facilitator services. Grant holders had little experience with granting body procedures and most frequently discussed administrative matters regarding their individual projects with the facilitator. Concerns about project progress and evaluation issues were other popular topics discussed during grant holder facilitator interactions. The present study did not seek to measure the impact of facilitation on the success of projects. A further study should be undertaken to examine the efficacy and effectiveness of facilitation on project outcome.
Haemophilus influenzae type b (Hib) is a bacterial pathogen that causes serious, sometimes fatal, infections primarily in young children, especially in the second 6 months of life. Immunisation of children against Hib is now an important issue and four conjugate Hib vaccines have become available. The various vaccines, and their characteristics are documented in this paper.
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There are many ways of improving immunisation rates in a practice. For most practices, however, the best methods will be a combination of opportunism, and accurate knowledge of contraindications. This means ensuring that every child that walks through the door will, if appropriate, be offered immunisation, and that children are not inappropriately excluded from immunisation.
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Hypertension is only one factor in the ultimate risk of developing cardiovascular or cerebrovascular disease. An outline of the relative importance of other factors, and the expected benefits from their modification is presented.
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OBJECTIVE: To investigate prescribing habits, educational approaches and perceived needs of general practitioners in the drug treatment of hypertension. DESIGN, SETTING AND PARTICIPANTS: Of 156 randomly selected South Australian general practitioners 132 responded to a questionnaire survey. MAIN FINDINGS: Diuretics are the most commonly chosen drug for the initial management of uncomplicated moderate hypertension. Equivalent patients aged 45, 60 and 75 years would be prescribed a diuretic as drug of first choice in 41%, 55% and 68% of cases respectively. Despite this, there are wide differences in the choice of initial therapy between individual practitioners. These differences can have a substantial cost impact, given that in Australia the cost of diuretic therapy for one month can be as low as $1.97 compared with $34.08 for standard angiotensin converting enzyme inhibitor therapy for one month. There was also a perceived need, and demand, for patient education materials to assist practitioners in the drug treatment of hypertension.
OBJECTIVE: To survey South Australian general practitioners to investigate their knowledge and reported management of patients with hypertension. DESIGN, SETTING AND PARTICIPANTS: Of 156 randomly selected SA general practitioners 132 responded to a questionnaire survey. RESULTS: This survey showed substantial differences between general practitioners in their knowledge about hypertension and in their reported practices for diagnostic levels, investigations to be undertaken once diagnosis had been made, levels at which pharmaceutical treatment should be initiated, at which level treatment was regarded as having attained satisfactory control, and length of time for routine review. There was also a demand for materials to be provided to assist in the management of this important condition. CONCLUSIONS: There is a perceived need for better and more appropriate educational materials and a need for a different approach to try and reduce the reported variability in management of patients with hypertension by general practitioners.
This paper explores the development and use of a Patient Satisfaction Questionnaire which was chosen by members of the South Australian Quality Assurance Research Officers' Association (SAQAROA) as a method of learning how to undertake quality assurance. Overall this process was rated as being successful by the members. Use of the Questionnaire revealed high overall satisfaction with services being provided. However, for most questions one or more hospitals returned comparatively high dissatisfaction rates, the significance of which was not appreciated until comparative data became available.