Screening for cervical cancer in general practice.
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Biomedical subjects
Publications and source records attributed to J O Woods.
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The results of a questionnaire were used to examine how primary care workers set about the management and surveillance of their elderly patients. The majority of practices had attached visitors (76 per cent) and attached district nurses (59 per cent), while 61 per cent of general practitioners worked in health centres. Over half of the responding practices had agesex registers. Few of the practices (14 per cent) had screened their elderly patients in the last five years and maintained an ;at-risk' register. Twenty per cent of practices held a regular meeting concerning their elderly patients but only half of these reviews involved the available health visitors and district nurses.At least half of the general practitioners and district nurses plus three quarters of the health visitors felt dissatisfied with the care of the elderly.A single and systematic review of elderly patients conducted jointly by general practitioners, health visitors and district nurses would do much to improve the care of this group of patients and the morale of these workers.
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Four hundred and eighty-one (75 per cent) of the male patients between 35 and 55 years of age in a health centre group practice were screened for risk factors for coronary heart disease. An attempt was made to alter these factors and the effectiveness of the intervention was later assessed. We consider that where there is an attached health visitor a screening programme can be carried out as part of general practice without too great an increase in work-load for the general practitioner. The continued surveillance of those at risk and the alteration of the risk factors is more arduous. We think the assistance of the other health care professionals such as the area health education officer and dietician is essential in such a programme.
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This paper describes a system of record keeping emphasising:(1) The collection of basic data on each patient recorded on a summary card,(2) The recording of chronic or continuing illnesses on the summary card,(3) The typing of medical records, at least the typing of referral letters with the retention of a copy in the record folder,(4) The use of a problem orientated record and a problem sheet either separately or as part of the summary card,(5) The use of a drug card,(6) The use of other specialised cards for special interests or clinics i.e. paediatric and geriatric cards.
A survey of perinatal mortality in Northern Ireland has shown that despite a progressive fall in the proportion of deliveries at home the perinatal mortality rate in domiciliary practice has risen in recent years. Overall, however, the perinatal mortality rate for all deliveries compares well with English figures. It seems that as the proportion of deliveries in hospital and general-practitioner obstetric unit rises a hard core of high risk patients is left who insist on delivery at home. Three prerequisites for good general-practice obstetrics are careful selection of cases, intelligent antenatal care, and close co-operation between the general practitioner and the consultant.