Training medical practitioners in information transfer skills: the new challenge.

Traditionally, undergraduate medical education has concentrated on teaching students how to gather information or take medical histories from their patients. However, research increasingly indicates that there is a need for medical practitioners to improve their skills in information transfer in a way which will increase the probability that patients are active collaborators in their treatment. Consequently, Newcastle Medical School has sought to develop training packages for medical students in information transfer skills.

Mechanisms of presynaptic inhibition studied using paired-pulse facilitation.

An investigation was made of the effect of presynaptic inhibition on paired-pulse facilitation (PPF) of group Ia afferent excitatory postsynaptic potentials (EPSPs). The main finding from this study was that PPF was enhanced during presynaptic inhibition of compound Ia EPSPs. This increase in PPF is identical to that seen at other synapses when the probability of transmitter release is decreased by lowering the extracellular calcium or raising the extracellular magnesium concentration, providing unequivocal evidence that presynaptic inhibition is associated with a decrease in the probability of transmitter release.

Prevalence and characteristics of women who have had a hysterectomy in a community survey.

A community survey of 8,896 households was undertaken in the Hunter region of New South Wales to assess women's health status. Consent was gained from 5,781 of the 6,361 eligible women between 18 and 69 years of age. The prevalence of hysterectomy in this sample was 16.

The reliability and stability of a quantity-frequency method and a diary method of measuring alcohol consumption.

The study aimed to assess the test-retest reliability of two commonly used measures of alcohol consumption, the quantity-frequency (QF) method and the diary method, as well as the stability of scores on the two measures over time. Two methods of assessing reliability and stability were employed. The first was a traditional method based on calculation of correlation coefficients for agreement between scores on repeated measures over a short retest interval to yield test-retest reliability coefficients, and over a long retest interval to yield stability coefficients.

The accuracy of Pap smear utilization self-report: a methodological consideration in cervical screening research.

One method used to determine utilization rates of cervical screening is women's self-report. Few studies have assessed the accuracy of this measure--none has been conducted in Australia--although there are a number of reasons for suspecting its validity. This study examined and quantified the accuracy of self-report of Pap smear use among a randomly selected sample of women from an Australian community.

Screening for melanoma: a community survey of prevalence and predictors.

Australian cancer councils recommend the practice of regular self screening of the skin or screening by another person for signs of melanoma and other skin cancers. They also recommend that medical practitioners screen adult patients annually. This study examined the prevalence and predictors of self screening (or screening by another person) and screening by a general practitioner in 1344 individuals from randomly selected households.

A community study of delay in presenting with signs of melanoma to medical practitioners.

In the absence of more effective treatment for advanced tumors, early diagnosis and treatment of localized tumors is the most effective way of reducing the burden of illness associated with melanoma. This study examined the following factors: prevalence of signs of melanoma (a mole changing in size, shape, appearance, or color, itching or tingling, bleeding or weeping, becoming raised) in 1344 individuals in a randomly selected sample of 1075 households; the length of delay in seeking medical advice; the factors associated with either going to a medical practitioner or not going/delaying; and the actions of the medical practitioners when first presented with these signs. The results indicate that a large proportion of the sample (11.

Cancer patient satisfaction with care.

A diagnosis of cancer places considerable stress on patients and requires them to make major adjustments in many areas of their lives. As a consequence, considerable demands are placed on health care providers to satisfy the complex care needs of cancer patients. Currently, there is little available information to indicate the extent to which cancer patients are satisfied with the quality of care they receive.

Drug research: a comparison of ongoing research and perceived research priorities.

Since drug abuse results in high costs to the community, it is vital that research funding be allocated in a way which ensures a maximum improvement in health for the money spent. This study explores the extent to which current research into drug and alcohol abuse in Australia reflects perceived research priorities. Two hundred and seventy-four ongoing research projects into drug and alcohol misuse were identified.

The effectiveness of two smoking cessation programmes for use in general practice: a randomised clinical trial.

Objective: To evaluate a structured, behavioural change, smoking cessation intervention designed for use within general practice.

Design: Randomised controlled clinical trial.

Setting: General practices in Newcastle, Australia.

Breast self-examination and breast examination by a health care provider: prevalence and predictors of screening in a randomly selected sample of Australian women.

Professional organizations recommend the practice of monthly breast self-examination (BSE), and examination of the breasts by a health care provider every three years for women up to the age of 40 and annually thereafter. These practices were examined in a randomly selected sample of 1454 women. Only 39% (95% confidence interval [CI], 36%-42%) of the sample reported monthly BSE.

Comparison of a quantity-frequency method and a diary method of measuring alcohol consumption.

This study compared the results obtained with two measures of alcohol consumption, a quantity-frequency (QF) method and a retrospective diary method, using a worksite sample. In order to control for the possibility of order effects, a subsample was chosen for readministration of the alcohol measures, when the order of presentation of the two measures was reversed for half of the subsample. Varying the order of presentation of the alcohol consumption items did not significantly affect the results obtained, except for an interaction effect between drinking group and order of presentation.

The prevalence and sociodemographic correlates of high-risk and problem drinking at an industrial worksite.

The study of 833 employees aimed to determine the prevalence and sociodemographic correlates of high-risk and problem drinking in an industrial population. Variables measured included stressful life events, neuroticism, job satisfaction, years of service, job classification and type of shift. As measured by a 7-day retrospective diary, 12.

The time course and amplitude of EPSPs evoked at synapses between pairs of CA3/CA1 neurons in the hippocampal slice.

Unitary EPSPs were evoked in CA1 pyramidal neurons by activation of single CA3 pyramidal neurons. Seventy-one EPSPs were recorded. The peak amplitudes of these EPSPs ranged from 30 to 665 microV with a mean of 131 microV.

Evaluation of long-term potentiation of small compound and unitary EPSPs at the hippocampal CA3-CA1 synapse.

Long-term potentiation (LTP) was evaluated for small monosynaptic CA3-mediated EPSPs in CA1 neurons in the guinea pig hippocampal slice. Small EPSPs included those elicited by stimulation of Schaffer axon collaterals of several CA3 neurons (160-480 microV amplitude, n = 40 EPSPs in 40 neurons) and those elicited by stimulation of an individual CA3 neuron (89-563 microV amplitude, n = 14 EPSPs in 11 neurons). Various protocols were employed to induce LTP and were deemed successful as evaluated by recording sustained enhancement of the mean peak amplitude of conventionally elicited large compound EPSPs and extracellular field potentials.

General practitioners and the provision of Papanicolaou smear-tests: current practice, knowledge and attitudes.

General practitioners are the main providers of Papanicolaou smear-tests yet, given the current suboptimal rates of cervical screening, it is clear that their full potential as screening providers is not being realized. To date, no information has been available concerning the possible barriers to the provision of Papanicolaou smear-tests by general practitioners. The present study assessed the views of a random sample of NSW general practitioners regarding the value of smear-tests, the most appropriate providers, the recommended screening protocol, and factors that were thought to influence both practitioners' provision and women's utilization of screening.

Feasibility of sigmoidoscopic screening for colorectal cancer in the Hunter Region.

The success of a cancer detection programme depends on the co-operation of the target population. The aim of this study was to identify factors which might influence those at average and at higher risk of developing colorectal cancer to undergo a sigmoidoscopic screening test if offered. This was addressed by means of a household survey of individuals aged 40 years and over.

Voltage dependence of Ia reciprocal inhibitory currents in cat spinal motoneurones.

1. Inhibitory postsynaptic currents (IPSCs) were recorded in voltage clamped posterior biceps or semitendinosus motoneurones of the cat during reciprocal inhibition. 2.

Community views about the role of general practitioners in disease prevention.

The role of preventive medicine in reducing mortality and morbidity is now widely recognized. Although general practitioners appear to be in an excellent position to offer preventive care, there is evidence that they currently do not detect or intervene for common risk behaviours. One reason for this may be the general practitioner's perception that patients do not expect such preventive activities to be a part of the doctor's role.

Measuring quality of life in cancer patients.

The diagnosis and management of cancer can have a major impact on every aspect of a patient's quality of life. Despite its importance, quality of life is rarely a reported outcome in randomized clinical trials in cancer patients. Failure to collect quality-of-life information may reflect a lack of information among researchers and clinicians about the adequacy and relative merits of measures available for assessing quality of life.

Reduction by general anaesthetics of group Ia excitatory postsynaptic potentials and currents in the cat spinal cord.

1. The effects of thiopentone and halothane on excitatory synaptic transmission at group Ia afferent synapses on lumbosacral motoneurones were studied in the anaesthetized or decerebrate cat. 2.

Filtering effects in reporting work injuries.

Research efforts in the field of occupational injuries have been hampered by difficulties in ascertaining true prevalence rates. Lack of accuracy in reporting and documentation of work injuries leads to loss of information and lack of comparability of work injury statistics. The paper explores some of the factors related to loss of information about work injuries and proposes a descriptive model of the information processing system.

Amplitude fluctuations in small EPSPs recorded from CA1 pyramidal cells in the guinea pig hippocampal slice.

EPSPs have been evoked in CA1 pyramidal cells by (1) activation of single CA3 neurons (unitary EPSPs), and (2) low-intensity stimuli to the CA1 stratum radiatum. Five unitary EPSPs were obtained; their mean peak amplitudes ranged from 85 to 275 microV and 3 of the 5 showed fluctuations in amplitude that were too great to be attributed to baseline noise. After subtraction of the variance due to the noise, these EPSPs had coefficients of variation much higher than those reported for variability in the quantal EPSP in other preparations.

Patient-provider interactions and patient outcomes.

Research shows that a number of provider interactional skills are empirically related to patient adherence, making interaction skills a necessary and important part of clinical competence. These skills fall into three broad categories: techniques to elicit and modify patients' health and treatment beliefs, to aid recall of information, and to aid adherence. Specific skills in each category are discussed.