Teaching and learning at the primary - secondary care interface: work in progress?

Teaching and learning across the primary -secondary care interface is more described than actually carried out. As such it could be said this mirrors patient care across the same interface. We argue that for very good reasons generalists and specialists could do a lot more learning together than they currently do.

Characteristics and career intentions of Scottish rural and urban GP registrars: cause for concern?

Objectives: To investigate the differences between the characteristics and career intentions of GP registrars in urban and rural areas, and to make recommendations to reduce a potential work force crisis in rural practice.

Design: Postal survey.

Setting: All general practices in Scotland.

A confidential enquiry into methadone-related deaths.

Aim: To assess the acceptability and usefulness of the "confidential enquiry" process in examining methadone-related deaths.

Design: An audit of patient care.

Setting: Glasgow, Scotland, UK (population 915,000) Participants.

Sex and attitude: a randomized vignette study of the management of depression by general practitioners.

Background: The management and detection of depression varies widely, and the causes of variation are incompletely understood.

Aims: To describe and explain general practitioners' (GPs') current practice in the recognition and management of depression in young adults, their attitudes towards depression, and to investigate associations of GP characteristics and patient sex with management.

Method: All GP principals in the Greater Glasgow Health Board were randomized to receive questionnaires with vignettes describing increasingly severe symptoms of depression in either male or female patients, and asked to indicate which clinical options they would be likely to take.

Randomised controlled trial of effect of Baby Check on use of health services in first 6 months of life.

Objective: To evaluate the effect of Baby Check, an illness scoring system for babies of 6 months or less, on parents' use of health services for their baby.

Design: Randomised controlled trial.

Setting: 13 general practices in Glasgow.

Evidence and clinical judgement.

Widespread acceptance of the neologism 'evidence-based medicine' (EBM) has had the consequences of obscuring what evidence really is, and of eroding the importance of judgement in clinical situations. In this essay I seek to correct this lack of balance in the view of clinical encounters as portrayed by EBM. A better understanding of what evidence is can be obtained by looking beyond medicine to the way in which scientists and detectives view evidence.

Attitudes of general practitioners who practice in remote island communities.

Objective: To describe the personal, social and medical attitudes of doctors who practice on the islands off the West coast of Scotland.

Design: Questionnaire survey with a single follow-up.

Subjects: All 65 general practitioners (GPs) who practice on the 17 islands located off the West coast of Scotland.

Special study modules: an opportunity not to be missed.

The General Medical Council's (GMC's) Tomorrow's Doctors has proposed a radical rethink of undergraduate medical education. The two main planks of the proposals are the core curriculum and special study modules (SSMs) or options. Medical schools around the country have been much exercised in creating their core curricula but there has been less time given to a consideration of the SSMs.

Is lead in tap water still a public health problem? An observational study in Glasgow.

Objective: To assess the relation between tap water lead and maternal blood lead concentrations and assess the exposure of infants to lead in tap water in a water supply area subjected to maximal water treatment to reduce plumbosolvency.

Design: Postal questionnaire survey and collection of kettle water from a representative sample of mothers; blood and further water samples were collected in a random sample of households and households with raised water lead concentrations.

Setting: Loch Katrine water supply area, Glasgow.

All together now: why social deprivation matters to everyone.

Inequalities in health in the United Kingdom are widening as a result of economic policy. By focusing on specific diseases, health policy fails to address why less prosperous groups die earlier from most major categories of death. By concentrating on actions which can be taken by individuals and local communities health policy ignores actions which require the support and involvement of society as a whole.

Has general practitioner computing made a difference to patient care? A systematic review of published reports.

Objective: To review findings from studies of the influence of desktop computers on primary care consultations.

Design: Systematic review of world reports from 1984 to 1994.

Setting: The computerised catalogues of Medline, BIDS, and GPlit were searched, as well as conference proceedings, books, bibliographies, and references in books and journal articles.

How to do it. Get patients' consent to enter clinical trials.

Gaining patients' consent to enter clinical trials is essential, but not easy. Giving careful thought to the design of the study itself, information which patients receive, and the use of a signed consent form may all help. To be properly informed, patients need to know something about their condition, the proposed study, and alternative options.

Intruders in the consultation.

A confidential consultation is the essence of family practice. That confidentiality is currently under attack from a number of disruptive influences. Several of these are physical intruders: telephone calls, undergraduate and postgraduate students, video recorders, computers, guidelines, protocols and health promotion activities.

Who are the providers of postgraduate medical education?

The view, background and motivation of providers of medical education was studied using a structured questionnaire which was sent to all those who organized courses for the Postgraduate Education Allowance in the West of Scotland. Two hundred and twenty-five replies were received from 254 course providers, giving an 88.6% response rate; 51.

Survey of minor surgery in general practice in the west of Scotland.

Since April 1990 certain minor surgical procedures have attracted an item-of-service payment for general practitioners (GPs). A postal survey was undertaken to obtain information about minor surgery in general practice in the West of Scotland and to find out whether further postgraduate education is required in this field. From a random stratified sample of 356 GPs, 311 (87.

Cisapride in functional dyspepsia: a double-blind, placebo-controlled randomized trial in general practice patients.

This trial included patients from general practice with endoscopy-negative chronic dyspepsia and epigastric pain or discomfort. Eleven eligible patients with sufficiently severe dyspeptic symptoms after a 2-week placebo run-in period were entered into a 4-week, parallel group, double-blind randomized comparison of 10 mg cisapride three times daily and matched placebo, and were subsequently evaluable. Symptoms were comparable in the two treatment groups at the start of double-blind treatment.

Argyll and Clyde general practitioners' attitudes to standard setting in hypertension.

A questionnaire was sent to a one in five sample (68 GPs) of General Practitioners (GPs) in Argyll and Clyde Health Board to determine attitudes to standard setting in hypertension and the response rate was 80.7% (55 GPs). Thirty-six GPs (65.

Children seen frequently out of hours in one general practice.

Objective: To identify reasons why some children receive more out of hours visits than most.

Design: A one year prospective study to identify the study group. This was followed by a case-control study involving a record search and personal interviews.

Rheumatology at the general practitioner/hospital interface: a study of prevalence and access to specialist care.

Four general practices with a combined population of 23,300 in the west of Scotland participated in a record research and questionnaire assessment of 551 patients with rheumatic diseases. The study describes the prevalence, levels of disability found, and the types of service used. Even with this number of patients it was not possible to detect any significant differences in disability levels, use of second line drugs, or aids/appliances when comparing practices with adequate or inadequate access to rheumatological facilities (general practitioner perception).