Objective To examine knowledge, attitudes and beliefs of general practitioners (GPs) in the field of drug and alcohol related health problems. Design A cross‐sectional survey in which self‐completion postal questionnaires were sent to all identifiable GPs in the Adelaide metropolitan area. Non‐responders received a reminder letter and second questionnaire. Setting, participants The target population was doctors whose principal activity was general practice, or who were in training for general practice. Main outcome measures Demographic and “practice characteristic” information on participants. Measures of knowledge, attitudes and beliefs regarding alcohol consumption, smoking and over the counter medication. Results The response rate was 59.8%. More responders than non‐responders were affiliated with the Royal Australian College of General Practitioners. Alcohol consumption was perceived to be a more difficult issue than smoking to raise during consultations. GPs indicated that significant proportions of their patients were participating in hazardous drinking (mean estimate was 13.8% of patients), but only a third of respondents believed their effort in changing alcohol related behaviour would be effective. Sixty‐ one per cent of respondents identified hazardous daily levels of alcohol consumption for men consistent with National Health and Medical Research Council guidelines. In the case of women this figure was 42%. Longer reported appointment times were associated with greater reported levels of enquiry about alcohol consumption. Conclusions New developments in medical training and systems of payment in general practice need to address both the pessimistic attitude of GPs in dealing with drug and alcohol related health problems, and apparent inconsistencies in defining hazardous alcohol consumption.

Objectives-To determine the level of agreement between senior medical staff when asked to perform retrospective case note review of nursing triage decisions, both before and after development of a consensus approach. Methods-Four medical reviewers independently allocated triage categories to 50 emergency department patients after review oftheir case notes. They were blind to the identity of the triage nurse and their triage categorisation. The process was repeated twice, firstly after agreement on a consensus approach and then using formal guidelines. Results-Agreement between reviewers was initially fair to moderate (ic = 0.27 to 0.53). This failed to improve after development of a consensus approach (K = 0.29 to 0.57). There was a trend towards better agreement when guidelines were used but agreement was still only moderate (I = 0.31 to 0.63).Conclusions-Audit of nurse triage categorisation by senior medical staff performing case note review has only fair to moderate consistency between reviewers. Use ofthis technique will result in frustration among those whose performance is being audited if they recognise inconsistency in the standard they are compared against. (JAccid Emerg Med 1999;16:322-324)

Background: Injury-causing events are not randomly distributed across a landscape, but how they are associated with the features and characteristics of the places where they occur in Arizona (AZ) remains understudied. Clustering of trauma events and associations with areal sociodemographic characteristics in the greater Phoenix (PHX), AZ region can promote understanding and inform efforts to ameliorate a leading cause of death and disability for Arizonans. The outcomes of interest are trauma events unrelated to motor vehicle crashes (MVC) and the subgroup of trauma events due to interpersonal assaults. Methods: A retrospective, ecological study was performed incorporating data from state and national sources for the years 2013-2017. Geographically weighted regression models explored associations between the rates of non-MVC trauma events (n/10,000 population) and the subgroup of assaultive trauma events per 1000 and areal characteristics of socioeconomic deprivation (areal deprivation index [ADI]), the density of retail alcohol outlets for offsite consumption, while controlling for race/ethnicity, population density, and the percentage urban population. Results: The 63,451 non-MVC traumas within a 3761 mile 2 study area encompassing PHX and 22 surrounding communities, an area with nearly 60% of the state's population and 54% of the trauma events in the AZ State Trauma Registry for the years 2013-2017. Adjusting for confounders, ADI was associated with the rates of non-MVC and assaultive traumas in all census block groups studied (mean coefficients 0.05 sd. 0.001 and 0.07 sd. 0.002 for non-MVC and assaultive trauma, respectively). Alcohol retail outlet density was also associated with non-MVC and assaultive traumas in fewer block groups compared to ADI. Conclusion: Socioeconomic deprivation and alcohol outlet density were associated with injury producing events in the greater PHX area. These features persist in the environment before and after the traumas occur. Ongoing research is warranted to identify the most influential areal predictors of traumatic injury-causing events in the greater PHX area to inform and geographically target prevention initiatives.