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Objectives: To describe Victorian general practitioners' attitudes towards and use of a range of complementary therapies.Design: A self-adm inistered postal survey sent to a random sample of 800 general practitioners (GPs) in Victoria in July 1997.Participants: 488 GPs (response rate, 64%). Main outcome measures:GPs' knowledge; opinions about harmfulness and effectiveness; appropriateness for GPs to practise ; perceived patient demand ; need for undergraduate education; referral rates to complementary practitioners; and training in and practice of each therapy.Results: Acupunctu re, hypnosis and meditation are well accepted by the surveyed GPs, as over 80% have referred patients to practitione rs of these therapies and nearly half have considered using them. General practitioners have trained in various therapies -meditation (34%), acupuncture (23%), vitamin and mineral therapy (23%), hypnosis (20%), herbal medicine (12%), chiropractic (8%), naturopathy (6%), homoeopathy (5%), spiritual healing (5%), osteopathy (4%), aromatherapy (4%), and reflexology (2%). A quarter to a third were interested in training in chiropractic, herbal medicine, naturopathy and vitamin and mineral therapy. General practitioners appear to underestimate thei r patients' use of complementary therapies .Conclusions: There is evidence in Australia of widesp read acceptance of acupunctu re, meditation , hypnosis and chiropract ic by GPs and lesser acceptance of the other therap ies. These findings generate an urgent need for evidence of these therapies ' effectiveness.With otler 36','" updates included and ",.. of Australia's doctors listed, you can rely on the MDA etlen more for your medical contact information! Brand new data on doctors and otherhealthcare professionals are now available in the Year 2000 Commemorative edition of The Medical Directory of Australia. Withover360,000 updates, the MDA contains the most accurate and comprehensive Information on over99% of Australia's doctors and otherhealthcare professionals. You will find information on over55,000 doctors, over 4,000

Patient privacy incidents occur frequently in an ED, risk factors being length of stay and absence of a walled cubicle. Patients who have their conversations overheard are more likely to withhold information from staff and less likely to have had their expectations of privacy met.

Persistent nipple pain in lactating women, burning in nature, and associated with radiating breast pain, has been claimed by some authorities to be due to ‘thrush’ (candida) infection. Yet, scientific proof has been lacking. This study compared microbiological assessment of 61 women with nipple pain, 64 women without nipple pain, and 31 non-lactating women. Swabs ofthe nipple and baby’s mouth, and expressed breast milk were collected for culture. Growth of Candida albicans (nipple and milk) was found more often in the women with nipple pain (19%) than in the control group (3%, p < 0.01). In addition. Staphylococcus aureus was also associated with nipple pain (p < 0.0001), and independently associated with nipple fissures (p < 0.0001). Neither C. albicans nor S. aureus was found on the nipples ofthe non-lactating group.

In this model of heart failure, ventricular constraint with a polyester jacket diminished the deterioration in cardiac function associated with progressive dilated cardiomyopathy. These results suggest that maintainance of a more normal cardiac size and shape may be beneficial in patients with dilated cardiomyopathy.

Objective: To survey prevocational doctors working in Australian hospitals on aspects of postgraduate learning. Participants and setting: 470 prevocational doctors in 36 health services in Australia, August 2003 to October 2004. Design: Cross‐sectional cohort survey with a mix of ordinal multicategory questions and free text. Main outcome measures: Perceived preparedness for aspects of clinical practice; perceptions of the quantity and usefulness of current teaching and learning methods and desired future exposure to learning methods. Results: 64% (299/467) of responding doctors felt generally prepared for their job, 91% (425/469) felt prepared for dealing with patients, and 70% (325/467) for dealing with relatives. A minority felt prepared for medicolegal problems (23%, 106/468), clinical emergencies (31%, 146/469), choosing a career (40%, 188/468), or performing procedures (45%, 213/469). Adequate contact with registrars was reported by 90% (418/465) and adequate contact with consultants by 56% (257/466); 20% (94/467) reported exposure to clinical skills training and 11% (38/356) to high‐fidelity simulation. Informal registrar contact was described as useful or very useful by 94% (433/463), and high‐fidelity simulation by 83% (179/216). Most prevocational doctors would prefer more formal instruction from their registrars (84%, 383/456) and consultants (81%, 362/447); 84% (265/316) want increased exposure to high‐fidelity simulation and 81% (283/350) to professional college tutorials. Conclusion: Our findings should assist planning and development of training programs for prevocational doctors in Australian hospitals.

Objective: To explore a possible association between Helicobacter pylori infection and iron status. Design: Cross‐sectional study. Setting: Ballarat (a major regional city in Victoria), population 78000, October­ November 1997. Participants: 160 women and 152 men, a subsample of participants in a cardiovascular disease risk factor prevalence survey for whom frozen plasma was available. Main outcome measures: H. pylori lgG antibody status by enzyme immunoassay; iron intake; plasma iron, transferrin and ferritin concentrations. Results: 28% of women and 33% of men were infected with H. pylori. The mean (SEM) plasma ferritin concentration of infected women (59.3 (7.6) µg/L) was significantly lower than for non‐infected women (88.8 (7.9) µg/L; P=0.002), after adjusting for age. Mean daily dietary iron intakes were similar in infected and non­ infected women. Conclusions: H. pylori infection appears to be an additional stressor on women's iron status, but the mechanism remains to be determined.

Objective To investigate the prevalence of Helicobacter pylori infection and potential risk factors for infection in an adult Australian population. Design Cross‐sectional study. Setting Ballarat, a major regional city in Victoria (population, 78 000; 92% born in Australia), November 1994 to July 1995. Participants 217 adults randomly selected from the electoral roll. Main outcome measures H. pylori lgG antibody status by enzyme immunoassay; amount of dental plaque; sociodemographic and other potential risk factors; odds ratios for risk factors determined by logistic regression analysis. Results Age‐standardised prevalence of H. pylori infection was 30.6%. After adjustment for age, sex and socioeconomic index, positive H. pylori status was significantly associated with increasing number of tooth surfaces with a high plaque score (odds ratio [OR], 1.7; 95% confidence interval [Cl], 1.1‐2.7), increasing number of years in a job with public contact (OR, 1.7; 95% Cl, 1.3‐2.3), blood group B antigen (OR, 3.1; 95% Cl, 1.1‐9.1), and having lived in a household with more than six members during childhood (OR, 2.5; 95% Cl, 1.1‐5.5). Negative H. pylori status was significantly associated with increasing education, having ever lived on a farm, and having teeth scaled less than once a year. Conclusions H. pylori infection is common. Dental plaque may be a reservoir for H. pylori, which is probably transmitted by person‐to‐person contact, and blood group B antigen may predispose to infection. Community education about effective oral hygiene and adoption of good hygiene practices by those with regular public contact may be important to prevent acquisition and transmission of H. pylori.