The Medical journal of Australia
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Comparative Study
A comparison of country and metropolitan general practice.
To provide a description of country general practice in Australia, and to determine the extent to which country and metropolitan general practice differ in terms of the characteristics of the practitioners, the morbidity managed, treatments provided and the availability of support services. ⋯ The general practitioners: Country GPs were less likely to be female or to conduct consultations in a language other than English, and were more likely to do some work on a salaried or sessional basis. GPs from small country towns were older, more likely to be in solo practice, and more likely to belong to a professional organisation. "Remoteness" of towns: Nearly all towns were within 25 km of a hospital, but far fewer small and medium country towns were within 50 km of a base hospital than large country towns. X-ray services were almost universally available within 50 km, and with the exception of small country towns so were pathology services. Access to medical specialists and to a lesser degree other health professionals decreased with population size--patients in 30% of small towns had to travel over 100 km to see many specialists and some health professionals. Self-reported procedural work: GPs in small and medium country towns were more likely than those in large towns to report performing procedural work, the largest difference being in the area of em
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(i) To describe birth size of Aboriginal babies by sex, gestational age, and Aboriginality; (ii) to analyse the results with reference to standards of ponderal index and birthweight for gestational age. ⋯ On the basis of postnatal clinical estimates of gestational age, Aboriginal babies have a preterm rate of 7% and Aboriginal babies without a non-Aboriginal ancestor are smaller in size at birth than babies with a non-Aboriginal ancestor.
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Typhoid remains a disease of major importance world-wide although improvements in public health have made it an exotic disease in developed countries like Australia. Effective antibiotic therapy with the advent of chloramphenicol, which was first used to treat typhoid in the 1940s, has also dramatically altered the natural course of the disease and reduced its mortality rate from around 25% to as low as 1%. The main areas of recent change include the emergence of resistance to previously effective antibiotics, more aggressive intervention in the management of severe typhoid and some of its complications such as perforation, and the development of an oral typhoid vaccine that may replace the equally effective but more unpleasant parenteral vaccination that has been widely used since World War.