OBJECTIVE:To document patients' practices and management of DM2, their satisfaction with diabetes care and their quality of life and functional status.DESIGN:Anonymous questionnaire completed by 467 patients recruited by 204 GPs in 124 practices in the Perth metropolitan area.RESULTS:Patients reported an adequate amount of monitoring for stable DM2. However, they lacked awareness of diabetes risk factors and complications from which they already suffered. Some 90% of patients reported a high level of satisfaction with GP care and only 2.4% of patients had more than a moderate degree of functional disability.CONCLUSION:Patients have a high level of satisfaction about the diabetes care received from their general practitioner. However, they lack awareness of their risk factors and complications of diabetes. A simple strategy is proposed to improve these deficits and to share the responsibility for diabetes care between patient and doctor.

Objective: To assess the effect of a four-week rural attachment on the knowledge and competency of medical students in basic practical and emergency procedures.Design: A before and after comparison of self-reported level of competence in 72 basic, emergency, diagnostic and therapeutic procedural skills.Participants: Eighty-five final year medical students at the University of Western Australia in 1991.Outcome measure: A student was considered competent if he or she claimed to be able to do a procedure either alone or with assistance.Results: Over 50% of students were competent in 57 procedures after the attachment compared with 37 procedures before it. There were 26 procedures in which more than 20% of students increased their competence.Conclusion: A higher priority needs to be paid to the undergraduate teaching of procedural skills. Rural attachments can play an important part in training medical students in the practical skills required of interns.

If research is to be of any use the phenomena being studied must be clearly defined. Almost 30 years ago the difficulty of classifying primary care problems using the International Classification of Diseases (ICD-8) was demonstrated. This led to the development of the International Classification of Health Problems in Primary Care-2-Defined which is based on ICD-9. Despite the work that has gone into the development of ICHPPC-2-Defined, relatively little work has been undertaken to assess the validity and reliability of its use. This paper describes the results of such a study conducted as a preliminary to the use of ICHPPC-2-Defined in a study of consulting patterns in general practice. The participating general practitioners were trained in the use of ICHPPC-2-Defined and then coded problems which they identified in a set of clinical vignettes. Following the coding exercise, a review session was held in which difficulties and errors in the use of ICHPPC-2-Defined were discussed. Subsequently, the general practitioners were required to code two more sets of vignettes, which included some problems repeated from the preceding sets. Comparisons were then made of changes in the validity and reliability of coding from one round to the next. The results of the study suggest that the reliability and validity of morbidity data collected using ICHPPC-2-Defined can be increased by training sessions for the coders which focus on the main sources of error in the use of ICHPPC-2-Defined.(ABSTRACT TRUNCATED AT 250 WORDS)