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Controversies about risks to public health regularly hit the news,
whether about food safety, environmental issues, medical
interventions, or "lifestyle" risks, such as drinking. To those
trying to manage or regulate risks, public reactions sometimes seem
bizarre. To the public, the behavior of those supposedly "in
charge" can seem no less odd. Trust is currently at a premium.
A significant number of patients seen by general practitioners are suffering from infections. Although many of these are minor and self-limiting, they provide an important opportunity for improving the doctor's own understanding of the patient's response to illness, and for enabling the GP to educate the patient in ways in which certain infections may be prevented. Infectious diseases are also a major cause of mortality and morbidity in the modern developed world and, with more people travelling internationally than ever before, there is an increased risk of the spread of serious, non-endemic disease. An important part of the primary health care team's work is directed towards the prevention of infection through health education, immunization, or a combination of both these approaches. Infection provides a unique insight into the role of infection, seen from the combined perspective of GPs, an infectious diseases physician, and a medical microbiologist. It provides detailed information on the wide range of infections which are seen by GPs, including trivial viral infections, life-threatening acute bacterial meningitis, and imported infections such as malaria or typhoid fever. Included are case histories which reflect common practice both in primary care and within the hospital setting, as well as proposed guidelines for the management of infections which may present in general practice. Throughout the authors emphasize the role of teamwork as well as prevention in contemporary primary care through improved patient education.
The application of audit to resource allocation and clinical practice has emerged as a fundamental principle in Western medical systems over recent years. Used effectively, audit can have wide-ranging benefits for both the patient and the practitioner, in terms of resource management and quality of care. This book reviews the concepts behind audit and the approaches that individual specialties take. First, the book describes the philosophy of audit and the requirements of various agencies such as the Department of Health and the Royal College of Surgeons for audit. Second, the book outlines the specific requirements of the major specialties and third, the book gives practical suggestions for the development of an audit strategy. There are comparisons between audit performed in the United Kingdom and that performed in the United States and Sweden. Further, the need to consider the relationship between resource management and medical audit particularly with reference to the data requirements is emphasized. Throughout the book the concept of "completing the loop," i.e.the need to effect change from the audit activity is discussed as well as the educational value of audit. The editors have stressed that there are no hard and fast rules in creating an audit strategy and as yet there are few experts.
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