Search

The role of general practitioners (GPs) is vital to implementation of the Organized Approach to Preventing Cancer of the Cervix (OAPCC), a program launched in Australia in 1991 as a response to shortcomings at each of the five steps of the cervical screening pathway. The impact in general practice has been studied in. Among GPs, female gender, professional affiliation, metropolitan area practice and awareness of the OOAPCC booklet were found to be independent predictors of an opportunistic orientation, and 91% indicated they would be very likely to include a Pap smear in a general health checkup. Some 5,600 person years of life were lost through premature death from cervical cancer in 1990.

Ways to maintain health survey response rates while saving labor have been studied using a randomized trial. Response rates were not significantly different with a group where exhaustive telephone prompts by a medical peer were given before the questionnaire was received, a group which received embossed pens with the questionnaire, a group receiving an advance letter, and a group getting a single-attempt advance telephone prompt by a nonmedical research assistant. Advance prompts by a medical peer were significantly more effective than other methods for male general practitioners (GPs).

Patients with DSM-III Agoraphobia, Panic Disorder, GAD, Social Phobia and normal controls underwent a series of experimental procedures and measures to determine whether panic attack patients show a greater tendency towards hyperventilation that is independent from their anxiety levels. Contrary to expectations, the Agoraphobia and Panic Disorder patients did not show significantly lower levels of expired [pCO.sub.2] at rest than the other anxious or non-anxious groups. However, the panic attack patients did show significantly higher levels of anxiety and hyperventilatory symptoms during a hyperventilation test and during breathing 5% [CO.sub.2] in air. A strong relationship was found between hyperventilatory symptoms and anxiety in all groups of patients and in the controls. On the basis of these results it was concluded that Agoraphobia and Panic Disorder patients do not show a unique tendency toward hyperventilation, but rather than their hyperventilatory symptoms and perhaps intermittent overbreathing episodes are a function of the high levels of anxiety they experience.

Summary--Subjects with agoraphobia (N = 25), panic disorder (N = 25), social phobia (N = 19) or generalized anxiety disorder (N = 10) and controls with no psychiatric history (N = 16) underwent two provocation tests, voluntary hyperventilation and inhalation of 5% [CO.sub.2] in air, and three experimental control conditions. They were measured on three elements of the panic reaction: somatic symptoms, psychic anxiety and fears of impending doom, and on a standard YES/NO measure of panic attack. The provocation conditions produced increased somatic symptoms and psyhic anxiety across all groups relative to the control conditions. The agoraphobic and panic disorder groups showed a significantly greater increase in fears of impending doom from control to provocation conditions than the social phobic and GAD patients. This difference was not observed on measures of somatic symptoms or psychic anxiety. The present results provide some support for the theory that panic attacks result from the catastrophic misinterpretation of anxious symptoms, in this case produced by the two provocation tests.