Headaches in persons attending polyclinics in Barbados

Headache is a very common problem in the community, but only a small proportion of people who have it presents to the health services. In the Caribbean little is known of its prevalence, the resulting morbidity or the nature of self care used. This paper reports on a survey of 679 adults who attended three polyclinics as patients, or accompanying young, elderly or acutely ill relatives. 68.9reported having experienced a headache in the previous month. Headaches were more prevalent among respondents aged 25-44 years (78.6) than among those in other age groups; in women (73) than in men; in those living in households of four or more people (72) than in those living in smaller households; in those whose family members were reported as using alcohol, tobacco or marijuana singly or in combination (70-72.5) compared to those whose families did not use any of these substances (55); and in those whose family members were reported as having allergy, asthma and migraine (72.5 to 77.1). No significant association was shown in relation to employment. 18.4of the respondents visited the doctor for their headache. In the clinical evaluation of these patient, the number of costly investigations may be reduced by attention to the epidemiological variables such as age and gender, domestic factors such as stress, and family diseases such as migraine, asthma and allergy.

Concepts of obesity in family practice

In this study, 502 adults (409 women, 93 men) attending a Group Teaching Family Practice were weighed, their heights were measured and they were then interviewed on their concepts and beliefs about obesity. The results conformed other reports that the prevalence of obesity is high; 46% of women and 17% of men were found to have body mass indices greater than 27.0 and 27.4 respectively. Of the 198 obese responts, only 94 (47%) considered themselves to be fat, whilw self-image in the nom-obese was more realistic with 176 (59%) thinking that they were right size; 18.7% of respondents thought that obesity was associated with good health, 29.9% associated obesity with wealth and 36.3% associated obesity with happiness. Two hundred and four respondents (40.6) believed that men preferred their women to be fat, female respondents being more often of this view. Concepts as to the cause of obesity were found to differ from medical teaching with 195 (39%) respondents believing obesity to be hereditary and only 215 (42.8%) associating obesity with overeating. These views should be appreciated by health-care provuders, who should try to change them, if necessary, before making efforts to prevent and treat obsity

Patient care in barbadian family practice

A survey was conducted in Barbados to determine the various practices the and services the family physuicians in government and private practice provided for the population. Nineteen physicians, seven of whom worked in government general medical clinics, recorded information on the practice procedures they used at 7,303 encounters over a four-week period. The results demonstrated the profile of attndance by age and sex, with more attendances in the reproductive (44.0%) and childhood (24.2%) years. People of the lower socio-economic classes attended in large numbers both the government (83,9%) and private facilities (66,7%). Prescribing was the most frequently used procedure (75.7%), buth the number of prescriptions written per doctor was much less than reported from developed countries. Only 13% of prescriptions were for long-term medication. Counselling occurred in 40% of encounters, buth only 7.1% were what physicians perceived as psycho-therapeutic care. Other services privided included minor operative procedures (16.2%), and certification (9.4%)