The year in a training practice: what has lasting value? Grounded theoretical categories and dimensions from a pilot study.

Experienced General Practitioners were asked about lasting value from GP Registrar training. Grounded theory was used to construct eight categories of training behaviours. In each category, dimensions spanned between learner-preferred behaviours and those the learners perceived as less helpful. Learners valued teaching based on evergreen approaches to problems. They welcomed exposure to a wide variety of styles and a safe, blame-free, environment, wherein to develop reflective practice. Modelling by trainers of personal development and team-skills has proved of lasting value in a changing world, particularly where change management is based on completed audit cycles. Help to see family medicine contexts of presenting problems enhanced Registrars' appetite for learning. Trainers centring education on learners, yet maintaining a sense of direction, are highly valued. General practice learners appreciate sensitive positive and negative feedback from their trainers. This work offers new possibilities for assessing and developing trainer behaviour.

Significance of dipstick haematuria. 1. Correlation with microscopy of the urine.

The reliability of a chemical test for haematuria has been evaluated in patients referred for investigation of suspected renal or urological disease. Red blood cells in concentrations of 10/microliter or greater were found in 24% of urines giving a negative dipstick result, 82% of urines giving a trace positive result and nearly 100% of urines giving dipstick results greater than this. The accuracy of the reagent strip in predicting the presence or absence of significant haematuria was improved by testing several urines from each patient. On the basis of this study, if significant haematuria is present, reagent strip urine testing is an efficient method for its detection.

Significance of dipstick haematuria. 2. Correlation with pathology.

In an evaluation of a chemical test for haematuria, all patients with positive results or a history of frank haematuria were investigated to determine the source of bleeding. In 10 of the 92 patients in whom the diagnosis was unknown at the time of admission, the presence of haematuria could not be confirmed. Of the remaining 82 patients urinary tract pathology was identified in 74. Of the other eight patients, four had exercise-induced haematuria with no other indications of significant pathology, and in four patients investigations stopped short of renal biopsy because of the patients' age.

Acute infantile thrombocytosis and vitamin K deficiency associated with intracranial haemorrhage.

A 5-week-old breast-fed girl presented unconscious and convulsing with heavily blood-stained CSF under increased pressure. This was associated with oozing from venepuncture sites, a grossly prolonged prothrombin time, and a raised platelet count. The prothrombin time became normal 18 hours after she had been given parenteral vitamin K and a transfusion of fresh plasma and red cells, but the thrombocytosis persisted. A moderate communicating hydrocephalus also remained and was treated, and one year later health and development appeared normal. The thrombocytosis resolved after a few weeks and has not recurred.