ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb93892.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objectives:To portray the changes in the place of death of South Australians during the 20th century and to examine the effects of sociodemographic and cause of death variables.Design:Data relating to 2566 deaths from 1910 to 1987 were extracted from the records of funeral directors. A comparison of our sample of deaths with State mortality statistics, in terms of age, sex and diagnosis, was made to assure the representativeness of the sample.Results:The proportion of deaths which occurred at home decreased from 55.6% in 1910 to 26.2% in 1970, and thereafter about a quarter of all deaths occurred at home. Most of the “institutionalisation of death” was due to increasing proportions of deaths in public hospitals; by 1970 over two‐thirds of all deaths occurred in hospitals. After 1970 death has been transferred from hospitals to nursing homes and inpatient hospices. Multivariate analyses indicated that the institutionalisation trend was present after taking account of confounders (age, sex, marital status, occupation, number of children, and cause of death).Conclusions:Mortality patterns are determined by social and demographic characteristics of those who die, the availability of hospital and nursing home beds, changes to health insurance schemes, and the emergence of hospice care and related services. Further study is required to determine whether patterns of terminal care are cost‐effective and medically appropriate.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb93893.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Most overseas trained doctors wishing to practise in Australia are required to sit for examinations set by the Australian Medical Council (AMC) before they can seek registration through State medical boards.In 1989, the South Western Sydney Area Health Service, which is responsible for the delivery of health services to 650 000 people, initiated a bridging program with the joint aim of providing overseas trained doctors with the opportunity to undertake a comprehensive program of study and facilitating the recruitment of doctors into the area. The program comprises two integrated components, each extending over five months. Stage 1 relates to the AMC's multiple choice questionnaire (MCQ) examination; stage 2 prepares candidates for the clinical examination. In addition, provision is made for developing awareness of professional responsibility, standards and ethical bases for the practice of medicine in Australia. Participants are also required to study English and communication skills throughout the program.Acceptance into the program is based on a number of criteria including successful completion of a screening test and an interview. Progression to the Clinical Course requires that candidates pass the MCQ Course and undertake to work in the area. The program has been funded jointly by State and Commonwealth Government bodies. Results obtained by program participants in the MCQ and clinical examinations conducted by the AMC have been well ahead of the national average.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb93894.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Guidelines for the protection of privacy in the conduct of medical research have been issued by the National Health and Medical Research Council, approved by the Commonwealth Privacy Commissioner, and gazetted on 1 July 1991 (Commonwealth of Australia Gazette No. P19) to remain in force until 30 June 1994. This paper examines the guidelines and seeks to inform researchers, institutional ethics committees and the institutions those committees represent of their content. Responsibilities are placed upon those engaged in the conduct of research and those involved in undertaking ethical review who now have to decide that the public interest in conducting the research substantially outweighs the public interest in privacy. There is also an emphasis on the requirement for surveillance of research projects by institutional ethics committees which has not previously been apparent. Questions are posed to assist in deciding whether a particular research protocol is subject to the guidelines.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb93895.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb93897.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb93898.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To assess the current status and future directions of therapy in cerebrovascular disease.Datasources: English language literature search using MEDLINE, Index Medicus, reviews, texts and relevant papers.Study selection:Information has been drawn from approximately 200 articles.Data extraction and synthesis:Those articles with most relevance to current practice and future directions in the therapy of cerebrovascular disease have been cited.Conclusions:Much progress has been made over the last 30 years in the therapy of primary and secondary prevention of cerebrovascular disease. The introduction of antihypertensive agents has been largely responsible for the decline in mortality from stroke and, in some areas, the incidence. Anticoagulants such as warfarin protect against ischaemic stroke in patients with mitral or aortic valve disease and/or atrial fibrillation. Antiplatelet agents are clearly effective in the secondary prevention of ischaemic stroke after transient ischaemic attacks; the risk of stroke or death is reduced, on average, by 22%. In patients with subarachnoid haemorrhage, ischaemic complications caused by vasospasm are reduced by calcium channel blockers.A new wave of therapies is now on the horizon to minimise tissue damage in the early stages of ischaemic stroke (“tissue rescue”) with the introduction of thrombolytic agents, calcium channel blockers, NMDA antagonists and haemodilution techniques and many of these are currently being subjected to clinical trial. If they prove to be effective, our current management of acute ischaemic stroke may alter dramatically.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb93899.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb93900.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb93902.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb93903.x

出版商:Wiley    

年代:1991

数据来源: WILEY