摘要:

ObjectiveTo estimate the prevalence of persistent insomnia and its correlates in samples of people living in the community and in institutional settings.MethodsRespondents were interviewed in their place of residence by trained interviewers using the Canberra Interview for the Elderly, a structured psychiatric examination.ResultsInformation about sleeping habits was obtained from 874 community and 59 institutional residents. Insomnia was persistent in 16% of the community‐dwelling population and 12% of the institutional residents, with 15% and 40%, respectively, regularly taking a hypnotic. Of those without insomnia, 10% in the community but over a third in institutions were using a hypnotic. Insomnia was associated with depression, pain and poor physical health.ConclusionsPersistent insomnia in the elderly, as in other age groups, is strongly associated with depressed mood, as well as with physical disease. Because of this, insomnia should not be dismissed as a normal part of ageing, and therefore ignored as a significant symptom. Continued surveillance is needed in general practice, geriatric services and nursing homes of the routine use of hypnotics by the elderly.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138406.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo analyse trends in prognostic factors at diagnosis of melanoma to indicate targets for health promotion.MethodsCases of melanoma notified to the South Australian Cancer Registry during 1981‐1992 (1361in situand 4509 invasive) were analysed by tumour site, histological type, stage, thickness, period of diagnosis and sociodemo‐graphic characteristics of the patient.ResultsThe relative probability of being diagnosed with an in‐situ, rather than a thin invasive, lesion increased progressively between 1984‐1986 and 1990‐1992. The relative probability of having an in‐situ melanoma diagnosed was: lower among those aged 80 years or more; higher among patients residing in the upper socioeconomic areas of Adelaide; high for lesions on the face; and high for lentigo maligna as opposed to superficial spreading lesions. The relative probability of invasive lesions being diagnosed when more than 1.5 mm thick decreased progressively between the 1981‐1983 and 1990‐1992 diagnosis periods. The relative probability of thick lesions being diagnosed was higher among older patients and for nodular lesions compared with superficial spreading or lentigo maligna lesions. Facial lesions and those in males tended to be thicker.ConclusionsThere are favourable trends towards earlier detection of melanomas in South Australia, probably reflecting the effect of skin‐cancer awareness campaigns. Further campaigns should emphasise early detection in people aged 60 years and over, males and residents of less affluent areas. Early detection of nodular melanomas and invasive lesions of the face also warrants special attention.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138407.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138408.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

I propose a new authority category for the Pharmaceutical Benefits Scheme (PBS) — authority to prescribe only within a controlled trial. This would benefit both the PBS and the pharmaceutical companies, but the main winners would be the Australian population, who would obtain better value for money spent by the PBS. Drugs which show promise, but for which conclusive evidence of advantage over standard therapy is lacking, or drugs for new indications, could be prescribed within a randomised trial. PBS support would fund a substantial portion of the trial costs. This proposal would greatly boost local and international investment in Australian medical research.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138409.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo determine the completeness of data acquired previously on the attendance patterns of patients visiting three general practices and the exclusivity of attendance at these practices.DesignA retrospective comparison of attendance data with data extracted from the Health Insurance Commission database. Three study practices were investigated to give a rough cross‐section of general practice in Western Australia.ResultsEighty‐nine per cent of patients and 92% of services recorded in our earlier study were also recorded by the HIC, with 31% of patients also attending another general practice during the six months, mostly only once or twice. However, there was considerable variation between practices in data match and attendance at other practices.ConclusionsWe found a high level of completeness of data. Sixty‐nine per cent of patients attended no other practice during the six months, indicating that doctors in the study practices have some opportunity to provide continuity of care to their patients. The implications for patients' needs and doctors' resources of variations in attendance patterns need to be examined further.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138410.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138411.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138412.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138413.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138414.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138418.x

出版商:Wiley    

年代:1995

数据来源: WILEY