ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127477.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127445.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127446.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127447.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectivesTo assess the attitudes of Victorian vaccine providers to the pertussis component of the diph‐theria‐tetanus‐pertussis vaccine (DTP), and to examine differences between kinds of health professionals. Also, to assess vaccine providers' understanding of National Health and Medical Research Council (NHMRC) guidelines on childhood immunisation with DTP.MethodsWe conducted a postal survey of 765 randomly selected Victorian health professionals involved in childhood vaccination, including medical officers of health (MOHs), general practitioners (GPs), maternal child health nurses (MCHNs), paediatricians and environmental health officers (EHOs).ResultsMost (83%) knew that the pertussis component was most frequently responsible for adverse effects of DTP. Thirty‐four per cent of all respondents (9% MCHNs, 23% paediatricians, 24% MOHs, 34% EHOs and 39% GPs) believed that pertussis vaccine causes permanent brain damage, 34% did not, and 32% were unsure; 39% believed it causes encephalopathy. Only 9% described vaccination practices entirely in accordance with NHMRC guidelines. Up to 58% of respondents would give diphtheria‐tetanus vaccine (DT) in situations when DTP was indicated, and up to 54% would give DTP when it is clearly contraindicated. There was no correlation between knowledge of the safety of DTP and vaccination practices.ConclusionVictorian vaccine providers have doubts about the safety of pertussis vaccine. There is a need to ensure the availability and clarity of immunisation guidelines for health workers, to educate them about the use of pertussis vaccine, and to ensure that this knowledge is put into practice.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127448.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo determine the vaccination status of Aboriginal children resident in the North Coast Health Region of NSW.DesignCross‐sectional descriptive study.Setting and participantsThe vaccination status of Aboriginal children aged 4 months to 11 years and resident in selected villages/isolated communities, small and large towns in the North Coast Health Region of NSW was determined by review of vaccination records. Data were obtained from general practitioners, the Aboriginal Health Service, Community Health Centres and Local Government Councils.Main outcome measuresVaccination status according to the childhood immunisation schedule recommended by the National Health and Medical Research Council, defined as fully or partially documented, with a generous lag time.ResultsThe study population comprised 1179 children —55% of the estimated Aboriginal population under 12 years of age in the North Coast Health Region. Data collection on Sabin vaccine was incomplete and was not included in the analysis. Of 1094 children whose records were analysed, 9% had fully documented and 27% fully or partially documented evidence of up‐to‐date vaccinations. For measles vaccination, 28% of children aged 18 months or more had fully documented and 35% fully or partially documented evidence of vaccination. There was no fully documented evidence of any vaccinations for 52% of children.ConclusionThe vaccination status of Aboriginal children in the North Coast Health Region is poor. The 1989‐1990 National Health Survey showed overall vaccination rates for NSW and Australia to be more than twice those found for this population.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127449.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo document and review the theoretical basis of vaccination practices and policies of homoeopaths in Sydney.MethodsAfter preliminary interviews, a questionnaire was designed and mailed to all 29 homoeopaths listed in the Sydney telephone directory and practising in central Sydney.ResultsSix homoeopaths (21%) returned the completed questionnaire and 10 others were interviewed. Their attitudes to vaccination varied widely. The two medically qualified homoeopaths recommended orthodox vaccination routinely for most children. Five of the six respondents did not recommend routine vaccination by any method. We could not obtain any scientific data about the contents of homoeopathic vaccinations. No reports evaluating homoeopathic vaccination were found in the peer‐reviewed medical literature from 1982‐1993.ConclusionsHomoeopathic vaccination practices are variable, with no statutory body regulating them in Australia. Medically qualified homoeopaths frequently recommend orthodox vaccination.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127450.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo assess the safety of percutaneous fluoroscopic gastrostomy (PFG) tube insertion for enteral nutrition.Design and settingThe records of 70 consecutive patients who had a PFG procedure at a tertiary referral hospital (Princess Alexandra Hospital) were analysed retrospectively.Main outcome measureIncidence of morbidity and mortality from PFG.ResultsSixty‐nine of 70 procedures were successfully performed. There were two deaths secondary to aspiration pneumonia and a morbidity rate of 13%. These figures are comparable with results from other series.ConclusionPFG is a safe, effective procedure for enteral nutrition.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127451.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectivesTo determine the rate of oophorectomy in, use of hormone replacement therapy by, and health, social and lifestyle factors of, midaged Australian women who have undergone hysterectomy.Design and participantsA community‐based cross‐sectional survey by telephone interview of a random sample of 2001 Australian‐born Melbourne women aged between 45 and 55 years.Main outcome measuresThe health status, sociodemographic and lifestyle correlates of women who had undergone hysterectomy compared with women in the natural menopause transition.ResultsTwenty‐two per cent of the women had undergone hysterectomy. Of these, 21% had had one ovary removed, and 20% both. Mean age at hysterectomy was 40.4 years. There was no trend in the bilateral oophorectomy rate over the last two decades. Current hormone replacement therapy use increased significantly with surgery, from 17% of non‐hysterectomised women to 31% of hysterectomised women, and 49% for women who had undergone hysterectomy and bilateral oophorectomy. Hysterectomised women were significantly more likely to be of lower educational level, and to report a history of troublesome premenstrual complaints, more dilatation and curettage procedures and non‐gynaecological operations, and use of prescription medications.ConclusionsSocial and pre‐existing health problems influence hysterectomy rates. Many women undergo oophorectomy at hysterectomy despite limited evidence of benefit.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127452.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo identify requirements for vocational training and continuing education programs in rural general practice.DesignA questionnaire was sent to all 487 rural doctors and 140 metropolitan and 140 provincial city general practitioners (GPs) in Queensland. A sample of medical educators, health professional and consumer representatives and rural doctors was also interviewed. Res‐ponses were compared by geographical area, practice characteristics and level of postgraduate training.ResultsThere are significant differences between rural and urban practice profiles. Rural doctors have to practise a range of clinical skills in an environment with restricted access to health professional support, although the need for advanced training in procedural or other skills depends on the type of rural practice. Rural and urban doctors want more influence in determining continuing medical education (CME) programs. Interactive learning methods were rated as the most effective education methods by both rural and urban GPs. Rural doctors were less likely to consider that they spent enough time on CME.ConclusionVocational training programs should accommodate various rural career objectives, including those requiring advanced levels of procedural work. There is a significant unmet demand for CME tailored to the needs of individual doctors, both rural and urban, but distance and isolation may make this more critical in rural practice. These issues need to be addressed as training opportunities can contribute to improved retention of the rural medical workforce.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127453.x

出版商:Wiley    

年代:1994

数据来源: WILEY