摘要:

Surely the most striking fact about maternal health in the world today is the extraordinary difference in maternal death rates between industrialized and developing countries.1What for many white women is a joyous, sharing and close experience is for most Aboriginal women an experience of pain, fear and "shame" from which they flee as soon as possible.2

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb138039.x

出版商:Wiley    

年代:1993

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb138040.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Clustering: A closely grouped series of events or cases of a disease or other health‐related phenomena with well‐defined distribution patterns, in relation to time or place or both. The term is normally used to describe aggregation of relatively uncommon events or diseases.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb138041.x

出版商:Wiley    

年代:1993

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb138042.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo assess the risks of death in police or prison custody in Australia for Aborigines and non‐Aborigines.Design, setting and participantsRetrospective collection and analysis of data about deaths occurring in police or prison custody in Australia in the 10‐year period 1980‐1989.ResultsFor the period 1980‐1989, Aboriginal and non‐Aboriginal people in prison had risks of death similar to those of the total Australian population, but the risks of death in police custody for both Aborigines and non‐Aborigines were between 10 and 20 times the risks of death experienced by the general population. Within each type of custody, there were no significant differences in the risks of death experienced by Aboriginal and non‐Aboriginal people.ConclusionAlthough some deaths in custody are inevitable, the very much higher risks of death in police custody for both Aborigines and non‐Aborigines has implications for custodial authorities in terms of preventive and remedial action. Reduction of the excess of Aboriginal over non‐Aboriginal deaths in police and prison custody relative to general population figures requires action to reduce the over‐representation of Aboriginal people in custody and to improve the general well‐being and health status of Aboriginal people in the community. (Med J Aust 1993; 159: 577‐581)

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb138043.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo assess the causes of death for people in police or prison custody in Australia, with particular attention to the differences between Aboriginal and non‐Aboriginal deaths.Design, setting and participantsRetrospective collection and analysis of data about deaths occurring in police or prison custody in Australia in the 10‐year period 1980‐1989.ResultsIn the period 1980‐1989, 527 deaths are known to have occurred in police or prison custody. About half these deaths were due to self‐harmful behaviour, including hanging. The next most frequent causes of death were diseases of the circulatory system, injuries and diseases of the respiratory system.ConclusionThe high number of deaths in custody resulting from self‐harmful behaviour has important implications for the criminal justice and corrections systems. Minimisation of the number of people held in police and prison custody is important in preventing such deaths. Close attention needs to be paid to ensuring the safety of lock‐ups and prisons and to the screening of people likely to be at risk of death from self‐harmful behaviour.Custodial authorities have a clear responsibility to provide quality preventive and clinical health services to all people in custody. Special attention needs to be directed to the specific health needs of Aborigines, many of whom are at much greater health risk than are non‐Aborigines. (Med J Aust 1993; 159: 581‐585)

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb138044.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Objectives(i) To describe birth size of Aboriginal babies by sex, gestational age, and Aboriginality; (ii) to analyse the results with reference to standards of ponderal index and birthweight for gestational age.Subjects570 liveborn singletons routinely delivered at Royal Darwin Hospital between January 1987 and March 1991, and recorded in the Delivery Suite Register as being born to an Aboriginal mother.Main outcome measuresWeight, length and head circumference at birth.ResultsThe mean birthweight was 3098 g (standard deviation, 601 g), peak gestational age was 39 weeks, 13% were low birthweight and 7% were preterm. Preterm rates did not differ significantly for sex and Aboriginality. Babies without a non‐Aboriginal ancestor had a lower mean birthweight and at term, were significantly smaller than babies with a non‐Aboriginal ancestor as assessed by mean birthweight, length, head circumference and ponderal index. More than a quarter of babies (27%) without a non‐Aboriginal ancestor were below the 10th percentile of birthweight for gestational age, compared with 14.2% of babies with a non‐Aboriginal ancestor.ConclusionsOn the basis of postnatal clinical estimates of gestational age, Aboriginal babies have a preterm rate of 7% and Aboriginal babies without a non‐Aboriginal ancestor are smaller in size at birth than babies with a non‐Aboriginal ancestor. (Med J Aust 1993; 159: 586‐591)

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb138045.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo review changes in the epidemiology, course, and outcome of bacteraemia caused byPseudomonas aeruginosa.Design and settingA retrospective, descriptive study of consecutive cases ofP. aeruginosabacteraemia occurring at a university teaching hospital.Patients and methodsBetween January 1980 and December 1989, 164 patients were admitted to Westmead Hospital withP. aeruginosabacteraemia. Patients in whom there was no clinical evidence of sepsis were excluded from analysis leaving a cohort of 152 patients. Hospital records were reviewed and details of demography, clinical features, therapy, and outcome were recorded.ResultsOne hundred and fifty‐five episodes ofP. aeruginosabacteraemia were recorded at an average rate of 0.39 per 1000 admissions per year. The respiratory and pancreatobiliary tracts were the most common sources of the bacteraemia. Pancreatobiliary disease, independent of an underlying malignancy or immunosuppression, emerged as a previously undescribed risk factor for pseudomonal bacteraemia (incidence of 3.0 episodes per 1000 hospital admissions for patients with this disease). The crude mortality rate was 52%; 35% was attributable to pseudomonal bacteraemia. Factors identified as being independently associated with an increased mortality included hypotension, age of 60 years or older, and the presence of an underlying malignancy. Combination therapy with an antipseudomonal penicillin and an aminoglycoside confers a significant survival advantage independent of underlying neutropenia.ConclusionsBacteraemia caused byP. aeruginosaremains an important cause of morbidity and mortality. Pancreatobiliary disease represents a new risk factor forP. aeruginosabacteraemia, independent of an underlying malignancy or immunosuppression. It may be prudent to considerP. aeruginosaas a cause of sepsis in these circumstances, especially if there has been instrumentation of the biliary tree.Hypotension, age of 60 years or older, and the presence of an underlying malignancy were independently associated with significantly increased mortality. Appropriate antibiotic therapy consisting of an antipseudomonal ß‐lactam in addition to an aminoglycoside resulted in a significant decrease in mortality compared with the use of an aminoglycoside alone, not only in the study population as a whole, but also in patients without neutropenia. (Med J Aust 1993; 159: 592‐597)

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb138046.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Typhoid remains a disease of major importance world‐wide although improvements in public health have made it an exotic disease in developed countries like Australia. Effective antibiotic therapy with the advent of chloramphenicol, which was first used to treat typhoid in the 1940s, has also dramatically altered the natural course of the disease and reduced its mortality rate from around 25% to as low as 1%. The main areas of recent change include the emergence of resistance to previously effective antibiotics, more aggressive intervention in the management of severe typhoid and some of its complications such as perforation, and the development of an oral typhoid vaccine that may replace the equally effective but more unpleasant parenteral vaccination that has been widely used since World War I.(Med J Aust 1993; 159: 598‐601)

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb138047.x

出版商:Wiley    

年代:1993

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb138048.x

出版商:Wiley    

年代:1993

数据来源: WILEY