ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124649.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124650.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

A balancing act unfolds between scientific evidence, cost‐effectiveness and the patient‐in‐question

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124651.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Despite improvements in diagnosis and therapy, there is still much to unravel

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124652.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The world is on track to eradicate poliomyelitis forever but vaccination is still required

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124653.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo investigate difficulties in public hospital admissions from the perspective of referring medical practitioners.MethodsReferring surgeons, physicians and general practitioners (GPs) were randomly selected from three metropolitan (Sydney) health areas and formed into focus groups. Thematic analyses were undertaken of the groups' discussion transcripts to explore the problems of securing patient admissions, practitioners' perceptions of the reasons for these problems and the strategies they used to overcome them.ResultsSurgeons in two health areas reported major constraints affecting patient admissions. Physicians experienced fewer difficulties as this group was able to utilise outpatient services but was not always satisfied with such arrangements. GPs reported difficulties in communicating with full‐time hospital medical staff. All practitioners felt that limited bed availability, restricted operating times, redefinition of many conditions as “non‐urgent” and hospital budgetary constraints resulted in long waiting times for admission to public hospitals. This has led to an increasing move to use private hospitals for elective admissions, and to investigate patients in the community.ConclusionsMedical practitioners experienced difficulty in having their patients admitted to metropolitan public hospitals for both elective and non‐elective procedures, and this was perceived to result in clinical and personal costs to patients.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124654.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo determine the rate of compliance of migrants issued with a health undertaking for tuberculosis requiring them to report within one month after arrival in Australia.DesignCompliance was monitored prospectively between 1 ovember 1992 and 31 October 1993.SettingThe Australian Government Health Service in Melbourne.Participants1660 migrants with a health undertaking for tuberculosis.Main outcome measureCompliance with the undertaking (making initial contact and presenting for examination).ResultsThe overall compliance rate was58%, but 89% of those who made contact complied with their undertakings. There were significant differences in the compliance rates according to country of application (P<0.001). It was estimated that about 150 people a year who require treatment for tuberculosis could be failing to comply with a health undertaking, eight of whom may require a full course ofantituberculous chemotherapy.ConclusionsThe administration of the current system of health undertakings for tuberculosis for migrants needs to be strengthened to increase compliance.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124655.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo assess the epidemiology of methicillin‐resistantStaphylococcus aureus(MRSA) in Western Australia.DesignRetrospective review of statutory notification data.SettingWestern Australia (WA), 1993.Outcome measuresNotification rates, antibiotic resistance patterns and classification of isolates as imported or WA MRSA strains on the basis of antibiotic susceptibility.ResultsThere were 204 notifications of MRSA, 78% of which were classified as WA MRSA. Three outbreaks of MRSA infection and colonisation occurred in separate WA hospitals. otification rates per 100000 were highest in the rural regions: the Kimberley (86.32), Goldfields (62.47), Mid West (37.21) and Pilbara (27.38) regions; and lowest in the metropolitan regions (5.52). All MRSA isolates were susceptible to vancomycin. Most imported strains were susceptible to amikacin, bacitracin, chloramphenicol, framycetin, fusidic acid and novobiocin, but only 23% to gent amicin. WA MRSA strains remained predominantly susceptible to all antibiotics tested, except 8‐lactams, erythromycin and tetracycline, but a few strains resistant to rifampicin (1%) and fusidic acid (3%) appeared in the second half of 1993.ConclusionsThe epidemiology of MRSA in WA is changing rapidly, with increases in both the numbers of notifications and the proportion from country regions. A new strain of MRSA (WA MRSA) that is less resistant to antibiotics than imported MRSA has emerged and is threatening the State's success in preventing establishment of MRSA in its hospitals.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124656.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo determine the prevalence among laboratory animal handlers of allergy to laboratory animals and of asthma and the factors associated with their development.DesignA cross‐sectional survey.SettingTeaching and research institutions in Sydney, between January 1989 and December 1992.ParticipantsLaboratory animal handlers (teaching and research staff, animal house workers and animal husbandry students and teachers).Main outcome measuresDuration of exposure to laboratory animals, allergic symptoms on contact, skin reactivity to laboratory and domestic animal allergens and evidence of current asthma.Results228 subjects were surveyed. Allergy symptoms occurred in 73 (56%) of the subjects exposed to laboratory animals for three months or more. This group also had significantly higher prevalences of skin reactivity to laboratory animal allergens (62%) and bronchial hyperresponsiveness (21%) than those with shorter exposure (14% and 8%, respectively). Atopic subjects exposed to laboratory animals (particularly those sensitised to domestic animals) and animal attendants (with a high intensity of exposure to laboratory animals) bad significantly higher frequencies of skin reactivity to laboratory animals and asthma than other subjects (77% and 30%, respectively, among exposed atopic subjects and 84% and 33%, respectively, among animal attendants).ConclusionsAllergy to laboratory animals is an occupational hazard among laboratory animal handlers, especially for those who are atopic and sensitised to domestic animals, and may lead to the development of asthma. Screening for atopy and skin reactivity to laboratory animals before and during employment would enable those at risk to take precautions.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124657.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectivesTo identify characteristics of women seeking termination of pregnancy, their reasons for having a termination, and whether they intended to submit a Medicare claim for the procedure.DesignSurvey by self‐administered questionnaire.Subjects and settingAll women who attended 11 private clinics in ew South Wales (NSW) over a six‐week period in 1992.Results2249 completed questionnaires were received (94% response rate). Terminations were frequent at all ages, but women in their 20s accounted for more than half the terminations (54%) and teenagers accounted for only 17%. Respondents were generally well educated and from various ethnic and religious backgrounds; 56% were single and 41% had had one or more previous terminations. Fifteen per cent of respondents could not or did not intend to make a Medicare claim. The most frequently cited factors contributing to the decision to seek a termination were concerns about finances, change in lifestyle, single parenthood and being too young.ConclusionsPrivate clinics, where most terminations are performed, clearly meet a major demand, but it is likely that terminations in SW as recorded by Health Insurance Commission claims are under‐reported by at least 15%.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124658.x

出版商:Wiley    

年代:1995

数据来源: WILEY