ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142124.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142125.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142126.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142127.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142128.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To study the use of psychoactive drugs for the treatment of long‐stay develop‐mentally disabled individuals in an institution in New South Wales.Setting:Three wards dedicated to the long‐term care of developmentally disabled individuals situated on the premises of a large psychiatric hospital.Subjects:All residents (n= 53) of these wards in August 1989.Method:All subjects were examined by the author. Charts and medication records were extensively reviewed. Mental retardation was classified by DSM‐III‐R criteria. Categorisation of problem behaviour was done with the assistance of nurses, who also supplied information on behavioural problems and functional level and completed checklists of self‐injurious and stereotypic behaviour. A standardised neurological examination was performed and scales for abnormal involuntary movements completed.Results:The most commonly used drugs were the neuroleptics, with 60.4% of subjects currently receiving one or more neuroleptic drug at relatively large doses. The use of these drugs was not associated with current or past psychiatric illness, but was more closely related with the severity of problem behaviour. Thirty‐four per cent of the subjects receiving neuroleptics had dyskinetic movements suggestive of tardive dyskinesia, and 30% had mild tremor. Antidepressant, anxiolytic and sedative drugs were used less commonly. The management of epilepsy was considered to be suboptimal.Conclusion:Even though studies over the last two decades have consistently highlighted the problem of overmedication of intellectually handicapped individuals in institutions, the problem does not seem to have been redressed in at least some institutions.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142129.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To compare the effectiveness of different recruitment strategies in encouraging older women to have a Papanicolaou (Pap) test.Design:A 2 × 2 factorial study.Setting:Two rural areas of Victoria, Australia.Participants:A total of 10 620 persons aged between 40 and 69 years and designated as female on electoral lists.Interventions:A personal letter of invitation and a community‐based campaign of 4 weeks’ duration alone and in combination. A control group received no active intervention.Outcome measure:The proportion of eligible women having a Pap test report issued by the Victorian Cytology Service during the 12 weeks after the intervention compared with the 12 weeks before the intervention, with an intervening two‐week washout period.Results:The odds ratio of an eligible woman being screened during the intervention period relative to the pre‐intervention period was 3.00 for women who were exposed to the campaign and sent the letter of invitation (95% confidence interval, 2.38–3.77,P<0.001), 1.86 for women who were exposed to the campaign (95% confidence interval, 1.49–2.33,P<0.001), 1.61 for women who were sent the letter of invitation (95% confidence interval, 1.34–1.92,P<0.001). The baseline was a control group who received no active intervention.Conclusions:Both personal invitation letters and community‐based campaigns are effective in recruiting women for Pap test screening. Combined strategies are more effective than single strategies.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142130.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To test the effects on snoring and sleep disordered breathing of a dental prosthesis (Snore‐No‐More) which is designed to decrease snoring by preventing mouth breathing during sleep.Design:A crossover controlled trial. Each subject was studied on two nights a week apart. There was a control (no treatment) night and an experimental (treatment) night. The order of control and experimental nights was randomised.Setting:The Royal Adelaide Hospital Sleep Laboratory.Participants:Fourteen male volunteers (age range, 36–59 years) were studied. All had a history of chronic snoring but denied other symptoms of obstructive sleep apnoea syndrome.Interventions:On experimental nights subjects wore the dental prosthesis for the whole study period. On control nights no device was worn.Main outcome measures:Studies were conducted overnight during the subject's normal sleep period. The following measurements were made: (i) frequency and loudness of snores; (ii) frequency of disordered breathing events (apnoeas and hypopnoeas); (iii) mean and minimum arterial oxygen saturation while asleep; and (iv) sleep stages.Results:The dental prosthesis did not change the mean frequency or mean intensity of snores. The number of sleep disordered breathing events per hour of sleep decreased by approximately one‐third on experimental nights (mean ± SEM events/h: control, 24.7 ± 5.3; experimental, 16.1 ± 3.3,P<0.05). Neither sleep architecture nor arterial oxygen saturation differed between control and experimental nights.Conclusion:Snorers using the dental prosthesis Snore‐No‐More to produce obligatory nasal breathing are unlikely to experience clinical benefit.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142131.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142132.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To determine the prevalence of non‐communicable disease, specifically hypertension, diabetes and obesity, amongst populations at different levels of urbanisation in Vanuatu, and to relate the frequency of these conditions to the modernisation of way of life.Design:A cross‐sectional population‐based comparative study of indicative cluster samples.Setting:Republic of Vanuatu (south‐west Pacific). A relatively undeveloped malarious island country.Participants:Adult (aged ≥ 20 years) Melanesian ni‐Vanuatu of both sexes. An occupation‐based (civil servants) urban sample (n = 623) and area‐based semi‐rural (n = 349) and rural (n = 397) samples were employed. Response rates were 78%–92%.Interventions:Cases detected were referred for assessment and treatment by local medical staff.Main outcome measures:Body mass index, triceps skinfold thickness, blood pressure, plasma glucose (fasting and 2 hours after 75 g glucose), plasma cholesterol and triglyceride levels.Results:Modernity scores confirmed that the three locations represented different levels of acculturation. Prevalences of non‐communicable disease were relatively low compared to other Pacific Island communities and industrialised countries. These conditions were nevertheless more common in the urban sample and least common in the rural sample. Non‐communicable disease correlated positively with modernity scores and negatively with physical activity scores. Obesity correlated with blood pressure in the urban sample, and there was indirect evidence (urine sodium concentration) of higher salt intake with modernisation. Mean plasma cholesterol levels were lowest in the rural group.Conclusions:Prevalences of non‐communicable disease are relatively low in Vanuatu, although rural‐urban differentials are present, and likely to increase with continued development. The evidence presented is consistent with non‐communicable disease being related to the modernisation of way of life; specifically: decreased exercise, obesity, and dietary change. Preventive activities should commence now.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142133.x

出版商:Wiley    

年代:1991

数据来源: WILEY