ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126954.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Women in the developing world still lack the power to control their own fertility

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126906.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Retrieval can be a complex game for the casual operator

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126907.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Our national medical research effort is fundamental to maintaining a high quality and cost‐effective health system

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126908.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126909.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo determine the trends in premature mortality due to selected causes in Australia and in selected States for the whole population and for adults aged 25 to 44 years.DesignAnalysis of data from the Australian Bureau of Statistics and the National AIDS Registry for the 10 years from 1983 to 1992. Premature mortality was measured in terms of years of potential life lost before the age of 75 years (YPLL‐75). Trends in premature mortality due to AIDS were compared with those for lung cancer, melanoma of the skin, breast cancer, diabetes mellitus, acute myocardial infarction, cerebrovascular disease, traffic accidents and suicide.ResultsThere have been marked increases in premature mortality due to AIDS and suicide in young men and an increase in deaths due to breast cancer in young women over the past decade. The overall number of potential years of life lost has remained constant, partially because these increases have been counterbalanced by declines in deaths from traffic accidents, acute myocardial infarction and cerebro‐vascular disease. The increasing trend in premature mortality due to AIDS is strongest in New South Wales, followed by Victoria and Queensland, with smaller increases in the other States and Territories.ConclusionsApparent advances in medical care have reduced pre‐mature deaths from acute myocardial infarction and stroke and public health measures are likely to have reduced traffic accident deaths; but at the same time there have been serious increases in HIV, suicide and breast cancer among young adults.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126910.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo improve the quality of clinical care through better continuity of services between the public hospital and general practitioners (GPs), focusing on expediting discharge of patients from hospital through improved use of resources provided by GPs.Design: Stage 1Participant observation during ward rounds and unstructured interviews to gain an understanding of the perceptions of hospital staff and GPs of the GP's role in the discharge process.Stage 2: Semi‐structured interviews with registrars and GPs of 30 patients (who were admitted to a medical ward and discharged to the care of their GP) to get the participants' views of each other's roles in providing continuity of care.ResultsThere was a general lack of trust on both sides, and poor communication owing to several structural and perceptual problems. Registrars focused on specialist care and outpatient follow‐up, being almost oblivious to GP functions, apart from monitoring the management plan developed in the hospital; they made no use of GPs' knowledge of the case or their experience in treating patients within their families and social milieu, and frequently wished to do everything within the hospital. GPs, on the other hand, often felt alienated from the hospital system, although they had much to offer by being able to contribute details of the patient's background and by using their special skills, which went well beyond passively monitoring progress.Recommendations1. Information about the patient's GP should be made available to hospital staff. 2. Interns should make telephone calls to GPs after admission and when the discharge date is known. 3. Early‐discharge summaries should be forwarded and include: (i) reasons for giving or altering medications; (ii) specific plans after discharge; (iii) information conveyed to the patient and family about the illness; and (iv) a summary of the case by the consultant. 4. Registrars and interns should be educated about the appropriate involvement of GPs in the discharge process and throughout the patient's stay in hospital. S. Direct involvement of the GP with the patient during hospital stay should be encouraged. 6. A pilot study should be set up to investigate the role of a liaison person in overcoming problems of the transition of care of hospitalised patients to the community.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126911.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126956.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo determine the chol‐esterol‐lowering effect of ready‐to‐eat cereal containing soluble fibre as psyllium (86%), oatmeal and barley on the plasma lipids of otherwise healthy men with mild hypercholes‐terolaemia, who were already eating a diet low in saturated fats.DesignDouble‐blind crossover trial, lasting 12 weeks, in volunteers eating each cereal for six weeks at home, in Sydney and Newcastle (New South Wales).ParticipantsEighty‐one men (average age SO years; range, 31‐69 years) who had initial plasma (total) cholesterol concentrations of 5.8‐8.8 mmoVL, but did not have major illness, obesity or diabetes, and were not on special diets or taking stool bulkers.InterventionOne box of cereal was eaten each day: control, 60 g wheat/wheat bran (2 g soluble fibre); or test, SO g of product containing psyllium/oats/barley (12 g soluble fibre). Subjects were allocated at random, when established on a low saturated fat diet, to wheat followed by psyllium cereal or psyllium followed by wheat cereal.Main outcome measuresPlasma total cholesterol, high density lipoprotein cholesterol, triglyceride and low density lipoprotein cholesterol concentrations measured twice, four to seven days apart before the start of the trial and then after six weeks of eating each cereal.ResultsCompliance was excellent with both cereals. There were no significant differences in subjects' macronutrient intake or body weight between the two six‐week periods. Total cholesterol and low density lipoprotein cholesterol con‐centrations fell significantly on psyllium cereal, relative to wheat cereal, in both periods at both centres (mean ‐3.2% and ‐4.4%, respectively). There were no consistent changes in triglyceride or high density lipoprotein cholesterol concen‐trations.ConclusionThis type of product, which is easy to consume on a daily basis, is a useful adjunct to the dietary management of mild hyper‐cholesterolaemia.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126912.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo assess how suitable psychiatric medical records are for access by patients.DesignWe examined a random selection of psychiatric records to identify features which we thought might be confusing or injurious to a patient reading his or her own record.ResultsPotentially offensive, alarming or upsetting entries were found in most records.ConclusionClinicians need to take care in recording information in medical records lest patients be adversely affected by the experience of reading their notes. Access should always be arranged in conjunction with a medical supervisor.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126913.x

出版商:Wiley    

年代:1994

数据来源: WILEY