ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1993.tb00112.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1993.tb00113.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:This paper describes an investigation of why an attempt at alcohol and drug problem prevention failed. Between 1986 and 1991 a comprehensive policy on alcohol and drug use was developed in a university in Western Australia. Using a key‐informant approach, 26 ‘players' central to the decision to reject the policy were interviewed, and relevant university documents were examined. The failure of the initiative was found to be caused not only by bad policy formulation (for example, the perceived poor tone of the document, concerns about content and general presentation) but also to bad process. Lack of effective consultation, suspicions about the origins of the policy, distrust and dislike of the policy presenters and concerns about the aim of the policy were cited as major impediments. The central tenet of the policy, that in order to reduce alcohol problems everyone must reduce their drinking, was rejected by most of the decision makers. Perceptions that members of the policy working party were taking an anti‐alcohol stance engendered criticisms that the policy reflected the work of ‘wowsers' and ‘health zealots’. The major lessons learned were that policy formulation, presentation and negotiation are skilled tasks. Preventers need a range of abilities with perhaps the foremost being the capacity to listen to criticism, consult genuinely and implement change slowly. The notion that preventers know what is good for other people needs to be avoided. Preventive policy, if it is to be implemented, has to be introduced by invitation not

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1993.tb00114.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:As part of a review of maternity services this study assessed satisfaction with antenatal care among 1193 women who gave birth in Victoria during two weeks of 1989, except for those who had a stillbirth or whose infant died between the birth and the survey. The survey questionnaire was mailed to women eight to nine months after the birth. The response rate, excluding duplicates, women who gave birth outside the survey period and those whose questionnaires were returned because of a change of address was 71.5 per cent. Women attending public hospital clinics were the least satisfied with antenatal care and those attending private obstetricians were the most satisfied, with general practitioners intermediate. These differences by provider accounted for almost all the differences by sociodemographic factors (age, marital status, family income, being of non‐English‐speaking background and health insurance status). While the majority of women were happy with their antenatal care, an inverse care law still applied: women whose economic and social circumstances meant they were most likely to need ‘care’ from caregivers were more likely to be limited in their choice of caregiver and to be dissatisfied with the care they r

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1993.tb00115.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:We aimed to examine the satisfaction and the predictors of reported satisfaction with the service offered by a pilot mammography screening service. Information was collected from 481 attenders at the screening clinic and from 318 consecutive attenders at the recall clinic using two different standard self‐administered questionnaires covering respectively six and five dimensions of satisfaction. For the screening clinic attenders, mean scores on most subscales indicated quite high levels of satisfaction. There were no significant differences among different samples over time for the perceptions of technical competence of the staff. Decreases in reported level of satisfaction were found for subscales measuring interpersonal skills, information giving, physical surroundings, convenience and accessibility, and general satisfaction. Waiting times, age and marital status were predictors in most satisfaction subscales. For those attending the recall clinic, mean satisfaction scores for most scales were high, except for the scale measuring satisfaction with the way the results were received. The median time between screening and recall visits for women in this study was 27 days (range 3 to 112 days). Attenders were most dissatisfied with the delay in getting results, an area where the service might improv

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1993.tb00116.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:A cardiovascular disease screening and education campaign was conducted throughout the North Coast Region of New South Wales from 1987 to 1991. Objectives were: to screen 20 per cent of the adult population for blood cholesterol and other heart disease risk factors; to raise awareness of the risks associated with a high‐fat diet; to provide nutrition counselling and referral advice for those with elevated cholesterol; and to monitor these participants' cholesterol levels with a follow‐up test at three months. During the five years, 42 869 individuals or 18 per cent of North Coast adults participated, with some overrepresentation of women aged 40 to 60 years. Initially, 65 per cent of participants had elevated cholesterol levels (≥5.5 mmol/L) and 46 per cent were overweight (body mass index over 25). A three‐month retest was offered to all participants with elevated cholesterol, of whom 53 per cent attended. Participants who received nutrition counselling generally reported dietary changes which were reflected in significant cholesterol and weight reductions. Of participants who attended retest, 63 to 87 per cent had reduced cholesterol levels and 57 to 71 per cent reduced weight. A stratified random sample of participants was retested at one and three years. Reductions in cholesterol were well maintained for one year but showed signs of relapse after three years. There was a tendency for initially lower cholesterol levels to increase over a three‐year period. Contributing factors included aging, regression to the mean and complacency. Maintenance may be enhanced by regular reinforcement of nutrition changes and development of more supportive env

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1993.tb00117.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:Children are more likely to be hospitalised because of burns from hot liquids than from contact with fire and flames. Many of these hot liquid burns are from contact with hot tap water, usually in the home. Hot tap water burns to young children can be prevented completely by lowering the delivery temperature of the hot tap water. This study reports on the evaluation of a program designed to lower the temperature of home hot tap water in Dunedin, New Zealand. In conjunction with a national media campaign, the program provided an educational intervention to households with young children. Before and after measures were made and comparison groups were used to determine the effect of the intervention on tap water temperatures. Mean tap water temperature was 64.2°C at baseline and 61.2°C at follow‐up. The proportion of households with water temperatures above 70°C decreased by 50 per cent between baseline and follow‐up while the proportion below 60°C increased from 33 per cent to 47 per cent. The group receiving the intervention did not differ significantly from the comparison groups. There were significant decreases in tap water temperature across all groups, but the majority of households still had temperatures above 55°C at the end of t

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1993.tb00118.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:There is little published information on the epidemiology of fracture in Australia. We have therefore carried out a population‐based retrospective study of fracture in an Australian population covering 1 073 subjects, 60 per cent of the eligible population over the age of 65 resident in Busselton in the southwest of Western Australia. They completed a questionnaire on the number of fractures, the skeletal site and the degree of trauma that caused the fracture. In this population, 39 per cent had sustained a total of 620 fractures, and 22 per cent of women and 6 per cent of men had sustained osteoporotic fractures. Hip and spine fractures accounted for only 9 per cent of osteoporotic fractures in females whereas wrist fractures accounted for 27 per cent, other upper limb fractures for 19 per cent and other lower limb fractures for 11 per cent. These results suggest that emphasis on spinal and hip fractures as the only manifestations of osteoporosis is inappropriat

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1993.tb00119.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:This paper sets road safety education in a health promotion context and describes the application of cost—utility analysis to the economic evaluation of road safety education in New South Wales. The application is tentative and designed to illustrate the advantages of the approach rather than to demonstrate the cost‐effectiveness of road safety educat

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1993.tb00120.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:The costs and experiences of caring for geriatric patients and the effectiveness of a geriatric assessment team have been reviewed in this study from the New South Wales Central Coast. The findings were: that some clients who are referred for placement in nursing homes and who meet standard criteria for admission can be maintained in the community; the cost to the taxpayer of persons admitted to nursing homes was at least $449 to $776 per week (1991 prices), compared to an average cost of $89 per week to maintain at home those whose original assessment met all the criteria for nursing home placement; assessments of needs of some clients were being conducted by five or more separate agencies which led to increased costs and created distrust and confusion for the client; a key factor in the decision to maintain a client in the community was found to be the availability and motivation of carers. A geriatric assessment team has an essential role in mobilising expert assessment and facilitates access to community‐based support services to obviate or delay admissions to nursing home

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1993.tb00121.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY