ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00212.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:The community of Busselton in Western Australia has participated in repeated cross‐sectional health surveys and other health interventions since 1966. Health surveys of adults were conducted every three years from 1966 to 1981. Health interventions, including programs for high blood pressure, smoking, high blood cholesterol levels and obesity, were implemented in the community. Mortality rates for the Busselton area are compared with rates for the remainder of the southwest region of Western Australia in an attempt to determine if the surveys and associated interventions have had any impact on survival. Statistical comparisons via Poisson regression analysis showed that mortality rates for males over the period 1965 to 1989 in Busselton declined at a similar rate to the southwest. However, for females, especially those aged 45 to 74 years, mortality rates declined significantly faster in Busselton than in the southwest, suggesting a beneficial impact on survival of the surveys and associated intervention

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00213.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:An investigation of an outbreak of Legionnaires' disease in 1992 in Fairfield, a municipality of Sydney, was carried out to determine the source of the outbreak. Cases of Legionnaires' disease with onset of symptoms between 11 and 20 April 1992 were included. Definite cases were individuals with a history consistent with Legionnaires' disease, confirmed by direct fluorescent antibody testing plus serology or culture. There were two control groups: patients admitted to the same hospital as the cases, matched for age and sex, and patients admitted to hospital with a presumptive diagnosis of Legionnaires' disease, in whom the diagnosis was subsequently excluded. There were 26 definite cases with onset of symptoms between 11 and 20 April 1992. Six (23 per cent) died. Twenty‐two cases (85 per cent) reported visiting the Fairfield business district during the ten days prior to the onset of symptoms. They were 20 times more likely to have visited Fairfield than were matched controls. Matching ofLegionella pneumophilaserogroup 1 from environmental and clinical samples was achieved by cytogenetic fingerprinting. Fourteen cases were linked to a single environmental sample. The epidemiological findings were consistent with a point source ofLegionellain the Fairfield business district. It is most likely that the exposure occurred on 10 April 199

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00214.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:Excess body weight is associated with increased health risk, but there are also risks to health related to weight‐control practices. While representative population data are available on the anthropometry of body weight and its sociodemographic correlates in Australia, less is known about the population prevalence and correlates of weight‐control behaviours. We examine the prevalence of overweight and obesity, and low body weight, in the Australian population, using data from studies in which height and weight have been objectively measured; we describe the sociodemographic correlates of overweight and obesity; we outline relevant aspects of Australian health‐system and private‐sector approaches to body weight control; and we describe the findings of Australian studies of weight‐control practices and related beliefs and attitudes. These findings relate mainly to women, particularly younger women, and little is known about the weight‐control practices of Australian men. We suggest research which may promote a better understanding of weight‐control practices in the Australi

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00215.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:Dementia‐free life expectancy is a synthetic indicator of an important aspect of mental health which may have considerable use in public health decision making. Dementia expectancies were derived from senile dementia prevalence rates in Australia in 1991–1992 in conjunction with national life tables using Sullivan's method. Dementia‐free life expectancy for Australian women aged 70 years was found to be 14 years within a total life expectancy of 15 years, and 11 years for men within a total life expectancy of 12 years. Between 70 and 85 years there is a constant average expectation of about one year of life expectancy with dementia. The age at which the largest number of persons with dementia is found is 82 years. Australians appear to have very similar dementia‐free life expectancies to those reported in the European studies, with small differences probably due to sampling variation or to differences in case‐findin

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00216.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:We compared the cost‐effectiveness of interventions to prevent osteoporosis using a decision analytic model for a hypothetical cohort of 100 000 healthy perimenopausal women. The interventions were: oestrogen from age 50 for life, oestrogen from age 50 for 15 years, oestrogen from age 65 years for life, and a lifestyle regime of calcium supplements and exercise. The four interventions were compared with the case of no intervention by examining the effects on medical and nursing home costs, life years gained, quality‐adjusted life years (QALYs) gained and costs per QALY gained. Lifetime oestrogen therapy from age 65 years achieved the lowest cost per life year gained and the lowest cost per QALY gained. The lifestyle intervention was the most expensive intervention by all measures but was sensitive to the cost of exercise and to the effects of exercise on cardiovascular mortality. Conventionally, oestrogen therapy begins at the menopause to avoid the rapid decline in bone mass that occurs with normally decreasing oestrogen levels. These results indicate that there is evidence, both in terms of fracture prevention and cost, to justify introduction of treatment at a later age. If a lifestyle intervention regimen can reduce cardiovascular mortality as well as hip fracture, this may provide an alternative means of reducing osteoporotic hip fracture at a reasonable c

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00217.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:There were substantial reductions in mortality rates for all causes of death and for cardiovascular diseases in all age groups examined and both sexes during the period 1969 to 1990. Among young and middle‐aged women, cardiovascular diseases were no longer the major cause of death; cancers were. In younger men, accidents, poisonings and violence (including suicides) were the leading cause of death. In middle‐aged men, cardiovascular mortality dropped to about the same level as cancer mortality. Only in older people did cardiovascular mortality still dominate. Nevertheless, the proportion of all deaths due to cardiovascular disease remained high and there are opportunities for further reductions. The relative lack of improvement in mortality from cancers suggests that these will form increasing proportions of the burden of disease and treatment costs in the next deca

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00218.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:The effect of the quality of information obtained by Standards Monitoring Teams on the compliance of 410 Australian nursing homes with Commonwealth regulatory standards is explored. We Find that information matters. Lack of openness is a hallmark of a poor quality facility, openness of a high quality facility. Secondly, open flow of information becomes a resource that does enable the regulatory process to improve the quality of care. From an industry perspective, therefore, openness pays because it 1. works against being marked off by an inspection team as a problem facility that is covering up; and 2. allows the facility to improve the quality of the service it delivers to the consumer.

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00219.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:This study aimed to assess the effect of reminder letters on Pap test rates for women enrolled on the New South Wales Cancer Council Pap Test Reminder Service and to identify predictors of response to the letter. Ten weeks after they had received their reminder letter a questionnaire was sent to 3086 women. It was completed by 1525 (49 percent) women, of whom 1393 (91 percent) said they had received their reminder letter. Of these 1393, 48 per cent (95 per cent confidence interval 46 per cent to 51 per cent) reported having had a Pap test within 10 weeks of the reminder letter arriving. The proportion of women having a Pap test in response to the reminder letter did not differ by age, region of residence or language spoken at home. Women were less likely to have had a Pap test if they did not know how they were enrolled, were of low socioeconomic status or had some tertiary education. Women on the reminder service have 15‐month rescreening rates at least 9 per cent higher than other women in New South Wales; for women aged 50 to 69 in nonmetropolitan areas the increase is estimated at 19 per cent. Reminder services may be a cost‐effective way to increase Pap test rescreening rates. Reminder services need accurate records and to follow up changes in address and date of next t

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00220.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00221.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY