ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1991.tb00330.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:To compare rates of ischaemic heart disease (IHD) among men in occupation groups defined by the new Australian Standard Classification of Occupations (ASCO) and to investigate whether their high mortality rates from IHD in the Hunter Region of New South Wales (NSW) could be explained by its occupational structure, we used official death records and data from the World Health Organization MONICA Project conducted in Newcastle. The study population consisted of men aged 25 to 64 years in NSW and in the Hunter Region for whom occupational information was available. For deaths from IHD between 1984 and 1988 in NSW, indirectly standardised mortality and morbidity ratios (SMRs) were: significantly low for professionals, 66 (95% confidence interval (CI) 60–71) and managers and administrators, 79 (95% CI 74–83); intermediate for paraprofessionals (92), clerks (94) and salesmen and personal service workers (97); and significantly high for tradesmen, 113 (95% CI 107–118), labourers and related workers, 118 (95% CI 113–124) and plant and machine operators and drivers, 125 (95% CI 118–133). Broadly similar patterns were found for IHD deaths and for fatal and nonfatal myocardial infarction in the Hunter Region. When occupation‐ and age‐specific mortality rates from IHD were used to calculate SMRs for the Hunter Region, SMRs for all ASCO groups except paraprofessionals were over 100. Mortality rates for occupational groups classified by ASCO were consistent with well‐established differences associated with socioeconomic status. Rates were higher, however, for most occupational groups in the Hunter Region than for the same groups in NSW as a whole, so the Region's occupational structure, as described by ASCO, cannot alone ‘explain’ t

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1991.tb00331.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:The relationship between sexuality, gay communities and class is potentially a very large problem for AIDS prevention. Class is a historical process which interacts with sexuality in ways still little understood. The complexities of modern class structures need full acknowledgment; labour market groupings are internally divided, and cultural privilege and exclusion are important. A community survey in New South Wales of men who have sex with men shows the class selectiveness usual in such research. An exploration of correlates of labour market position, income and education finds few relationships with attachment to milieu except for involvement with gay organisations, and minor differences in broad measures of sexuality but some class differences in HIV risk‐taking and some differences in exposure to information and in attitude. An exploration of several cases from a life‐history study of working‐class gay men shows the impact of class circumstance on the formation of sexual relationships and points to the accessibility of unlabelled homosexual activity in working‐class milieux. Research on working‐class education points to the importance of curriculum change in overcoming class exclusion, and is moving towards empowerment models of great relevance in AIDS

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1991.tb00332.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:A roadside breath alcohol survey was conducted by the NHMRC Road Accident Research Unit in 1989 to monitor the efficacy of random breath testing (RBT) by the police. A reduction of 40 per cent in the proportion of drivers above the legal blood alcohol limit of 0.08 g/100 ml was found to coincide with a marked increase in the level of publicity of police RBT operations. Other factors may also have contributed to these large reductions in illegal drink‐driving but this result was similar to that observed in 1987 when a major increase in publicity was accompanied by an increase in the level of enforcement of RBT. Although the full effect of these reductions has diminished with time, there appears to have been a decrease in illegal drink‐driving in Adelaide from 1983 to 1987 and again to 1

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1991.tb00333.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:Recent policy initiatives in Australia have continued the debate concerning the appropriate model of health care for this country. A market economy model, predicated on the existence of true consumerism, has been promoted by influential organisations to replace the current system. To test the validity of this perception and to explore the level of consumerism which exists in the Australian health care setting, we undertook a cross‐sectional survey of general practitioner attenders in the outer western and northern suburbs of Sydney. Three hundred and thirty‐three patients from six general practices were polled over a two‐week period in March 1990. Far from demonstrating consumerist behaviour (especially the considered selection and evaluation of services), the survey population was strongly attracted to the traditional model of medical care, which is characterised by the trusting and dependent relationship of patients with their do

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1991.tb00334.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:A comparison of folk categories of types of drinker and recorded alcohol consumption data, both derived from New Zealand women, with established risky levels of drinking indicates that there is some correspondence between folk categories of non‐‘ordinary’ drinking and drinking at epidemiologically defined risky levels. However, of more importance to the majority of women drinkers, women's drinking which is completely socially acceptable and certainly regarded as quite ‘ordinary’, can also be at or well above risky levels. These findings are discussed in the context of the increasing normalisation of alcohol in women's lives. I argue that they support a ‘reduced consumption’ rather than a ‘safe limits

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1991.tb00335.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:Inhabitants of Pacific island countries experience a wide range of levels and cause structures of mortality. Data on socioeconomic, geopolitical and demographic variables have been analysed here to identify correlates and determinants of mortality in Pacific island countries circa 1980. The mortality data used in the study were the best available for the period and are reasonably accurate; descriptive data were derived from recognised sources.Political status was a major correlate, with independence positively associated with mortality. However, the influence of political status was partly accounted for by economic and social variables. Economic indices, particularly imports per capita, were major inverse correlates of mortality. Disparities in life expectancy occurred between malarious and nonmalarious countries, and these were not explicable by other factors. Melanesians, especially women, experienced high mortality rates. Education and doctor availability were both associated with increased life expectancy. Intercorrelation and confounding need to be taken into account in the interpretation of this analysis. The results have ramifications for policy development in the Pacific island countries themselves, and for investment and aid programs from major donor nations and organisations.

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1991.tb00336.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:In a study of nursing home applicants, residential care decisions made by a multidisciplinary assessment team were examined. The team agreed that of the 296 applicants assessed, 54 per cent required the high level of physical and supportive care provided in a nursing home. Hostel care was recommended for 17 per cent, continuing care at home for 17 per cent, hospice care for 1 subject, and in 13 per cent of cases the team postponed their decision. A decision for nursing home care was associated with low Barthel Index of Activities of Daily Living scores, dementia, incontinence and the absence of a carer willing to continue care. A decision to delay was associated, in most cases, with a requirement for further in‐patient assessment and/or rehabilitation, and therefore with a potential for functional improvement. A decision for hostel care instead of home care was associated with a low level of informal support and the absence of a carer who was a spouse or daughter. The findings suggest that a program of geriatric assessment will accurately identify the differing care needs of nursing home applicants. The initial value of such an assessment program may be to contribute to the planning of residential and other long‐term care services rather than to reduce inappropriate nursing home admissi

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1991.tb00337.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:In accordance with thePrivacy Act 1988(Cth), interim guidelines for the protection of privacy in the conduct of medical research have been issued by the National Health and Medical Research Council (NHMRC) with the approval of the Privacy Commissioner. The guidelines are intended to ensure that the privacy of the individual is not interfered with when a researcher seeks the release of personal information held by a Commonwealth agency, or when a Commonwealth agency conducts medical research, and to ensure that the conduct of medical research is not inhibited by the privacy legislation. However, the procedures established by the guidelines and the responsibilities placed upon researchers and institutional ethics committees could themselves have the effect of inhibiting research. In considering amendment, NHMRC and the Privacy Commissioner are urged to produce final guidelines which do not act as the straw to break the back of the current system of institutional ethics committees, which seeks to ensure proper ethical scrutiny and the facilitation of human research.

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1991.tb00338.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:The 1985 electoral roll was used as a register to invite 1013 women to participate in a screening program. Appointment times and a choice of venues for having a smear were not provided. Overall, 26 per cent of the women sent invitations registered with the program. After adjustment for the prevalence of hysterectomy, the proportion who registered with the program was about 32 per cent. The low level of registration and difficulties experienced in tracing registrants and nonregistrants over time using the electoral roll resulted in the cessation of the program after 3 years. An assessment of the original invitation was made using a small case‐control study, and associations between the screening history stated at interview and screening over the duration of the program were examined in nonregistrant

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1991.tb00339.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY