摘要:

AbstractThe existence in western countries of an overall gradient in mortality related to social status has been established in a large number of studies from a variety of countries, including Australia. Due to lack of data, however, there has been much less work done on a similar national scale, investigating the relationship between social status and morbidity. This is particularly so in Australia.The recent release of unit record data from the 1977–78 Australian Health Survey (AHS) conducted by the Australian Bureau of Statistics (ABS) means that data linking social status and morbidity at a national level are now available. This paper reports the findings of an investigation into the relationship between social status and morbidity, based on the AHS data.For men, those in lower status occupations tend to suffer a higher, age‐standardised rate of self‐reported recent illnesses, chronic conditions and days of reduced activity; the trends, however, are not straightforward. Mean levels of nonpsychotic mental illness show no clear association. Women show no simple correspondence between occupation and self‐reported health, with the exception of those who give “home duties” as their usual major activity. These women report consistently higher age‐standardised rates of illness and disability than those in paid employment.Males show a significant inverse gradient (after age‐standardisation) in association with education‐level‐attained for all the above‐mentioned morbidity indicators except chronic conditions. Even with chronic conditions, however, the least educated report significantly worse health than the rest of the population. Women show clear inverse trends (after age‐standardisation) for both recent illnesses and nonpsychotic mental illness, but not for chronic conditions and days of reduced activity.The most striking differences occur when relative affluence, based on income adjusted for family size, is used as the discriminatory variable. All four indicators of morbidity show significant relationships to affluence for both sexes after standardisation for age.The higher morbidity of those of low social status is partly reflected in their usage of doctors. The poor have significantly higher rates of consultations. As with morbidity, educational and occupational differences have a l

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1985.tb00470.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

AbstractAs part of a long‐term study of the effects of a dietary fibre supplementation programme on bowel function in a group of institutionalised elderly, various aspects of nutritional status were assessed before, and three, six and twelve months after introducing a fibre supplementation programme.Mean dietary intakes were satisfactory throughout the programme, although some individuals had intakes well below recommended levels for certain nutrients. The fibre supplementation programme not only improved bowel function, but also improved the nutrient density of the diet. Despite a slight increase in total energy intake, supplementation did not increase mean body weights in the group. Trace element status was not adversely affected by the supplementation programm

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1985.tb00471.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

AbstractThis paper examines the claims made by the Vietnam Veterans' Association of Australia that the health of Vietnam veterans has been adversely affected by exposure to the herbicide Agent Orange and other pesticides while serving in Vietnam. Three claims are dealt with in detail: those concerning the effects of exposure to pesticides on the rates of birth defects among the children of Vietnam veterans and of psychiatric disorders and premature death among themselves. Epidemiological evidence on the rate at which these adverse outcomes occur among Vietnam veterans is reviewed, as is evidence on the effects of occupational pesticide exposure on reproductive outcomes, mental health and premature death. The review indicates that there is little evidence to sustain any of the claims and much evidence against them. An analysis of the reasons for the persistence of the controversy in the face of negative evidence suggests that there has been an unfortunate confusion of two questions: are Vietnam veterans owed justice for the injustices they have suffered in the past? is their present suffering a consequence of their chemical exposure in Vietnam? The community owes it to Vietnam veterans and their families to distinguish the two questions to ensure that an affirmative answer to the first question does not depend upon an affirmative answer to the second.

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1985.tb00472.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

AbstractTo assess the feasibility of developing a subjective measurement of exposure to pesticides (herbicides and insecticides) among Australian Vietnam veterans, a series of questions was asked in a survey of 300 randomly selected former soldiers on the electoral roll in Sydney metropolitan electorates, who had served in Vietnam. Data quality was measured in terms of adequacy and reliability of responses to exposure questions, while validity was assessed by reference to army records or by examining the content of answers. Exposure to pesticides in Vietnam was difficult to ascertain; reliability was low and the content of responses did not differentiate clearly between herbicide and insecticide exposure. Similarly, the quality of responses to questions of chemical exposure in a civilian environment was also low. In attempting to assess the sequelae of chemical exposure, questions on circumstances of exposure should be limited to occupational exposure, since such data are amenable to validity checks. In studying Vietnam veterans and using control groups who did not go to Vietnam it may be necessary to assume that all veterans were potentially exposed and all non‐veterans were not, and stratification undertaken by potential for occupational exposure to chemicals both in the army and in civilian lif

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1985.tb00473.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

AbstractProgrammes to promote health, which appear with increasing frequency, should be based on sound principles. This paper deals with an approach to health promotion based on behavioural theories to explain the change and maintenance of habitual patterns of activity. It derives from work to determine programme guidelines and policy recommendations in the promotion of exercising, and is presented so as to have more general application to health‐related behaviours. It describes some relevant theoretical approaches to behaviour change and maintenance, and outlines a set of principles which may be used as guidelines. This involves an account of stages of behaviour change, operant conditioning and associative learning theories, cognitive‐behavioural and self‐management theories, and social learning theory, and suggests judicious integration of these theories and the use of attitudinal theories. Eleven principles derived from these theories and from research on health behaviour change are described. These perspectives may be useful in work to influence the health‐related behaviours of individuals, and as suggestions for the modification of some environmental and social factors which constrain individuals' capacities to choose health promoting

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1985.tb00474.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SummaryThe setting of an occupational health standard requires consideration of many issues. To illustrate this, the setting of the National Health and Medical Research Council occupational health standard on eyesight tests for screen‐based equipment operators is reviewed. Problems of a technical, professional, political and economic nature are identified. Two systems to help avoid these problems in the proposed National Occupational Health and Safety Commission are discussed; one involves setting standards by consensus, the other uses an adversary proces

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1985.tb00475.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

AbstractThis paper examines one particular problem in medical education: the rapid accumulation of technical medical knowledge. It is suggested that this development contributes significantly to several major deficiencies in training for clinical practice: it encourages a passive learning model, it helps to undervalue consultation skills and it inappropriately increases the student's anxiety in “not knowing all the facts.” In addition, the emphasis on technical knowledge helps to narrow the focus of attention to technical details at the expense of essential information on the patient's relationships and environment. Knowledge will continue to accumulate; a number of suggestions are made to ameliorate some of the harmful effects of this accumulation on teaching and learning in medical school. They include more emphasis on the process of the consultation and on problem‐solving skills learned experientially rather than mastery of facts. A further recommendation is made to re‐evaluate what is the essential knowledge base so that greater weight is given to information about the patient's relationships, attitudes and beliefs. The paper concludes with an assessment of the major institutional constraints standing in the way of the educational reforms outlined and suggests some ways these could be o

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1985.tb00476.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

AbstractThis paper includes a brief outline of the research literature on comparisons of different modes of questionnaire completion (face to face, telephone, self‐administered), and the results of a pilot study which used a questionnaire to obtain data on maternal experiences and exposures to drugs and environmental agents during pregnancy. Questionnaires were completed for the three modes and comparisons made of the quality of the data and the actual responses obtained. The findings suggest that when using a highly structured questionnaire, and where a favourable rapport has been established between the researcher and the respondents, there are few differences between the modes in those aspects examined in this stud

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1985.tb00477.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1985.tb00478.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1985.tb00479.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY