ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1996.tb02929.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1996.tb02930.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1996.tb02931.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1996.tb02932.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground:Nutrition is recognised as an integral aspect of Australian medical education. Since medical students will learn more of a subject they consider important, there is a need for their perceptions of nutrition to be investigated.Aims:To identify final year medical students' perceptions about nutrition and its inclusion in their medical course, and to compare priority nutrition topics identified with those previously identified by Faculty and General Practitioners (GPs) who teach in the undergraduate curriculum.Methods:A cross‐sectional survey of all final year medical students attending the University of Newcastle was conducted, using a distributed questionnaire, comprising three sections: demographics, perceptions about nutrition and its inclusion in the medical course, and a listing of 38 major nutrition topics. Main outcome measures were: interest in nutrition, and whether it should be included in the undergraduate medical curriculum; rated importance of listed nutrition topics; comparison between students and Faculty and GPs. Frequency distributions and Chi square analyses were used to compare group responses.Results:Seventy‐one per cent of the students were interested in nutrition and 94% believed it should be included in the medical curriculum. More than 60% of the students nominated 21 of the 38 topicsessentialorimportant. Thirteen of these topics were also highly rated by Faculty and GPs, although Faculty and GPs rated more topics asessentialorimportant.Conclusions:Newcastle medical students are interested in nutrition and believe it should be included in their medical curriculum. This may be due to their clinical exposure and the educational milieu of the University of Newcastle Medical School. Exposure to nutrition in their undergraduate education appears to be an important determinant for priority designated nutrition top

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1996.tb02933.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground: Helicobacter pyloriinfection is a major risk factor for peptic ulcer disease and gastric cancer. A study of patients with dyspepsia attending for gastroscopy showed significant differences inH.pyloriseropositivity between ethnic groups.Aims:To determine the prevalence ofH.pyloriin children and adults in the community in different ethnic groups and to identify risk factors for infection.Methods:Serum samples (324) were randomly selected from a cross‐sectional survey of 11–12 year old school children with a high proportion of Maori and Pacific Island groups. Serum samples (579) were randomly selected from a cross‐sectional workforce survey of 5677 participants aged 40–64 years. Serum samples were tested forH.pyloriIgG.Results:The percentage seropositivity in 11–12 year old children was European 7%, Maori/part Maori 21%, all Pacific Island groups 48% and for the workforce survey 35.8%, 57.4% and 73.2% respectively. Compared with Europeans the increased relative risk of seropositivity forH.pyloriin Maori and Pacific Island participants was significant after adjusting for age and socio‐economic status (1.43 [1.13, 1.80] and 1.76 [1.43, 2.18]) respectively. The relative risk ofH.pyloriinfection significantly increased with age, lower socio‐economic status and lower household income, but was not significantly associated with gender, alcohol or cigarette use.Conclusions:The high seroprevalence ofH.pyloriin Maori and Pacific Island groups is consistent with the differences in incidence of gastric cancer.H.pyloricontinues to be a common infection in Maori and Pacific Island school children. Ethnicity appears to be a risk factor forH.pyloriindependent of socio‐

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1996.tb02934.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground:There is uncertainty regarding the effects of physician training on planned practice features of Australian physician trainees, for example plans for urban or rural, full‐time or part‐time and academic/research or purely clinical practice. These plans may differ between male and female trainees and between generalists and sub‐specialists.Aim:To examine the changes in anticipated practice patterns over the course of advanced physician training.Methods:Longitudinal study of doctors in Australia who passed the Part I clinical examination of the Royal Australasian College of Physicians in 1991, 1992 and 1993, followed annually up until 1995. Changes in future practice plans regarding full‐ or part‐time work, rural or urban practice and pure clinical work or a mixture with research were examined among generalist and specialist trainees and among men and women. Statistical analysis included the calculation of chi square for trend statistics and intraclass correlation coefficients.Results:At least one follow‐up questionnaire was received from 80% of the 334 original respondents. The majority had been able to obtain their training job of choice. By the time of last follow‐up, around 80% planned to practise in a capital city, indicating a shift during training from those who initially stated no preference. There was also a shift towards combining research with clinical practice and among women wishing to practise part‐time only. Generalists were more likely to wish to practise outside a capital city than specialists.Conclusions:The training programme should be revised so that careers in rural and provincial centres are encouraged and so that it is sensitive to the needs for physicians to develop research capacity. Training and career opportunities should allow all candidates (particularly women) wishing part‐time employment to achieve their full

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1996.tb02935.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground:Several previous studies have reported an increased frequency of the E4 allele of the gene for Apolipoprotein (APOE4) in both familial and sporadic Alzheimer's disease (AD). We report the results of a study of this association in an Australian clinic‐based sample.Aim:To investigate the relationship between APOE4 frequency and AD in an Australian clinic‐based sample and compare the results with previous studies.Methods:Subject DNA was PCR amplified, enzymatically digested withHhaland the resulting fragments electrophoretically separated. The genotypes were ascertained according to the resulting fragment sizes and the resulting allele frequencies analysed by calculating a z‐statistic for comparison of two proportions.Results:The frequency of the APOE4 allele was 53% in the AD group and 11% in the control group. This difference is statistically significant. There was no significant difference in E4 allele frequencies between AD subjects with a family history and those without. At least one E4 allele was found in 26/30 (87%) of AD patients and 10/50 (20%) of controls. The allele frequencies of the control subjects used in this study were found to be consistent with those of several previous studies.Conclusion:The frequency of the APOE4 allele was significantly higher in AD subjects than in unaffected controls. This provides further evidence of an association between APOE4 and both familial and sporad

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1996.tb02936.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground:A prospective study in non‐institutionalised Australian elderly aged 60 years and over commenced in Dubbo, NSW in 1988.Aim:To examine the relationship between all‐causes mortality and alcohol intake.Methods:The data were derived from a community‐based sample comprising 1236 men and 1569 women followed for a median period of 77 months. Regular alcohol intake was reported by 78% of men and 52% of women. Eighty‐seven per cent of men and 44% of women primarily drank beer.Results:Death occurred in 305 men and 236 women, 34% and 39% respectively from coronary heart disease (CHD). In a proportional hazards model, the hazard ratio (HR) for all‐causes mortality in male drinkers, compared with abstainers, was 0.75 at one‐seven drinks/week, 0.76 at eight‐14 drinks/week, 0.69 at 15–28 drinks/week and 0.49 at>28 drinks/week (p<0.04), an inverse relationship. In female drinkers, HR was 0.78 at one‐seven drinks/week, 0.49 at eight‐14 drinks/week (p<0.04) and 0.62 at 15–28 drinks/week, potentially a U shaped relationship. The effect on all‐causes mortality could not be attributed to a differential effect of beer versus wine/spirit intake. Although the mortality rate was lower in those taking any alcohol compared with abstainers, those taking any alcohol exhibited an increased proportion of deaths due to cancer at the expense of a reduced proportion of CHD and stroke deaths.Conclusions:Alcohol intake in the Dubbo elderly appears to be independently associated with a significant increase in life expectancy. Mechanisms underlying the effect may emerge at a longe

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1996.tb02937.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground:Approximately 40–60% of patients with asthma have gastro‐oesophageal reflux (GOR) and it has been postulated that this may worsen asthma severity.Aims:To investigate the effect of the potent gastric acid inhibitor omeprazole 40 mg orally daily on peak expiratory flow rate (PEFR), asthma symptoms and histamine bronchial responsiveness in adult patients with both asthma and GOR.Methods:This was a double blind, randomised, placebo controlled, crossover study. Upper gastrointestinal endoscopy, 24 hour oesophageal pH measurements, spirometry and histamine bronchoprovocation test (HIT) were performed prior to entry. Phase 1:2 week placebo run‐in period, with baseline recording of PEFR, asthma and GOR symptoms, and use of inhaled p2‐agonist. Phase 2: patients randomised to receive either placebo or omeprazole 40 mg/d for four weeks. Phase 3: placebo for two weeks. Phase 4: patients crossed over to opposite treatment from that of phase 2. Spirometry, and diary cards were assessed at beginning and end of phases 2 and 4. HIT was performed at the end of phase 2 and at the beginning and end of phase 4.Results:Twenty patients (eight female and 12 male) completed the study. The evening but not morning PEFR (% predicted) were significantly higher on omeprazolevsplacebo (82 ± 4% SEMvs79 ± 4% SEM;p<0.05).No significant differences were found in FEVj, FVC, histamine bronchial responsiveness and diurnal variation of PEFR between placebo and omeprazole treatments. Similarly, there were no significant differences during placebo and omeprazole periods in day time wheeze, cough, breathlessness, p2‐agonist use or night time wheeze and breathlessness. Day and night heartburn symptoms were significantly better on omeprazolevsplacebo (p<0.05).Conclusions:Omeprazole 40 mg daily improved evening PEFR in asthma patients with GOR. However, asthma symptoms, inhaled β2‐agonist use and histamine bronchial responsiveness

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1996.tb02938.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY