摘要:

Abstract:The proportion of the Australian population from non‐English‐speaking backgrounds is increasing (particularly among the elderly, who are more likely to be disabled), but their use of health services and institutions is proportionately lower than that for other Australians, and many care for a family member with a disability or illness at home. The study objective was to document the experiences of such carers in using health and other support services in order to understand the reasons for underutilisation. This study differs from most other carer studies in concentrating on carers with little or no English, and by using a semistructured interview that enabled carers to describe their experiences and attitudes more openly. Forty women carers were interviewed, with bilingual interviewers or interpreters being used where necessary. Interviews were tape‐recorded and content‐analysed. The services used, sources of information and referral, and the reasons for not using a service were identified. Some of the difficulties experienced in using services were common to many carers, irrespective of background, whereas others related specifically to English language deficits and cultural differences. Carers were reluctant to institutionalise a family member, despite their own health problems, emphasising the need for greater support from existing and expanded services to enable the relative to be cared for

ISSN:1326-0200    

DOI:10.1111/j.1467-842X.1996.tb01332.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:To examine how functional, medical and psychosocial factors influence the differences in use of community and residential services by Australian‐born and ethnic aged persons, all persons (n= 31 737) assessed by aged care assessment teams in Queensland in 1992 and 1993 were surveyed. Subjects were classified as Australian‐born, overseas‐born in countries where English is the primary language, or overseas‐born in countries where English is not the primary language. Factors compared included use of services and residential care both prior to assessment and following assessment, and functional, medical and psychosocial factors. The group with non‐English‐speaking background were more likely to be both younger and underreferred compared to their proportion in the community. They were more likely to be referred for, and more likely to be recommended for, nursing home placement than the English‐speaking groups. They were more commonly referred for assessment because of mental deficit problems, carer stress and/or social isolation, more likely to be diagnosed with dementia and diabetes, and less likely to be diagnosed with respiratory disease and vision disorders. That clients of non‐English‐speaking background are more likely to be recommended for nursing home placement is probably largely because of more advanced disease at the time of referral and therefore more functional dependence. Aged care assessment teams should increase ethnic communities' awareness of their services, particularly of the benefits of

ISSN:1326-0200    

DOI:10.1111/j.1467-842X.1996.tb01333.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:This paper reports the findings of the evaluation of the South Australian component of the National Better Health Program. The evaluation used analysis of focus‐group interviews and key documents to assess the value of the state program. The evaluation demonstrated that for a relatively small investment ($2.4 million was allocated to the project over four years, representing only 0.5 per cent of the annual budget for teaching hospitals in South Australia), much can be achieved by harnessing the energy of local communities. The evaluation concluded that more attention should be directed to structural change, with an emphasis on collaboration across sectors, and community participation. Some key issues for the planning and implementation of health promotion were highlighted: the challenge of marrying local initiatives based on community development with national health promotion objectives; the importance of dedicated cind assured funding; the need for increased training and support for health promotion workers; and the importance of continuing a focus on equity in the implementation of health promotion. The paper concludes by questioning the value of the current Australian goals, targets and strategies for health, given the findings from this evaluatio

ISSN:1326-0200    

DOI:10.1111/j.1467-842X.1996.tb01334.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:The aim of this study was to assess the relationship between previous child care outside the home (day care or family care) and acute respiratory illness in the first year at primary school. Participants were 445 Adelaide school children (mean age 5 years 2 months), 73 per cent of those eligible. Information about early childhood, family, child care arrangements and illness history was obtained from a questionnaire completed by parents. A respiratory illness score was calculated from the parental reports of respiratory illness experience in the winter months of the second school term in 1992. Absences from school owing to respiratory illness were counted from school records. Children who had attended child care before commencing school had fewer episodes of acute respiratory illness and had fewer absences from school than children with no child care experience. Children who had attended child care prior to commencing school experienced half as many episodes of asthma as those children who had never attended child care. Children who attend day care before age five tend to experience less acute respiratory illness than their peers on school entry. Possible explanations include selection of illness‐prone children into home care, protection against respiratory illness as a result of early exposure, and a shift in the age‐related peak of illn

ISSN:1326-0200    

DOI:10.1111/j.1467-842X.1996.tb01335.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:The decision about whether the findings from analytical epidemiological studies can be extrapolated to another setting is an important one. We discuss some of the issues involved in the process of generalisation. A critical systematic qualitative approach should be used. This involves an assessment of the internal validity of the study and of the nature of the study base. The study subject matter and choice of epidemiologic measure should be considered. A study base similar to the target population is essential if the study is descriptive or if there is concern about effect modifiers whose effects cannot be predicted. In addition, data from quantitative tests of study findings in different populations should be considered.

ISSN:1326-0200    

DOI:10.1111/j.1467-842X.1996.tb01336.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:The practice of testing for human immunodeficiency virus (HIV) without the specific knowledge and consent of the patient raises ethical and legal issues. This report argues that diagnostic HIV testing of specific patients, without their consent, is unethical and may also be illegal. Testing for HIV prevalence on an anonymous, unlinked basis, however, is an important aspect of public health surveillance, and the ethics of clinical intervention should not be confused with the ethics of epidemiological research. Specific consent is usually desirable in view of privacy concerns, the importance of patient autonomy, and the potential for conflict of interest. However, where otherwise appropriate, the law should be clarified to permit nonconsensual HIV testing to proceed legally, possibly following scrutiny by an institutional ethics committee.

ISSN:1326-0200    

DOI:10.1111/j.1467-842X.1996.tb01337.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:The aim of the study was to estimate the prevalence of hepatitis C infection among attenders of several high‐volume needle exchanges in southeast Queensland, and to compare the prevalences among the needle exchanges. Clients at four needle exchanges were surveyed over a five‐day period by means of a self‐administered questionnaire. A high proportion of respondents (76 per cent) reported having been tested for hepatitis C antibodies and the overall prevalence of reported hepatitis C infection was 34 per cent. Thirty‐one per cent of the respondents were amphetamine injectors, among whom there was a lower prevalence of reported hepatitis C infection than among opioid injectors (odds ratio 0.18,P<0.01). There were some differences in the respondents' characteristics and in hepatitis C prevalence between different needle exchanges. The reported prevalence of HIV infection was 2 per cent. This study highlights the importance of surveying a range of needle exchanges to obtain a representative sample of needle‐exchange clients overall. The low prevalence of hepatitis C in some groups of injecting drug users suggests that it is possible to prevent hepatitis C transmission among injecting drug users, and points to the opportunity for aiming hepatitis C prevention strategies at the

ISSN:1326-0200    

DOI:10.1111/j.1467-842X.1996.tb01338.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:This article reports on terminations of pregnancy done in New South Wales (NSW) for NSW residents, using routinely collected data from the Health Insurance Commission (HIC) and the NSW Inpatient Statistics Collection (ISC). The HIC and ISC recorded 29 348 terminations for NSW residents in 1990, representing a termination rate of 21.6 per 1000 women aged 15 to 44. Terminations were frequent at all ages, but the highest termination rate was in the 20 to 24 age range (36.8 per 1000). About one‐quarter of all known pregnancies were terminated (excluding spontaneous abortions). The majority of terminations were done in private clinics; only 10 per cent of women having terminations were public patients in public hospitals. Outside the Sydney metropolitan area, termination rates were lower than in Sydney, and the procedures were more likely to be done in public hospitals. Large numbers of terminations are done in NSW, but the rate appears to have been constant since the early 1980

ISSN:1326-0200    

DOI:10.1111/j.1467-842X.1996.tb01339.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:Health outcomes have become an important public health policy focus in Australia. The New South Wales Health Department's Health Outcomes Program includes asthma as one of its priority areas. This study combined a survey of a non‐random sample of 14 asthma researchers and clinicians and the results of a literature review to determine the current status and validity of outcome indicators used in relation to asthma. A written questionnaire was used to present individual patient, clinical trial, school intervention and public health scenarios, and respondents were asked to nominate asthma outcome indicators they would use in each scenario as well as their estimate of the indicators' validity. The results provide a critical appraisal of a variety of asthma outcome indicators with regard to their repeatability, and their concurrent and predictive validit

ISSN:1326-0200    

DOI:10.1111/j.1467-842X.1996.tb01340.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:This study aimed to identify sociodemographic factors associated with edentulism (loss of all teeth) and the average number of teeth lost, and to investigate relationships between tooth loss and chewing capacity. Data were obtained in 1991–92 from a cross‐sectional oral epidemiological survey of Adelaide residents aged 60+ years. Interviews with 1160 participants provided information on edentulism while oral examinations among 560 dentate participants and 313 edentulous participants provided information on the number of missing teeth. People were asked if they could chew or bite six common foods. Some 41.1 per cent of persons were edentulous, and nearly half the natural teeth (mean 15.2) were missing among dentate people. Multivariate analyses revealed higher rates of edentulism (P≤ 0.05) for people who were older, female, Australian‐born, or holders of pensioner health benefit cards, and for people who left school at an early age, or who did not own their residence. Among dentate people there were more (P≤ 0.05) missing teeth among those who were older, Australian‐born, health benefit card holders, and who left school at an early age. Some 37.9 per cent of people reported difficulty chewing at least one food, although 57 per cent of dentate people and virtually all edentulous people wore dentures. Difficulty chewing was associated with tooth loss: 6.1 per cent of people with fewer than nine missing teeth reported difficulty compared with S8.6 per cent of edentulous people (P<0.01). The findings show substantially compromised oral health among older adults, particularly the oldest‐old and disadva

ISSN:1326-0200    

DOI:10.1111/j.1467-842X.1996.tb01341.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY