ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00183.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.tb00184.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.tb00185.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.tb00186.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.tb00187.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:This study aimed to determine the immunisation status of preschool‐aged children attending formal child‐care facilities in north Queensland, and to examine factors associated with failure to be completely immunised by two years of age. Child‐care centres and kindergartens within the Cairns City and Mulgrave Shire local government boundaries were selected randomly with probability proportional to size, and 613 children (median age of 47.0 months) were selected randomly from the facilities. Only 60.3 per cent (95 per cent confidence interval (CI) 56.3 to 64.3) of the children were fully immunised by two years of age. Children who had not received any vaccines by three months of age (that is, ‘late starters’) were less likely to be fully up‐to‐date at two years of age than children who started on time (odds ratio (OR) 10.3; CI 5.2 to 20.9). Children without a parent‐held immunisation record were less likely to be up‐to‐date at two years of age than those children with a parent‐held immunisation record (OR 2.8; CI 1.9 to 4.0). With follow‐up of late‐starters, and with the simultaneous administration of overdue vaccines with vaccines given in the second year of life, the percentage of children up‐to‐date at 24 months of age could have increased from 60.3 per cent to 82.3 per cent (CI 79.1 to 85.5). The immunisation coverage rates were inadequate to prevent outbreaks of vaccine‐preventable diseases. Innovative strategies will be required if the vaccine coverage rates are to be improved. The parent‐held immunisation record is of fundamental i

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00188.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:Our aims were to describe the epidemiology ofBordetella pertussisinfection in Victoria during the last decade and to evaluate surveillance ofB. pertussisby comparing notifications with laboratory isolations and hospital diagnoses. Whooping cough was once a leading cause of childhood morbidity and mortality but there was a dramatic reduction in the 1940s because of immunisation. During the last two decades, controversy about the vaccine's toxicity has resulted in waning immunisation rates and outbreaks of the disease. The notification system in Victoria has undergone changes which make interpretation of surveillance data difficult. We compared notifications ofB. pertussiswith laboratory data from the Royal Children's Hospital and hospital separations withB. pertussisfrom all hospitals in Victoria. The latter sources revealed epidemic years of infection in 1982, 1985 and 1989. This was not apparent from notifications alone and highlights the importance of using multiple sources of surveillance data. We also found a higher rate of notification from Geelong than rural Victoria and metropolitan Melbourne. The fluctuating incidence ofB. pertussisinfection in the last decade may reflect changing immunisation practices. Unfounded fears that pertussis vaccine causes serious neurological sequelae have inappropriately influenced individual practice and legislation. The increased notification ofB. pertussisin the early 1980s may have reflected the omission of the fourth dose of pertussis vaccine from the Australian schedule in 1979. Surveillance data should be used not only for descriptive epidemiology, but for public health action, and efforts should be made to ensure that immunisation rates remain high.

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00189.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:Following a decade of accumulating clinical reports on child drowning in domestic swimming pools, paediatricians began advocating legislation that would require all pools to be ‘isolation' fenced. In 1990, the New South Wales Government introduced and then repealed such legislation following intense lobbying and media advocacy from a group of pool owners. This paper reviews the ways in which isolation fence advocates and opponents framed their public arguments. Five main areas of competing public discourse are identified: why pool drownings occur; the effects of fencing; expert views and community support; the role of the state in prevention; and personalised references to the value systems of those involved in the debate. Two factors seem likely to have contributed most to the overthrow of the legislation: fence opponents inhabiting the same noninterventionist ideological frame of reference as the government; and fence advocates' refusal to compromise on retrospective fencing seems likely to have inspired a commitment in opposition which would have been absent if an incrementalist, prospective fencing policy had been adopte

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00190.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:This paper reports on a recent research project which explored the social meaning of heterosexual relationships for young women aged 16 to 18. Drawing on intensive interviews with 95 young women from a diverse range of backgrounds, the study provided evidence that young women remain relatively ignorant about all aspects of sexually transmitted diseases (STDs), that the provision of health services to young women is far from adequate and that public health measures have failed to address the issue of the social and political context in which young women operate. Furthermore, there is evidence that the public health campaign to reduce infection with the human immunodeficiency virus has had a counter productive effect on the prevention of STDs. There are three key dimensions to the prevention of STDs through public health measures: ensuring that young women have adequate knowledge to prevent STDs; provision of adequate health services for young women and fostering a social and political milieu which will support women's control over their sexuality.

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00191.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:The study aimed to assess rates of illegal cigarette sales to children and the impact on these rates of publicity and a warning letter threatening prosecution. Children aged 12 and 13 made two repeat purchasing attempts, three months apart, at 255 randomly selected tobacco retail outlets in Sydney. A randomly selected 50 per cent of retail outlets which sold cigarettes illegally at the first attempt were sent warning letters threatening prosecution. Publicity about the undercover buying operation was organised between the attempts. At the first attempts, 39 per cent of shops sold cigarettes to the children and 32 per cent sold them at the second attempt. Shops which sold on the first occasion and received warning letters reduced selling by 69 per cent compared to the 40 per cent reduction in shops which sold cigarettes on the first attempt and were not sent warning letters, a net reduction of 29 per cent seemingly attributable to the warning letters (95 per cent confidence interval 8 per cent to 50 per cent). It is extremely easy for children as young as 12 to buy cigarettes. The combined effects of publicity about undercover buying operations and warning letters threatening prosecution seem capable of reducing selling by about 29 per cent. Because of inconsistencies in selling or refusals, future attempts to measure selling rates to children should use repeat purchasing attempts and classify outlets as ‘selling’, ‘not selling’ or ‘sometimes

ISSN:1035-7319    

DOI:10.1111/j.1753-6405.1994.tb00192.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY