Australasian Medical Journal
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Selling addictions
Get PDFBackgroundThe purpose of this research was to identify, through alcohol industry documents, similarities between tobacco and alcohol companies in approaches to evidence and counter-arguments to public health measures.Method A search of the tobacco document archives through the World Wide Web for alcohol industry documents was conducted. Alcohol-related search terms were entered into search fields of the tobacco document archives.ResultsThe documents show that alcohol and tobacco companies have worked closely together, have shared information, share similar concerns and have used similar arguments to defend their products and prevent or delay restrictions being placed on their products.ConclusionThis paper provides evidence that alcohol and tobacco companies are similar in a number of ways and there is scope to use these similarities in developing more effective public health approaches to addressing alcohol consumption and related harms
Seasonal Variation of Acute Urolithiasis
Get PDFBackgroundUrolithiasis is a common condition. It often affects patients in the prime of life causing significant burden to the society. In our study we are interested in determining whether seasonal variation is a risk factor of acute urolithiasis. Method A retrospective study was performed at a tertiary hospital in Canberra, ACT, Australia. Data pertaining to patient demographics, history of renal colic and management were extracted from charts over a 10-year period. Climatic data for the Australia Capital Territory during this period was retrieved from the Australian Bureau of Meteorology and correlated to renal colic presentations.ResultsData was obtained for 637 patients all with radiologically confirmed calculi of the urinary tract. The median age at diagnosis was 50 years of age. Overall 37.4% of patients had a previous history of urolithiasis and the male to female ratio was 2.8:1. Presentation was most common in the autumn months (32.8%), with the fewest cases of urolithiasis during the winter months (18.7%). At presentations the majority of the calculi were ≤ 5mm and located within the distal ureter. Conservative treatments were instituted more often when stone size was ≤ 5mm. Proximal ureteric calculi were more likely to be treated with surgical intervention.ConclusionWe demonstrate an association between the presentation of primary urolithiasis and season. A better understanding in the subject may help future health care planning to deal with the seasonal increase in presentations of renal colic to the urology service
Misinterpreting P-Values in Research
Get PDFThe overuse of p-values to dichotomize the results of research studies as either being either significant or non-significant has taken some investigators away from the main task of determining the size of the difference between groups and the precision with which it is measured. Presenting the results of research as statements such as “p 0.05”, “NS” or as precise p-values has the effect of oversimplifying study findings. Further information regarding the size of the difference between groups is required. Presenting confidence intervals for the difference in effect, of say two treatments, in addition to p-values, has the distinct advantage of presenting imprecision on the scale of the original measurement. A statistically significant test also does not imply that the observed difference is clinically important or meaningful
Indications for Caesarean Section in Coastal South India
No full textBackgroundIncreasing Caesarean Section (CS) rates is a concern in the health care systems all over the world, in a developing country an increase in the CS rate has major implications on the limited health care resources, this study was carried out with an objective to find out the trends and indications of CS in a government hospital. Method A hospital based retrospective study was carried out in a tertiary Government-run hospital specializing in Obstetrics and Gynaecology and all deliveries conducted from Jan 1st 2009 to Dec 31st 2009 were included, the data was collected using a pro forma designed based on the recommendations for routine reporting on caesarean delivery in developing countries. ResultsThere were 7543 deliveries in the study period with 1756 being CS, giving a rate of 23.27%. Most of the CSs were performed because of a previous CS. Foetal distress, breech presentation and failed induction were the other prominent indications. Placenta praevia and malpresentations were the most important absolute Indications of CS. ConclusionThere has been a steady rise in CS rates in our hospital over the years; major indications were Previous caesarean section, followed by Foetal Distress and Breech presentation. Trial of Vaginal Birth After Caesarean should be given, failing which, a CS has to be performed if indicated
Australia the Healthiest Nation
Get PDFBackgroundThe National Preventative Health Taskforce has set a 30% target reduction in the proportion of risky and high-risk drinkers by 2020. This study estimated the potential saving in deaths, hospitalisations and associated economic cost savings to premature mortality and health of achieving the target.Method Past national estimates of alcohol-attributable hospitalisations and deaths were used to forecast trends from 2007 to 2020. Estimated potential savings in deaths and hospitalisations were based on incremental decline in the prevalence of risky/high-risk drinking reaching a total of 30% by 2020 (about 2.3% per year). Associated economic costs of premature death were estimated using the Value of Statistical Life method (willingness to pay). Hospital costs were estimated from known trends in annual national costs for recent past years and taking inflation into account.ResultsA 30% reduction in risky/high-risk drinkers would avoid an estimated 7,200 deaths and some 94,000 person-years-of-life lost due to premature death by 2020. The estimated benefit to the health sector would include 330,000 fewer hospitalisations and 1.5 million associated bed days. The net present value of these benefits is AUD 22.7 billion from deaths avoided and AUD 1.7 billion from fewer hospital separations totalling AUD 24.4 billion.ConclusionThe potential savings in premature deaths, health and associated financial costs of a 30% reduction in risky and high-risk drinking by 2020 across the Australian population are considerable
Participation in the National Bowel Cancer Screening Program
No full textBackground The National Bowel Cancer Screening Program (NBCSP) is a population-based screening program based on a mailed screening invitation and immunochemical faecal occult blood test. Initial published evidence from the NBCSP concurs with international evidence on similar colorectal cancer screening programs about the unequal participation by different population sub-groups. The aim of the paper is to present a cross-sectional analysis of participation in the NBCSP for Adelaide, in order to identify geographical areas and population groups which may benefit from targeted approaches to increase participation rates in colorectal cancer screening. Method De-identified data from the NBCSP (February 2007 to July 2008) were provided by Medicare Australia. Mapping and analysis of the NBCSP data was performed using ESRI ArcGIS software, MapInfo, Microsoft Access and Microsoft Excel. Data was aggregated to postcode and participation was then mapped according to overall participation rates, sex and age. Results The overall participation rate was 46.9%, although this differed by age, gender and geographical location. Maps provided in the paper reveal a socio-economic patterning of participation in the NBCSP, whereby areas with higher participation rates are also more affluent, whereas areas with lower participation rates tend to be more disadvantaged. Conclusion Findings from this study suggest inequities in participation in the NBCSP on the basis of gender, geographical location, and socio-economic status
Anaemia and Pregnancy in Rural India
No full textBackgroundAnaemia is the most frequently observed nutritional diseases in the world. In India, anaemia is the second most common cause of maternal death, accounting for 20% of total maternal deaths. This study aims to determine the prevalence of anaemia and to explore factors associated with anaemia in one rural Indian pregnant population.Method The study was conducted in the Maternity Clinic of Pravara Rural Hospital (PRH), Loni, Ahmednagar, Maharashtra, India... Only pregnant women who were 12-20 weeks of gestation were eligible for inclusion. Anaemia was classified as per the World Health Organisation (WHO) grading criteria. The diagnosis of anaemia was undertaken using the standard peripheral blood smear examination. Consenting participants were interviewed using a pre- structured, pre-tested questionnaire.ResultsThree hundred and ten subjects were enrolled, of whom 232 (74.8%) were found to be anaemic. The majority (50.9%) demonstrated moderate anaemia while mild and severe anaemia were recorded in 70 (30.17%) and 44 (18.9%) respectively. A highly significant association was found with the mother‘s age, educational and socio-economic status, religion, parity and Body Mass Index (BMI). Other factors such as family structure and size, dietary habits and attainment of menarche were not significantly associated with anaemia.ConclusionVery high prevalence of anaemia (74.8%) early in pregnancy is an indicator of the failure of WHO and national programmes aimed at reducing anaemia in this group. Those pregnant for the first time are at greatest risk of developing anaemia