Trachoma in the Northern Territory of Australia, 1940-1986

All known surveys of the prevalence of trachoma in the Northern Territory from 1940 to the present were reviewed. The crude (overall) prevalence rates for trachoma were calculated from the results of those surveys which involved whole Aboriginal communities. When three-or-more surveys had been conducted in a community over a period of 10 years or more, the results were plotted against the year of the survey. In most communities in the north of the Northern Territory (the "Top End"), the prevalence of trachoma appeared to have increased dramatically between 1950 and 1955 and then to have declined substantially at a rate of 2% per annum. This fall occurred before the mass-treatment programmes of the late 1970s and its most likely explanation is the improvement in living conditions. In five- to 10-years' time, trachoma may have disappeared completely from these communities. In most Central Australian communities, the prevalence of trachoma appears to have been constant or even to have increased. If social conditions were to begin to improve in Central Australian communities this year, and if those communities were to show the same response rates as in the Top End communities, then it could be well into the next century before the prevalence of trachoma there falls to the low rates of the Top End. This should be an impetus for social change in Central Australia; however, there might be a case for medically based control programmes in Central Australia, at least in the short term.     

Measures of tobacco smoking in Australia 1974-1986 by means of a standard method

Trends in smoking among Australian adults as based upon surveys with a standard method in 1974, 1976, 1980, 1983 and 1986 are presented. The percentage of male cigarette smokers fell from 42.2% in 1974 to 31.9% in 1986 and the percentage of female smokers was 29.5% in 1974 and 28.8% in 1986. Over the period of observation, the percentage of past smokers of both sexes climbed steadily and, in 1986, reached 28.1% of men and 16.8% of women.     

The incidence and distribution of RSI in South Australia 1980-81 to 1986-87

Despite the human and financial cost of repetition strain injury (RSI), comprehensive incidence data have been lacking. A unique opportunity exists to obtain such data in South Australia, where since 1980-81 the Australian Bureau of Statistics has assigned all injuries, not explicitly diagnosed as diseases but stated as having been caused by repetitive movement, to a unique "type of accident" code, and has subclassified them according to bodily location. The statistical profile of diseases and accidents affecting the upper limb resulting from repetitive movement is not simply one of a keyboard operators' epidemic. Rather, it has revealed a problem which is endemic in sections of the blue-collar workforce, in whom both the numbers and the incidence rates are higher than in keyboard operators, and were higher even when the incidence in keyboard operators peaked in 1984-85. These conditions have been especially frequent in particular sections of the female blue-collar workforce, and interventions which have resulted in (or coincided with) benefits to keyboard operators have failed to improve the situation in the former group. It is suggested that the groups most at risk are female workers performing unfulfilling, unskilled tasks, and that interventions to benefit these workers will have to give attention to more fundamental issues than those hitherto addressed.     

Pregnancy outcomes in primigravid women aged 35 years and over in South Australia, 1986-1988

The South Australian perinatal data collection for 1986-1988 was used to compare the characteristics and outcomes of singleton pregnancies in 515 primigravid women aged 35 years and over with those in 4175 younger primigravid women aged 20-29 years. Notable differences observed were a higher prevalence of medical, obstetric and labour complications and assisted deliveries in the older group. Breech presentations were almost twice as common in the older women, as were caesarean sections. Only 27% achieved a spontaneous vaginal delivery. The mean duration of hospital stay for the older women was longer for both vaginal and caesarean deliveries. However, although their babies were more likely to be premature or of low birthweight, the perinatal mortality rate was not significantly increased and the great majority of older primigravid women managed by modern obstetric methods can expect a good pregnancy outcome.     

克林澳治疗糖尿病大血管病变的临床意义

目的:探讨克林澳治疗糖尿病大血管病变临床疗效,方法:将130例糖尿病大血管病变患者分为治疗组对照组各65例,治疗组采用克林澳治疗,对照组采用复方丹参、参麦治疗,观察临床疗效和血液流变学指标及药物不良反应。结果:治疗组总有效率86.1%、明显优于对照组58.6%(P<0.01),两组治疗后血粘度检查差异有显著性(P<0.05),无明显不良反应。结论:克林澳是治疗糖尿病大血管病变的一种有效药。     

Aboriginal and white births in Western Australia, 1980-1986. Part I: Birthweight and gestational age

This article describes the distributions of birthweight and gestational age of all singleton Aboriginal and white live-born infants in Western Australia for the period 1980-1986. At early gestational ages, the mean birthweight was greater for Aboriginal infants. However, after 34-weeks' gestation for male infants and 32-weeks' gestation for female infants, the pattern was reversed. More Aboriginal infants were of low birthweight--male Aboriginal infants, 9.8%; male white infants, 4.0%; female Aboriginal infants, 12.4%; and female white infants, 4.6%, this excess only occurred in term (37- to 41-weeks' gestation) and post-term (42- to 52-weeks' gestation) infants. The birthweight distributions for Aboriginal and white infants were similar in preterm infants, but at term and beyond Aboriginal infants tended to be lighter. Preterm (fewer than 37-weeks' gestation) births were more common among Aborigines (male Aboriginal infants, 16.0%; white male infants, 6.8%; female Aboriginal infants, 15.9%; and female white infants, 6.0%). Thus, it seems that the distributions of both birthweight and gestational age in Aboriginal infants are shifted downward compared with those for white infants. Aboriginal infants normally may be smaller and more likely to be born earlier than are white infants as well as having a definite shift towards pathological growth retardation at term and beyond.     

Diabetes among aboriginal people in central Australia: a high prevalence based on health service attendance

The prevalence of diagnosed diabetes in Aboriginal people living in central Australia (population, 9983) was determined by collating data from the hospital, rural and urban health services, nursing homes and death registers. A total of 98 male and 183 female Aboriginal residents with diabetes attended health services in central Australia between January 1984 and December 1986. The point prevalence of diagnosed diabetes at the end of 1986 in the age group 25-34 years was 1.6% in men and 3.1% in women, and in those over 35 years, 8.8% and 14.1%, respectively. The true prevalence of diabetes (diagnosed and undetected) is likely to be at least twice this rate, and constitutes a major public health problem in central Australia. Diabetes and other disorders such as obesity, hypertension and ischaemic heart disease have common antecedents and outcomes. The control of these non-communicable diseases requires integrated and culturally appropriate educational, social and medical strategies.     

仲景消渴学说在糖尿病治疗中的运用

根据仲景消渴学说的基本特点和理论内涵,将《伤寒杂病论》有关消渴的病机整理归纳为燥热内盛、气阴双亏、阴阳并虚、水湿内停、气机郁滞、瘀血内阻、湿热蕴结七种类型,并探讨张仲景创立的清热润燥、益气养阴、调补阴阳、通阳行水、疏理气机、活血化瘀、清化湿热等治法在糖尿病治疗中的运用。认为深入系统研究仲景消渴学说,对指导目前糖尿病的治疗和挖掘有效方药具有重要意义。     

Overweight and obesity in Australia: the 1999-2000 Australian Diabetes,Obesity and Lifestyle Study (AusDiab)

OBJECTIVE: To measure the prevalence of obesity in Australian adults and to examine the associations of obesity with socioeconomic and lifestyle factors. DESIGN: AusDiab, a cross-sectional study conducted between May 1999 and December 2000, involved participants from 42 randomly selected districts throughout Australia. PARTICIPANTS: Of 20,347 eligible people aged > or = 25 years who completed a household interview, 11,247 attended the physical examination at local survey sites (response rate, 55%). MAIN OUTCOME MEASURES: Overweight and obesity defined by body mass index (BMI; kg/m(2)) and waist circumference (cm); sociodemographic factors (including smoking, physical activity and television viewing time). RESULTS: The prevalence of overweight and obesity (BMI > or = 25.0 kg/m(2); waist circumference > 80.0 cm [women] or > or = 94.0 cm [men]) in both sexes was almost 60%, defined by either BMI or waist circumference. The prevalence of obesity was 2.5 times higher than in 1980. Using waist circumference, the prevalence of obesity was higher in women than men (34.1% v 26.8%; P < 0.01). Lower educational status, higher television viewing time and lower physical activity time were each strongly associated with obesity, with television viewing time showing a stronger relationship than physical activity time. CONCLUSIONS: The prevalence of obesity in Australia has more than doubled in the past 20 years. Strong positive associations between obesity and each of television viewing time and lower physical activity time confirm the influence of sedentary lifestyles on obesity, and underline the potential benefits of reducing sedentary behaviour, as well as increasing physical activity, to curb the obesity epidemic.     

Drownings in Florida 1977-1986

Drowning is a serious public health problem in Florida. It is the leading cause of death among children aged one to four years. We studied Florida drownings for 1977-1986 using data from the Florida vital statistics mortality file and found that 5,525 occurred, the greatest number in 1980 (688), the fewest in 1985 (453). The reasons for this decrease are not clear, but the greatest decrease occurred in swimming pool drownings. Nonwhite males had the highest overall drowning rates, except for those under age five or 80 and above. White males had the highest drowning rates for persons under age five; most of these occurred in swimming pools. No single approach will prevent drownings in all high risk groups. Priority should be given to foursided fencing of swimming pools and to further study of nonwhite male drownings.