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Biomedical subjects

C Rissel

Publications and source records attributed to C Rissel.

At least 19 recordsLinked to original sources

Sexual behaviour and risk in Vietnamese men living in metropolitan Sydney.

OBJECTIVE: To describe sexual risk in Vietnamese men who have sex with female sex workers by describing the prevalence of sexual risk behaviours among Vietnamese men living in inner Sydney and comparing this prevalence with national data. METHOD: Telephone interviews were completed with a random sample of 499 Vietnamese men, selected from the electronic telephone book using a list of common Vietnamese surnames. RESULTS: Of the 761 eligible men contacted, data were obtained from 499 men, giving a response rate of 66%. 20% reported having had sex with a sex worker, including 12% of Vietnamese men who had had sex with a sex worker outside Australia, predominantly in Vietnam. Of the men who had had sex with a sex worker in the past year, 28% had unprotected vaginal or anal sex at their most recent commercial sexual encounter. Ever having paid for sex was significantly associated with a higher lifetime number of sexual partners (p<0.001), history of a sexually transmitted infection (p<0.001) and ever having an HIV test. 1% of respondents reported injecting non-prescription drugs. Less than 1% said they had had sex with another man. CONCLUSION: Vietnamese men living in Sydney generally show lower levels of sexual and related risk behaviours than other Australian men. However, sex with a sex worker is common among Vietnamese men in Sydney and also when they travel outside Australia. Unprotected vaginal sex with sex workers is surprisingly common. Programmes are needed to deal with vulnerabilities in these areas.

Adolescent↗

Encouraging cycling through a pilot cycling proficiency training program among adults in central Sydney.

In the face of declining population levels of physical activity, programs that encourage cycling represent an under-developed strategy in Australia. In 2003, we implemented a pilot cycling proficiency training (CPT) program for adults in central Sydney, New South Wales. To evaluate the program, participants completed pre- and post-course self-administered questionnaires and participated in a follow-up telephone interview 2 months after their course. Between April and December 2003, 20 CPT courses were conducted. Of 113 people who started a course, 81 (72%) completed at least one course (beginner or intermediate) and 105 (93%) took part in the pre and follow-up interview. Participant satisfaction with all aspects of the course was high. At 2-month follow-up, the course had significantly increased participants' self-reported skills and confidence for cycling. More than half of the participants (56%) said they cycled more 2 months after the course. There was a 40% increase in participants having cycled in the previous week at follow-up among baseline non-cyclists, although this was not statistically significant. There was also a significant increase in weekly participation in other forms of moderate intensity physical activity. Overall, the program was reasonably successful, particularly among those people not cycling at baseline. Cycling proficiency training for adults is one strategy that can supplement other active transport policies to encourage physical activity, although bicycle friendly urban planning and policies are still required to create more supportive environments for cyclists.

Adult↗

Driving to work and overweight and obesity: findings from the 2003 New South Wales Health Survey, Australia.

OBJECTIVES: To examine possible associations between driving to work, physical activity and overweight and obesity. DESIGN: Secondary analysis of cross-sectional data from a representative sample of the 2003 New South Wales Adult Health Survey, Australia. SUBJECTS: A total of 6810 respondents aged 16 years or over. MEASUREMENTS: Self-reported height and weight, modes of transport to work, level of physical activity, fruit and vegetable intake and social-economic status. RESULTS: Almost half of the respondents (49%) were overweight. The main mode of transport to work was driving a car (69%), 15% used public transport, 7% walked, 2% cycled and 6% worked at home. People who drove to work were less likely to achieve recommended levels of physical activity compared to non-car users (56.3 vs 44.3%, chi2 = 82.5, P<0.0001). Driving to work was associated with being overweight or obese (adjusted odds ratio = 1.13 (95% CI 1.01-1.27), P = 0.047). Inadequate level of physical activity was independently associated with overweight or obesity. Socially and economically disadvantaged people were also more likely to be overweight and obese. In addition, being female or never married or having higher level of education was associated with a significantly reduced odds ratio of being overweight or obese, as was speaking a language other than English at home. No association was found between weight status and recommended vegetable or fruit intake. CONCLUSIONS: Driving to work is the dominant mode of commuting in a modern society and its impact on health requires scrutiny. The association found in this study between driving to work and overweight and obesity warrants further investigation to establish whether this relationship is causal. If proved as such, then promoting active transport modes such as walking, cycling and public transport should form a key component of global obesity prevention efforts.

Adolescent↗

Smoking and erectile dysfunction: findings from a representative sample of Australian men.

OBJECTIVES: To examine whether there is an association between smoking and erectile dysfunction in a representative sample of Australian men. DESIGN: Secondary analysis of cross-sectional survey data from the Australian Study of Health and Relationships. PARTICIPANTS: 8367 Australian men aged 16-59 years. MAIN OUTCOME MEASURES: Erectile dysfunction was identified in men who reported having had trouble keeping an erection when they wanted to, a problem which persisted for at least one month over the previous year. Variables examined in multivariate logistic regression analyses included age, education, presence of cardiovascular disease and diabetes, and current alcohol and tobacco consumption. RESULTS: Almost one in 10 of the respondents (9.1%) reported erectile dysfunction that lasted for at least one month over the previous year. More than a quarter (27.2%) of respondents were current smokers, with 20.9% smoking < or = 20 cigarettes per day, and 6.3% smoking > 20 cigarettes per day. Compared with non-smokers, the adjusted odds ratios for erectile dysfunction were 1.24 (95% confidence interval (CI) 1.01 to 1.52, p = 0.04) for those smoking < or = 20 cigarettes per day and 1.39 (95% CI 1.05 to 1.83, p = 0.02) for those smoking > 20 cigarettes per day, after adjusting for other confounding factors. Older age, low level of education, and taking medications for cardiovascular disease were also independently and positively associated with erectile dysfunction. In contrast, moderate alcohol consumption (1-4 drinks per day) significantly reduced the likelihood of having erectile dysfunction. CONCLUSIONS: Erectile dysfunction is a significant health concern affecting around one in 10 Australian men aged 16-59 years. Current smoking is significantly associated with erectile dysfunction in Australian males. This association was strengthened as the number of cigarettes smoked increased. Health promotion programmes could use the link between smoking and erectile dysfunction to help reduce smoking levels among men.

Adolescent↗

Sexual health behaviours among Pacific Island youth in Vanuatu, Tonga and the Federated States of Micronesia.

ISSUES ADDRESSED: This study was conducted to describe the sexual risk behaviours of youth within the Pacific Island nations of Vanuatu, Tonga and the Federated States of Micronesia. METHODS: General health behaviour surveys were conducted with youth aged 15-19 years and not attending school in the three countries. A sample of 390 Ni-Vanuatu youth from the Shefa Province, 934 youth from three island provinces of Tonga and 92 youth from Pohnpei, the main island of the four island states of the Federated States of Micronesia, were interviewed in gender-specific groups. Questions were asked about sexual behaviours that may contribute to unintended pregnancy or sexually transmitted infections (STIs). RESULTS: Moderate to high percentages of youth were sexually active (had a least one sexual partner) in the Pacific island nations of Vanuatu (49.7%), Tonga (35.5%) and the Federated States of Micronesia (76.1%). Young men were more likely to engage in sexually risky behaviour than young women. They were more likely to be sexually active, have had multiple sexual partners and have had sex when drunk or high. Of those sexually active, more young men than women in Vanuatu (36.1% compared with 30.6%) and Micronesia (54.2% compared with 50%) never used protection against STIs. However, of the sexually active Tongan youth, the proportion of females (61.1%) who reported never using protection against STIs was nearly double the proportion reported by Tongan males (32.2%). CONCLUSION: A high percentage of young people not attending school in the Pacific island nations of Vanuatu, Tonga and the Federated States of Micronesia are at risk of unintended pregnancy and STIs, including HIV, because of patterns of sexual risk behaviour.

Adolescent↗

A programme for reducing smoking in pre-operative surgical patients: randomised controlled trial.

We assessed the efficacy of a comprehensive programme for stopping smoking in 210 smokers scheduled for surgery, before admission and 3 months after attending a pre-operative clinic. Participants were randomly allocated to receive an intervention incorporating nicotine replacement therapy for patients smoking more than 10 cigarettes per day ("dependent smokers"), or to a control group to receive usual care. Dependent smokers allocated to the intervention group were more likely to report abstinence before surgery than those allocated to receive usual-care (63 (73%) vs. 29 (56%), respectively; OR 2.2 (95% CI 1.0-4.8)), and 3 months after attendance (16 (18%) vs. 3 (5%), respectively; OR = 3.9 (95% CI 1.0-21.7).

Adult↗

Urinary symptoms and incontinence in an urban community: prevalence and associated factors in older men and women.

BACKGROUND: There is increasing recognition of the importance of a wide range of urinary symptoms in both men and women and that these symptoms are undertreated. AIMS: To determine the prevalence of and factors associated with urinary symptoms, including nocturia, urgency, urge and stress incontinence and, in men, urinary stream difficulties; and the prevalence of being bothered by the symptoms and ever seeking treatment for them. METHOD: Household survey by computer-assisted telephone interviews of people aged 41 years and over and living in inner metropolitan Sydney. RESULTS: Fifty-three per cent (95% confidence interval (CI) 46-60) of men and 61% (95% CI 55-67) of women reported one or more symptoms in the previous month. In men, the most frequently reported symptoms were urgency (30%, 95% CI 24-36) and nocturia (25%, 95% CI 19-31). In women, stress incontinence (35%, 95% CI 29-41) and urgency (33%, 95% CI 27-39) were the most common symptoms reported. In men, the significant factors associated with reporting one or more symptoms, after adjustment for other variables, were age 60 years or more, no private medical insurance, obesity and fair or poor self-rated health. For women, the significant associations were age 50-59 years, age 70 years or more, no private health insurance, high psychological distress and fair or poor self-rated health. CONCLUSIONS: Urinary symptoms are experienced by more than half of men and women aged over 40 in the central Sydney community, but many do not seek treatment. Such symptoms should be considered more broadly than the traditional focus on male 'prostatism' and female incontinence.

Adult↗

Factors associated with smoke-free homes in NSW: results from the 1998 NSW Health Survey.

OBJECTIVE: To examine the sociodemographic characteristics associated with smoke-free homes (SFHs) in NSW and specify high-risk groups with a low prevalence of household smoking restrictions. METHODS: Data were drawn from the 1998 NSW Health Survey, a computer-assisted telephone interview survey of 17,494 randomly selected respondents aged > or = 16 years across NSW (response rate = 70%). Logistic regression analyses, stratified by smoking status, were used. RESULTS: Overall, 72% of adults reported having a SFH; 87% of never-smokers, 81% of ex- and 35% of current smokers. The highest percentages of SFHs were reported in households with young children (78%) and with older children (72%) or with adults only (72%). For smokers, SFHs were independently associated with the presence of young children (OR=3.8, 95% CI 3.1-4.7) compared with those who lived alone, but the odds of living in a SFH were only slightly increased for smokers living with older children (aged 6-15) and for those living with adults only (OR=1.9, OR=1.8 respectively). Speaking a language other than English at home, having more than 10 years' education, and being <35 years old were independently and positively associated with SFH. Being employed in smoke-free workplaces increased the likelihood of SFHs for both current and past smokers (OR=1.6, OR=1.2 respectively). CONCLUSION: Most NSW homes have restrictions on smoking inside, but more than half the households with children and at least one smoker adult are not smoke free. IMPLICATIONS: Interventions to shape parents' smoking behaviour around older children are warranted. Strategies need to address never-smokers in communities with high prevalence of smoking and adults with lower levels of education. A continued commitment to workplace smoking bans is important as they may affect household smoking restrictions.

Adolescent↗

Substance use in high school students in New South Wales, Australia, in relation to language spoken at home.

PURPOSE: To examine for the first time adolescent substance use by ethnicity, given the high proportion of migrants from non-English-speaking countries in New South Wales, (NSW), Australia. METHODS: Data from four surveys of NSW secondary school students in 1983, 1986, 1989, and 1992 were used for this analysis. The prevalence of substance use by whether English was spoken at home was stratified by sex and age using data from the most recent survey year. Adjusted odds ratios and 95% confidence intervals were produced by simultaneous logistic regression, adjusting for sex, age group, and the interaction term of sex and age for each of these substances, and for each survey year separately. Data from 1989 and 1992 were pooled together to examine rates of substance use by ethnic subgroups which reflect migration patterns. RESULTS: The prevalence of smoking and alcohol and illicit drug use was consistently lower among NSW adolescents speaking a language other than English at home, compared with those speaking English at home in all survey years. Only the prevalence of solvent sniffing was higher among younger adolescents speaking a language other than English at home. Students from Southeast Asia showed consistently lower rates of usage of all substances compared to all other groups. CONCLUSIONS: There may be different opportunities for the prevention of adolescent substance use among native English speakers to be gained from non-English-speaking cultures.

Adolescent↗

Social factors associated with ethnic differences in alcohol and marijuana use by Vietnamese-, Arabic- and English-speaking youths in Sydney, Australia.

OBJECTIVE: To describe the use of marijuana and alcohol among Arabic- and Vietnamese-speaking senior school students compared with English-speaking background senior school students in Sydney Australia. METHOD: A quantitative survey of 2573 school students attending Years 10 and 11 from 12 high schools with a high Vietnamese and Arabic population was conducted in Sydney in 1998. Self-reported marijuana use, school and cultural background information was collected. RESULTS: Students from an English-speaking background, both males and females, had almost double the prevalence of marijuana use (once or more) during their lifetime (48.3 and 43.6%), the 12 months (40.9 and 36.3%) and 1 month prior to survey administration (23.1 and 13.4%) than the group with the second highest frequency of use (students of European and other backgrounds). Female Vietnamese (7.3% lifetime use) and Arabic students (8.6% lifetime use) had the lowest marijuana use rates, which were less than half that of male Vietnamese (23.5% lifetime use) and Arabic students (28% lifetime use). A similar pattern was found for three types of alcohol use. Spending three or more evenings a week out with friends was associated with higher alcohol use for Vietnamese students (relative risk ratio of 2.76). CONCLUSIONS: These results confirm lower marijuana and alcohol use among students from Vietnamese- and Arabic-speaking backgrounds compared with students from an English-speaking background. Harm minimization strategies may be learned from some migrant communities.

Acculturation↗

Evaluation of a (pilot) stage-tailored brief smoking cessation intervention among hospital patients presenting to a hospital pre-admission clinic.

Despite the significant benefits of advising all smokers to quit, hospital patients who smoke do not systematically receive this advice. This study sought to determine the prevalence of smoking, attitudes of patients towards not smoking while in hospital, and the feasibility and effectiveness of a brief smoking cessation intervention in a pre-admission clinic context. Over 230 smokers received a brief smoking cessation intervention, while a control group (n = 114) received only a free Quit Kit. The age-standardised smoking prevalence was 19%; a further 3% of patients were recent quitters. Most smokers do not expect or experience problems with not smoking while in hospital. Brief smoking cessation advice tailored to stage-of-change by a health worker in a hospital pre-admission clinic significantly increased the quit rates for females.

Adolescent↗

Factors associated with delayed tobacco uptake among Vietnamese/Asian and Arabic youth in Sydney, NSW.

OBJECTIVE: To describe the smoking behaviour and possible reasons for delayed uptake of tobacco smoking among Arabic and Vietnamese/Asian speaking senior school students in Sydney METHOD: A descriptive study involving four adult in-depth interviews and five student focus groups plus a quantitative survey of 2,573 school students attending Years 10 and 11 from 12 high schools with high Vietnamese and Arabic populations was conducted in Sydney in 1998. Self-reported smoking behaviour and peer, parent, school and cultural background information was collected. RESULTS: Students who smoke were more likely to have more than $20 a week pocket money, be from an English-speaking background, have no rules at home about smoking, have family members who smoke, not feel close to their father, spend three or more evenings a week out with friends, and have negative perceptions of the school environment and of the level of teacher support. They were less likely to smoke if they perceived their peers to be unsupportive. CONCLUSIONS: These results confirm the delayed uptake of smoking among students from a Vietnamese/Asian and Arabic-speaking backgrounds compared with those from an English-speaking background. A number of family and school factors were associated with smoking. IMPLICATIONS: Positive parental modelling, active parenting including awareness of or supervision of student leisure time, strict rules about not smoking and less pocket money are important strategies for preventing smoking among all adolescents.

Acculturation↗

Bullying behaviour and psychosocial health among school students in New South Wales, Australia: cross sectional survey.

OBJECTIVES: To examine the prevalence of bullying behaviours in schoolchildren and the association of bullying with psychological and psychosomatic health. DESIGN: Cross sectional survey. SETTING: Government and non-government schools in New South Wales, Australia. PARTICIPANTS: 3918 schoolchildren attending year 6 (mean age 11.88 years), year 8 (13.96), and year 10 (15.97) classes from 115 schools. MAIN OUTCOME MEASURES: Self reported bullying behaviours and psychological and psychosomatic symptoms. RESULTS: Almost a quarter of students (23.7%) bullied other students, 12.7% were bullied, 21.5% were both bullied and bullied others on one or more occasions in the last term of school, and 42.4% were neither bullied nor bullied others. More boys than girls reported bullying others and being victims of bullying. Bullying behaviour was associated with increased psychosomatic symptoms. Bullies tended to be unhappy with school; students who were bullied tended to like school and to feel alone. Students who both bullied and were bullied had the greatest number of psychological and psychosomatic symptoms. CONCLUSIONS: Being bullied seems to be widespread in schools in New South Wales and is associated with increased psychosomatic symptoms and poor mental health. Health practitioners evaluating students with common psychological and psychosomatic symptoms should consider bullying and the student's school environment as potential causes.

Adolescent↗

Health behaviour and the school environment in New South Wales, Australia.

The relationship between the school environment and health has infrequently been examined. This study sought to examine the association between school students' perceptions of their school environment, teachers' and peers' support and their health behaviours. A cross sectional descriptive survey by supervised self-administration was conducted in 1996 based on the international WHO collaborative survey of school children's health and lifestyle (the HBSC Study) and extended in an Australian setting. Randomly sampled primary and secondary schools from Catholic, Independent and Government education sectors throughout New South Wales (NSW), Australia, were invited to participate. The final sample included 3918 school students attending Year 6 (primary school), Year 8 and Year 10 (high school) from 115 schools. The main outcome measures were self-reported health status and 7 health behaviours (tobacco use, alcohol use, physical activity, dental hygiene, nutritional intake, seat belt and bicycle helmet use). Independent variables included student perceptions of the school environment, perceptions of teachers' and peers' support. Girls, Year 6 students and students who have less than $19 a week to spend were significantly more likely to have positive perceptions towards their school environment, teacher(s) and peers. Students who had positive perceptions regarding their school environment and perceived their teachers as supportive were significantly more likely to engage in health promoting behaviours adjusting for age, sex and average weekly pocket money. A supportive peer environment was not associated with positive health behaviour. Health promotion practitioners need to consider the impact of the school environment on health behaviours of school students. In particular, practitioners should consider intervention models that improve the school environment as a key strategy within a health promoting school.

Adolescent↗

Smoking: rates and attitudes among nursing staff in central Sydney.

The objectives of this study were to determine the prevalence and predictors of smoking and attitudes to smoking-related issues among nurses employed by the Central Sydney Area Health Service in Sydney, Australia. A self-administered questionnaire, was distributed via the internal mail system of the Central Sydney Area Health Service in November 1997 to 610 randomly selected nursing staff. Twenty-one per cent (n = 127) of respondents smoked. Smokers were significantly younger than non-smokers and were more likely to speak mainly English at home. There were clear differences between smokers and non-smokers in response to all attitude statements. Interventions specifically directed at nurses who smoke to assist them to stop and maintain cessation are indicated. Future health service workplace tobacco control programmes should address deficits in knowledge about the health effects of passive smoking, should raise awareness among nurses who smoke about their potential to affect the behaviours of others through modelling, and should provide all nurses with the skills required to be smoking educators and advocates for tobacco control.

Adult↗

Obtaining resources for evidence-based public health initiatives at the local level: insights from the Central Sydney Tobacco Control Plan.

OBJECTIVE: In response to inquiries regarding the processes of developing a Tobacco Control Plan (TCP) for the Central Sydney Area Health Service (which in 1997 allocated dedicated funding of $ 800,000 over 2 1/2 years to implement the plan), this article describes the strengths and weaknesses of the TCP and outlines the process which contributed to its funding. CONCLUSIONS: Consistent with national and state priorities, the TCP recommended strategies based on best available evidence in the four action areas: reducing sales of cigarettes to minors, marketing, passive smoking and smoking cessation. Funding of this amount for a single public health issue at a local level represents a unique achievement in the application of an evidence-based approach to population health. IMPLICATIONS: Key elements of our advocacy methods included the involvement of all key primary health care and clinical stakeholders; comprehensive background research to identify evidence-based strategies; careful attention to budget options; strategic lobbying of senior staff and decision makers; the proposal for a multidisciplinary management structure for the TCP and specifications for funding allocation and evaluation. Early achievements and other reflections are discussed.

Adolescent↗