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Biomedical subjects

P Hawe

Publications and source records attributed to P Hawe.

29 records · Page 2Linked to original sources

The Good Heart, Good Life survey: self-reported cardiovascular disease risk factors, health knowledge and attitudes among Greek-Australians in Sydney.

This survey aimed to assess the prevalence and knowledge of coronary risk factors and self-perceived coronary heart disease risk among Greek-Australians in the Marrickville area of inner Sydney. A random sample of 834 household addresses was selected from the 2,403 households having Greek-Australian surnames on the electoral roll. In each household, one individual aged 18 years or over was selected using a Kish grid, and a questionnaire was administered by a bilingual interviewer. Questions concerned knowledge of and self-reported risk factors for coronary heart disease, and ratings of perceived stress, social support and networks. There was a response rate of 81 per cent of actual Greek-Australian households, a total of 541 interviews (61 per cent women). Most of the sample (86 per cent) were born in Greece and 77 per cent of interviews were administered in Greek. The age-adjusted male prevalences of self-reported smoking, high blood pressure, high blood cholesterol and body mass index over 26 kg/m2 were 44 per cent, 5 per cent, 14 per cent and 58 per cent, respectively. The age-adjusted female prevalences of self-reported smoking, high blood pressure, high blood cholesterol and body mass index over 26 kg/m2 were 19 per cent, 8 per cent, 15 per cent and 40 per cent, respectively. Compared to the National Heart Foundation risk-factor prevalence survey, the prevalence of self-reported high blood pressure was lower, but obesity and, among males, smoking, were higher. Low levels of education and poor English-language skills among older Greek-Australians may be contributing to the problem.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The validity of parental report of vaccination as a measure of a child's measles immunisation status.

OBJECTIVE: To determine the validity of parental report of vaccination as a measure of a child's measles immunisation status. DESIGN: Cross-sectional survey. SETTING: Four 24-hour medical centres in western Sydney. PATIENTS: Parents of children aged 12-36 months were approached in the clinic waiting room. Of the 160 parents approached, 137 agreed to be interviewed and a successful venepuncture to yield a 2 mL blood sample was achieved with 128 children. MAIN OUTCOME MEASURES: Measles IgG antibody, determined by means of an indirect ELISA, was compared with parental report of measles vaccination status by McNemar's chi 2 test. RESULTS: Parental report significantly over-estimates the immunisation status of children. Eighty-four per cent of the parents in the sample stated that their child had been vaccinated, but only 74% were immune (95% confidence interval, 65%-81%). A positive predictive value of 84% meant that only 84% of children who were reported to have been vaccinated were immune to measles. Further, of all those who were not immune to measles, only one half would have been identified by asking the parents. Failed seroconversion may have accounted for up to 70% of cases of non-immunity in children reported to have been vaccinated. CONCLUSIONS: Parental report is limited as a measure of a child's measles immunisation status.

Child, Preschool↗

Can medication education improve the drug compliance of the elderly? Evaluation of an in hospital program.

We report the evaluation of a pharmacist-led medication education program for the elderly. The program consisted of a single group-based education session followed by individual pre-discharge counseling. Patients also received an individual medication record card. The study design was a nonrandomised trial. Patients in the control group received a "dummy" intervention conducted on alternate months to the medication program. Drug compliance was assessed by interviewer-administered questionnaire in the patients' homes at 1 and 3 months post-discharge. The main outcome factor of interest was severe noncompliance with essential medications. This meant taking 80% or less or conversely 120% or more of those medications prescribed for the control of the patient's medical condition. At 1 and 3 months post-discharge, no effect of the program was detected. However, among the sub-group of patients taking four drugs or more the effect of the program was evident at 3 months post-discharge. Among this group at 3 months post-discharge, 55% of control group patients were severely noncompliant with essential medications as compared to 32% of the education group (a difference of 23%, 95% confidence interval 4-42%). This effect was not accounted for by possible confounding factors such as age, sex, number of medications and the patient's living arrangements.

Aged↗

Elderly patients after they leave hospital.

A follow-up survey was conducted of 125 patients, aged 75 years and over, who had been discharged from a general teaching hospital in western Sydney. Assessments were made of the patients' functional status, living arrangements, reliance on family care and use of health and community services in the three-month period after discharge. Results indicate that immediately after leaving hospital more patients were living with family or friends than were prior to hospitalization and there was a slight increase in the number of patients who were living in nursing homes. However, by three months after discharge, the living arrangements resembled the pattern of arrangements before the hospital admission. At three months after discharge from hospital, 66% of patients were fully independent with regard to basic activities of daily living such as bathing, dressing and eating, but only 34% of men and 17% of women were fully independent in broader activities such as shopping and meal preparation. By this stage, 88% of patients were in daily contact with family carers who were providing for many of their elderly relatives' needs. A consideration of the needs of carers upon admission to hospital of elderly patients and the provision of support services for carers after discharge should become high priorities in comprehensive geriatric care.

Activities of Daily Living↗

Potential for cost saving by recycling of drugs in hospital.

To investigate the potential benefits of recycling of drugs in hospital two studies were conducted. In the main study, 219 consecutively admitted medical and surgical patients were asked to surrender their drugs on admission to hospital. fifty six per cent of patients complied with the request and 79% of the drugs they brought in were suitable for redistribution within the hospital. Patients were given one months supply for all discharge medications. The cost of reusable drugs surrendered on entry corresponded to 36% of discharge medication costs. In the second study, a telephone survey of a random sample of hospitals in NSW, it was revealed that 31% of metropolitan hospitals and 21% of country hospitals recycle medications. It was concluded that the extension of the practice of recycling to remaining hospitals may substantially offset discharge medication costs and reduce the total bill for pharmaceuticals in hospitals in NSW. However, further discussion of acceptable standards for recycling and further investigation of the cost benefit equation of drug recycling is urged.

Australia↗

Health promotion community development and the tyranny of individualism.

Economic evaluation of health promotion poses few major difficulties when the theoretical approach of the programme and the evaluation of cost and benefits are confined within the context of the individual. Methodological individualism has a long history in economics and the techniques of microeconomics are well suited to the examination of individually focused behaviour change programmes. However, new developments in community health promotion pose special challenges. These programmes have the community, not the individual, as the focus of programme theory and "community' means something completely different from the sum of individuals. Community empowerment and promotion of the community's capacity to deal with health issues are the goals of such programmes. To reflect these notions, sense of community and community competence should be considered as "functionings', an extra-welfarist constituent of well-being. Their inclusion as outcomes of community health promotion requires a shift from individualist utilitarian economics into a communitarian framework which respects the programme's notion of community. If health economics fails to develop new constructs to deal with these new approaches in health promotion, the application of existing techniques to community programmes will mislead health decision makers about their value and potential.

Bias↗

Values and preferences are not necessarily the same.

Economic theory typically draws no distinction between preferences and values, assumes that preferences are stable and complete and that all that need be done to elicit them is to ask the right question in the right way. It is argued here that values for some fundamental aspects of life, such as health, are not the same as preferences. The former are less differentiated and require construction and clarification before they can be elicited. The implications of this for health state valuation are discussed.

Choice Behavior↗