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Biomedical subjects

R G Cumming

Publications and source records attributed to R G Cumming.

100 records · Page 6Linked to original sources
PubMed1989

Cardiovascular disease-related knowledge and attitudes in a high-risk Australian population.

The population of Sydney's western suburbs has higher-than-average mortality rates of heart disease and has raised prevalence rates of the associated risk factors. To enquire into the cardiovascular disease-related knowledge, attitudes and behaviours of this population, a survey that used a multistage area-probability sampling method was conducted in May 1987. A total of 484 subjects was interviewed. The self-reported prevalence rates of angina, heart attacks, strokes and diabetes all were high compared with the rates from the Australia-wide National Heart Foundation's Risk Factor Prevalence Study in 1983. The rates of smoking, hypertension, high blood-lipid levels and sedentary life-style also were raised. Awareness of cardiovascular disease-related issues was high but detailed knowledge often was deficient. The majority of respondents reported having attempted to change their health-related behaviours. Of special note was the finding that 80% of current smokers had tried to quit smoking. The high level of awareness of the importance of making life-style changes, and the frequency with which attempts at behavioural changes were reported, suggest that improvements in the health of the population of Sydney's western suburbs will require two complementary strategies: the teaching of the skills that are needed to maintain healthy behaviours successfully and environmental changes to facilitate healthy life-style choices.

Adolescent↗
PubMed1989

Medical practitioners and health promotion: results from a community survey in Sydney's western suburbs.

A health survey of 484 persons aged 14 to 89 years was conducted in Sydney's western suburbs in May 1987. Its aims included a description of preventive activities undertaken by medical practitioners and an assessment of the community's perception of the doctor's role in health promotion. Ninety-three per cent reported visiting a doctor in the previous year and 31 per cent of respondents reported having contact with a general practitioner the fortnight before the survey, either for their own health or that of another. Eighty per cent of respondents reported having had their blood pressure measured in the previous year and 63 per cent of female respondents aged 18 years and over who had not had a hysterectomy reported having had a Pap smear in the last five years. However, few respondents reported receiving any lifestyle-related advice at their most recent doctor visit and 77 per cent said that the food they ate was rarely or never discussed with their doctor. Despite this low level of advice, doctors and nurses were perceived to be the most important source of health information by nearly half the respondents. Strategies for increasing the involvement of doctors in health promotion are discussed.

Adolescent↗
PubMed1988

The Western Sydney Health Study: results of the shopping-centre survey.

The Western Sydney Health Study is a two-phase descriptive study that is designed to provide data on the health-related knowledge, attitudes and behaviour of persons in the Western Metropolitan health region, which has higher-than-average death rates of many disorders that are associated with life-style. In the first phase of the study, 2164 respondents were interviewed in six shopping centres in the region. The prevalence rates of self-reported cardiovascular disease and diabetes were about twice those that were found in the Australia-wide National Heart Foundation Risk Factor Prevalence Study in 1983. The prevalence rates of smoking and self-reported raised blood lipid levels were also high. Doctors and nurses were the main sources of health information, and the media was less important as a source of health information than was found in the Better Health Commission's national survey in 1985. Over 80% of respondents believed that a lowering of the dietary fat intake and an increase in exercise were health-enhancing behaviours. Given this high level of health knowledge, the major aims for health promotion in the region should be a social change to facilitate choices towards healthy behaviour and the provision of skills to enable individual behavioural changes.

Adolescent↗
PubMed1983

Reducing state hospitalizations through a community screening program.

The role of State hospitals has been limited to admitting persons, and then performing elaborate assessments, treatment interventions, and aftercare planning on an inpatient basis. Because of the division of roles and often physical distance from local communities, State hospitals have had limited ability to reinforce community treatment as a means to prevent re-admissions. This paper describes "Pre-Admission Screening" and "Admission Coordination", two programs initiated by a community mental health center, designed to maintain persons in the community through intensive evaluation, crisis intervention, and treatment planning on an outpatient basis.

Community Mental Health Services↗
PubMedDate not supplied

HIV and tuberculosis in rural sub-Saharan Africa: a cohort study with two year follow-up.

The objective was to examine the effect of HIV seropositivity on outcomes in tuberculosis (TB) patients in a rural African setting, including rates of TB relapse, other morbid events and mortality. The study setting was a district level hospital in Mzuzu, Malawi. Adult TB patients presenting between November 1991 and May 1993 were included in the study. Treatment was given according to national guidelines. Patients with smear-positive TB received 8 months of rifampicin-containing short-course chemotherapy. Patients with smear-negative or extrapulmonary TB received 12 months of 'standard' treatment. Subjects were followed until they died or until the study concluded (December 1994). There were 225 eligible patients; 187 were tested for HIV and enrolled in the study (66.8% HIV seropositive). Ninety-four percent had complete follow-up information. The cure rate in smear-positive patients who survived to the end of treatment was over 90% and not significantly affected by HIV. Disorders of the gastrointestinal, neurological and dermatological systems were significantly more common in HIV-seropositive patients. HIV had a significant effect on the risk of relapse of TB (hazard ratio [HR] = 10.55 [95% CI 1.38, 80.93]) and on all-cause mortality (HR = 2.81 [95% CI 1.63, 4.64]). Despite high HIV prevalence, high rates of TB cure are achievable using the usual treatment protocols. However, excess TB relapse, other illnesses and mortality associated with HIV seropositivity have serious implications for TB control. There is an urgent need to identify effective intervention strategies aimed at prevention, early diagnosis and treatment of these illnesses.

Adolescent↗
PubMedDate not supplied

Renal impairment and anaemia in a population-based study of older people.

BACKGROUND: Established renal failure is a known cause of anaemia. However, the association between more modest levels of renal impairment and anaemia is unclear. AIMS: The aim of the present study was to investigate the association between mild renal impairment and anaemia in the general population. METHODS: A population-based, cross-sectional study was conducted in the general community in an urban area of the Blue Mountains, just west of Sydney, Australia. The study included 3222 people aged > or =49 years (mean age 65 years). Serum creatinine and haemoglobin were measured using standard laboratory techniques. Creatinine clearance was estimated from serum creatinine, body weight, sex and age. RESULTS: Two hundred and seventy subjects (8.4%) had serum creatinine levels > or =125 micromol/L and estimated -creatinine clearances were <0.84 mL/s (50 mL/min) in 894 subjects (27.7%) and <0.50 mL/s (30 mL/min) in 120 subjects (3.7%). There was a strong association between reduced renal function and anaemia. Compared to those with serum creatinine <125 micromol/L, the age-adjusted relative risk (RR) of anaemia in women (haemoglobin <12.0 g/dL) with serum creatinine > or =125 micromol/L was 5.5 (95% confidence interval (CI) 2.9-10.7) and the RR of anaemia in men (haemoglobin < 13.0 g/dL) was 3.1 (95% CI 1.6-6.0). Estimated -creatinine clearance <50 mL/min was associated with a three-fold increased risk of anaemia in women and a five-fold increased risk in men. CONCLUSIONS: The results of the present study suggest that even modestly impaired renal function is associated with anaemia in older men and women. The possibility of renal impairment should be considered in the diagnosis and management of anaemia in people aged>50 years.

Age Factors↗
PubMedDate not supplied

Adherence to occupational therapist recommendations for home modifications for falls prevention.

OBJECTIVE: This study examined adherence to home modification recommendations made by an occupational therapist and attempted to identify predictors of adherence. METHOD: An experienced occupational therapist visited the homes of 178 people (mean age = 764 years) to evaluate for and recommend appropriate home modifications for falls prevention. One year later, a research assistant visited these persons' homes to assess adherence. RESULTS: At least one home modification was recommended in 150 of the 178 homes visited. The most common recommendations were to remove mats and throw rugs (48%), to change footwear (24%), and to use a nonslip bathmat (21%). In the 121 homes revisited after 12 months, 419 home modifications had been recommended, and 216 (52%) were met with partial or complete adherence. The only significant predictors of adherence were a belief that home modifications can prevent falls and having help at home from relatives. CONCLUSION: A major barrier to adherence to home modification recommendations is that many older people do not believe that home modifications can reduce their risk of falling.

Accidental Falls↗