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Biomedical subjects

W Hall

Publications and source records attributed to W Hall.

At least 109 records · Page 6Linked to original sources
PubMed1996

Prescription drug utilization following patient co-payment changes in Australia.

In November 1990 major patient co-payment changes were introduced into the Pharmaceutical Benefits Scheme (PBS), which accounts for around 90% of all community prescriptions in Australia. Interrupted time series analyses were performed to assess the impact of these co-payment changes on the prescription levels of defined groups of 'discretionary' and 'essential' drugs for both the general community and for a subgroup comprising elderly returned servicemen and women. While the co-payment changes themselves had a significant immediate effect on lowering the use of both categories of drugs, the effects were substantially larger for the 'discretionary' groups in both cases. Notably there was a clear post-intervention trend for increased prescriptions of 'essential' drugs after the initial decline, which was not evident for the 'discretionary' drugs. The introduction of programmes to compensate high risk groups in Australia may have enabled the co-payment to become a more selective policy instrument than has been shown in other settings.

Journal Article↗
PubMed1996

Psychological morbidity and route of administration among amphetamine users in Sydney, Australia.

A sample of 301 amphetamine users were interviewed about their experiences of psychological symptoms prior to, and subsequent to, their initiation of amphetamine use. Psychological morbidity was common, with 44% scoring greater than a conservative cut-off of 8 on the General Health Questionnaire. The most commonly reported symptoms subsequent to the onset of amphetamine use were depression (79%), anxiety (76%), paranoia (52%), hallucinations (46%) and violent behaviour (44%). All these symptoms increased in prevalence after the onset of amphetamine use. Route and frequency of amphetamine administration were significant independent predictors of overall psychological morbidity, while route of administration was related to the experience of hallucinations, violent behaviour and paranoia. The avoidance of injection as a route of administration and the use of amphetamines less than weekly are recommended as steps that users can take to reduce the psychological sequelae of amphetamine use.

Adult↗
PubMed1996

Overdose among heroin users in Sydney, Australia: II. responses to overdose.

A sample of 329 heroin users were interviewed about their experiences at other peoples' heroin overdoses. The overwhelming majority (86%) had witnessed a heroin overdose, on a median of six occasions. Heroin users were reluctant to seek medical attention, with an ambulance being called on only half (56%) of the most recent overdose occasions. At only 17% of most recent overdoses was calling an ambulance the first action taken. Males reported taking significantly longer than females to call an ambulance. Nearly half (44%) of subjects reported that there were factors that had delayed or stopped them seeking medical assistance, the most common impediment being a fear of police involvement. The importance of interventions to encourage help-seeking at overdoses are discussed.

Adolescent↗
PubMed1996

Characteristics of women with alcohol and other drug problems: findings of an Australian national survey.

Two hundred and sixty-seven women were interviewed in a national survey examining the characteristics, treatment needs and treatment experiences of Australian women who had received treatment for their alcohol and other drug problems. More than half the women were mothers, of whom almost one-third had surrendered custody of their children. Polydrug use was the norm among these women, who in general had substantial experience with the legal system. A sizeable proportion of women had experienced physical and psychological health problems such as hepatitis, eating disorders, self-mutilation, suicide attempts and low self-esteem. The majority of the sample had a life-time history of physical or sexual violence. The implications of these findings are discussed and recommendations are provided for attracting and retaining women in appropriate services.

Adolescent↗
PubMed1996

Characteristics of admissions to residential drug treatment agencies in New South Wales, 1988-92: I. Illicit drug problems.

The Clients at Residential Agencies (CARA) database of the New South Wales Drug and Alcohol Directorate was analysed for trends in admissions of clients with illicit drug problems over the years 1988-92. The mean age of admissions rose from 26.8 years to 27.9 years over the study period. There was a small increase in the proportion of male admissions to agencies (66.5% in 1988 to 69.9% in 1992). The proportion of admissions reporting opiates as their primary drug problem declined from 81% to 65%, while the proportion of admissions for stimulant problems doubled in that period (8% to 16%), as did those for cannabis (3.6% to 8.7%). There was a significant increase in the proportions of admissions who had drug problems of 10 or more years' standing (34.9-41.3%). The proportion of admissions that had never been in treatment decreased from 51% to 15% over the study period. Admissions with prior methadone experience rose from 37% to 69% between 1988 and 1992.

Journal Article↗
PubMed1996

Characteristics of admissions to residential drug treatment agencies in New South Wales, 1988-92: II. Alcohol problems.

The Clients at Residential Agencies (CARA) database of the New South Wales Drug and Alcohol Directorate was analysed for trends in admissions of clients with alcohol problems over the years 1988-92. There were no changes in the mean age and sex ratio of admissions, with the treatment population in all years predominantly males in their mid-thirties. There was a decrease in the proportion of clients who were employed full-time (25.1-16.4%), and an increase in admissions with criminal histories (45.7-59.3%). More than half of admissions in all years had alcohol problems of greater then 10 years' standing. The percentage of people who had never been in treatment before decreased from 44.4% in 1988 to 18.7% in 1992.

Journal Article↗
PubMed1996

Correlates of the perceived health risks of marijuana use among Australian adults.

A quota sample of 3272 people from the Australian population was surveyed by telephone about the health risks of marijuana use. Three-fifths of the sample (62%) believed that there were health problems caused by marijuana use and one in four (27%) were uncertain. The most commonly cited health effects were: lung cancer, mental problems, memory loss and respiratory disease. The health risks of marijuana use were perceived to increase with increasing frequency of use, and to be greater when the user was a teenager rather than an adult. The perceived health risks of marijuana increased with age, were higher among women than men, decreased with increasing education and frequency and quantity of alcohol and were substantially lower among those who had used marijuana, and those who knew someone who had used marijuana.

Journal Article↗
PubMed1996

What have population surveys revealed about substance use disorders and their co-morbidity with other mental disorders?

This paper reviews the epidemiology of alcohol and drug abuse and dependence as revealed in recent US general population surveys of the prevalence and correlates of mental disorders, the Epidemiologic Catchment Area (ECA) studies, and the National Comorbidity Study (NCS). These surveys indicate that mental disorders affect between a third and a half of people at some time in their lives, and around one in four in any year. Among the most common forms of mental disorder are phobias, alcohol use disorders, affective disorders and drug use disorders. There are marked gender differences in the prevalence of these disorders: substance use disorders and anti-social personality disorders predominate in men while affective and anxiety disorders predominate in women. The co-occurrence of substance use and other mental disorders is less common in the community than in the clinic because the presence of other mental disorders increases the chances of people with substance use disorders receiving specialist treatment. Only a minority of those with substance use and other mental disorders in the community are treated, with the more severe cases with multiple co-morbid mental disorders and manifest distress the most likely to be treated.

Journal Article↗
PubMed1996

Benzodiazepine use among heroin users in Sydney: patterns of use, availability and procurement.

A sample of 210 heroin users who had used benzodiazepines during the preceding 6 months were interviewed about their benzodiazepine use. Forty-one percent of the sample reported having used benzodiazepines more than once a week during the 6 months preceding interview. Forty-eight percent had injected benzodiazepines, with 17% having done so during the preceding 6 months. Eleven percent of the sample reported having experienced convulsions when attempting detoxification from benzodiazepines. The majority of subjects (86%) indicated that benzodiazepines are easy or very easy to obtain. Only a third of the sample reported obtaining benzodiazepines exclusively through a doctor in the last 6 months. Over a half of the sample indicated that they had given or sold benzodiazepines to someone during that time. Diazepam was considered by subjects to be the easiest benzodiazepine to procure. Doctors should avoid the prescription of benzodiazepines to injecting drug users, particularly the more readily injectable drug temazepam. Given the widespread use of benzodiazepines by injection, research needs to examine the harm associated with the parenteral use of these drugs.

Journal Article↗
PubMed1996

Short-term prognosis of depression in adults with Down's syndrome: association with thyroid status and effects on adaptive behaviour.

Findings for Down's syndrome adults with depression were compared to those for non-depressed Down's syndrome controls. Mean age of onset of depression was 30.1 years, the majority of subjects were female and biological more so than psychotic symptoms were presenting features. No statistically significant association between depression and thyroid dysfunction was found. For the depressed group, scores for level of adaptive functioning were significantly lower and those for maladaptive behaviour significantly higher. At one-year follow-up, although some improvement was found, the majority of depressed subjects were still symptomatic. The short-term prognosis for depression in adults with Down's syndrome appears to be poor but possibly better the earlier the age of onset.

Adolescent↗
PubMed1996

Changes in the public perceptions of the health benefits of alcohol use, 1989 to 1994.

Data from a telephone survey of a national quota sample of the Australian community were used to assess changes in the public's perception of the benefits of alcohol use between 1989 and 1994, during which time there was media coverage of a debate about the health benefits of moderate alcohol consumption. The proportion identifying health benefits of alcohol use increased from 28 per cent in 1990 in New South Wales to 46 per cent in 1994 in Australia. The most commonly identified benefits of alcohol use remained relaxation (54 per cent), followed by cardiovascular benefits (39 per cent), which had not been mentioned in the previous survey. The likelihood of identifying any health benefits of alcohol use was higher among men than women, increased with age to the middle 30s, was higher among those with a tertiary education, and increased with frequency of alcohol use.

Adolescent↗
PubMed1996

Telemedicine and security. Confidentiality, integrity, and availability: a Canadian perspective.

The health care system is undergoing major reform, characterized by organized delivery systems (regionalization, decentralization, devolution, etc); shifts in care delivery sites; changing health provider roles; increasing consumer responsibilities; and accountability. Rapid advances in information technology and telecommunications have led to a new type of information infrastructure which can play a major role in this reform. Compatible health information systems are now being integrated and connected across institutional, regional, and sectorial boundaries. In the near future, these information systems will readily be accessed and shared by health providers, researchers, policy makers, health consumers, and the public. SECURITY is a critical characteristic of any health information system. This paper will address three fields associated with SECURITY: confidentiality, integrity, and availability. These will be defined and examined as they relate to specific aspects of Telemedicine, such as electronic integrated records and clinical databases; electronic transfer of documents; as well as data storage and disposal. The guiding principles, standards, and safeguards being considered and put in place to ensure that telemedicine information intrastructures can protect and benefit all stakeholders' rights and needs in both primary and secondary uses of information will be reviewed. Implemented, proposed, and tested institutional, System, and Network solutions will be discussed; for example, encryption-decryption methods; data transfer standards; individual and terminal access and entry I.D. and password levels; smart card access and PIN number control; data loss prevention strategies; interference alerts; information access keys; algorithm safeguards; and active marketing to users of standards and principles. Issues such as policy, implementation, and ownership will be addressed.

Canada↗
PubMed1996

The effect of soothing music on neonatal behavioral states in the hospital newborn nursery.

Most newborns born in Western countries spend their first transitional hours in hospital nurseries. Noxious noise levels in the nursery can interfere with neonatal efforts to achieve physiological and behavioral homeostasis. Literature indicates that music has been used to induce relaxation states and reduce stress responses. This study used a one-group, pretest, posttest design. A convenience sample of 20 term, Caucasian neonates was recruited. The number of high arousal behavioral states and the number of state changes of the newborns was recorded for a control and an experimental period. Soothing, lyrical music was played in the baby's bed during the experimental period. The data was compared using McNemar's test statistic. A significant difference (p < .01) was observed. The results suggest that soothing music may be a feasible intervention to help newborns demonstrate fewer high arousal states and less state lability.

Arousal↗
PubMed1996

Overdose among heroin users in Sydney, Australia: I. Prevalence and correlates of non-fatal overdose.

A sample of 329 heroin users were interviewed regarding their personal experience of non-fatal heroin overdose. Experience of overdose was widespread, with two-thirds of subjects (68%) reporting having overdosed. The median number of life-time overdoses was three, with males and females equally likely to have overdosed. The majority (62%) of most recent heroin overdoses occurred in conjunction with the consumption of other central nervous system depressants (alcohol, benzodiazepines and other opioids). Logistic regression analyses indicated three independent factors associated with having overdosed: longer heroin using careers, greater heroin dependence and higher levels of alcohol consumption. Implications for the reduction in the prevalence and frequency of overdose are discussed.

Adolescent↗