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At least 19 recordsLinked to original sources
PubMed1992

Regional variation in coronary mortality within Tasmania.

OBJECTIVE: To measure regional rates of mortality from ischaemic heart disease (IHD) within Tasmania and to analyse factors associated with regional differences. DESIGN: Descriptive epidemiological study. SETTING: Community-based study. SUBJECTS: Male residents of Tasmania aged 30-69 years dying from IHD between 1986 and 1989. MAIN OUTCOME MEASURES: Coronary death as coded by the Australian Bureau of Statistics and place of death validated by hospital and community data. RESULTS: This study identifies substantial differences in coronary death rates among the three Health Regions of Tasmania. These differences are real and are not caused by variations in diagnostic or coding practices between regions. The two northern Health Regions, which represent approximately 52% of the total population, account for 98% of the excess mortality from IHD in Tasmania compared with the national rate. More detailed analysis of these differences suggests that variation in the number of deaths occurring in hospital contributes significantly to the regional differences in death rate from IHD. CONCLUSION: Rates of coronary mortality in Tasmania have been significantly higher than in all other Australian States for much of the past decade because of a higher death rate within the population of the northern half of Tasmania. Differences in mortality rates between regions in Tasmania provide a focus for further study into the causes of the unacceptably high rates of death from IHD in Tasmania and underline the need for the funding of a coronary register in Tasmania.

Adult↗
PubMed1992

Sudden infant death syndrome: factors contributing to the difference in incidence between Victoria and Tasmania.

OBJECTIVE: To examine how much of the difference in incidence of sudden infant death syndrome (SIDS) between Tasmania and Victoria could be accounted for by the effect of differing climatic temperature and the effect of the differing prevalence of maternal and infant characteristics in the two State populations. DESIGN: A two population ecological comparison. Two previously published predictive models were applied to quantify the contribution of several factors to the higher incidence of SIDS in Tasmania compared with Victoria. SETTING: A population based study involving the two Australian States of Tasmania and Victoria. PATIENTS: The characteristics of the 1985 to 1987 live birth cohorts of Tasmania and Victoria were examined. Cases were defined as all infants dying in 1985 to 1987 whose cause of death was stated as SIDS. RESULTS: The rate of SIDS for Tasmania and Victoria 1985 to 1987 was 3.76 per 1000 live births and 2.18 per 1000 live births respectively. Adjustment of the Tasmanian rate for the effect of the interstate difference in climatic temperature resulted in a lower Tasmanian rate of 2.92 per 1000 live births. Adjustment for the effect of interstate differences in maternal age, birthweight, infant sex, month of birth and intention to breast-feed at hospital discharge decreased the Tasmanian rate to 2.47 per 1000 live births. CONCLUSION: Approximately 82% of the interstate difference in SIDS incidence between Tasmania and Victoria from 1985 to 1987 can be accounted for by differences in climatic temperature, maternal age, birth-weight, infant sex, month of birth and feeding intention at hospital discharge.

Adult↗
PubMed1995

The contribution of changes in the prevalence of prone sleeping position to the decline in sudden infant death syndrome in Tasmania.

OBJECTIVE: To determine the independent contribution of changes in infant sleep position to the recent decline in sudden infant death syndrome (SIDS) rate in Tasmania. DESIGN: (1) A comparison of the whole population incidence of SIDS before and after an intervention to reduce the prevalence of prone sleeping position. (2) A within-cohort analysis of the contribution of sleep position and other exposures to the decline in SIDS after the intervention. SETTING: Tasmania, Australia. PARTICIPANTS: (1) All SIDS cases from 1975 through 1992. (2) A sample of one in five infants born in Tasmania who at perinatal assessment were scored to be at higher risk for SIDS since January 1988. Of 5534 infants included in the study, 39 later died of SIDS. INTERVENTIONS: Multiple public health activities to reduce the prevalence of the prone infant sleeping position in Tasmania and verbal information on the association between prone position and SIDS to cohort participants from May 1, 1991. MAIN OUTCOME MEASURE: Sudden infant death syndrome incidence. RESULTS: The Tasmanian SIDS rate decreased (P < .01) from 3.8 (95% confidence interval [CI], 3.5 to 4.2) deaths per 1000 live births from 1975 through 1990 to a rate of 1.5 (95% CI, 0.9 to 2.2) deaths per 1000 live births in 1991 through 1992. The SIDS mortality rate in the cohort by period of birth was 7.6 (95% CI, 4.9 to 10.3) deaths per 1000 live births for those born from May 1, 1988, through April 30, 1991, and 4.1 (95% CI, 1.3 to 7.0) deaths per 1000 infants for those born from May 1, 1991, through October 31, 1992. The prevalence of usual prone sleeping position at 1 month of age was 29.9% and 4.3% in these two cohorts, respectively (adjusted odds ratio, 0.11; 95% CI, 0.08 to 0.13). Logistic regression demonstrated that 70% of the SIDS rate reduction in the cohort could be accounted for by the decreased prevalence of the prone sleeping position. Other factors examined individually contributed to less than 10% of the SIDS rate reduction. CONCLUSIONS: The major contributing factor to the recent SIDS rate decline in Tasmania has been the reduction in the proportion of infants usually sleeping prone.

Cohort Studies↗
PubMed1996

The prevalence of MEN-1 in Tasmania.

BACKGROUND: An extensive programme was undertaken to trace and screen four known families in Tasmania with multiple endocrine neoplasia type 1 (MEN-1). METHODS: Written and personal contact was made with family members over the age of 20 years recommending a review by family practitioners for the purpose of recording their medical history and collecting a blood sample. Those suspected of MEN-1 were referred to our Department for further investigation. RESULTS: In January 1993, the total number of individuals alive and known to be affected by MEN-1 was 107, giving a prevalence of MEN-1 disease in Tasmania of 23/100 000. The estimated prevalence of MEN-1 trait in Tasmania (including affected cases and those considered at 50% risk of possessing the trait) is 45/100 000. CONCLUSION: The prevalence of MEN-1 has never previously been determined accurately. The prevalence of MEN-1 in Tasmania is at the upper end of the possible range and would justify the allocation of resources for screening programmes equal to those available for the detection of several less prevalent genetic diseases.

Adolescent↗
PubMed1998

Graduates of the University of Tasmania Medical School: career achievements 10 to 23 years after graduation.

OBJECTIVE: To assess the postgraduate achievements of graduates of the University of Tasmania Medical School. DESIGN: Postal questionnaire survey in October 1994 and March and May 1995. PARTICIPANTS AND SETTING: 262 of the 400 medical graduates of the University of Tasmania who graduated between 1970 and 1983 for whom addresses were held (65.5% response rate). MAIN OUTCOME MEASURES: Achievement of postgraduate qualifications; senior hospital and university appointments; publications in the medical literature; practice location (rural or urban); and sex distribution. RESULTS: College fellowships had been obtained by 56%, other formal postgraduate qualifications by 24%. MDs or PhDs by 7%, senior hospital appointments by 46%, and senior university appointments by 21%; 30% had published in the medical literature. Equal proportions of men and women had obtained postgraduate qualifications, but women were less likely to have a college fellowship, a senior hospital or university appointment, or to have published (P < 0.05). 56% worked in Tasmania, and of the 95% working in Australia 17% were in rural or remote locations. CONCLUSIONS: More than two-thirds of Tasmanian medical graduates achieved postgraduate qualifications and a small majority were practising in Tasmania. Postgraduate career path was significantly influenced by the sex of the graduates.

Fellowships and Scholarships↗
PubMed1991

The origin of a new focus of infection with Echinococcus granulosus in Tasmania.

Hydatid cysts were discovered in cattle on King Island, north of Tasmania, where Echinococcus granulosus was thought to have been eradicated. Using enzyme electrophoresis, isolates from King Island were compared genetically with isolates from Tasmania and the mainland of Australia. The genetic distinctness of the King Island isolates make it unlikely that they originated from a recent introduction from either Tasmania or mainland Australia. Alternative possibilities, that the infection resulted from a recent introduction from another source or from previously undetected persistence of E. granulosus on King Island, could not be distinguished from available data.

Animals↗
PubMed2000

Seasonal variation in hospital admission for bipolar disorder, depression and schizophrenia in Tasmania.

OBJECTIVE: Seasonal variation has been reported for both affective disorders and schizophrenia. The current study examines seasonal variation in admissions in schizophrenia, depression and bipolar disorder in Tasmania, the southernmost state of Australia. METHOD: All admissions with a diagnosis of schizophrenia, bipolar disorder and depression in Tasmania between 1983 and 1989 were examined for evidence of seasonal variation in admission patterns. RESULTS: Using the modified Kolmogorov-Smirnov statistic defined by Freedman no significant seasonal variation was found in admissions with diagnoses of mania, depression or schizophrenia. There was a significant seasonal variation in admissions with schizoaffective disorder (winter peak). CONCLUSION: There is no significant seasonal variation in admissions with schizophrenia, depression or bipolar disorder in Tasmania. This may be due to a combination of geographical location and the stringent test of seasonal variation used in the current study.

Bipolar Disorder↗
PubMed1992

Death certification and coding for ischaemic heart disease in Tasmania.

Official records show that the rates of mortality from ischaemic heart disease (IHD) in Tasmania have been the highest of all the Australian states for most of the past decade. This study assesses the accuracy of the official Tasmanian mortality data for IHD in 1987 and 1988 for males aged 25 to 74 years using routinely available clinical and pathological data supplemented by information from the attending doctor. Our findings show that a death officially coded to ICD 9 rubrics 410-414 (IHD) in Tasmania has 94% sensitivity and a positive predictive value of 90% for fatal definite acute myocardial infarction or possible coronary death as defined by the WHO. Comparison of our results with those of two earlier studies undertaken in Australian mainland centres indicates that differences in the official statistics for coronary mortality between Tasmania and the mainland states reflect true differences in the risk of coronary death. While the results from three Australian studies suggest that the routine system of death certification is reasonably accurate, careful monitoring of death certification and coding practices need to be undertaken regularly in all states of Australia if secular changes in regional patterns of coronary mortality are to be regarded as credible.

Adult↗
PubMed1995

Regional differences in cardiovascular risk factor prevalence in Tasmania: are they consistent with the increased cardiovascular mortality?

BACKGROUND: The death rate from cardiovascular disease in Tasmania has been among the highest in Australian States for a number of years. The North-West (NW) and Northern regions of Tasmania account for most of the increased mortality. AIMS: To determine the prevalence of cardiovascular risk factors in the North and NW regions of Tasmania and to ascertain whether any differences are consistent with the regional patterns of mortality for ischaemic heart disease (IHD) within the State. METHODS: The design of the study was almost identical to the previous National Heart Foundation (NHF) Risk Factor Prevalence Survey conducted in 1989. The subjects, aged 20-69 years, were randomly selected from the Electoral Roll with 1146 subjects participating in the North and 1219 in the NW. Subjects answered a detailed questionnaire and then underwent a brief physical examination with venipuncture for blood lipids. Hobart data from the NHF Risk Factor Prevalence Survey in 1989 were used as an estimate of risk factor prevalence in the Southern region. RESULTS: In both males and females, mean systolic blood pressure was significantly higher in the NW than the South which was in turn higher than the North. Mean serum cholesterol levels in males were higher in the NW than the North. Smoking behaviour was similar in males and females in all regions. Males and females in the NW and North were more inactive than those in the South. Similar proportions in all regions were on either 'no specific' or 'fat modified' diets. Body mass index in males and females was higher in the NW and North but waist to hip ratios failed to show a consistent trend. CONCLUSIONS: While the NW has an unfavourable risk factor profile compared with the South, the North does not. The risk factor data are broadly consistent with, but unlikely to be sufficient to explain fully, the regional differences in mortality from IHD.

Adult↗
PubMed1996

Drowning fatalities of children in Tasmania: differences from national data.

All drownings of people under 15 years of age in Tasmania from 1981 to 1993 were identified from the Tasmanian coroner's case files. Age- and sex-specific mortality rates were calculated and found to be similar to Australian drowning mortality rates. An exception was the lower drowning rate for Tasmanian females aged 0 to 4 years. Only 9 per cent of drowning deaths were caused by immersion in a swimming pool, 32 per cent of deaths occurred in dams and ponds and 21 per cent occurred in a river. Most drownings (88 per cent) associated with dams, ponds, swimming pools and baths were in the 0-to-4-year age group. Compared with Australia as a whole, toddlers drowning in swimming pools is uncommon in Tasmania; however, there are relatively more drownings in dams and ponds. Strategies for the prevention of drowning in childhood in Tasmania should consider the hazards associated with rural living.

Adolescent↗
PubMed1998

Epidemiology of giardiasis in Tasmania: a potential risk to residents and visitors.

BACKGROUND: Giardia infection is an ongoing problem in Tasmania and occurs throughout the state. It has been postulated that part of the problem is the reservoir of infection in native animals which is suggested to contribute to infections in humans. To date, however, no detailed study on the epidemiology of giardiasis in Tasmania has been carried out. METHODS: Information regarding the prevalence of Giardia infection in humans and the risk of intrafamilial transmission was obtained from the Department of Community and Health Services and from the direct examination of human or animal fecal samples. RESULTS: Giardia has been found to be present in a wide range of native and domestic animals and in humans of all ages from all over the state. CONCLUSIONS: Giardiasis is endemic in Tasmania and poses a risk to locals as well as to visitors to the state, especially those who participate in wilderness activities such as bushwalking. These people must be aware of the possible risk of Giardia infection and should take precautionary measures to avoid infection.

Adolescent↗
PubMed2002

Mandibular fracture patterns in Tasmania, Australia.

BACKGROUND: No previous studies on mandibular fracture patterns in Tasmania, and very few elsewhere in Australia, have undertaken to discover which identified age, gender, aetiology, anatomical location of the fracture, period of injury, whether alcohol consumption was associated with the injury, and treatment of mandibular fractures. METHOD: A retrospective study was undertaken of 251 patients with fractured mandibles presenting to the Royal Hobart Hospital, Tasmania from 1993-1999. Data were obtained from the Oral and Maxillofacial Surgery unit fracture record books cross-checked with patients, impatient/outpatient hospital records. RESULTS: The male to female ratio was 4.5:1, with mandibular fractures most common in the male age group of 21-30 years. Assaults (55 per cent of all patients) were the major cause of fractures. Males accounted for 85.5 per cent of assaults, with punching being the most common method, followed by motor vehicle accidents (MVA), 18.3 per cent and sport, 16.7 per cent. In sport, Australian Rules Football was the most common cause, accounting for 45.2 per cent of sporting injuries. The site most frequently fractured was the angle of the mandible. Alcohol abuse was seen in 41.4 per cent of the patients with 84.6 per cent being male. Open reduction and internal fixation with miniplate osteosynthesis, was the preferred treatment modality. The results are compared with other series. CONCLUSIONS: Mandibular fractures are common in Tasmania, with the highest rates involved in assaults and sport (especially Australian Rules Football) and a low rate in MVA. These fractures commonly occurred in young males in which assaults, alcohol and social issues were associated. Therefore, preventive measures and strong public awareness addressing this group may be of benefit in reducing the rate of assaults and sporting injuries to the mandible.

Accidents, Traffic↗
PubMed1999

An analysis of breastfeeding initiation in Tasmania by demographic and socioeconomic factors for the period 1981-1995.

Breastfeeding initiation and duration trend data is an important component of infant health and nutrition monitoring and surveillance systems. It is also an important basis for identifying breastfeeding promotion needs, prioritising target groups and strategies and in evaluating the effectiveness of breastfeeding promotion efforts. A collation and analysis of available Tasmanian breastfeeding initiation data was undertaken in order to help direct statewide breastfeeding promotion planning and evaluation and to begin the development of a minimum data set for statewide breastfeeding monitoring and surveillance. Perinatally collected breastfeeding initiation data (breastfeeding at discharge from hospital) was analysed against available demographic and socioeconomic variables and compared with initiation rates from interstate Australian populations. Data suggest that breastfeeding initiation rates in Tasmania have been static over the 15 years to 1995 (a three percent increase from 1981 to 1995) and that the associations between breastfeeding initiation and occupational classification, maternal age and parity in Tasmania are consistent with those reported elsewere. Whilst caution needs to be applied to between-population comparisons, breastfeeding initiation rates in Tasmania appear to be considerably lower than that reported in other states. This suggests relatively greater efforts are required to influence breastfeeding initiation. Further research is required to investigate reasons for this difference.

Adult↗
PubMed2002

Recurrent iodine deficiency in Tasmania, Australia: a salutary lesson in sustainable iodine prophylaxis and its monitoring.

Even mild iodine deficiency during early childhood and pregnancy has the potential to impair neurological development. Often considered a problem of developing nations, a number of industrialized countries are at risk of deficiency. Despite past success with intentional and unintentional iodine fortification, recurrence of deficiency is an ever-present risk. Tasmania, an island state of the Commonwealth of Australia, has a history of endemic iodine deficiency, which was successfully eliminated by iodine prophylaxis initiated in 1950. In this report we describe a formal assessment of iodine nutrition in the Tasmanian population, 50 yr after initiation of the prophylaxis program. The requirements and obstacles to achieving sustainable iodine prophylaxis in an otherwise affluent community are considered. A cross-sectional study was undertaken during the yr 2000. Urinary iodine excretion (UIE) and thyroid ultrasonography were assessed in a representative statewide sample of school-age children. Children (n = 225) aged 4 to 17 yr from throughout Tasmania were studied. The sample comprised 99 girls and 126 boys. The median UIE was 84 microg/liter (87 microg/liter for males and 81 microg/liter for females), with UIE 50 microg/liter or less in 20%. Based on age-specific World Health Organization/International Council for the Control of Iodine Deficiency Disorders normative data for thyroid volume, the prevalence of elevated thyroid volume was 5.3% for boys and 3.5% for girls. However, after correcting the World Health Organization/International Council for the Control of Iodine Deficiency Disorders reference data, the prevalence increased to 24.6% for boys and 20.7% for girls. No significant difference in the thyroid volumes was found between males and females in this study. These data confirm the recurrence of mild iodine deficiency in Tasmania. The failure of sustained iodine prophylaxis highlights the universal importance of persistent surveillance, use of sustainable measures, public awareness, and a specific legislative framework for managing ongoing iodine prophylaxis. Our findings also emphasize the importance of accurate reference data for assessment thyroid volume.

Adolescent↗
PubMed1986

Sudden infant death syndrome in Tasmania, 1975-81.

A survey of all infants dying from the Sudden Infant Death Syndrome (SIDS) in Tasmania from 1975 to 1981 showed an incidence of 4.4 per 1000 live births; SIDS comprised 68% of infant deaths. The peak incidence of death was at 3 months of age and the following factors were significant: male sex, gestation less than 38 weeks, birthweight less than 2500 g, unmarried mothers, maternal age below 24 years and unskilled fathers. Analysis of these factors in combination showed each to be independently significant. SIDS was more frequent in the southern and western regions of Tasmania, and there was a higher incidence of death in the colder months in infants over 13 weeks of age. The monthly incidence of SIDS was inversely proportional to the monthly mean temperature in Tasmania and directly proportional to monthly hospital admissions for respiratory infections and apnoea. However, admissions for apnoea were more common in infants under 14 weeks of age. From these observations it is suggested that cold and respiratory infections are associated with the onset of SIDS in older infants.

Adult↗
PubMed1988

Type 1 (insulin-dependent) diabetes in Tasmania: prevalence and apparent regional differences.

The results of a cross-sectional study of Type 1 (insulin-dependent) diabetes in the total population of Tasmania are described. Tasmanians, predominantly of British origin, live in a temperate island situated to the south-east of mainland Australia. For males and females respectively, prevalence in 1984 was 1.1 +/- 0.1 and 0.9 +/- 0.1 per 1,000 at all ages, 0.6 +/- 0.2 and 0.5 +/- 0.2 per 1,000 in subjects aged 0-14 years, rising to 1.2 +/- 0.2 and 1.1 +/- 0.2 per 1,000 in those aged 0-29 years. Prevalence in the 0-19 year age range was 0.8 +/- 0.2 per 1,000 in both sexes. Prevalence fell in both sexes from the third decade of life. A statistically significant excess in prevalence was found in the urban, as compared with the rural, sector of the community. The urban relative risk was greatest in subjects aged 10-19 years. According to reported month of onset (commencement of insulin treatment) there was a suggestion of seasonal trend in the rural, but not in the urban subjects. Longitudinal studies of Type 1 diabetes in Tasmania are now required if these findings are to be confirmed, and their possible aetiological implications explored.

Adolescent↗
PubMed1994

Higher lung cancer rates in young women than young men: Tasmania, 1983 to 1992.

In a background of changing lung cancer rates in the past decade, mean incidence and mortality rates for persons aged 25-44 in Tasmania for the decade 1983 through 1992 were examined using Tasmanian Cancer Registry data. The smoking behavior of Tasmanian adults and schoolchildren was also investigated, using data from a social survey conducted by the Australian Bureau of Statistics and from five secondary school smoking surveys. The Tasmanian age-standardized lung cancer incidence rates in 25-44 year olds for the 10-year period were 6.2 per 100,000 females and 3.3 per 100,000 males. Mean rates of incidence were higher for females than for males (P = 0.02). The corresponding mortality rates were 4.2 in females and 2.4 in males (P = 0.08). The prevalence of smoking by adult Tasmanian women is higher than that for other Australian women (P < 0.05), and their duration of smoking is longer (P < 0.01). Tasmanian schoolgirls have a higher smoking prevalence than Australian mainland schoolgirls (P = 0.01) and higher prevalence than Tasmanian schoolboys (P = 0.01). The data suggest that smoking prevalence among teenagers passed that for males only a decade before the observed excess of female incident cases among 25-44 year olds in Tasmania.

Adenocarcinoma↗
PubMed2001

A population-based study of fracture incidence in southern Tasmania: lifetime fracture risk and evidence for geographic variations within the same country.

Symptomatic fractures are a significant problem in terms of both morbidity and financial cost. Marked variation in both total and site-specific fracture incidence has been documented internationally but there is limited within-country data. This prospective population-based study documented the incidence of all symptomatic fractures occurring from July 1, 1997 to June 30, 1999 in adults > or =50 years of age resident in Southern Tasmania (total population > or = 50 years: 64688). Fractures were ascertained by reviewing reports from all the radiology providers within the area. There were 701 fractures in men and 1309 fractures in women. The corresponding fracture incidence in men and women was 1248 and 1916 per 100000 person-years, respectively. Residual lifetime fracture risk in a person aged 50 years was 27% for men and 44% for women with fractures other than hip fractures constituting the majority of symptomatic fracture events. These fracture risk estimates remained remarkably constant with increasing age. In comparison to Geelong, there were significantly lower hip fracture rates (males: RR 0.59, 95% CI 0.45-0.76; females: RR 0.61, 95% CI 0.53-0.71) but significantly higher distal forearm fractures (males: RR 1.87, 95% CI 1.10-3.78; females: RR 1.31, 95% CI 1.11-1.55) and total fractures in men (RR 1.31, 95% CI 1.17-1.46) but not women (RR 1.05, 95% CI 0.98-1.13). In contrast, Southern Tasmania had lower age-standardized rates of all fractures compared with Dubbo (RR 0.28-0.79). In conclusion, this study provides compelling evidence that fracture incidence varies between different geographic sites within the same country, which has important implications for health planning. In addition, the combination of high residual fracture risk and short life expectancy in elderly subjects suggests fracture prevention will be most cost-effective in later life.

Age Distribution↗