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Biomedical subjects

A Bauman

Publications and source records attributed to A Bauman.

At least 19 recordsLinked to original sources
PubMed1992

Improved care of patients with diabetes through telecommunications.

This project tested the importance of enhanced information transfer of home monitoring results to health care providers. The study tested whether computer-assisted communication of medical information between the chronic care patient and the physician can result in health care benefit. The information tools were constructed/adapted as a test of this hypothesis for diabetes mellitus. Patients connected a glucometer to an intelligent modem weekly for six to nine months. Graphical and mathematical tools extracted and emphasized the information content of the home monitoring data arriving at the central site. Data smoothing, trend analysis, and calculation of quality control statistics were incorporated into a graphical time series oriented report that was used by the health care provider during an outpatient visit. The integrated home monitoring system was tested on 20 patients with diabetes in a double cross-over design over a 15-month period. A significant improvement in serum glucose control as measured by glycated hemoglobin was shown in the study group, but not in the control group.

Algorithms↗
PubMed1992

Asthma morbidity in Australia: an epidemiological study.

OBJECTIVE: To examine the prevalence and management of asthma in adults and children in a population sample in eastern Australia. SETTING: A random sample of children from 33 primary schools in Sydney, Melbourne, Brisbane, and the Upper Hunter Valley (New South Wales), and their parents. DESIGN: A cross-sectional analytic survey of 8753 primary school children aged between 5 and 12 years, and their parents (n = 13,945 adults). Asthma prevalence and management practices were determined by parental responses to a questionnaire, and spirometry was performed in children with "probable asthma". RESULTS: Of 8753 children whose parents responded, the prevalence of current wheeze was 19.5% and diagnosed asthma was 17.1%. Of the children with "probable asthma", 30% had their lung function measured in the previous year, and 6% possessed both a peak flow meter and an action plan for their asthma. Undertreatment was likely, as preventive asthma medications (inhaled corticosteroids or sodium cromoglycate) were used regularly by only 25.5% of these children and by 44.3% of children who had asthma symptoms more than twice per week. Children with the diagnosis of asthma reported higher rates of preventive medication use and ventilatory function measurement than children with frequent symptoms without the diagnosis. In the 13,945 adults, the reported prevalence of asthma was 7%, of whom 39% were using preventive medications, 34% had their ventilatory function assessed in the previous year, and 7% had both a peak flow meter and an asthma action plan. CONCLUSIONS: The study illustrated the gap between the current level of asthma management in the community and the standards set by the Thoracic Society of Australia and New Zealand. Undertreatment and suboptimal management of asthma remain important problems in Australia.

Administration, Inhalation↗
PubMed1992

Asthma prevalence and management in Australian adolescents: results from three community surveys.

Three population surveys of asthma, conducted as part of a community-based asthma education program in southwestern Sydney, Australia, illustrate the relationship between health behaviors and asthma morbidity. The first survey was carried out in five secondary schools (n = 2514, 52% participation rate); the second survey, in eight schools (n = 4550, 82% participation rate); and, the third survey was conducted among patients who attended 38 general practices in the region (n = 633 adolescents, 72% participation rate). The prevalence of diagnosed asthma in Australian adolescents across all three studies was 16.5% (95% CI, 15.7%-17.3%). Asthma prevalence declined in males, but increased in females from ages 12-15 years. It was noted that smoking prevalence was similar in asthmatic adolescents, compared with nonasthmatics, and that the adoption of smoking occurred at similar ages. Further, behavioral self-management of asthma was infrequent in this group, with low levels of preventive practice and preventive medication use. We present a conceptual model of the barriers to optimal asthma management among asthmatic adolescents. The results of these surveys have led to community-wide efforts to improve asthma management and decrease smoking prevalence among these adolescents.

Adolescent↗
PubMed1992

The descriptive epidemiology of a sedentary lifestyle in adult Australians.

Regular exercise is important for the maintenance of good health, but many people do very little exercise. There are public health concerns about activating the sedentary and, from an epidemiological measurement perspective, there are advantages in assessing physical inactivity. Using pooled data from 17,053 participants in Australian population surveys, we identified 5078 people (29.7%) who could be classified as sedentary in their recreational exercise habits. Logistic regression analyses found the inactive to be more likely to be older, less well educated, and to have lower incomes. The main reasons given for not exercising were no time (33%), being physically unable (23%), and not wanting to exercise (13%): these were more likely to be reported by those who were older, and who had lower incomes; the only exception was that being 55 years or older was not associated with having less time. Women were more likely to report being physically unable to exercise. Lower income was associated with being physically unable, and with not wanting to exercise. Those with children, while wanting to exercise, were more likely to report having no time. The greatest health benefits will result from the sedentary becoming more active, and inexpensive and convenient activities such as walking need to be emphasized.

Adult↗
PubMed1992

Risk estimation of radioactive contamination after the Chernobyl accident using bioindicators.

After the Chernobyl nuclear accident, game meat and, in particular, sheep meat in the Republic of Croatia showed a high degree of radioactive contamination compared to large livestock. The activity concentrations of 131I, 134Cs, and 137Cs were measured in meat and internal organs (i.e., lung, liver, kidney, and heart) of game (e.g., venison, hare, and wild boar) and sheep that were used as biological indicators of radioactive contamination. In order to estimate the importance of game and sheep as a dietary source of radioactivity, the effective dose equivalent for the average and critical population (hunters and livestock raising families) were calculated. The data indicated that sheep meat represents greater risk for the human population, in case of a nuclear accident, than game meat. The share of meat from sheep (4.4%) prevailed over the share of meat from game (0.5%) when comparing the average intake of meat per inhabitant in Croatia. This result pointed to an increased risk for families who depend mostly on sheep meat in the case of a nuclear accident.

Accidents↗
PubMed1992

Asthma under-recognition and under-treatment in an Australian community.

In a study in south-western Sydney, we examined asthma symptoms in a random sample of 4239 schoolchildren aged five-12 years. The prevalence of current wheeze and cough was 17.1% (95% CI 16.0-18.2%). Interviews were conducted with the parents of all 214 symptomatic children from two of the six schools. Only 60% of these children had ever been labelled as asthma, and only 20% were using appropriate asthma treatment. Fewer than 6% had ever had their airway function assessed. There was a socio-economic difference, with better levels of asthma recognition and management in children attending the school in the more affluent region. The findings suggest that asthma recognition, assessment and management in the Australian community, as in New Zealand and the UK, may need to be improved.

Asthma↗
PubMed1992

Reliability of a respiratory history questionnaire and effect of mode of administration on classification of asthma in children.

Because there is no consensus definition of asthma for epidemiology, we have examined the reliability of a questionnaire and the effect of its mode of administration on classification of asthma in children. A symptom history questionnaire was parent self-administered and then readministered within three months by a nurse. The questions of diagnosed asthma, cumulative wheeze, and recent wheeze (wheeze in the previous 12 months) were more repeatable than questions of night cough, but 7 percent of children changed diagnosed asthma category, 13 percent changed cumulative wheeze category, and 9 percent changed recent wheeze category at second questionnaire. Because the numbers who changed from symptom positive to negative roughly equalled the changes from negative to positive, prevalence estimates were not affected. Methods of measuring asthma with greater precision are urgently needed. Because of reporting bias, epidemiologic information collected by current questionnaires should be treated with some caution.

Asthma↗
PubMed1992

[Radioactive contamination of cistern waters along the Croatian coast of the Adriatic Sea].

Measurements of radioactive contamination of cistern waters with 90Sr, 134Cs and 137Cs have been carried out along the Croatian coast of the Adriatic Sea. An exponential decline of radioactivity followed the moratorium on nuclear tests. After the nuclear accident at Chernobyl, high radioactivity levels were detected again. The pre-Chernobyl and the post-Chernobyl mean residence times of 90Sr in cistern waters reflect the mechanism by which strontium was released to the atmosphere (atmospheric nuclear weapon tests conducted in the stratosphere or explosions in the Chernobyl nuclear reactor releasing radioactive material to the troposphere). For the pre-Chernobyl period, the mean residence time of 90Sr in cistern waters was similar to that calculated for fallout, being approximately 10 years. The post-Chernobyl 137Cs/90Sr activity ratio has been decreasing, but it has not yet reached the pre-Chernobyl values (approximately 1.6). The time-dependent 134Cs/137Cs activity ratio reflects the Chernobyl reactor inventory of these radionuclides. The annual dose for the critical adult population received from 90Sr, 134Cs and 137Cs by consumption of cistern water was estimated to be a few percentages of the dose from natural background radiation.

Cesium Radioisotopes↗
PubMed1991

Habitual physical activity and cardiovascular risk factors.

The relationships between different levels of participation in physical activity and biological indices of cardiovascular risk were examined in a sample of 6814 male and female adults who took part in a national risk factor prevalence survey. Participation in physical activity was classified as "aerobic" (14.6% of total), "moderate" (53.6%) or "inactive" (31.8%). Bivariate analyses found significant associations between level of exercise participation and diastolic blood pressures in men, but not in women; significant associations were found between reported physical activity and systolic blood pressure, total serum cholesterol, high-density lipoprotein (HDL) cholesterol, HDL/total cholesterol ratio and triglycerides for both men and women. Further analyses were controlled for age, education, and the survey site, which were potential confounders of the association between physical activity and other coronary heart disease risk factors. After adjustment, significant associations remained between levels of exercise participation and HDL cholesterol level, HDL/total cholesterol ratio and serum triglyceride levels for both sexes. In women, there was also a significant relationship between activity level and body mass index. In addition, for men only, there was a significant inverse relationship between physical activity and total cholesterol, and, for older men, between physical activity and systolic blood pressure. It is well recognised that physical activity has an independent effect on reducing the risk of coronary heart disease. The results of this study suggest that there may be small supplementary effects mediated through the relationship between exercise and other biological cardiovascular risk factors.

Adult↗
PubMed1991

Characteristics of attenders and non-attenders at an asthma education programme.

BACKGROUND: A controlled trial of asthma education was conducted but only 51 out of 164 eligible patients participated. METHODS: Differences between subjects who participated in the trial and those who expressed initial interest but subsequently declined were studied. RESULTS: Women, non-smokers, and those whose attending physician was concerned in the study were significantly more likely to attend the programme. Higher socioeconomic status was associated with greater attendance, but this did not reach significance. Psychosocial malfunctioning due to asthma was also associated with attendance, but this was not significant when sex and education level were taken into account. There was no difference between attenders and non-attenders with respect to age, number of previous admissions, airway function, self reported asthma severity, knowledge about asthma, and self management practices. CONCLUSION: The results suggest that many asthmatic patients recovering from a severe exacerbation of airflow obstruction will not participate in hospital based health education programmes. Alternative strategies may be required to improve the self management behaviour of these patients.

Adult↗
PubMed1991

Repeatability of histamine bronchial challenge and comparability with methacholine bronchial challenge in a population of Australian schoolchildren.

To measure the repeatability of the bronchial challenge test and the comparability of histamine and methacholine as provoking agents, we studied a population sample of children and conducted histamine bronchial challenge tests on each of 3 consecutive days followed by a methacholine bronchial challenge on the fourth day. Bronchial responsiveness was measured using the rapid inhalation method. A total of 393 children had satisfactory bronchial challenge data for all 4 days. The measurements derived from the dose-response curve were the PD20 FEV1, which was measured as the provoking dose causing a 20% fall in FEV1, and the dose-response slope (DRS), which was measured as the percentage fall in FEV1 at final dose/total dose administered. Children who had a PD20 FEV1 were categorized as having bronchial hyperresponsiveness (BHR). The percentage of children with BHR each day was between 7 and 11. One-third of the children with BHR reacted only to histamine or methacholine. The within-subject range for histamine PD20 FEV1 values compared with methacholine suggested that histamine and methacholine are not directly comparable bronchial challenge agents. The dose-response slope values, which could be obtained for all children, had slightly better repeatability than PD20 FEV1 values. Because DRS values obtain data for the entire sample, have good repeatability, and are equally repeatable in children with normal responsiveness or bronchial hyperresponsiveness, they should prove more useful than PD20 FEV1 values for measuring bronchial responsiveness in populations.

Asthma↗
PubMed1991

Asthma management in general practice.

A postal survey of selected general practitioners from Brisbane, Melbourne, Sydney and rural New South Wales was conducted to compare general practitioners' self-reported asthma management practices with the Asthma Management Plan (1989) of the Thoracic Society of Australia and New Zealand. The results suggest that most general practitioners know and practise appropriate asthma management. Room for improvement, however, was detected in the following areas: 1. appropriate understanding of the use of theophyllines, 2. the use of preventive medications such as inhaled steroid and sodium cromoglycate, 3. use of crisis planning for severe asthma attacks, 4. lung function measurement.

Administration, Inhalation↗
PubMed1991

Comparison between the psychopathological profile of dental anxiety patients and an average dental population.

The psychological characteristics of 38 patients with extreme dental fear were compared with those of an age and sex matched control group chosen from the average population visiting the dental clinic. The results were assessed by means of the Kleinknecht Dental Anxiety test, the Brief Symptom Inventory and Spielberger Anxiety State questionnaires. The majority of the dental fear patients were women, the male/female ration being 0.29. In the sample group, the dental anxiety manifested as a state and not as a trait: the anxiety state mean score of the dental phobic group was significantly higher than that of the controls (p less than 0.05), while the mean score for anxiety trait did not differ. Profound psychopathological distress other than anxiety was present only among the phobic males.

Adolescent↗
PubMed1991

Improved diabetic prognosis following telecommunication and graphical processing of diabetic data.

The thesis that an integrated telecommunications/reporting system would affect diabetic prognosis was tested. Over fifteen months a double crossover study compared traditional diaries versus graphical display of telecommunicated blood glucose data. Significant drops in glycohemoglobin were observed in both groups during the telecommunications period, while no significant drops were observed in the groups while diaries were employed.

Blood Glucose Self-Monitoring↗