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J A Streeton

Publications and source records attributed to J A Streeton.

At least 19 recordsLinked to original sources
PubMed1999

The effectiveness of a directly mailed smoking cessation intervention to Australian discharged hospital patients.

BACKGROUND: The objective was to assess the effectiveness of a directly mailed smoking cessation intervention to discharged hospital patients. METHODS: A randomized controlled trial was used. In the 2 weeks after discharge, smokers in the intervention group were sent by mail a personally addressed letter from their medical consultant urging them to quit plus a self-help quitting manual, and smokers in the control group received usual care. Patients were surveyed about their smoking status at 6 and 12 months after discharge. A total of 1858 discharged patients responded to both questionnaires. The main outcome measures were self-reported smoking in past week at 6 and 12 months after discharge. Quitters at 12 months were biochemically tested for evidence of smoking. RESULTS: The results failed to show that smoking cessation advice directly mailed to a broad cross-section of discharged hospital patients who smoke led to smoking cessation. However, the intervention increased cessation among smokers with medical conditions for which quitting is highly relevant. In general, patients who were more likely to quit were older, had entered the hospital as an emergency case, and had a medical diagnosis for which quitting is highly relevant. CONCLUSIONS: This study suggests that hospital patients who smoke and are also diagnosed with conditions which call for quitting are more likely to quit if they receive from their consultant a personalized letter advising them to quit and a self-help manual.

Adolescent↗
PubMed1998

Sensitivity and specificity of a gamma interferon blood test for tuberculosis infection.

SETTING: Victoria, Australia. OBJECTIVE: To determine the sensitivity and specificity of a gamma interferon (IFN-gamma) blood test for tuberculosis infection. DESIGN: Heparinised blood samples from 952 volunteers were analysed using the QuantiFERON-TB blood test. The levels of IFN-gamma in whole blood aliquots stimulated in vitro with human, avian or bovine purified protein derivative (PPD), or phytohaemagglutinin (PHA), were compared to tuberculin reactivity and clinical presentation. RESULTS: IFN-gamma (IU/ml) responses were expressed as % PPD/PHA response ratios. The proportion of responders detected by both the IFN-gamma assay and tuberculin skin test (TST) was not significantly different when the % human PPD response ratio was 15%. Using this threshold, the specificity of the IFN-gamma assay was 98% (407/417 individuals with no known exposure to tuberculosis were negative) and sensitivity was 90% (163/182 untreated TST reactors were positive). The test detected positive responses in 83% (10/12) of individuals with proven active disease, 59% (24/41) of those previously treated, 80% (134/168) of those with untreated inactive disease, and 43% (55/128) of those exposed but TST-negative. CONCLUSION: The measurement of IFN-gamma released from PPD-stimulated blood lymphocytes is a specific, sensitive and rapid method of detecting Mycobacterium tuberculosis infection. The IFN-gamma assay may be a useful and practical tool for the early diagnosis of tuberculosis infection, especially in immunocompetent individuals.

Adult↗
PubMed1997

Missed opportunities for prevention of tuberculosis in Victoria, Australia.

SETTING: Victoria, Australia. OBJECTIVE: To ascertain missed opportunities for prevention in all persons notified in 1991 to the state registry with active tuberculosis (TB), and to examine aspects of case management relevant to prevention. DESIGN: A descriptive study. Records were reviewed for 231/236 cases of TB notified in the state of Victoria in 1991. Documentation of past screening for TB, preventive therapy, treatment of active disease and follow up was sought for all cases. Past screening was defined as past contact screening, migrant screening, refugee screening and health undertakings for TB. RESULTS: Of the 231 cases, 13 were not confirmed to have TB. Of the remaining 218 cases, 78% were foreign born, and of these, nearly half were diagnosed within 3 years of arriving in Australia. Nearly half of all cases (97/218) had some form of past screening for TB. The most common type of screening was refugee and migrant screening (45/218, 21%) followed by tuberculosis health undertakings (25/218, 12%) and contact screening (15/218, 7%). Of those with past screening, 70% (68/97) had a positive screening result at the time. Among these, the first screening episode resulted in the diagnosis of active TB in 5/68, and TB infection in 63/68. In the latter group only 5% (3/63) received preventive therapy. CONCLUSION: There are significant missed opportunities for prevention in Victoria, particularly in the foreign born cases who receive screening on entry into the country. For screening to be a meaningful exercise, preventive therapy should be used where medically indicated.

Adolescent↗
PubMed1995

High rate of transmission of tuberculosis in an office: impact of delayed diagnosis.

We identified two cases of tuberculosis (TB) in office co-workers in Melbourne, Victoria, Australia; the Mycobacterium tuberculosis isolates were found to be identical with use of restriction fragment length polymorphism. Contact tracing was performed for 195 of 210 workers by means of the tuberculin skin test. Risk of infection was assessed according to a number of variables. Office contacts were exposed to infectious TB for 4 months; at least 24% of employees were infected. There was an association between sitting in proximity to the case during the period of exposure (OR, 4.24; 95% CI, 1.06-19.67). On-site workers had a higher risk of being infected (OR, 5.48; CI, 1.51-23.54) than did visiting workers. Workers in this office were exposed to open pulmonary TB for prolonged periods. The prevalence of TB infection (24%) among these workers was high compared with the infection rate (2%-7%) in the general community. Delay in diagnosis was the major factor responsible for the spread of TB in this office.

Adult↗
PubMed1995

Do doctors stop giving quit-smoking advice when other programs are reaching their patients?

The authors attempted to determine if the self-reported practices of hospital doctors regarding smoking cessation advice to their patients, would be influenced by the introduction of a scheme in which smokers were routinely identified on admission to hospital and were subsequently mailed letters including cessation advice. The second objective was to assess the relative levels of cessation counselling among different categories of doctors. Five hundred and fifteen doctors from two large public teaching hospitals in Melbourne, Australia participated in the study. Mail-out cessation advice took place in one hospital (the intervention hospital). In both hospitals, half of the doctors were surveyed 6 weeks before the mailing had commenced, and the remaining half were surveyed 6 months after. There were no significant differences between doctors at the intervention hospital and doctors at the control hospital in the self-reported advice to patients. Most doctors "encouraged patients to quit whenever possible." However, this encouragement seemed to be limited to talking to patients about the risks of smoking. Doctors less frequently gave advice concerning how to stop smoking. Compared with other doctors, internists seemed to be the most willing to encourage patients to quit and they reported higher levels of assisting patients to quit. There was no evidence that reminding doctors regularly that their patients were receiving mailed cessation advice significantly increased or decreased doctor's reporting smoking cessation activities with their patients. Internists are more involved in smoking cessation counselling than other types of doctors.

Australia↗
PubMed1993

The epidemiology of tuberculosis in Victoria.

AIMS: To describe the epidemiology of Mycobacterium tuberculosis (MTb) in Victoria, Australia. METHODS: We analysed data from the Victorian Mycobacterium Reference Laboratory database and MTb notifications to Health and Community Services Victoria, for the period 1948 to 1992. RESULTS: The annual number of notified tuberculosis cases peaked at 1143 in 1954 and declined to 266 in 1992. The incidence rate decreased from 47 to 6.2 per 100,000 in the same period. The pattern of tuberculosis has changed significantly over the last two decades, reflecting the high prevalence of MTb in recent immigrants, particularly in those from South-East Asia. Among people born overseas the number of cases increased from 40% of notifications in 1970 to 80% in 1990; they are younger, more likely to be female and to have extrapulmonary disease, than their Australian-born counterparts. Between 1987 and 1991, the mean annual incidence of tuberculosis in people born in Australia and South-East Asia respectively was 1.5 and 47.5 per 100,000. People born in Vietnam, Cambodia and the Philippines had rates between 100 and 400 per 100,000. These rates have remained stable during the last six years. Almost 50% of migrant patients presented within five years, and 30% within two years, of arrival in Australia. The estimated mean annual incidence of MTb in homeless men between 1984 and June 1992 was 80 per 100,000. Resistance to all first-line drugs increased from 10.8% of all isolates in 1981 to 14.7% in 1990. The incidence of multi-drug resistant MTb (MDR-MTb) has been consistently less than 2% of isolates per year in the past 15 years. There were 14 cases of MTb and HIV between 1985 and June 1992. The mean annual incidence of MTb in people with AIDS is 1579 per 100,000 (range, 570-2420 per 100,000), with a relative risk of 236 (95% confidence interval [CI], 134-414). MDR-MTb has not been documented in HIV-infected individuals in Victoria. CONCLUSION: Tuberculosis remains an important public health concern. Groups at high risk include people born overseas, the homeless, and people infected with HIV. Physicians caring for AIDS patients should consider the diagnosis of MTb, since its incidence in AIDS patients is so high. Our data suggest possible shortcomings in current methods of screening and prophylactic treatment of migrants and refugees. The rising rate of drug resistance cannot be ignored. We should consider strategies to ensure judicious use of anti-tuberculous drugs by physicians, and optimal patient compliance. These issues are critical to the future of tuberculosis control in Victoria.

Adolescent↗
PubMed1985

Weather or not.

Explore the source record for details and available documents.

Asthma↗
PubMed1985

Evaluation of six oxygen concentrators.

Examples of six oxygen concentrators (DeVO2, Dom 10, Econo 2, Hudson, Permox, and Roomate) were evaluated over a 9-28 day period to determine (1) the oxygen yield (% O2) over the flow range 1-4 l min-1; (2) 90% oxygen rise time (90% RT) from a cold start when they were operated at 2 l min-1; (3) accuracy and readability of the flow device; (4) static outlet pressure; (5) major components comprising the product gas (Hudson only); and (6) general characteristics. At an outlet flow of 2 l min-1 the mean % O2 generated by all models, except the Permox (which was lower, mean (SD) 90.5% (3.1%), were between 94% and 95% with a range of less than +/- 0.5%. The Dom 10, Econo 2, and Hudson consistently generated higher oxygen concentrations than the other models at flow rates greater than 2 l min-1. The 90% RT was less than 10.5 minutes for all models. Deviations of up to 22% were observed between predicted and measured flow rates in all models except the DeVO2, Hudson, and Permox. It was possible to set the orifice type flow devices fitted to the Permox and Roomate between indicated flow settings, resulting in cessation of flow. Spectral analysis of the output of one device showed that argon and oxygen were concentrated to similar extents, indicating that the maximal attainable oxygen yield for a molecular sieve concentrator is about 96%.

Evaluation Studies as Topic↗
PubMed1982

Measurement of gas viscosity with a Fleisch pneumotachograph.

A simple rapid method of measuring gas viscosity using a standard Fleisch pneumotachograph and a 3-liter hand-driven syringe is described. Comparison of pneumotachographic and predicted viscosity of five pure gases (CO2, N2, He, O2, and Ar), two binary mixtures (He-O2 and N2-O2), and one quaternary mixture (He-air) gave an overall coefficient of correlation of 0.987 and an accuracy of better than 1.7%. Our data show the well-known marked curvilinear relationship between viscosity and the concentration of helium in air and oxygen mixtures. These studies indicate that a Fleisch pneumotachograph can be used as a simple accurate gas viscometer to characterize gas mixtures in terms of viscosity.

Gases↗