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R W Gibberd

Publications and source records attributed to R W Gibberd.

36 records · Page 2Linked to original sources
PubMed1988

Ischemic heart disease in the Hunter Region of New South Wales, Australia, 1979-1985.

In Australia, mortality rates from ischemic heart disease have declined by more than 40 per cent in the last 20 years. To investigate the reasons for this trend, detailed studies are being conducted in the Hunter Region of New South Wales, an area with high heart disease rates. Data on death rates and attack rates from 1979 to 1984-1985 were obtained from three sources: national mortality records, local hospital statistics, and heart disease registers conducted in 1979 and 1984-1985 using World Health Organization protocols. Age-standardized death rates from ischemic heart disease, hospitalization rates for acute myocardial infarction, and attack rates from myocardial infarction determined from the disease registers all showed declines of approximately 3-4 per cent per year from 1979 to 1985. The results differ from findings in New Zealand, where the decrease in ischemic heart disease mortality has been attributed to fewer sudden deaths. These discrepancies demonstrate the need for carefully standardized studies to gain insight into evolving patterns of heart disease in different populations.

Adult↗
PubMed1988

Coronary events in the Hunter region of New South Wales, Australia: 1984-1986.

The results of coronary event registration using the protocol of the World Health Organization MONICA Project are reported for two years for the Hunter Region, the area in and around Newcastle in New South Wales, Australia. The Newcastle MONICA Project monitors all suspected cases of heart attack by identifying patients from hospital admissions and obtaining information while they are still in hospital. For people who die out of hospital, the initial source of information is usually the death certificate. Rates for the most robust MONICA diagnostic categories, non-fatal definite myocardial infarction and all coronary deaths, differed for the two years reported here. Monthly rates suggested possible seasonal effects, and the possible influence of lower respiratory infections including an epidemic of influenza A. The results demonstrate that consistent monitoring over several years will be necessary to establish clear trends in coronary heart disease.

Adult↗
PubMed1987

Determinants of non-compliance with short term antibiotic regimens.

The contribution of doctor, patient, and consultation interaction patterns to compliance with antibiotic treatment was examined in 233 adult patients seen in general practice. Twelve variables were shown to discriminate between compliers and non-compliers. Discriminating variables relating to patients included health state, employment state, knowledge of tablet, and perception of anxiety level, difficulty in complying, and their observed anger, distance, and assertiveness in the consultation. Discriminating variables relating to doctors included provision of advice on duration of treatment, complexity of dosage schedule, age of doctor, and number of years in practice. For the most part these results confirmed previous research. It is concluded that the doctor should consider both the dosage schedule and the patient's daily routine when prescribing antibiotic tablets. Advice on how to take the tablets should be given in specific rather than in general terms. The significant effect of the age of the doctor and the years spent in practice has not been found in previous work. This finding may reflect differences in behavior between younger doctors and their patients. This difference was not detected in the observation of consultation events.

Adult↗
PubMed1987

Agreement between two measures of alcohol consumption.

Responses on the Quantity-Frequency Questionnaire (QF) were compared with those on the self-report diary. The QF was administered to 778 general practice patients prior to their consultation and the same patients completed the diary at home within 24 hours. The diary overestimated the number of nondrinkers in the population relative to the QF and classified a higher proportion of patients as heavy drinkers. The QF failed to detect 78% of heavy drinkers identified by the diary. Significantly (p less than .001) more alcohol was reported to be consumed overall on the diary (mean, 10.51 drinks/week) than on the QF (mean, 6.87 drinks/week). The relationship between responses on the two measures was nonlinear. At low consumption levels patients indicated drinking twice as much on the diary as on the QF, but the magnitude of the reported consumption difference decreased with increasing consumption levels. The results are discussed in terms of their implications for self-report measures of alcohol consumption.

Adolescent↗
PubMed1986

Risk factors and heart disease mortality. A regional perspective.

The mortality rates from ischaemic heart disease in the Hunter Region of New South Wales are among the highest in Australia. Within the Region substantial differences occur in death rates from heart disease among the five urban local government areas, the highest being in the coal-mining district of Cessnock and the lowest in the resort and dormitory area of Port Stephens. A recent survey in the Region of risk factors for heart disease has revealed prevalence patterns for high blood pressure, serum cholesterol levels, smoking and overweight and obesity which largely parallel the pattern of heart disease mortality. This suggests that changes in life-style in the communities could reduce the intraregional differences in mortality. In addition, the widespread prevalence of an unhealthy diet and a lack of exercise may explain the Region's high death rates from heart disease and suggests that mortality could be reduced by effective preventive measures.

Adult↗
PubMed1985

Effects of random breath testing on hospital admissions of traffic-accident casualties in the Hunter Health Region.

During the period of six years from 1977 to 1982, the number of admissions of victims of traffic accidents to public hospitals in the Hunter Health Region of New South Wales fell from 2099 to 1734, a decline of 21%. About three-quarters of these patients were male; one-quarter were in the 15-20 year age group. Since the introduction of random breath testing (RBT) in 1982, there has been a further decline in admissions of traffic accident victims to hospitals of nearly 20%, attributable to the introduction of RBT. The initial decline of 30% appears to have stabilized at 20% after 12 months. The decline in admissions occurred in the urban hospitals (31%), and not in the rural hospitals; it was greater among male (31%) than among female (8%) accident victims. In the Hunter region, it is estimated that RBT has resulted in a saving of more than 3000 hospital bed-days in its first year.

Accidents, Traffic↗
PubMed1985

Occupational differences in ischemic heart disease mortality and risk factors in Australia.

Mortality rates from ischemic heart disease in Australia declined by about 25% over the period 1969-1978. The greatest declines were experienced by the professional occupations, while lower socioeconomic groups had higher mortality rates at the beginning of the period and experienced smaller declines. From a national survey in 1980, significantly and consistently lower risk levels of blood pressure, triglyceride, cigarette smoking, body mass and exercise were found among higher status occupation groups. This suggests that there is a pattern of coronary prevention behavior spanning multiple risk factors that is associated with a reduction in ischemic heart disease.

Adult↗
PubMed1984

Antihypertensive treatment, body mass, and survival after myocardial infarction.

In a community-based study of heart attack, which was conducted in the Hunter Region of New South Wales in 1979, the prognosis was found to be poorer for patients who had received therapy with diuretic agents before the index attack, compared with those who either had received no treatment or were treated with other antihypertensive agents. There was also some evidence of a better prognosis for overweight people or those of normal weight, compared with those whose body weight was below normal.

Age Factors↗
PubMed1984

Differences and comparative declines in ischaemic heart disease mortality among subpopulations in Australia, 1969-1978.

Mortality rates from ischaemic heart disease (IHD) in Australia for the period 1969-78 have been analysed by place of residence, occupation and country of birth. Large variations were found among subpopulations. Throughout the period IHD mortality was lowest among professional and farming occupations and highest among workers in mining, transport and communications. Geographically, mortality from IHD was highest on the east coast and lowest in Western Australia. Mortality among immigrants was lower than among people born in Australia, with death rates for those born in Greece, Italy and Yugoslavia about half the average rates. Mortality from IHD in Australia has declined by about 25% over the last decade. However, the decline has not occurred uniformly. By occupation, the professional, technical and related workers showed the largest decline, while administrative, executive and managerial workers experienced the smallest decline. By place of residence in Australia, the largest declines occurred in the Hunter and Geelong regions, although the Hunter region still has the highest rate. Western Australia, excluding Perth, and rural Victoria did not show any marked decline. The remaining regions particularly the capital cities all experienced similar declines. When analysed by country of birth, Australian born residents showed a greater decline, while men born in Greece and Italy may have had an increase in IHD mortality. There is every indication that the decline will continue. Even those subpopulations with low initial IHD mortality experienced the decline, thus Perth and Adelaide (with low rates) had similar declines to Brisbane and Sydney (with high rates) and the professional occupation group which had the lowest rate also experienced the greatest decline.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Declining mortality rates from ischemic heart disease in Australia.

Ischemic heart disease is the major cause of death in Australia. Australian attack and mortality rates from this disease are high compared with most other countries. Over the last thirty years there have been remarkable changes in heart disease death rates which rose from the 1950's until around 1965-7 and then declined by about 40% over the period 1965-7 to 1980-81. Although the pattern of this decline was similar for most age groups and both sexes it varied among subgroups of the population defined by country of birth, geographic region and occupation. For example, Australian-born men initially had higher death rates than immigrants and they experienced relatively greater declines; Perth and Adelaide (with low initial rates) had similar declines to Sydney and Brisbane (with high rates); professionals (with the lowest rates) had the greatest decline among occupational groups. While the decline in mortality is encouraging the cause is still unclear so control programmes must proceed, to some extent, by guesswork. If the subpopulations with high mortality can achieve rates comparable with subpopulations with low rates further substantial decline in heart disease mortality is possible.

Adult↗
PubMed1983

Death certification and coding for ischemic heart disease in Australia.

Trends in ischemic heart disease mortality are of current interest because death rates have declined rapidly in the United States, Australia, and some other countries during the last decade, although they have risen elsewhere. There is a need to assess the quality of the data from which such trends are calculated and to consider what information will be required to monitor accurately future patterns of incidence and mortality for this disease. This paper describes two investigations of routinely collected mortality data for ischemic heart disease in Australia. First, information obtained from a heart attack surveillance study was compared with officially recorded causes of death for a defined population during 1979. Second, mortality trends from 1969 to 1978 were compared between the major Australian states. Both studies showed that mortality data were accurate to within about 10%. However, for acute myocardial infarction and other subcategories of ischemic heart disease, the data were neither valid nor reliable. New diagnostic and coding practices are required before it will be possible to monitor accurately long-term trends in subcategories of ischemic heart disease.

Adult↗
PubMed1983

Attack and case fatality rates for acute myocardial infarction in the Hunter Region of New South Wales, Australia, in 1979.

The Hunter Valley Heart Attack Study was conducted throughout 1979 to investigate all cases of suspected heart attack among permanent residents 20 to 69 years of age in a well-defined area in New South Wales, Australia. The study design followed that for the Myocardial Infarction Community Registers coordinated by the World Health Organization (WHO) in Europe and elsewhere around 1971. The attack rates obtained confirm that in Australia myocardial infarction incidence, like mortality, is high by international standards. Case fatality rates were somewhat lower than those reported elsewhere. To discover whether heart attack rates are changing with the decrease in heart disease mortality, it is proposed to carry out longitudinal surveillance in the study population. Experience with this baseline survey indicates that there may be difficulties in reliably interpreting the WHO diagnostic criteria and that changes in medical management of heart disease may affect the numbers of cases diagnosed. This highlights an epidemiologic need for clear definitions of myocardial infarction.

Adult↗
PubMed1981

Age-specific trends in mortality from ischemic heart disease and cerebrovascular disease in Australia.

Analysis of ischemic heart disease (IHD) and cerebrovascular disease mortality rates in Australia shows that: first, deaths from IHD increased from 1950 to the mid-1960s with successive cohorts experiencing higher mortality rates. Around 1967 this trend stopped simultaneously in men over 35 years and women over 45 years and mortality rates from IHD began to decline at similar rates throughout the population. Second, deaths from cerebrovascular disease have declined in both sexes and all age groups over 35 years throughout the period 1950-1978. This change has been more pronounced for women than men. Third, the relative frequency of IHD and cerebrovascular disease as the cause of death has changed in women. IHD has become the more frequent cause of death in the older age groups. More recently this change in relative frequency has occurred in younger women as well.

Adult↗
PubMed1980

Failure of therapy to improve prognosis in elderly males with hypertension.

Male patients, born between 1900 and 1925, have been entered in a study to ascertain the effect of therapy on the lifespan of people with different levels of blood pressure. Patients were divided into three groups--those with diastolic blood pressure below 12.6 kPa (95 mmHg), those with diastolic blood pressure between 12.6 kPa and 14.5 kPa (95 mmHg and 109 mmHg), and those with diastolic blood pressure higher than 14.6 kPa (110 mmHg). Patients in the first group were not treated, and all patients in the last group were treated. Patients in the middle group were subdivided into four subgroups, one of which received no treatment. Those in the second subgroup were placed on a reduced salt intake diet; those in the third subgroup were given a thiazide diuretic followed by alpha-methyldopa; and patients in the fourth subgroup were given a beta-blocking drug followed by a thiazide diuretic. The mortality rates in all groups, except one, were similar, and similar to that predicted for a normal population. The patients who were treated with thiazide diuretic regimen had a higher mortality rate which was due to a greater number of fatal myocardial infarcts and sudden deaths. These occurred in the first 2 1/2 years of therapy, and the cause of this is unknown. In this study, therapy did not produce an improvement in the lifespan of elderly males with hypertension.

Aged↗
PubMed1980

Mortality in the Hunter Region, New South Wales, 1970 to 1977.

For the past two decades, crude mortality rates for the Hunter Health Region of New South Wales have been consistently higher by about 5% than those for the State in general. This is, in part, attributable to a concentration of deaths, particularly of those from ischaemic heart disease and stroke, in two major industrial areas within the Region. Favourable modification of these mortality inequalities may be possible in some cases through legislation and education. The importance of these inequalities for planning health care resources is also discussed.

Accidents, Traffic↗