ABSTRACT
BACKGROUND: Urban birth and migrant status have been identified as risk factors for psychosis in North American and European studies. The aim of this study was to explore these variables in an Australian case-control study. METHOD: Country of birth of subjects and their parents, and place of birth of Australian-born subjects, were examined in individuals with psychosis drawn from a prevalence study (n = 310) and well controls recruited from the same catchment area (n = 303). RESULTS: Migrant status was associated with a significantly decreased odds of having a psychotic disorder. For those born in Australia, neither migrant status of parents nor urban birth was associated with having a psychotic disorder. CONCLUSIONS: The lack of effect for urban birth and second-generation migrant status may help generate candidate environmental risk factors that operate in Europe but not in Australia.
Subject(s)
Emigration and Immigration/statistics & numerical data , Psychotic Disorders/epidemiology , Schizophrenia/epidemiology , Schizophrenic Psychology , Urban Population/statistics & numerical data , Adolescent , Adult , Case-Control Studies , Female , Health Surveys , Humans , Male , Middle Aged , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Queensland/epidemiology , Risk Factors , Schizophrenia/diagnosisABSTRACT
OBJECTIVE: To examine primary noncompliance in patients suffering with asthma. METHOD: A prospective matching of prescriptions written and then dispensed for patients with asthma. The subjects were patients who were given a general practitioner's prescription for asthma during a 3 month period (1993) in an isolated rural setting. RESULTS: During the period of the study, participating GPs documented 359 prescriptions and of these only 251 (70%) were dispensed by the pharmacies. Primary noncompliance was therefore 30%. The relative risk (RR) of mild asthmatics not filling their prescriptions is 0.81 (95% CI; 0.771 < RR < 0.92) when compared to severe asthma. Compared to patients of high socioeconomic status; patients of low and medium socioeconomic status have decreased relative odds of filling their prescriptions, that is, RR = 0.84 (95% CI; 0.71 < RR < 1.00). Gender and age had no bearing on primary compliance. CONCLUSIONS: Primary noncompliance is high in patients with asthma and is another factor contributing to morbidity. GPs should spend more time counselling patients on the need for treatment and not only its correct use. Patients with mild to moderate asthma and those in lower socioeconomic groups may need more intensive counselling.
Subject(s)
Anti-Asthmatic Agents/therapeutic use , Asthma/drug therapy , Patient Compliance , Female , Humans , Male , Social Class , South AustraliaABSTRACT
OBJECTIVE: To investigate whether exposure to Murray River and allied water sources during a period of raised cyanobacterial cell counts was associated with gastrointestinal and dermatological symptoms. DESIGN: A case-control study selecting gastrointestinal and dermatological cases and controls from subjects attending 21 general practitioners in eight Murray River towns. The association between the proportion of consultations for such symptoms and mean log cyanobacterial count was also examined. SUBJECTS: 102 gastrointestinal cases, 86 dermatological cases and 132 controls. MAIN OUTCOME MEASURE: The relative odds of gastrointestinal and dermatological symptoms, respectively, as opposed to no such symptoms, according to water-contact history during the week preceding the medical consultation. RESULTS: After adjusting for concurrent risk factors, subjects drinking chlorinated river water rather than rain water had a raised risk of gastrointestinal symptoms (P = 0.008), and those using untreated river water for domestic purposes rather than rain water had a raised risk of gastrointestinal (P = 0.034) and of dermatological (P = 0.048) symptoms. The proportion of consultations for gastrointestinal and dermatological symptoms correlated on a weekly basis with the mean log cyanobacterial cell count, although statistical significance was not achieved for the correlation with dermatological consultations or for separate reaches of the river. CONCLUSIONS: The raised risks of gastrointestinal and dermatological symptoms in those using Murray River water for drinking and other domestic purposes are consistent with causal relationships. However, the evidence for adverse health effects is, at best, only suggestive. Further research is indicated.
