Allergy in the elderly: A case note review of referrals to an adult allergy clinic.

The UK population is ageing and we can expect more referrals to allergy clinics for this age group. 16% of patients to our clinic are aged >60. Compared to younger patients, 3 times as many referrals were for angioedema. Overall, allergy was excluded in 79% of cases. 15% were diagnosed with previously unrecognised allergies, while allergic disease was confirmed in 6%, enabling optimised management. While the differential diagnosis of allergic conditions is wider in older people, assessment in the allergy clinic is helpful and adds value.

"Sometimes I feel like a pharmacist": identity and medication use among adolescents with juvenile arthritis.

BACKGROUND: Taking medicines as intended is difficult for everybody, but young people going through adolescence have greater problems than adults and younger children. One of the most important things that happen during the teenage years is the development of individual identities, which might not remain constant during this time and can be affected deeply by the diagnosis of a long-term condition. The aim of this study was to examine the relationships between identity and medication use among young people with juvenile arthritis. METHODS: A prospective qualitative study was undertaken to collect private online 'blog' style data from young people (aged 11-19 years) with juvenile arthritis, and their parents, to examine their views about their condition, identity, medication and use of health services. Participants were identified from a large paediatric hospital in the UK. RESULTS: Young people (n = 21) with a median age 14 years (range 11-17 years) posted a median (range) of 8 (1-36) blogs and parents (n = 6) posted 4 (1-12) blogs. Young people gave a strong sense of both private and public identity that was intertwined with their arthritis and treatment. It was evident that young people's self-care was intrinsically linked to their attempts to maintain a sense of individually and socially constructed definitions of normality. The act of taking medication, and the consequences (positive or negative) of that act, had an impact both personally and socially. CONCLUSIONS: Young people with juvenile arthritis reflect on their medication as a factor affecting their perception of themselves. Acknowledging the roles of both personal and social identity will be important in any strategies to support optimal medication use. This includes an understanding of the identity transformations that young people can experience and how decision-making may be affected by their attempts to retain pre-diagnosis identities and/or develop new social identities.

The risks and benefits of antithrombotic therapy in chronic atrial fibrillation.

As the risks of adverse effects of warfarin and aspirin in certain patients with chronic atrial fibrillation are high, intervention with these agents should be targeted towards those who will derive most benefit. Clearer guidelines are emerging to identify those patients and to standardise current prescribing practices.

Australian patterns of tobacco smoking in 1989.

OBJECTIVE: To estimate the national prevalence of smoking. DESIGN: A total of 4820 adults aged 16 years and over (2364 men, 2456 women) were surveyed throughout Australia in 1989 by a large market research company. SETTING: Interviews were conducted in the participants' homes. RESULTS: Overall, 30.2% of men and 27.0% of women were current smokers; 29.8% of men and 19.3% of women were past smokers. The mean daily consumption of factory-made cigarettes among male smokers was 22 and among female smokers 18.9. Taking into account the published tar content of the brand smoked, it was estimated that the average daily exposure to tobacco tar for men was 204 mg and for women 157 mg. Occupational and educational status were inversely related to the prevalence of smoking. The most popular packet size was 25 (preferred by 48% of smokers) and those in lower occupational and educational categories were more likely to purchase cigarettes in large packet sizes. CONCLUSIONS: Comparison with an earlier series of studies commenced in 1974 showed that the national prevalence of smoking among adults has continued to fall, particularly among men.

Measures of tobacco smoking in Australia 1974-1986 by means of a standard method.

Trends in smoking among Australian adults as based upon surveys with a standard method in 1974, 1976, 1980, 1983 and 1986 are presented. The percentage of male cigarette smokers fell from 42.2% in 1974 to 31.9% in 1986 and the percentage of female smokers was 29.5% in 1974 and 28.8% in 1986. Over the period of observation, the percentage of past smokers of both sexes climbed steadily and, in 1986, reached 28.1% of men and 16.8% of women.

Patterns of tobacco smoking in Australia.

We report the results of a survey of cigarette smoking rates in Australia. A representative sample of 4309 people (2137 men and 2172 women) aged 16 years and over was interviewed in winter 1980. Forty per cent of men and 31% of women smoked cigarettes, the same percentages as in 1976. The highest rate of cigarette smoking (56%, up 10%) was amongst men aged 20 to 24 years. The rate of cigarette smoking peaks when smokers are in their twenties and again at around 50 years of age. Health education is urgently needed for these age groups. There is a negative relationship between smoking and occupational/educational levels in men.

Patterns of tobacco smoking in Australia. 2.

Australian smoking patterns have been surveyed in 1974 and 1976. There appears to be a slight downward trend in male smoking and a slight increase in female smoking. Smoking is more prevalent in the cities than in the country, and among blue collar workers than among white collar workers. Usage of "low tar" cigarettes is also increasing.

Patterns of tobacco smoking in Australia.

A large representative sample of Australians aged 14 years or more was interviewed about smoking. Forty-one per cent of the males and 29% of the females aged 16 years and over currently smoked cigarettes. Smoking rates for both sexes were highest in the 20 to 24 years age group. People in metropolitan areas smoked more than those in rural areas. There was a clear excess of smoking among British immigrants. Higher socioeconomic level was associated with lower smoking rates, with higher ex-smoking rates and with more frequent choice of low-tar brands. Low-tar cigarrettes were used more where health education had emphasized the importance of tar content. Choice of brands among young smokers appeared related to the advertising strategies employed by cigarette companies. The majority of ex-smokers over 60 years of age had given up more than five years previously. Although comparison with earlier surveys of smoking habits is difficult, the results suggested a decrease in cigarette smoking among males and a slight increase among females.

Attitudes and smoking habits of Australian doctors.

In a national survey of 1,276 Australian doctors, information was obtained about their present smoking havits, any changes in their smoking habits, their opinions of the health risks associated with smoking, and the advice they gave to their patients about smoking. The results indicated that only 14% of doctors currently smoked cigarettes, and that, of all the doctors who were now ex-smokers, 72% had given up smoking more than five years before-most of them for health reasons. Most exressed a strong belief that smoking and ill health were associated and 63% encouraged their patients to give up smoking whenever possible.