ANU National Centre for Epidemiology and Population Health (NCEPH)
Permanent URI for this collectionhttps://hdl.handle.net/1885/138166
Since 1988, NCEPH has devoted itself to improving the population's health through discovery, training and the translation of research into effective health policy. We strive to provide a work environment that is supportive and enriched by expertise in the broad range of disciplines needed to achieve excellence in population health research.
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Item Open Access Aboriginal fertility in Central Australia(National Centre for Epidemiology and Population Health (NCEPH), Australian National University, 1989) Khalidi, Noor A.Item Open Access The Social Context of HIV Transmission in Afirca: A Review of the Historical and Cultural Bases of East and Central African Sexual Relations(The Australian National University, 1989)The literature relating to the social context of sexual relations in East and Central Africa has several implications for the heterosexual transmission of human immunodeficiency virus (HIV) . Colonially-created cities in the region still discriminate economicall y and socially against women . Rapid urbanization is occurr ing but migrants maintain strong ties with rural areas . Traditional attitudes towards marriage and sexuality affect urban behavior in the extent of marital stability, frequency of polygyny and the emotional bond between couples . Ethnic groups in Kampala and Nairobi demonstrate the cultural foundations of two forms of sexual re l ations found in the region : one characterized by prostitution and the other by small circles of interchanging lovers . The first results in a more rapid spread of HIV through the urban population and outwards into rural areas . Each pattern has unique constraints on behavioral change and require different prevention campaigns .Item Open Access Aboriginal fertility: trends and prospects(National Centre for Epidemiology and Population Health, Australian National University, 1989) Gray, AlanItem Open Access Disaster in an Alternative Civilization The Social Dimension of Aids in Sub-Saharan Africa(The Australian National University, 1989)Item Open Access The family and sexual networking in sub-Saharan Africa: historic regional differences and present day implications(The Australian National University, 1990)Item Open Access Research Priorities: Behavioural Research (with an Annex on needed research with priority sugestions)(The Australian National University, 1990)Item Open Access Experimental Research on Sexual Netowrking in the Ekiti District of Nigeria(The Australian National University, 1990)Publication Open Access Do treatment costs vary by stage of detection of breast cancer?(Canberra : Australian National University, 1990) Butler, J. R. G. (James Robert Gerard), 1952-; Furnival C. M.; Hart, R. F. G.; Cawdell, G.; Brunello, M.; National Centre for Epidemiology and Population Health (Australia)This paper reports the results of a study wherein full treatment data were collected from the medical records of 301 women treated for breast cancer at a major public hospital. The objective of the study was to ascertain whether, and to what extent, treatment costs for breast cancer vary by stage of detection of the disease. This issue is of importance in the economic evaluation of breast cancer screening programs, as any treatment cost savings arising from early detection of the disease should be offset against the costs of the screening program. The results indicate that there is a statistically significant relationship between stage of detection and treatment costs for breast cancer, with mean treatment costs being higher the more advanced is the disease on presentation. This relationship was found to be robust even aftertaking into account the age of patients, their discharge status (alive or deceased at last separation) and their year of first admission. The results also indicate that there is a substantial amount of variation in treatment costs within each stage of detection. Nevertheless, the between-stage variation in treatment costs is substantial and highly statistically significant, lending support to the contention that detecting this disease at an earlier stage may indeed significantly reduce treatment costs.Publication Open Access Disease and the destruction of indigenous populations(Canberra : National Centre for Epidemiology and Population Health, Australian National University, 1990) Kunitz, Stephen J.; National Centre for Epidemiology and Population Health (Australia)My focus in this chapter is upon the impact that European contact has had upon non-Europeans. The topic is vast since indigenous populations, by which I mean the native peoples of non-European lands, are enormously diverse - a diversity that is matched by their disease experience. I shall proceed by examining the sources of diversity, on a series of progressively finer levels of analysis.Item Open Access Gender Implications for survival in South Asia(The Australian National University, 1991)This paper will take as its focus 'differential female care', in the sense of any aspect of care which has an impact on health. Inevitably the measure of health will usually be mortality rates, not because measures of health and sickness are not important, but because they are so difficult to achieve and because we lack them for most populations. First, we should intrude a few notes of demographic caution.Item Open Access The impact of family and budget structure on health treatment in Nigeria(The Australian National University, 1991)Item Open Access Feasibility research into the controlled availability of opioids, Volume 1(1991) Australian National University. National Centre for Epidemiology and Population Health (NCEPH); Australian Institute of CriminologyExecutive Summary: The results of a three month exploration of legal, ethical, political, medical and logistic issues lead us to the interim conclusion that it would be feasible to undertake a randomised controlled trial as a test of the policy of expanding the availability of heroin in a controlled fashion for the management of heroin dependent users in the ACT. There is evidence that the ACT community is willing to consider such a trial, but also that ACT police have significant concerns about its logistics and possible ill effects. The trial would compare oral methadone treatment with a program of expanded opioid availability, in which dependent individuals would be able to take intravenous, oral or smoked heroin and/or methadone under careful medical supervision. Volunteers would be subject to strict residential eligibility criteria and would need to agree to extensive medical tests and data collections. They would be randomly assigned either to methadone treatment or to the expanded availability program. The two groups would be carefully followed for at least one year in an effort to discover whether or not the expanded availability program provides benefits for dependent drug users, their families and to society at large which methadone programs cannot provide. The purpose of the study would be to discover whether or not a policy of controlled heroin availability could ameliorate the massive burden which illegal heroin use currently imposes on Australian and ACT societies. Our exploration of these matters leads us to recommend to the Select Committee on HIV, Illegal Drugs and Prostitution of the ACT Legislative Assembly that it cautiously proceeds to a second stage exploration of the feasibility of such a study without commitment to the trial until logistic issues are more fully described.Item Open Access A model for estimating the incremental cost of breast cancer screening programs(National Centre for Epidemiology and Population Health, Australian National University, 1991) Butler, J. R. G.; Hart, R. F. GItem Open Access Feasibility research into the controlled availability of opioids, Volume 2a - Background Papers(Canberra, ACT: National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, 1991) Australian National University. National Centre for Epidemiology and Population Health (NCEPH); Australian Institute of CriminologyExecutive Summary: The results of a three month exploration of legal, ethical, political, medical and logistic issues lead us to the interim conclusion that it would be feasible to undertake a randomised controlled trial as a test of the policy of expanding the availability of heroin in a controlled fashion for the management of heroin dependent users in the ACT. There is evidence that the ACT community is willing to consider such a trial, but also that ACT police have significant concerns about its logistics and possible ill effects. The trial would compare oral methadone treatment with a program of expanded opioid availability, in which dependent individuals would be able to take intravenous, oral or smoked heroin and/or methadone under careful medical supervision. Volunteers would be subject to strict residential eligibility criteria and would need to agree to extensive medical tests and data collections. They would be randomly assigned either to methadone treatment or to the expanded availability program. The two groups would be carefully followed for at least one year in an effort to discover whether or not the expanded availability program provides benefits for dependent drug users, their families and to society at large which methadone programs cannot provide. The purpose of the study would be to discover whether or not a policy of controlled heroin availability could ameliorate the massive burden which illegal heroin use currently imposes on Australian and ACT societies. Our exploration of these matters leads us to recommend to the Select Committee on HIV, Illegal Drugs and Prostitution of the ACT Legislative Assembly that it cautiously proceeds to a second stage exploration of the feasibility of such a study without commitment to the trial until logistic issues are more fully described.Item Open Access Feasibility research into the controlled availability of opioids, Volume 2b - Appendices(Canberra, ACT: National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, 1991) Australian National University. National Centre for Epidemiology and Population Health (NCEPH); Australian Institute of CriminologyExecutive Summary: The results of a three month exploration of legal, ethical, political, medical and logistic issues lead us to the interim conclusion that it would be feasible to undertake a randomised controlled trial as a test of the policy of expanding the availability of heroin in a controlled fashion for the management of heroin dependent users in the ACT. There is evidence that the ACT community is willing to consider such a trial, but also that ACT police have significant concerns about its logistics and possible ill effects. The trial would compare oral methadone treatment with a program of expanded opioid availability, in which dependent individuals would be able to take intravenous, oral or smoked heroin and/or methadone under careful medical supervision. Volunteers would be subject to strict residential eligibility criteria and would need to agree to extensive medical tests and data collections. They would be randomly assigned either to methadone treatment or to the expanded availability program. The two groups would be carefully followed for at least one year in an effort to discover whether or not the expanded availability program provides benefits for dependent drug users, their families and to society at large which methadone programs cannot provide. The purpose of the study would be to discover whether or not a policy of controlled heroin availability could ameliorate the massive burden which illegal heroin use currently imposes on Australian and ACT societies. Our exploration of these matters leads us to recommend to the Select Committee on HIV, Illegal Drugs and Prostitution of the ACT Legislative Assembly that it cautiously proceeds to a second stage exploration of the feasibility of such a study without commitment to the trial until logistic issues are more fully described.Item Open Access Feasibility Research into the Controlled Availability of Opioids (Stage 1)(Canberra, ACT : National Centre for Epidemiology and Population Health, The Australian National University, 1991-09) Bammer, GabrieleIllegal drug use is a problem worldwide. Prisons are overcrowded with people whose criminal activity is related to illegal drug use and/or distribution. Yet illegal drug use apparently goes unchecked. Addiction to opioids is no recent phenomenon. The opium trade is centuries old. The question is increasingly being asked whether the costs of current social and legal policies concerning opioid use outweigh their benefits. Urgency has been given to the issue by the advent of the human immunodeficiency virus and its wildfire spread through shared use of injecting equipment in some drug using communities. Opioid use has become synonymous with criminal activity, 'chaotic lifestyles' and living dangerously.The present report covers stage 1 (feasibility). It has been prepared at NCEPH by Dr Gabriele Bammer who has co-ordinated a multi-disciplinary team drawn both from within and outside the Centre. Our collaboration with the Australian Institute of Criminology on this exercise has been particularly important, and the process has been monitored and modified by an advisory committee and informed by a large reference group of experts, both in Australia and overseas. Responsibility for the report and its recommendations rests with me and the authors. We have carefully considered the advice of all members of the advisory committee and the suggestions of the reference group. Not all of the recommendations in the report are necessarily endorsed by all individuals in either group. The two volume report is being submitted to Mr Moore’s committee and being widely disseminated in the ACT community and beyond, to inform and provoke discussion about whether or not to proceed to Stage 2. The report offers our advice that an ACT trial of controlled availability of opioids is feasible. It argues that such a trial would need to be very carefully structured as a randomised control trial which can provide answers to specific questions. These answers do not exist anywhere in the world at this time. We recognise that there are many uncertainties associated with undertaking such a trial, but conclude that there is a sound basis for proceeding to a Stage 2 feasibility study.Item Open Access The role of high-risk occupations in the spread of AIDS: truck drivers and itinerant market women in Nigeria(The Australian National University, 1992)Item Open Access The role of religious leaders in changing sexual behaviour in South Nigeria in an era of AIDS(The Australian National University, 1992)Item Open Access Underreaction to AIDS in sub-Saharan Africa(The Australian National University, 1992)Item Open Access African families and AIDS(The Australian National University, 1992)