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Analysis of 5,989 couples, for whom fathers' and mothers' heights and weights were recorded, showed that paternal height had a significant influence (p less than 0.0007) on birth-weight while paternal body mass index (Quetelets Index) had no significant effect (p greater than 0.05). Depending upon mother's height, the average effect of father's height (ranging from 165 cm to 184 cm) on birth-weight was up to 152 g, with a greater effect where the mother was taller (up to 235 g) and a lesser effect where the mother was shorter (confirming the effect of maternal constraint). The significance of these findings lies more with the need to consider this effect as an important variable in statistical analysis involving birth-weight than in its immediate obstetrical implications.

Objective: To determine the impact of the introduction of a plastic shield-shaped device (Needleguard, Biosafe, Auckland, New Zealand) and education program designed to allow safer recapping, on recorded rates of needlestick injury., Design: A before-after trial with a two-year duration of follow-up., Setting: Tertiary referral hospital., Participants: Nursing and other hospital personnel., Results: Prospectively collected baseline data, together with the results of an anonymous questionnaire of 25% of the hospital nursing staff, defined a reported needlestick injury rate of 6.9 per hundred full-time nursing staff per year. In the pre-intervention period, there were 6.7 needlestick injuries per 100 nursing staff members per year reported. This increased to 15.4 (p less than .0001) needlestick injuries per 100 nursing staff members per year after the intervention. An anonymous survey undertaken at both time periods suggests that the apparent increase in officially reported needlestick injuries is due to an increase in the willingness of nurses to now report previously unreported needlestick injuries., Conclusions: The impact of the safety device and education program was the more accurate reporting of needlestick injuries; many nursing staff continued to resheath needles contrary to hospital policy. Many staff simply did not use the newly designed safety device. Approaches to improving compliance with such safety devices are considered.

This study reports a longitudinal prospective study of the impact of an unwanted pregnancy on the mental health of the mother. Data are derived from a Brisbane, Australian sample of 8556 mothers who were enrolled at their first clinic visit (mean gestation 18 weeks) and then interviewed again some 3-5 days after the birth and when the baby was 6 months of age. Standard scales of mental health were administered on each of these occasions and mothers whose babies were unwanted were compared with the rest of the sample. The results indicate that mothers of unwanted children have somewhat higher rates of anxiety and depression than the comparison group, but that the magnitude of the mental health differences between the two groups: (a) diminishes over the period of the follow-up, (b) may be partly attributable to the prior poor mental health of women giving birth to an unplanned and unwanted baby, (c) is such that relatively few women who give birth to an unwanted baby experience mental health problems. The paper considers the implications of these results for health planners, notes the absence of contrary data and the need to acknowledge that these results may reflect situational factors which are characteristic of but not necessarily limited to Brisbane.

Little is known about the characteristics, social circumstances and mental health of women who give a child up for adoption. This paper reports data from a longitudinal study of 8556 women interviewed initially at their first obstetrical visit. In total, 7668 proceeded to give birth to a live singleton baby, of which 64 then relinquished the baby for adoption. Relinquishing mothers were predominantly 18 years of age or younger, in the lowest family income group, single, having an unplanned and/or unwanted baby and reported that they were not living with a partner. These women were somewhat more likely to manifest symptoms of anxiety and depression both prior, and subsequent to, the adoption, but the majority of relinquishing mothers were of 'normal' mental health. The decision to relinquish a baby appears to be a consequence of an unwanted pregnancy experienced by an economically deprived single mother rather than the result of emotional or psychological/psychiatric considerations. These findings document a particular dimension of the impact of poverty on health.

The Mater-University of Queensland Study involves the follow-up of 8556 pregnant women who were enrolled at their first clinic visit. This analysis compares four groups of women categorized according to their own and their partners' employment status. Group 1 comprised women unemployed, partners not unemployed. Group 2 comprised women not unemployed with unemployed partners. Group 3 comprised women and partners who were both unemployed. In group 4 neither partner was unemployed. Initial analysis showed that there was a significant association between birthweight and birthweight for gestational age, and unemployment as reported by mothers. After adjustment for lifestyle variables (principally smoking) there were no remaining statistically significant associations.

Previous studies suggest that medical students and doctors may express a range of positive and negative attitudes and behaviours towards patients. As an initial attempt to understand how attitudes toward patients are formed, first-year medical students were asked to describe their feelings about six categories of patients. These reactions were then correlated with the students' social background, social values and perception of these conditions.

In the decade of the 1970s there were some significant changes to the Australian health system while the health systems of most other countries remained stable. By comparing the Australian health system with that of a number of other countries in the 1970s, the paper examines both the causes and consequences of these changes. The substance of the various Australian health system initiatives was a change from a voluntary to a mandatory health insurance system and then, after a short period of 'catastrophic' health insurance, a return to a voluntary system. Most of these changes appeared to be motivated by political and ideological preferences rather than by a rational assessment of their likely efficiency or effectiveness. In any event, and despite claims to the contrary, these changes were minor when viewed in the broad context of international systems of health care. The conclusions of the analysis, while tentative, suggest that the health system changes had little, if any, direct impact on health costs, service use and indicators of health outcomes.

In this report 6566 women enrolled in the Mater-University of Queensland Study of Pregnancy (MUSP) were separated into three groups; members of religious sects, Christians who attend church frequently and Christians who are infrequent attenders. These three groups, respectively labelled Christian sects, Christian attenders and lukewarm Christians were compared on a number of social background, lifestyle and pregnancy outcome variables. The sect members appeared to have the most favourable health, lifestyles and healthy babies at delivery, though this latter finding appears attributable to specific characteristics of the mother and her lifestyle. On most measures the children of lukewarm Christians appear to manifest the worst health while Christian attenders form a group whose children's health is between that of sect members and lukewarm Christians.

We report the results of an age standardized comparison of the mortality rates of Queenslanders and persons living in 14 Aboriginal reserves (or communities) in Queensland. The analysis distinguishes four categories of cause of death. For all causes of death, mortality rates for people living on reserves exceeded the rates for the comparable Queensland population. On some Aboriginal reserves mortality rates were substantially higher than on others. Mortality rates from infectious diseases on some reserves were 200 (Doomadgee, Woorabinda) to 300 (Lockhart River) times those which prevailed in Queensland as a whole.

A prospective cohort of 8556 pregnant women attending the Mater Misericordiae Mothers' Hospital in Brisbane was examined to consider the impact of socio-economic status on pregnancy outcome. The indicators of socio-economic status selected were family income, maternal education and paternal occupational status. Pregnancy outcomes considered were preterm delivery, low birthweight, low birthweight for gestational age, and perinatal death. Subsidiary analyses were also undertaken for Apgar scores, time to establish respiration, need for mechanical respiration and admission to intensive care. Before adjustment, the main consistent association was between the occupational status of the father and three measures of perinatal morbidity. Initial adjustment for the mother's socio-demographic background and weight/height ratio reduced the strength and statistical significance of the above associations, while further adjustment for lifestyle variations between the three status groups further reduced the above associations to marginal statistical significance. The findings suggest that observed class differences in pregnancy outcome are attributable to the mother's personal characteristics (height/weight, parity) and her lifestyle.

Medication is one important aspect of health care delivery. The sources of information used to select appropriate medication include drug advertisements which appear in professional journals. There is a need to monitor the quality of these advertisements. The study reported in this paper includes a longitudinal (1961 to 1977) and cross-societal (Britain, United States and Australia) content analysis of drug advertisements. Such a comparison contributes to the debate concerning the type of regulation likely to be effective for this form of advertising.

The increasing role of general practitioners in the medical curriculum has been accompanied by a greater concern for those aspects of the medical course directed toward an understanding of human behaviour. Medical sociology is one of the new disciplines which provides an understanding of this behaviour. As with any other new discipline, two types of question stand out. Firstly, what are medical sociologists trying to teach? Secondly, how do students react to this content? Both these questions are addressed via an evaluation of two medical sociology courses at Queensland University. Students begin a medical sociology course with a somewhat negative stereotype of how relevant the subject is likely to be. Following the two courses, some of their previously held views are modified. The nature of the modification appears to depend upon the balance between practical or theoretical orientations in the course, and their reflection in specific components of the course content.

This paper introduces the Mater Misericordiae Mothers' Hospital-University of Queensland Study of Pregnancy, a prospective study of 8556 pregnant women interviewed at their first clinic visit, and subsequently interviewed some days after the birth of the baby and again 6 months later. Additional data were derived from the medical record of the pregnancy and delivery. The study was designed to assess the impact of social, psychological and obstetric factors on pregnancy outcome. We present here details of the study design, sampling, response rates and demographic characteristics of the sample.

Since the early 1970s there have been almost yearly reorganisations of the Australian health care system. These reorganisations provide an interesting case study for those who wish to distinguish the rhetoric and the reality of health planning in this country. This paper reviews the changes in the Australian health care system in the decade 1970-80. It examines the impact of these changes on the cost of health care, the use of medical services and the health of the population. Finally, the paper contrasts the available data with successive politically inspired attempts to mislead the community about the true basis and consequences of these changes.

A variety of studies demonstrate the existence of prejudice in the manner and content of health care delivery. Alcoholics, attempted suicides, drug addicts, prostitutes, the mentally retarded or mentally ill, the aged and women have been found to receive less adequate health care. Previous studies have identified manifestations of prejudice in health care delivery but have generally failed to determine the prevalence of negative stereotypes in a sample comprising a cross section of medical practitioners. This study reviews the negative patient stereotypes reported by 2421 Victorian (Australia) and Michigan (U.S.A.) doctors. The characteristics of patients so stereotyped are found to be remarkably consistent. The most commonly held negative stereotypes (patients who abuse alcohol, unhygienic patients, abusive patients, substance abusers and those with minor mental disorders) appear to be determined by the social values which prevail in our society. Many negative stereotypes appear to reflect a response to patients who deviate from the sick role. Other stereotypes may involve reactions to patients or to the types of problems which raise important therapeutic dilemmas.

Interactions between doctor and patient involve participants with unequal power and possibly different interests. While a number of studies have focused upon the doctor/patient relationship, few have examined the utility of the concept of power and its capacity to help us understand the outcome of these interactions. The information sought by pregnant women from their obstetricians is used to provide a case study of one conceptualization and test of the utility of the concept of power. Pregnant women and their obstetricians are found to have different perceptions of the information that should be exchanged during their interactions. Women generally fail to obtain the information they want. Lower social class patients desire more and obtain less information than their higher status counterparts.

One of the more dramatic structural changes in a number of western industrial societies has involved the increased participation of women in the paid labour force. Little is known about the health consequences of this change. This paper reports the findings of a prospective longitudinal study of 8,556 pregnant women who were interviewed on three occasions; early in their pregnancy, shortly after the birth of the baby and some six months later. Additional data were derived from the medical record of the delivery. The findings suggest that employed women and housewives differ in their health behaviour (e.g. number of missed appointments, attendance at antenatal classes, smoking) and emotional health in pregnancy, but that there are no significant differences between employed women and housewives in their physical health or pregnancy outcomes. Although none of the differences was statistically significant, virtually all of the indices of outcome were slightly more favourable for the housewives than for the employed women.

A recent change in many medical curricula has been the introduction of courses in the behavioural sciences. These courses, while introduced with the intention of emphasizing interpersonal and behavioural skills, have not been shown to lead to any of the changes towards which they are directed. Rather, there is evidence that students find these courses 'waffly' and boring. If the sociology component of these courses is to lead to change, then there is the need for a continuing process of evaluation and modification. In this paper we report upon one medical sociology course, its evaluation, subsequent modification and re-evaluation. Our evidence would suggest that sociology courses can lead to changed attitudes and values, but that such changes are contingent upon the overt application of relevant sociological concepts to the health care field.