Melbourne School of Population and Global Health - Research Publications
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ItemMortality from cutaneous melanoma: evidence for contrasting trends between populations(NATURE PUBLISHING GROUP, 2000-06)In recent years several reports have been published concerning trends in melanoma mortality in different countries, some of which have indicated that rates are beginning to fall. Many of these reports, however, have been based on small populations and have used different forms of statistical analysis. Our objective was to analyse systematically to what degree the epidemic of melanoma mortality had evolved similarly in different populations and whether there were any divergent trends that might increase our understanding. Instead of using all available data, we focused on countries with a minimum time series of 30 years and a minimum of 100 deaths annually in at least one sex from melanoma. We first inspected sex-specific age-standardized mortality rates and then performed age-period-cohort modelling. We found that the increase in mortality observed after 1950 was more pronounced in the age group 60-79. Statistical modelling showed a general increase in mortality rates in generations born after the turn of the century. Downturns in mortality, essentially in women and starting with generations born just before World War II, were found in Australia (where the earliest decreases were noted), the Nordic countries and the USA. Small decreases in rates in more recent generations were found in the UK and Canada. However, in France, Italy and Czechoslovakia, mortality rates were seen to be still increasing in recent cohorts. Our analysis suggests that populations are at different places on the melanoma mortality epidemic curve. The three trend patterns we observed are in agreement with time differences between populations with respect to the promotion of sun protection and the surveillance of pigmented skin lesions.
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ItemSunscreen use and intentional exposure to ultraviolet A and B radiation: a double blind randomized trial using personal dosimeters.(Springer Science and Business Media LLC, 2000-11)A previous randomized trial found that sunscreen use could extend intentional sun exposure, thereby possibly increasing the risk of cutaneous melanoma. In a similarly designed trial, we examined the effect of the use of sunscreens having different sun protection factor (SPF) on actual exposure to ultraviolet B (UVB) and ultraviolet A (UVA) radiation. In June 1998, 58 European participants 18-24 years old were randomized to receive a SPF 10 or 30 sunscreens and were asked to complete daily records of their sun exposure during their summer holidays of whom 44 utilized a personal UVA and UVB dosimeter in a standard way during their sunbathing sessions. The median daily sunbathing duration was 2.4 hours in the SPF 10 group and 3.0 hours in the SPF 30 group (P = 0.054). The increase in daily sunbathing duration was paralleled by an increase in daily UVB exposure, but not by changes in UVA or UVB accumulated over all sunbathing sessions, or in daily UVA exposure. Of all participants, those who used the SPF 30 sunscreen and had no sunburn spent the highest number of hours in sunbathing activities. Differences between the two SPF groups in total number of sunbathing hours, daily sunbathing duration, and daily UVB exposure were largest among participants without sunburn during holidays. Among those with sunburn, the differences between the two groups tended to reduce. In conclusion, sunscreens used during sunbathing tended to increase the duration of exposures to doses of ultraviolet radiation below the sunburn threshold.
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ItemFamilies courting the Web: the Internet in the everyday life of household families( 2000)Popular reactions to having the Internet at home include exaggerated fears that families will split up as a result of secret on-line romances and fears that children will learn how to build bombs at home. The Preliminary Stanford Institute Report Internet and Society (2000) which looks at the social consequences of the Internet similarly seems to presume that people are passive consumers of the technology. At the other extreme are studies which suppose that consumers have complete control over the effects of the technology. For example, Silverstone and Hirsch (1992) tend towards a notion of complete agency of the consumer with their model of the appropriation, objectification, incorporation and conversion of information and communication technologies into the household. In this paper, I present findings from a series of in-depth interviews with different types of Australian household families to reveal the diversity of responses to the Internet. Conceiving of the family as a process of continual renegotiation, I theorise the way in which the Internet intersects with the daily life of household families as both an effect of the way in which individuals enact their understanding of family, while simultaneously, use of the Internet enables new performances of the family. Both the technology and the individual members are actors and the performance of family at any time is always an achievement rather than the predictable result of the interaction of the technology with a coherent household.
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ItemSuzanne Cory: combining individuality with teamwork(Elsevier, 2000-04)Profile of Professor Suzanne Cory of Walter and Eliza Hall Institute