f'· I 1.

91/1974

THE AUSTRALIAN tJATIONAL UNIVERSITY

UNIVERSITY HEALTH SERVICE

ANNUAL REPORT 1973

STAFF

Director: s. B. Furnass,. MA,BM, (Oxon) FRACP, MRCP.

Physician : R. J. Jenkins MB, BS, Syd.

Locum Physician D. A. Rose, MB,~S, (Hons) Syd.

Nursing Sister: P. M. Sorby, SRN.

Physiotherapist: P. Levick

- 1 -·

-2- 91/1974

1. LOCATION & STAFFING

The Health Service moved to the ground floor of the new Real th and Counselling Centre i n l'lorth Road in time for the beginning of first te:n:n. At the end of its first year of functioning the central location, special planning and pleasant environment of the new Health Centre has been appreciated by patients and staff alike.

Dr. Furnass departed on study leave at the end of r11ay and the role of Acting Director was ably fulfilled by Dr. Robin Jenkins, assisted on a full tine basis by Dr. David Rose, aSydney honours graduate. Dr. Jenkins has nm'l left the Health Service to accompany her hushan1 on a ?Ost-graduate course in Vancouver. During 1973 Dr. Pargaret nallner successfully completea a Diploma of Education course at the Canberra College of Advance0 Education, develo~ing special interest in health education.

2 • ENilOLMENTS •

The student population eligible to use the Health Service remained virtually unchanged compared ,.,ith 1972, although there was a slightly greater preponderance of full-time students (?able I> .

TA:ULE l Student Enrolments

Course Full-time % of All Part-· r.ourse Students Full-time Time Totals

Under- Students Gr ads

Arts 829 (801) 32.7 (33.3) 906 885) 1735 (168G} Arts/Law 222 (207) 8.8 ( 8.6) 14 13) 236 { 220) Asian Studies 167 (174) 6.6 ( 7.2) '."'4 73) 261 ( 247) Asian Stm~ies/

Law 8 ( 8) 0.3 ( 0 . 3} ( --· ·- } 8 ( 8} Economics 285 (302) 11. 2 (12.5) 43,1 { 123) 719 ( 795) Eco/As.Studies 10 ( ~ ) I). 4 ( - )) 1 ( - ) 11 ( - } Economics/Law 1 J2 ( 81)" 4.0 ( 3.4) G ( 3) 108 ( 34) LaN llE (124) 4.6 ( 5.2) 128 ( 135) ?.44 ( ?59) Science 6'>6 (564) 23.9 (23.4) 138 (154) 744 ( 71(3) Forestry 189 (147) 7.5 (l".l} 7 ( 12) 196 (159 )

Total Un"l.er-Gr ads 2534 (2408) 100.0 (100.0} 1728 (1768) 4262 (IJ176)

Total Post-Grads) 575 ( 637) 251 259) 826 ( 896)

Total 3109 (3045) 1979 (2027) 5088 (5072) Students

(Figures in parentheses indicate 1972 Statistics)

Group

-3-91/1974

3.l.CONSULTATION RATES.

There was a 16 per cent increase in the number of patients attending the Health Service and a twelve per cent increase in the number of consultations, co111pared with -1972 (Table 11).

TABLE 11

Total Consultation Rates

No. of Patients

No. of Consultations

Average No. % Increase Consultations in Patients per Patient

% In­crease in Con· ~

sulta­tion Rates

Full­time Under­grads. 1828 (1462) 5135 (4497) 2.8 (3.1) 25 (24) 14 ( 23)

Part~

time Under­grads.

Post­Grads .

Student's Wives

28 8

438

75

( 242) 779 (64)

(401 ) 1090 ( 991)

64) 271 (233)

2.7 (2. 6) 19 (15) 22 ( 23)

2.5 (2. 5) 9 (41) 11 ( 15)

3.6 (3.6) 17 (52) 16 ( 62)

Academic Staff 4~ 68) 74 ( 88) 1. 5 (1. 3) -29(+48) -16(+ 2)

Non­Academic Staff 58 (117) 97 (187) 1. 7 (1. 6) -50(+75) -48(+ 29)

Totals 2735 (2354) 7446(66 36) 2.7 (2. 8) 16 ( 27)

(Figures in parentheses indicate 1972 Statistics)

The increase was largely made up of full-time under­graduate students, 72% of whom attended the health centre

12

at least once during the year. Full-time first year under­graduates were under- represented, 456 attending the health service out of· 876 new enrolments. This is a 52% represen­tation, compared with 83% for students in the sec;ond- or sub­sequent year of their full-tir11e course. Of the 5914 consul­tations on undergraduates 3133 (53%) '·Jere on students living in Halls or Colleges and 2781 (47%) on non-resident stuaents, rates being exactly proportioned to the distribution of full time students living on, 53%) and off (47%) campus.

(22)

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" l/F7·1

3. 2. "\nalvsi~ of uyi/'0 r.~rar"uatn conr.;ul tr\tio~~ rw c0ur""e nrea is r;riven in .,.,a~ 1 lc 111. and b y diagnosis in Table lV.

'TI rt.r: 111

Course >10. of Consultations

~, of ~ot0·: ~onsnl t1t ;_on'5

s:; o:- "'11V · ti~l~

-r~nrol~ents

f'.atio

a. a./ ' -..

7'.rtB

Asian Studies

Economics

Law (Total)

Science

Fore8try

2638 6()9

511

75 8

1233

173

( '.;' 107) 44 .(. ( 561) 10.3

( G0 3) 8 .6

728) l ? .8 992) ?O . 8

14f.) ;:>. !)

(111.l) 32.7 c:n.3> l. 3r ( l. 23} (10.9) f. (i ( 7.2) i.sr (l. 51)

01. 7) 11. G ( 12. 5) c. 7 4. (0. 94 )

(14. ? ) 17.7 (17.5) (). 72 ("l.81)

{19. 3) / 3.~ ('D. 4) "· n (0.82) ( 3. 3) 7. 5 (16.1) (). 19 (rl. -1~ ) :

Totals (Exel. visitors) 5922 (5137) 100. fi 100.0 l."l0

(Figures in parenth~ses jndicate 1972 statistic~)

Women tend to be over- renresented in visits to the university health service (41i4 consultations Vs. 3332 for males, com:??ared ·with student enroiment figures of 11''14 an.::. 34 7 4 respectively) , a diff.erenc~ mainly accounted !_or :~y different consultation rates for I. C. D. categories ~ and Xl -· see 'l'abl c lV). This sex r"'.i. fferer.ce is largL!ly responsible for the~re~ter consultation rate in hrts students (4 7% ~·1onen) and Asian Studies students (61% wol"'.len) compared ~vith the enrolf"l.ent ratio as a i-rhole (32%) ~·1orr..en).

3 • 3 • !"ENT AL HE.ALTH

There was a ~~ reduction in the nurll...'l:ler of con<1ultation? by students presentinq with problems of emotio':1.al s tress (Table ~).

Tl\BL:C V

P~ychological Counselling

DIZ\.GNOSIS

:Personal Identity and Family Problems

Study Problems .?\.~xiety State, including

Examination Stress ~epressive Re~ction Psychoneurosis

Totals

no. of Consultations

1970 1971 1972 1973

54 22

155 (4

9

304

187 171

7

564

165 H

406 75

2

% 2

77 ?.9

394 108

608

:

-5-

'EABLE IV 91/1974

Diagnostic Categories of Consultation

I.C.D. Presenting Reason for No. of Consultation Consultations

Xl Counselling on Sexual Problems 1220 (918)

Vlll Diseases of the Respir-atory System 1184 (1178)

X Disorders of the Genito- 782 ( 709) urinary System

Xll Diseases of the Skin and 769 (568) Cellular tissues

V Psychological Difficulties 608 (662)

r Infective & Parasitic 591 (364) Diseases

VI' Diseases of the Central Nervous System & Sense Organs 550 (524)

XVll Accidents, Poisonings & 519 (397) Violence

lX Diseases of th~ Gastro­intestinal Tract

Xlll Diseases of Bones & Organs of movement

rrf Allergic & Heta:bolic Diseases

XVlll Routine !~ealth Examinations

XVl Abdominal pain, Backache & Unknown Causes of Morbidity

11

Diseases of the Circulatory System

Neoplasms

Diseases of Blood and Blood Forming Organs

325 (275)

243 (155)

232 (255)

198 (327)

151 (201)

43

17

14

76)

14)

13)

7446 (6636)

Percentage of Total Consultations

16.4 (13.7)

15.9 (17.7)

10.5 (10. 7)

10.3 ( 8.6)

8.2 (lf'.O)

7.9 ( 5.5)

7.4 ( 7.9)

7.0 (6.0)

4.4 4.1)

3.2 2.3)

3.1· 3';8)

2.7 4.9)

?.O 3.0)

0.6 1. 4)

0.2 0.2)

0.2 0.2)

100.0

(Figures in parenthesis indicate 1972 st~ istics

-6-91/1974

Although presentation ~·1it1- tmxiety reaction ~,•as

Il'lore co!'.'mor. -:luring the first terr:i., this T·rns folloPed hy 2. droi".> in consul t.::i.tion ratas for the second and thirc1 terms :res~ectively, Tab ~.e Tn ·

:~ec'.ica.l Couns<-.:!lling for l'..nxicty or Bxar·.inati.o.n :;-tres f;

1~72 r 1:'73, Chan0e " ~,'\

l.st TP..rrn 92 118 + ;: 9

2nd Term 134 122 9

3rd ~:en:' 180 154 ]_(

'l'otal 406 394 3

Th.is a.?parent levelling of:f of consultations for stress ren.ction is encour1.ging, a'.s is the relatively sr.v:t2.i number of students re0uiring referral for a rysyc":·datri.:: O?inion durins the year (Table~).

3. 4. R.1-!:FERRALS

l-1. consultant opinion r·1as obtair..ecI on 254 students during the year r~presenting an increase in 41 coM~ 7ared r-rit· · 1972.

'l'ABJ....E Vll

Referrals for Consultant Ory in ion

1970 1971 1972 1973 ------Eye Disorders 55 9/1 78 79 Gynaecology 29 .2 4 27 43

·Skin Disorders 25 19 22 17 OrthoJ?aedics 2 (l 22 15 13 General Surgery 2? 9 13 27 Ear, Nose & Throat 17 p 7 17 Urologf 6 5 5 7 Psychiatry .3 15 5 11 :?1"1.fltic Surgery 4 2 4 5 I n ternal ·edicine 6 3 1 14 2'.. llergy ?. 3 1 3 Dental Surgery ') 2 l 1 t:..

E ·l ?.15 180 254

There was a 59% increase in the referral rate to consultant gynaecologists, in parallel to the 38% incre~se

in ccnsultations for counsellin0 on sexual oroblerns (Table lV). ~ .

;"·

-7- 91/1974

3. 5. PEYSIOT!::0P._'!\PY

TherE: '"as "l marked increa;.;e (froJ"'l 718 to 1312) in the number of phvsiothe~aoy treatmentr: carried out ~y r!rs. Levick, ~ classification o~ ?atients being given in talJle Vlll. Tr8 , tment nas carri.ecJ. out in the sr0all laboratory area in the new hen.l t'., centre rather than in the T(i:n.gs ley Str.eet Hall. P·.l t!1ough sorn.~tines overcro•·!dec. the r .ore c entral location e nab le,- the follow-·up of treat­ment o-E sporting injuriec; to '-ie carriec1 out J'Tlore conveniently fro:ro the 1_,ati8nt~ t point of view-, leading to a speedier return to normal :!:unction.

'::'.' .:::;LE Vlll

Diagnosis '~o. of Patients

Orthopaedic (incl~ding s~orts i:'.'.juries)

C~est conditions

Skin conch tions

Tota].

;:>,n ~ (13~

22 n> 18 J.S)

244: (174)

(Firures in Parentheses indicate 197? statistics)

'1. PR"CV?:;~:JTIVE .' ~DICINE

4 .1. FBDIC.AL HIS'rORY CARDS

~irst year students entering halls of resiaence or affiliate<:"!. colleges were ci.s~:ecJ. to su:br:~it to a :rn.erUcal examination hy th.eir family 0.octors. Information f!'."om the 2'14 medical record cards returned is given in Table lX.

TABLE IX IfecUcal 'lecords of P.e"" h1ent l?irst Year Students

•Iec1icci.l Problems

Total Eyes Stated Continuing fmoJ::er:> Illness

: :.ale 103 2 f) (20%) 19 (18%) 15 (15%) Fenale 101 16 (li::l%) 11 (ll!J) 11 (11%)

4. 2. PROPEYLACTIC INOCULl~.TIOi:lS

A total of '153 oersons attended the health service during 19 7 3·, for inoculations and advice on overseas visits, -::ornpared \·1ith 743 in the previous year (27% increase), \vith a 51% rise in total V'1Ccines given. A T'real:/1.o•m of inoculation fj.gures appe2.rs in Ta~~ J.e X.

91/1974

Tl'.DLB X

Pro~~ylactic inoculations

Inoculo_tion 1:;70 1971 1972 1973

Tetanus Toxoi0. 180 330 351 37" Smallp ox Vaccine 141 12 1.! 215 313 Typhoid ?.5 '.2 432 473 749 Other;- 57 66 91 153 ~:1olera 243 485 580 991

Tota~s 873 1'1:43 1710 ~531

This rise reflects an increas~n0 interest in travel b y staff memb ers and stude::lts 1?articularly to countrie s in S . E. Asia.

4. 3. PITNESS TE.STPr

12 1) fitness tests ~·Jere perfcrrn.Ad Cluring tJ-:e ve"X r URing electrocardiographic monitoring of heart rate rE'!c: ::·onse to suhmaxi~:tal ~·10rk loads. The resul tc:;, calculatecl on the basis of predicte{ maximum oxyqen consum1::>tion '"'er J~g body ''.:!eight (1'.strand) are given in. Table ~:.l.

'J'.l\BLE Xl

v ,--:- :.ues for Predicted l\erobic Capaciti'.:

Group Fitness Category

no. VO'J "' 'ia;c S.D. (ml/kg/i:.iri ) Lou '..'Tor- Eiql•.

:nml

a. Females

rJndergrac.uates .7 ( 15) 33.0(34.2) L1 .4(7.l) 6 (7) 1(7) - (1) Postgraduo.tes 4 ( 'S ) 35.7(3 C- .7) 3.5( 9 .0) 2 ( 3) ') p) - ( 1)

b. !!ales

Unders_rraduates 40 (~,5) 44.5( ~ 1.3) 7.lj(8 .8 ) 19(2G) 13(4) <) (13) Postgrad uates 24 ( 30) 43.2(11 0 .1) 9.1(10.2) 14(20) G ( (;) 4 ( !'. )

Staff 15(10) ~5.1(42.1 ) 12. 7 (11. 0) c ( 4) 4 (2) 3 ( 11)

c.A.C.T. Sportsroen

Hocl~ey Teams 21 59.0 8.7 4 5 12 Sruash Team 13 56.C 6.5 1 5 Skiers 3 59.0 3

Totals 120(106) 53(62) 32 (21) 35 (23)

(Figures iP parentheses indic~te 1972 statistics )

-9-

91/)974

These figures include a number of people who were retested from the previous year, showing an imnrovernent in aerobic capacity as a result of training.54% of the university group as a whole showec1. a low category of ·fitness compared with the . standard obtained from S1·1eflish studies. The .. fitness of those engaged in competitive sport (54. 4 ml o2kg/min.) ~·1as 23% higher than the group of se<lentci.ry males not in regular intensive training ( 42. 4 ml .0 2 /kg/min.)

In addition to the figures given above, fitness testing was carried out on 42 young ~.,omen embarking on an "Outward Bound" course. They showed a 23% improvement in predicted aerobic capacity as a result of 3 weeks of intensive physical activity in bushland. Although impossihle to assess objectively, all subjects ~·Jho embarked on some form of personal training progranune reported an improved sense of wellbeing, illustrating a favourab le effect of moderate pl1ysical activity on mental health.

COL!CLUSIONS AND RECOMMENDATIONS

( l) r'IENTAL :3EALTH

During 1973 there was a leveliing off in the rise of consultations for emotional profulems compared with the previous two years. To what extent this observation, if a true reflection of mental health, may be related to adjustment to pressures of work and examinations and to -i;v-hat extent it might be influenced by the preventive group programmes initiated °':Jy the Counselling Service is a matter ·ficr speculation at present.

(2) r!.EDIC.AL SCREENING

The return of cards requesting a medical examination from a general practitioner prior to entry to a hall of residence or affiliated college has been disappointingly small, at 34% , although the virtual absence of reported serious illness has been encouraging. In view of the poor response, medical screening of incoming students is nm·r being replaced by a personal health questionnaire, designed to obtain more information on behavioural aspects of health. This questionnaire has been distributed to all first year students Moving into halls of residence and colleges in 1974. If the response rate i s good, the method may be ~xtended to include non-resident and part-time students in 1975. ..

~10- ~1/1974

Publications.

1. Anderson, r1 . c. , Furnas s, s. B. , Jenkins , 'Pi "; Pang, R. and Pennington, ,; . "Rffects of Three hleeks' f>trenous Exercise on the Cardiovascular Fitness of Young Nomen 11 Med. J . . J\.ust. 2 966-·969

2. ~urnass, S.B. "The Fealth of Students", Editorial ~!ed. J. AusL 1 514.

3. Furnass S.B. (Conference ·Editor) "The Problems of University Life" Proceedings of the Coml)ined Triennial Conference of Australia and NeN Zealand· ~Student Health Association and Australian Association of University Cou~sellors. 570 p.p.

4. Furnass, S.B. 11 A method for the assessment of Cardio­vascular '?itness 11

• ?\.NZSH.7\ Conference Proceedings, 345·- 352.

5. Jenkins, R. "Coagulation Studies and the Pilla ANZSHA Conference Proceedings 197~20?..

G. Sorhy, P. "The Person of !i'irst Contact" ANZSH~

Conference Proceedings , 71·- 7 3 •

7. T'Tallner I rt. R. nHuman Sexuality - Educational Aspectc; 11 I

l\NZSP~. Proceedings 167-176.