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1
Metcalfe, Jenni, and Michelle Riedlinger. "Identifying and Testing Engagement and Public Literacy Indicators for River Health." Science, Technology and Society 14, no. 2 (July 2009): 241–67. http://dx.doi.org/10.1177/097172180901400203.
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Natural resource management (NRM) organisations in Australia are increasingly recognising the need for complement studies of biophysical condition of the environment with studies of social condition, such as values, understanding, and participation related to the environment. Relevant and reliable social indicators that can be scaled and measured on a regular basis are essential to meet this need. In this study, we identified four indicators to test the social condition of the public in the State of Victoria in Australia with regard to river health. These indicators were river use, river knowledge and literacy, values and aspirations, and river health behaviours. We tested the four indicators through telephone and web-based surveys with over 1000 people in three areas of Victoria. We analysed the survey data statistically and gathered baseline data on the social condition of river health in the three regions. We made recommendations for how this data could be interpreted and used in community engagement and science communication programmes about river health. We also examined the limitations of the methodology and recommended modifications to the survey design and application for an anticipated roll-out of the survey across the entire State of Victoria. The Victorian Department of Sustainability and Environment (DSE) will use this survey instrument to test social indicators on a regular basis.
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Griffiths, Daniel, Luke Sheehan, Dennis Petrie, Caryn van Vreden, Peter Whiteford, and Alex Collie. "The health impacts of a 4-month long community-wide COVID-19 lockdown: Findings from a prospective longitudinal study in the state of Victoria, Australia." PLOS ONE 17, no. 4 (April 7, 2022): e0266650. http://dx.doi.org/10.1371/journal.pone.0266650.
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Objectives To determine health impacts during, and following, an extended community lockdown and COVID-19 outbreak in the Australian state of Victoria, compared with the rest of Australia. Methods A national cohort of 898 working-age Australians enrolled in a longitudinal cohort study, completing surveys before, during, and after a 112-day community lockdown in Victoria (8 July– 27 October 2020). Outcomes included psychological distress, mental and physical health, work, social interactions and finances. Regression models examined health changes during and following lockdown. Results The Victorian lockdown led to increased psychological distress. Health impacts coincided with greater social isolation and work loss. Following the extended lockdown, mental health, work and social interactions recovered to an extent whereby no significant long-lasting effects were identified in Victoria compared to the rest of Australia. Conclusion The Victorian community lockdown had adverse health consequences, which reversed upon release from lockdown. Governments should weigh all potential health impacts of lockdown. Services and programs to reduce the negative impacts of lockdown may include increases in mental health care, encouraging safe social interactions and supports to maintain employment relationships.
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Johnston, Kim, and Jessica Oliva. "COVID-19 Lockdown Landslides: The negative impact of subsequent lockdowns on loneliness, wellbeing, and mental health of Australians." Asia Pacific Journal of Health Management 16, no. 4 (December 13, 2021): 125–33. http://dx.doi.org/10.24083/apjhm.v16i4.855.
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Objective. We previously reported on loneliness, depression, anxiety and stress of Australians living alone during the first COVID-19-related government enforced lockdown in Australia. At this time, those living alone were experiencing relatively low levels of emotional distress. Since then, one state, Victoria, underwent a second extended lockdown period and until now, it was unclear what impact this sequential lockdown might have had on the mental health and wellbeing of Victorian citizens. The current study aimed to add to the emerging literature on the lockdown experience in Australia by directly comparing the levels of anxiety, depression, stress, loneliness, and wellbeing between Victorians in the second extended lockdown and Australians in the first lockdown. Design. Data from our original study of 384 Australians was compared with cross-sectional surveys of 340 Victorians during the second lockdown period. Setting. An online survey was administered with people residing in Victoria self-selecting to complete the study. Outcome Measures. Participants were asked to complete the Depression, Anxiety and Stress Scale (DASS-21), WHO-5 Wellbeing Scale, and the University of California Los Angeles (UCLA) Loneliness Scale. They were also invited to offer their insights into how the second extended lockdown experience had differed from the first. Results. Independent samples t-tests revealed that Australians were significantly more depressed, anxious, stressed, and lonely, and experienced reduced psychological wellbeing in the second lockdown compared to the first however overall, the levels indicated mild psychological distress. Qualitative insights revealed impact on mental health and a feeling of increased restrictions during lockdown two. Conclusions. Participants demonstrated adaptation to the lockdowns, providing support for the measures the Australian government have adopted to physically protect Australians from COVID-19. Management of the negative psychological impact through attention to wellbeing practices is however recommended in light of the increase in mental health concerns and likely further lockdown periods.
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Jorm, Christine, Robyn Hudson, and Euan Wallace AM. "Turning attention to clinician engagement in Victoria." Australian Health Review 43, no. 2 (2019): 123. http://dx.doi.org/10.1071/ah17100.
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The engagement of clinicians with employing organisations and with the broader health system results in better safer care for patients. Concerns about the adequacy of clinician engagement in the state of Victoria led the Victorian Department of Health and Human Services to commission a scoping study. During this investigation more than 100 clinicians were spoken with and 1800 responded to surveys. The result was creation of a clear picture of what engagement and disengagement looked like at all levels – from the clinical microsystem to state health policy making. Multiple interventions are possible to enhance clinician engagement and thus the care of future patients. A framework was developed to guide future Victorian work with four elements: setting the agenda, informing, involving and empowering clinicians. Concepts of work or employee engagement that are used in other industries don’t directly translate to healthcare and thus the definition of engagement chosen for use centred on involvement. This was designed to encourage system managers to ensure clinicians are full participants in design, planning and evaluation and in all decisions that affect them and their patients.
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Kleve, Sue, Zoe E. Davidson, Emma Gearon, Sue Booth, and Claire Palermo. "Are low-to-middle-income households experiencing food insecurity in Victoria, Australia? An examination of the Victorian Population Health Survey, 2006–2009." Australian Journal of Primary Health 23, no. 3 (2017): 249. http://dx.doi.org/10.1071/py16082.
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Food insecurity affects health and wellbeing. Little is known about the relationship between food insecurity across income levels. This study aims to investigate the prevalence and frequency of food insecurity in low-to-middle-income Victorian households over time and identify factors associated with food insecurity in these households. Prevalence and frequency of food insecurity was analysed across household income levels using data from the cross-sectional 2006–09 Victorian Population Health Surveys (VPHS). Respondents were categorised as food insecure, if in the last 12 months they had run out of food and were unable to afford to buy more. Multivariable logistic regression was used to describe factors associated with food insecurity in low-to-middle-income households (A$40000–$80000 in 2008). Between 4.9 and 5.5% for total survey populations and 3.9–4.8% in low-to-middle-income respondents were food insecure. Food insecurity was associated with limited help from friends, home ownership status, inability to raise money in an emergency and cost of some foods. Food insecurity exists in households beyond those on a very low income. Understanding the extent and implications of household food insecurity across all income groups in Australia will inform effective and appropriate public health responses.
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Falster, Kathleen, Linda Gelgor, Ansari Shaik, Iryna Zablotska, Garrett Prestage, Jeffrey Grierson, Rachel Thorpe, et al. "Trends in antiretroviral treatment use and treatment response in three Australian states in the first decade of combination antiretroviral treatment." Sexual Health 5, no. 2 (2008): 141. http://dx.doi.org/10.1071/sh07082.
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Objectives: To determine if there were any differences in antiretroviral treatment (ART) use across the three eastern states of Australia, New South Wales (NSW), Victoria and Queensland, during the period 1997 to 2006. Methods: We used data from a clinic-based cohort, the Australian HIV Observational Database (AHOD), to determine the proportion of HIV-infected patients on ART in selected clinics in each state and the proportion of treated patients with an undetectable viral load. Data from the national Highly Specialised Drugs program and AHOD were used to estimate total numbers of individuals on ART and the proportion of individuals living with HIV on ART nationally and by state. Data from the HIV Futures Survey and the Gay Community Periodic Survey were used to determine the proportion of community-based men who have sex with men on ART. The proportion of patients with primary HIV infection (PHI) who commenced ART within 1 year of diagnosis was obtained from the Acute Infection and Early Disease Research Program (AIEDRP) CORE01 protocol and Primary HIV and Early Disease Research: Australian Cohort (PHAEDRA) cohorts. Results: We estimated that the numbers of individuals on ART increased from 3181 to 4553 in NSW, 1309 to 1926 in Victoria and 809 to 1615 in Queensland between 2000 and 2006. However, these numbers may reflect a lower proportion of individuals living with HIV on ART in NSW compared with the other states (37% compared with 49 and 55% in 2000). We found similar proportions of HIV-positive men who have sex with men participants were on ART in all three states over the study period in the clinic-based AHOD cohort (81–92%) and two large, community-based surveys in Australia (69–85% and 49–83%). Similar proportions of treated patients had an undetectable viral load across the three states, with a consistently increasing trend over time observed in all states. We found that more PHI patients commenced treatment in the first year following HIV diagnosis in NSW compared with Victoria; however, the sample size was very small. Conclusions: For the most part, patterns of ART use were similar across NSW, Victoria and Queensland using a range of available data from cohort studies, community surveys and national prescription databases in Australia. However, there may be a lower proportion of individuals living with HIV on ART in NSW compared with the other states, and there is some indication of a more aggressive treatment approach with PHI patients in NSW compared with Victoria.
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Goller, Jane L., Rebecca J. Guy, Judy Gold, Megan S. C. Lim, Carol El-Hayek, Mark A. Stoove, Isabel Bergeri, et al. "Establishing a linked sentinel surveillance system for blood-borne viruses and sexually transmissible infections: methods, system attributes and early findings." Sexual Health 7, no. 4 (2010): 425. http://dx.doi.org/10.1071/sh09116.
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Objective: To describe the attributes and key findings from implementation of a new blood-borne virus (BBV) and sexually transmissible infection (STI) sentinel surveillance system based on routine testing at clinical sites in Victoria, Australia. Methods: The Victorian Primary Care Network for Sentinel Surveillance (VPCNSS) on BBV and STI was established in 2006 at 17 sites. Target populations included men who have sex with men (MSM), young people and injecting drug users (IDU). Sites collected demographic and risk behaviour information electronically or using paper surveys from patients undergoing routine HIV or STI (syphilis, chlamydia (Chlamydia trachomatis)) or hepatitis C virus (HCV) testing. These data were linked with laboratory results. Results: Between April 2006 and June 2008, data were received for 67 466 tests and 52 042 questionnaires. In clinics providing electronic data, >90% of individuals tested for HIV, syphilis and chlamydia had risk behaviour information collected. In other clinics, survey response rates were >85% (HIV), 43.5% (syphilis), 42.7–66.5% (chlamydia) and <20% (HCV). Data completeness was >85% for most core variables. Over time, HIV, syphilis and chlamydia testing increased in MSM, and chlamydia testing declined in females (P = 0.05). The proportion of positive tests among MSM was 1.9% for HIV and 2.1% for syphilis. Among 16–24-year-olds, the proportion positive for chlamydia was 10.7% in males and 6.9% in females. Among IDU, 19.4% of HCV tests were antibody positive. Conclusions: The VPCNSS has collected a large, rich dataset through which testing, risk behaviours and the proportion positive can be monitored in high-risk groups, offering a more comprehensive BBV and STI surveillance system for Victoria. Building system sustainability requires an ongoing focus.
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Swerissen, Hal, and Linda Tilgner. "Development and Validation of the Primary Care Consumer Opinion Survey." Australian Journal of Primary Health 7, no. 1 (2001): 34. http://dx.doi.org/10.1071/py01005.
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Using past measures of consumer feedback, the aim of the present study was to construct a consumer opinion survey for use in community health centre settings; to pilot the survey instrument across a number of community health centres; and to validate the instrument. A total of 950 consumers attending one of six targeted services (physiotherapy, dental, podiatry, counselling/social work, dietetics, and speech pathology) across four northern metropolitan community health centres in Victoria were invited to participate. Returned surveys were analysed using principal component analysis and the extracted scales were tested for internal consistency and validity. Out of the 950 surveys distributed 471 were returned (response rate of 50%). The survey instrument was found to measure consumer opinion regarding satisfaction with centre environment and satisfaction with service provision. The centre environment scale consisted of one factor, with a Cronbach alpha of .80. The service provision scale consisted of two factors: 'aspects of the service provider' and 'benefits of the visit'. Reliability for the total scale was .93. The two scales correlated moderately with a validity item measuring overall satisfaction. The Primary Health Care Consumer Opinion Survey is a reliable and valid measure, which provides the potential for the establishment of norms to assess consumer opinion.
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Woodward, Michael Clifford, and Erin Woodward. "A national survey of memory clinics in Australia." International Psychogeriatrics 21, no. 4 (August 2009): 696–702. http://dx.doi.org/10.1017/s1041610209009156.
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ABSTRACTBackground:There is limited information describing memory clinics at a national level in Australia. The aim of this study was to gather information about the resourcing, practices and clinical diagnoses of Australian memory clinics.Methods:A postal survey was sent to all Australian memory clinics identified by key specialists working in dementia assessment services.Results:Of 23 surveys sent out, 14 were returned. Most clinics are located in Victoria where they receive Victorian state funding. The average clinic has 1.67 effective full time clinical staff including 0.42 medical staff, 0.24 allied health staff, 0.53 clinical nursing staff and 0.48 psychologists. Clinics are open on average twice a week and each half-day clinic has two new and three review patients, seeing new patients twice initially then once more over 12 months. Patients wait 10 weeks for initial assessment with 59% referred by general practitioners. The Mini-mental State Examination and clock drawing are utilized universally. The most common diagnoses are Alzheimer's disease (37.8%) and mild cognitive impairment (19.8%) but 6.9% of patients have no cognitive impairment.Conclusions:This survey has provided useful benchmarking data on Australian memory clinics which can also be used by other countries for comparative analyses.
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Iansek, Robert, and Mary Danoudis. "Patients’ Perspective of Comprehensive Parkinson Care in Rural Victoria." Parkinson's Disease 2020 (March 31, 2020): 1–7. http://dx.doi.org/10.1155/2020/2679501.
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Introduction. There is a higher prevalence of Parkinson’s disease (PD) in rural Australia and a poorer perceived quality of life of rural Australians with PD. Coordinated multidisciplinary teams specialised and experienced in the treatment of PD are recommended as the preferred model of care best able to manage the complexities of this disorder. There remains a lack of team-based specialised PD services in rural Australia available to people living with PD. This study aims to explore how the lack of specialised PD services impacts on the person’s experiences of the health care they receive in rural Victoria. This study compared the health-care experiences of two different cohorts of people with PD living in rural Victoria; one cohort living in East Gippsland have had an established comprehensive care model implemented with local trained teams and supported by a metropolitan PD centre, and the other cohort was recruited from the remainder of Victoria who had received standard rural care. Methods. This descriptive study used a survey to explore health-care experiences. Questionnaires were mailed to participants living in rural Victoria. Eligibility criteria included having a diagnosis of PD or Parkinsonism and sufficient English to respond to the survey. The validated Patient-Centred Questionnaire for PD was used to measure health-care experiences. The questions are grouped accordingly under one of the 6 subscales or domains. Outcomes from the questionnaire included summary experience scores (SES) for 6 subscales; overall patient-centeredness score (OPS); and quality improvement scores (QIS). Secondary outcomes included health-related quality of life using the disease-specific questionnaire PDQ39; disease severity using the Hoehn and Yahr staging tool; and disability using the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale, part II. Results. Thirty-nine surveys were returned from the East Gippsland group and 68 from the rural group. The East Gippsland group rated significantly more positive the subscales “empathy and PD expertise,” P=0.02, and “continuity and collaboration of professionals,” P=0.01. The groups did not differ significantly for the remaining 4 subscales (P>0.05) nor for the OPS (P=0.17). The QIS showed both groups prioritised the health-care aspect “provision of tailored information” for improvement. Quality of life was greater (P<0.05) and impairment (P=0.012) and disability were less (P=0.002) in the East Gippsland group. Conclusion. Participants who received health care from the East Gippsland program had better key health-care experiences along with better QOL and less impairment and disability. Participants prioritised provision of information as needing further improvement.
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Prestage, Garrett, Jason Ferris, Jeffrey Grierson, Rachel Thorpe, Iryna Zablotska, John Imrie, Anthony Smith, and Andrew E. Grulich. "Homosexual men in Australia: population, distributionand HIV prevalence." Sexual Health 5, no. 2 (2008): 97. http://dx.doi.org/10.1071/sh07080.
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Objectives: To assess the size, distribution and changes in the population of homosexual and bisexual men in Australia, and the capacity of available measures to make this estimation. Methods: We used data from five sources: the Australian Study of Health and Relationships, the Gay Community Periodic Surveys, HIV Futures, the Health in Men cohort study, the Australian National HIV and AIDS Registries and the Australian Household Census. Results: We estimated that in 2001 there were ~74 000 homosexual and bisexual men in New South Wales (NSW), ~42 000 in Victoria and ~37 000 in Queensland. There was, however, some discrepancy between datasets in the estimates of the overall proportions and distribution of homosexual and bisexual men across states. We also estimated HIV prevalence rates among homosexual and bisexual men in 2001 at ~8% in NSW, 5% in Victoria and 4% in Queensland. There were insufficient data to estimate whether the state-specific populations of homosexual men were changing with time. Conclusion: There are ~75% more homosexual and bisexual men in NSW than in Victoria and about twice as many as in Queensland. There are about two-thirds as many HIV-positive men in NSW as in Victoria and Queensland combined. Improved collection of population-based data on homosexuality are required.
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Davies, Sarah, Cathryn Keenan, and Bernice Redley. "Health Assistant in Nursing: a Victorian health service pilot." Asia Pacific Journal of Health Management 12, no. 2 (July 18, 2017): 17–24. http://dx.doi.org/10.24083/apjhm.v12i2.73.
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Objective: Develop and evaluate pilot of a new role to support nursing care delivery in hospital settings.
Design: A naturalistic, three-stage pre-post, multimethod pilot design used data collected from hospital administrative datasets, and surveys and focus groups with staff participants.
Setting: Three wards at three hospital sites of a large tertiary health service in Victoria, Australia.
Subjects: Staff performing the new role and registered nurses working on participating wards.
Intervention: Pilot of a new Health Assistant in Nursing (HAN) role.
Main outcome measures: Staff outcomes were work satisfaction and workload of registered nurses; quality outcomes included reported patient falls and medication errors; organisational outcomes included service costs and sick leave.
Results: Work satisfaction and workload of registered nurses remained stable after introducing the new role. The frequency of reported patient falls reduced in two of the three wards. Costing outcomes suggested potential for cost benefits attributed to reduced falls in acute wards.
Conclusions: This pilot identified the new HAN role has capacity to contribute to improved patient quality and safety outcomes without compromising nurse job satisfaction and workload. Potential cost benefits of thenew role warrant further consideration in the acute care sector.
Abbreviations: CPO – Constant Patient Observer; CSN – Clinical Support Nurse; HAN – Health Assistant in Nursing. NWSQ – Nursing Workplace Satisfaction
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Hocking, Jane S., Jessika Willis, Sepehr Tabrizi, Christopher K. Fairley, Suzanne M. Garland, and Margaret Hellard. "A chlamydia prevalence survey of young women living in Melbourne, Victoria." Sexual Health 3, no. 4 (2006): 235. http://dx.doi.org/10.1071/sh06033.
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Background: To estimate the population-based chlamydia prevalence among women aged 18 to 35 years living in Melbourne, Victoria, and to assess the feasibility of using mailed urine specimens to test women. Methods: A simple random sample of 11 001 households in Melbourne was selected from the telephone directory. Participants completed telephone interviews and provided urine specimens through the mail for chlamydia testing. Urines were tested using polymerase chain reaction. Results: 11 001 households were contacted, with 1532 households identified as including eligible women; telephone interviews were completed, with 979 women giving a response rate of 64%. Six hundred and fifty-seven women provided a urine specimen with a response rate of 43%. Among sexually active women aged 18–24 years, the chlamydia prevalence was 3.7% (95% CI: 1.2%, 8.4%) and 0.2% (95% CI: 0.0%, 1.1%) among 25–35 year olds. Chlamydia prevalence increased significantly with an increasing number of male sexual partners. Conclusions: This is the first study of its kind in Australia and shows that chlamydia prevalence increases with an increasing number of male sexual partners in the last 12 months. Mailed urine specimens are feasible for conducting population-based chlamydia-prevalence surveys but it is difficult to obtain high response rates with this methodology. Public health resources should now be directed towards investigating how to reach young women at increased risk of infection, ensuring that they are tested for chlamydia.
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Starnes, Joseph R., Jane Wamae, Vincent Okoth, Daniele J. Ressler, Vincent Were, Lawrence P. O. Were, Troy D. Moon, and Richard Wamai. "Population-based socio-demographic household assessment of livelihoods and health among communities in Migori County, Kenya over multiple timepoints (2021, 2024, 2027): A study protocol." PLOS ONE 16, no. 8 (August 25, 2021): e0256555. http://dx.doi.org/10.1371/journal.pone.0256555.
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Migori County is located in western Kenya bordering Lake Victoria and has traditionally performed poorly on important health metrics, including child mortality and HIV prevalence. The Lwala Community Alliance is a non-governmental organization that serves to promote the health and well-being of communities in Migori County through an innovative model utilizing community health workers, community committees, and high-quality facility-based care. This has led to improved outcomes in areas served, including improvements in childhood mortality. As the Lwala Community Alliance expands to new programming areas, it has partnered with multiple academic institutions to rigorously evaluate outcomes. We describe a repeated cross-sectional survey study to evaluate key health metrics in both areas served by the Lwala Community Alliance and comparison areas. This will allow for longitudinal evaluation of changes in metrics over time. Surveys will be administered by trained enumerators on a tablet-based platform to maintain high data quality.
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Winters, Meghan, Michael Branion-Calles, Suzanne Therrien, Daniel Fuller, Lise Gauvin, David G. T. Whitehurst, and Trisalyn Nelson. "Impacts of Bicycle Infrastructure in Mid-Sized Cities (IBIMS): protocol for a natural experiment study in three Canadian cities." BMJ Open 8, no. 1 (January 2018): e019130. http://dx.doi.org/10.1136/bmjopen-2017-019130.
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IntroductionBicycling is promoted as a transportation and population health strategy globally. Yet bicycling has low uptake in North America (1%–2% of trips) compared with European bicycling cities (15%–40% of trips) and shows marked sex and age trends. Safety concerns due to collisions with motor vehicles are primary barriers.To attract the broader population to bicycling, many cities are making investments in bicycle infrastructure. These interventions hold promise for improving population health given the potential for increased physical activity and improved safety, but such outcomes have been largely unstudied. In 2016, the City of Victoria, Canada, committed to build a connected network of infrastructure that separates bicycles from motor vehicles, designed to attract people of ‘all ages and abilities’ to bicycling.This natural experiment study examines the impacts of the City of Victoria’s investment in a bicycle network on active travel and safety outcomes. The specific objectives are to (1) estimate changes in active travel, perceived safety and bicycle safety incidents; (2) analyse spatial inequities in access to bicycle infrastructure and safety incidents; and (3) assess health-related economic benefits.Methods and analysisThe study is in three Canadian cities (intervention: Victoria; comparison: Kelowna, Halifax). We will administer population-based surveys in 2016, 2018 and 2021 (1000 people/city). The primary outcome is the proportion of people reporting bicycling. Secondary outcomes are perceived safety and bicycle safety incidents. Spatial analyses will compare the distribution of bicycle infrastructure and bicycle safety incidents across neighbourhoods and across time. We will also calculate the economic benefits of bicycling using WHO’s Health Economic Assessment Tool.Ethics and disseminationThis study received approval from the Simon Fraser University Office of Research Ethics (study no. 2016s0401). Findings will be disseminated via a website, presentations to stakeholders, at academic conferences and through peer-reviewed journal articles.
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GREEN, HELEN K., JOSE C. SOUSA-FIGUEIREDO, MARIA-GLORIA BASÁÑEZ, MARTHA BETSON, NARCIS B. KABATEREINE, ALAN FENWICK, and J. RUSSELL STOTHARD. "Anaemia in Ugandan preschool-aged children: the relative contribution of intestinal parasites and malaria." Parasitology 138, no. 12 (August 8, 2011): 1534–45. http://dx.doi.org/10.1017/s0031182011001016.
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SUMMARYAnaemia is a severe public health issue among African preschool-aged children, yet little effective progress has been made towards its amelioration, in part due to difficulties in unravelling its complex, multifactorial aetiology. To determine the current anaemia situation and assess the relative contribution of malaria, intestinal schistosomiasis and infection with soil-transmitted helminths, two separate cross-sectional epidemiological surveys were carried out in Uganda including 573 and 455 preschool-aged children (⩽6 years) living along the shores of Lake Albert and on the islands in Lake Victoria, respectively. Anaemia was found to be a severe public health problem in Lake Albert, affecting 68·9% of children (ninety-five percent confidence intervals (95% CI) 64·9–72·7%), a statistically significant higher prevalence relative to the 27·3% detected in Lake Victoria (95% CI: 23·3–31·7%). After multivariate analysis (controlling for sex and age of the child), the only factor found to be significantly associated with increased odds of anaemia in both lake systems was malaria (Lake Albert, odds ratio (OR)=2·1, 95% CI: 1·4–3·2; Lake Victoria, OR=1·9, 95% CI: 1·2–2·9). Thus intervention strategies primarily focusing on very young children and combating malaria appear to represent the most appropriate use of human and financial resources for the prevention of anaemia in this age group and area. Looking to the future, these activities could be further emphasised within the National Child Health DaysPLUSagenda.
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Finlay, Sarah, Elizabeth Meggetto, Anske Robinson, and Claire Davis. "Health literacy education for rural health professionals: shifting perspectives." Australian Health Review 43, no. 4 (2019): 404. http://dx.doi.org/10.1071/ah18019.
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Health literacy is a major issue for improving health outcomes of clients. In rural Victoria, Australia, the Gippsland Health Literacy Project (GHLP) educated local health services staff about health literacy and provided tools and techniques for health literacy implementation in services. This paper reports the outcomes of this project. Participants’ change in knowledge was measured through pre- and post-project surveys and interviews. Descriptive analysis of survey data and analysis of interviews using qualitative description enabled exploration of individual and organisational shifts in health literacy perspectives. Healthcare professionals’ knowledge of health literacy has improved as a result of the health literacy education. Health service organisations are also taking greater responsibility for health literacy responsiveness in their services. Systematic changes to policy and procedures that support health literacy are required. Although health literacy education provides more accessible health care for consumers, where projects had executive-level support the changes implemented were more likely to be successful and sustainable. What is known about this topic? Low health literacy is a strong predictor of health status and it is important for health organisations to ensure they provide health care and information in a way that can be understood, interpreted and acted on by all clients, regardless of their health literacy levels. What does this paper add? This paper presents findings on staff training and resources that can effectively support staff to improve health literacy practices. What are the implications for practitioners? Addressing health literacy issues appears to result in more accessible health care for consumers. Executive support and health literacy champions are key requirements to successfully address health literacy issues.
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Graham, Susan K., and Ian D. Cameron. "A survey of rehabilitation services in Australia." Australian Health Review 32, no. 3 (2008): 392. http://dx.doi.org/10.1071/ah080392.
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A survey, which achieved a 54% response rate, was completed to assess the availability and type of rehabilitation health services in Australia. 1044 surveys were sent out and 561 were returned. The details of a total of 346 rehabilitation services were obtained. There were more services in metropolitan compared with rural areas, more services in New South Wales and Victoria than in the other states, and a higher proportion of services led by health care workers other than rehabilitation physicians in rural compared with metropolitan areas. There is likely to be a need for additional rehabilitation services of all types across Australia. The majority of rural, regional and remote areas are likely to need additional physician-led, allied health and nursing services. Further work is needed to assess the size and catchment areas of services in the capital cities and other large population centres to assess whether additional services are also needed in these areas.
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Mak, Vivienne, Daniel Malone, Nilushi Karunaratne, Wendy Yao, Lauren Randell, and Thao Vu. "A Video-Based Reflective Design to Prepare First Year Pharmacy Students for Their First Objective Structured Clinical Examination (OSCE)." Healthcare 10, no. 2 (January 31, 2022): 280. http://dx.doi.org/10.3390/healthcare10020280.
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We explored the use of a video-based reflective design in preparing first-year pharmacy students for their Objective Structured Clinical Examination (OSCE) in Victoria, Australia. This involved pre-workshop activities (a recording of themselves simulating the pharmacist responding to a simple primary care problem, written reflection, review of the OSCE video examples and pre-workshop survey); workshop activities (peer feedback on videos) and post-workshop activities (summative MCQ quiz and post-workshop survey). These activities took place three weeks before their OSCE. A mixed-method study design was employed with quantitative and qualitative analyses of the surveys and a focus group. A total of 137 students (77.4%) completed the pre- and post-workshop surveys, and ten students participated in the focus group. More student participants (54%) reported feeling prepared for the OSCE post-workshop than pre-workshop (13%). The majority (92%) agreed that filming, watching and reflecting on their video allowed them to learn and improve on their skills for the OSCE. The regression analysis found that video recording submissions and written reflections correlated positively with student OSCE performances, and the video-based reflective design learning experience was perceived to be beneficial in multiple ways. Thematic analysis of the focus group data revealed that students acquired metacognitive skills through the self-assessment of their video recordings, developed an awareness of their learning and were able to identify learning strategies to prepare for their first OSCE. Fostering students’ feedback literacy could be considered in future educational designs.
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Zablotska, Iryna B., Garrett Prestage, Andrew E. Grulich, and John Imrie. "Differing trends in sexual risk behaviours in three Australian states: New South Wales, Victoria and Queensland, 1998-2006." Sexual Health 5, no. 2 (2008): 125. http://dx.doi.org/10.1071/sh07076.
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Background: In Australia, the HIV epidemic is concentrated among gay men. In recent years, the number of new diagnoses stabilised in New South Wales (NSW), but increased in other states. We reviewed the trends in sexual behaviours to explain this difference. Methods: We used the Gay Community Periodic Surveys in NSW, Victoria and Queensland during 1998–2006 and restricted analyses to the 30–49 year olds who contribute most of the HIV cases. We used the χ2-test for trends in unprotected anal intercourse with casual partners (UAIC) and regular partners, number of partners, type of relationships, knowledge of HIV serostatus and its disclosure. We compared behaviours of HIV-positive and -negative men and men across states using logistic regression adjusted for the year of report. Results: Trends in behaviours differed across the states: following a period of increase, UAIC prevalence declined in NSW since 2001, but continued to increase in Victoria and Queensland. There were other changes in NSW that were not observed in Victoria and Queensland: a decline in factors increasing HIV risk (the proportions of men with multiple sex partners and men engaging in UAIC and not knowing or not disclosing HIV serostatus) and an increase in behaviours reducing it (the proportions of men in monogamous relationships and men disclosing HIV serostatus while having UAIC). Conclusion: There were patterns of declining HIV risk behaviours in NSW, and increasing risk behaviours elsewhere, that mirrored recent changes in HIV case notifications in Australia. These data suggest that behavioural surveillance can predict changes in HIV epidemiology.
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Pathiravasan, Chathurangi, Alexa Beiser, Sudha Seshadri, Claudia Satizabal, Yuankai Zhang, Xuzhi Wang, Chunyu Liu, and Joanne Murabito. "ASSOCIATION OF COGNITION AND SMARTPHONE SURVEY ATTRIBUTES IN THE ELECTRONIC FRAMINGHAM HEART STUDY." Innovation in Aging 6, Supplement_1 (November 1, 2022): 822–23. http://dx.doi.org/10.1093/geroni/igac059.2958.
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Abstract Mobile technology offers a remote method to monitor health in older adults and it may provide a platform for early detection of cognitive decline. We aimed to examine attributes of smartphone survey use in the electronic Framingham Heart Study (eFHS) cohort in relation to cognitive testing performed at the time of enrollment. eFHS participants who returned smartphone surveys and underwent cognitive testing were considered in the study (n=1810). The CERAD recall score, Victoria Stroop test interference score, and dichotomous AD8 and MOCA (MOCA score ≤ 19, AD8 score ≥2) were considered as primary exposures. App-based survey adherence was defined as a dichotomous outcome based on whether at least one survey was completed at each 3-month period from baseline to 12 months. Several time attributes were considered including survey return time, touch time, step time, and question completion time. Linear mixed models (LMM for time attributes outcomes and generalized LMM for adherence outcome) were fitted for each cognitive score as the predictor adjusting for age, sex, race/ethnicity, and education level. Results suggest that higher CERAD recall scores were associated with higher odds of completing surveys. There was a significant association between all cognitive exposures and survey time attributes. Participants with poorer cognitive function (lower CERAD, higher stroop interference, MOCA score ≤ 19, AD8 score ≥2) had delayed survey return times, higher touch time, higher step time and higher question completion time. This study contributes to the growing body of evidence that smartphones may be an important tool to identify cognitive decline.
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Gopal, Sucharita, Yaxiong Ma, Chen Xin, Joshua Pitts, and Lawrence Were. "Characterizing the Spatial Determinants and Prevention of Malaria in Kenya." International Journal of Environmental Research and Public Health 16, no. 24 (December 12, 2019): 5078. http://dx.doi.org/10.3390/ijerph16245078.
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The United Nations’ Sustainable Development Goal 3 is to ensure health and well-being for all at all ages with a specific target to end malaria by 2030. Aligned with this goal, the primary objective of this study is to determine the effectiveness of utilizing local spatial variations to uncover the statistical relationships between malaria incidence rate and environmental and behavioral factors across the counties of Kenya. Two data sources are used—Kenya Demographic and Health Surveys of 2000, 2005, 2010, and 2015, and the national Malaria Indicator Survey of 2015. The spatial analysis shows clustering of counties with high malaria incidence rate, or hot spots, in the Lake Victoria region and the east coastal area around Mombasa; there are significant clusters of counties with low incidence rate, or cold spot areas in Nairobi. We apply an analysis technique, geographically weighted regression, that helps to better model how environmental and social determinants are related to malaria incidence rate while accounting for the confounding effects of spatial non-stationarity. Some general patterns persist over the four years of observation. We establish that variables including rainfall, proximity to water, vegetation, and population density, show differential impacts on the incidence of malaria in Kenya. The El-Nino–southern oscillation (ENSO) event in 2015 was significant in driving up malaria in the southern region of Lake Victoria compared with prior time-periods. The applied spatial multivariate clustering analysis indicates the significance of social and behavioral survey responses. This study can help build a better spatially explicit predictive model for malaria in Kenya capturing the role and spatial distribution of environmental, social, behavioral, and other characteristics of the households.
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Easthope, Gary, Bruce Tranter, and Gerard Gill. "The Incorporation of a Complementary Therapy by Australian General Practitioners: The Case of Acupuncture." Australian Journal of Primary Health 7, no. 1 (2001): 76. http://dx.doi.org/10.1071/py01012.
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Complementary therapies may be rejected by doctors as quackery or incorporated as part of their practice, although such incorporation may be limited. In Australia acupuncture has been incorporated as a normal part of general practice, although it is not accepted as an orthodox technique. This incorporation is demonstrated through analysis of national data on acupuncture usage and through analysis of two surveys of general practitioners undertaken independently in the states of Tasmania and Victoria, Australia. Further, it is argued, from examination of interview and focus group responses, that experienced doctors turn to acupuncture to deal with patients who do not respond to orthodox therapies. This move is possible because the valuing of clinical judgement allows practitioners to suspend their scientific judgement of the therapy although they are uneasy about doing so.
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Measday, Danielle, and Rosemary Goodall. "Measuring and Mitigating Mercury Gases in the Museums Victoria Collection." Biodiversity Information Science and Standards 2 (June 13, 2018): e27044. http://dx.doi.org/10.3897/biss.2.27044.
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For the past six years the conservation and collection management departments at Museums Victoria have been conducting a major survey to determine the type and extent of hazardous substances in the collections to better inform safe handling and storage practices. This paper focuses on mercury compounds in the collection, including mercury chloride applied as a pesticide, mercury sulfide pigments, liquid mercury used in scientific equipment, and mineral specimens such as native mercury and cinnabar. All these compounds can release volatile mercury vapour into storage furniture and have the potential to contaminate both the cabinet and other specimens stored nearby. Although previous testing had confirmed that the air in storage rooms and workspaces contained no detectable levels of mercury vapour, recent publications by Hawks et al. 2004, Havermans et al. 2015 and Marcotte et al. 2017 showing high levels of mercury vapour inside storage containers in herbaria raised concern that there could be higher than acceptable levels of mercury vapour building up inside storage cabinets at Museums Victoria. This prompted analysis of the headspace in cabinets using a Jerome J405 portable mercury vapour meter. Testing was informed by the results of previous hazards surveys using X-ray fluorescence spectrography to target cabinets where mercury vapour was likely to be present. Air from cabinets was sampled across the indigenous cultures, history, technology and natural sciences collections. Results showed levels of mercury vapour could be considerably above 25 μg/m3 the Australian time-weighted average (TWA) exposure standard for an 8 hour workday in cabinets of bird skins and indigenous artefacts treated with mercuric chloride pesticides. Results above 150 μg/m3 the temporary emergency exposure level (TEEL) were measured in the mineralogy collection. Mitigation strategies are being implemented to reduce the risks to staff health and contamination of other collection materials, including enclosing mercury-containing species of minerals in gas barrier film, venting high risk cabinets to dissipate vapour before accessing specimens, and engineering controls during the handling of specimens.
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Lopez-Carr, David, Kevin M. Mwenda, Narcisa G. Pricope, Phaedon C. Kyriakidis, Marta M. Jankowska, John Weeks, Chris Funk, Gregory Husak, and Joel Michaelsen. "Climate-Related Child Undernutrition in the Lake Victoria Basin: An Integrated Spatial Analysis of Health Surveys, NDVI, and Precipitation Data." IEEE Journal of Selected Topics in Applied Earth Observations and Remote Sensing 9, no. 6 (June 2016): 2830–35. http://dx.doi.org/10.1109/jstars.2016.2569411.
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Tomnay, Jane E., Rachelle L. Gebert, and Christopher K. Fairley. "A survey of partner notification practices among general practitioners and their use of an internet resource for partner notification for Chlamydia trachomatis." Sexual Health 3, no. 4 (2006): 217. http://dx.doi.org/10.1071/sh05052.
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Objectives: To determine in which circumstances Victorian general practitioners (GPs) offer chlamydia testing to patients, the attitudes of GPs in relation to contact tracing, how often GPs use a pre-printed partner letter and patient brochure and what proportion of GPs have immediate internet access in their consulting rooms. Methods: This study involved two parts, an initial survey of a sample of GPs in Victoria and a study of GP use of a website that provided treatment guidelines, a printable client brochure and a partner letter. Results: Of 418 eligible GPs, 221 (53%, 48–58%, 95% CI) returned completed surveys. Of these, 213 (97%, 93–99%, 95% CI) GPs believed that patients were largely responsible for notifying partners. Partner letters were rarely used: 167 (76%, 70–81%, 95% CI) GPs reported they never used partner letters, 18 (8%, 5–13%, 95% CI) GPs reported rare use and 23 (10%, 7–15%, 95% CI) GPs reportedusing them sometimes. Of the GPs, 181 (82%, 77–87%, 95% CI) reported they would find a partner letter and patient brochure on a website helpful. During the study, the website was accessed by 28 GPs (25%, 17–34%, 95% CI) in Gippsland and 17 GPs (8%, 5–13%, 95% CI) in Geelong who received positive chlamydia results on 110 and 208 clients respectively. Conclusions: GPs mostly considered patients responsible for partner notification but uncommonly used partner letters or an information brochure to assist them. Importantly, GPs reported that they could improve partner notification if further support was provided. In addition, when a website was provided with useful documents on it, up to 25% of GPs used it. This indicates that simple and inexpensive interventions can support GPs with strategies that may improve the control of chlamydia.
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Dow, Briony, Betty Haralambous, Courtney Hempton, Susan Hunt, and Diane Calleja. "Evaluation of Alzheimer's Australia Vic Memory Lane Cafés." International Psychogeriatrics 23, no. 2 (July 30, 2010): 246–55. http://dx.doi.org/10.1017/s1041610210001560.
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ABSTRACTBackground: This paper describes the evaluation of the Memory Lane Café service in Victoria, Australia. The Alzheimer's Australia Vic Memory Lane Café model aims to provide a social and educational service to people living with dementia and their carers, family members or friends. Dementia is a serious health issue in Australia, with prevalence estimated at 6.5% of people over 65 years of age. Living with dementia has significant social and psychological ramifications, often negatively affecting quality of life. Social support groups can improve quality of life for people living with dementia.Methods: The evaluation included focus groups and surveys of people with dementia and their carers, staff consultation, service provider interviews, and researcher observation. The Melbourne Health Mental Health Human Research Ethics Committee approved the project. Participants included people with dementia (aged 60 to 93 years, previously enrolled in the Alzheimer's Australia Vic's six-week Living With Memory Loss Program), their carers, friends and/or family members, staff working in the Cafés, and service providers with links to the Cafés.Results: This evaluation found that Memory Lane Cafés promote social inclusion, prevent isolation, and improve the social and emotional well-being of attendees. However, Cafés did not meet the needs of all potential attendees.Conclusions: The evaluation recommended that existing Café services be continued and possibilities for extending the Cafés be explored. Based on evaluation outcomes, the Department of Health Victoria is funding four additional pilot programs in café style support services.
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Olokotum, Mark, Jean-François Humbert, Catherine Quiblier, William Okello, Ronald Semyalo, Marc Troussellier, Benjamin Marie, Kathrin Baumann, Rainer Kurmayer, and Cécile Bernard. "Characterization of Potential Threats from Cyanobacterial Toxins in Lake Victoria Embayments and during Water Treatment." Toxins 14, no. 10 (September 23, 2022): 664. http://dx.doi.org/10.3390/toxins14100664.
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Africa’s water needs are often supported by eutrophic water bodies dominated by cyanobacteria posing health threats to riparian populations from cyanotoxins, and Lake Victoria is no exception. In two embayments of the lake (Murchison Bay and Napoleon Gulf), cyanobacterial surveys were conducted to characterize the dynamics of cyanotoxins in lake water and water treatment plants. Forty-six cyanobacterial taxa were recorded, and out of these, fourteen were considered potentially toxigenic (i.e., from the genera Dolichospermum, Microcystis, Oscillatoria, Pseudanabaena and Raphidiopsis). A higher concentration (ranging from 5 to 10 µg MC-LR equiv. L−1) of microcystins (MC) was detected in Murchison Bay compared to Napoleon Gulf, with a declining gradient from the inshore (max. 15 µg MC-LR equiv. L−1) to the open lake. In Murchison Bay, an increase in Microcystis sp. biovolume and MC was observed over the last two decades. Despite high cell densities of toxigenic Microcystis and high MC concentrations, the water treatment plant in Murchison Bay efficiently removed the cyanobacterial biomass, intracellular and dissolved MC to below the lifetime guideline value for exposure via drinking water (<1.0 µg MC-LR equiv. L−1). Thus, the potential health threats stem from the consumption of untreated water and recreational activities along the shores of the lake embayments. MC concentrations were predicted from Microcystis cell numbers regulated by environmental factors, such as solar radiation, wind speed in the N–S direction and turbidity. Thus, an early warning through microscopical counting of Microcystis cell numbers is proposed to better manage health risks from toxigenic cyanobacteria in Lake Victoria.
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Torr, Jennifer, Nicholas Lennox, Sally-Ann Cooper, Therese Rey-Conde, Robert S. Ware, Jennifer Galea, and Miriam Taylor. "Psychiatric Care of Adults with Intellectual Disabilities: Changing Perceptions Over a Decade." Australian & New Zealand Journal of Psychiatry 42, no. 10 (January 1, 2008): 890–97. http://dx.doi.org/10.1080/00048670802345474.
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Objective: In light of developments in training and service provision, the aim of the present study was to compare two state-wide surveys, undertaken in 1994 and in 2004, of psychiatrists about their perceptions of their training and psychiatric treatment of adults with intellectual disabilities who also have mental health needs. Methods: A 50-item self-administered questionnaire was developed for the 2004 survey, based on the 1994 study. This was sent to all 624 Fellows of the Royal Australian and New Zealand College of Psychiatry registered in Victoria at the time. A series of questions was asked based on workload, training, the role of psychiatry in intellectual disabilities, opinions on assessment and management, improving services, and the demographics of participant psychiatrists. Results of the 2004 survey are compared with the 1994 study. Results: There has been some change in psychiatrists’ opinions about acute admission wards, believing strongly that they do not meet the needs of the adults with severe intellectual disabilities, leaving them vulnerable to exploitation. There has been some improvement in their ability to adequately manage adults with intellectual disabilities who have mental health needs and/or problem behaviours. Conclusions: Mainstream mental health services fail to meet the needs of adults with intellectual disabilities. Improved specialist clinical services and more clinical training opportunities are required.
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Zablotska, I., G. Prestage, A. Grulich, J. Imrie, and S. Kippax. "27. CAN UNPROTECTED ANAL INTERCOURSE WITH REGULAR AND CASUAL PARTNERS EXPLAIN THE DIVERGING TRENDS IN HIV EPIDEMIC IN AUSTRALIA?" Sexual Health 4, no. 4 (2007): 295. http://dx.doi.org/10.1071/shv4n4ab27.
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Introduction: Worldwide, increases in unprotected anal intercourse have been linked to the resurgence in HIV and STI in gay men. We assessed whether changes in UAI within regular and casual relationships may explain the diverging trends in HIV in three Australian states - NSW, Victoria and Queensland. Methods: We used the data from the annual cross-sectional Gay Community Periodic Surveys conducted annually in Sydney since 1996 and in Melbourne and Queensland since 1998. A short self-administered questionnaire asks about HIV serostatus, sexual health testing and behaviours relevant to HIV epidemic. We present time trends in seroconcordance and unprotected sex with regular and casual partners. Results: Currently, about one third of gay men report being in monogamous regular relationships, and this proportion has been slowly increasing everywhere. The self-reported UAI with regular partners (UAIR) was highest among men in seroconcordant positive relationships, lower among seroconcordant negative partners and lowest in non seroconcordant relationships. From 1998 to 2006, the rates of UAIR consistently increased by 10% in all three states and in all relationships by serostatus. The rates of UAI with casual partners (UAIC) were historically highest in NSW. From a peak in 2001, UAIC rates have consistently declined in NSW, but continuing increases were observed in Victoria and Queensland. Higher rates of nondisclosure of HIV were also observed in the context of UAIC in the latter two states. Conclusion: Changes in unprotected sex with casual partners may be responsible for the slowing of HIV epidemic in NSW. Sustained investment in policies and programs are important in achieving behaviour change.
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Elechi, Iheanyichukwu M. "Aircraft Noise Levels, Annoyance and General Health of Residents of Communities contiguous to a Major Airport in Lagos State." TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH 8, no. 4 (December 27, 2020): 47–59. http://dx.doi.org/10.21522/tijph.2013.08.04.art006.
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The purpose of this study was to investigate the relationship between the aircraft noise exposure, annoyance reactions and health status of the residents living within the vicinity of the Murtala Muhammed International Airport (MMA) in Lagos state, Nigeria. Aircraft noise monitoring was conducted in five locations within the vicinity (0-5Km) of MMA, and a sixth distant location (14km away). Levels of aircraft noise for all five locations within the vicinity of the airport exceeded the EPA Victoria threshold of 75 dB LAmax for the residential area (outdoor). A survey on annoyance induced by aircraft noise exposure and general health status was conducted on 450 local residents in the study locations using the International Commission on Biological Effect of Noise question and a single question that has been applied in Dutch national health care surveys since 1983 on self-reported general health status respectively. Percentage of residents within the vicinity of MMA that were highly annoyed (%HA) exceeded 15% guideline limit stipulated by Federal Interagency Committee on Urban Noise while 14.5% reported poor health status. There was a significant association between the annoyance reactions and aircraft noise levels in the study locations while the association between self-reported health status and aircraft noise levels was not significant. Taken together, the residents within the vicinity of the airport are exposed to aircraft noise levels above permissible limit which may be associated with high annoyance reaction but may not be associated with poor health rating. Evidence-based aircraft noise related policies by government are advocated.
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Bergin, R., J. Emery, R. Bollard, A. Falborg, H. Jensen, D. Weller, U. Menon, et al. "Rural-Urban Variation in Time to Diagnosis and Treatment of Colorectal or Breast Cancer in Victoria, Australia." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 47s. http://dx.doi.org/10.1200/jgo.18.10700.
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Background: Rural-urban disparities in cancer outcomes are found in many countries, though these vary by cancer type. In Victoria, Australia, survival is poorer for rural patients with colorectal cancer, but not breast cancer. Delayed diagnosis and treatment may contribute to disparities, but previous studies have not compared the timeliness of rural and urban pathways to treatment of these common cancers. Aim: We investigated whether time to diagnosis and treatment differed for rural and urban patients with colorectal or breast cancer in Victoria, Australia. Methods: Population-based, cross-sectional surveys examining events and dates on the pathway to treatment completed by patients aged ≥ 40 and approached within six months of diagnosis, their general practitioner (GP) and specialist. Data were collected from 2013 to 2014 as part of the International Cancer Benchmarking Partnership, Module 4. Six intervals were explored: patient (symptom to presentation), primary care (presentation to referral), diagnostic (presentation/screening to diagnosis), treatment (diagnosis to treatment), health system (presentation to treatment) and total intervals (symptom/screening to treatment). Rural-urban differences were examined for each cancer using quantile regression (50th, 75th and 90th percentiles) models including age, gender, health insurance and socioeconomic status. Results: 433 colorectal (48% rural) and 489 breast (42% rural) patients, 621 GPs and 370 specialists completed surveys. Compared with urban patients, symptomatic colorectal cancer patients from rural areas had a significantly longer total interval at all percentiles: 50th (18 days longer, 95% confidence interval (CI): 9-27), 75th (53, 95% CI: 47-59) 90th (44, 95% CI: 40-48). These patients also had longer health system intervals, ranging 7-85 days longer. This appeared mostly due to longer diagnostic intervals (range: 6-54 days longer). Results were similar when including screen-detected cases. In contrast, breast cancer intervals were similar for rural and urban patients, except the patient interval, which was shorter for rural patients. Conclusion: Consistent with variation in survival, we found longer total and diagnostic intervals for rural compared with urban patients with colorectal cancer, but not breast cancer. The lack of rural-urban differences observed for breast cancer suggest that inequities in the timeliness of colorectal cancer pathways can be ameliorated, and may improve clinical outcomes. Indeed, based on previous research, delays observed in this study could result in stage progression and hence reduced survival. From our results, interventions targeting the time from presentation to colorectal cancer diagnosis in rural populations should be pursued. Countries seeking to understand cancer disparities in their local context may also consider using a pathways approach to identify possible targets for policy intervention.
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Bush, R. D., R. Barnett, I. J. Links, and P. A. Windsor. "Using abattoir surveillance and producer surveys to investigate the prevalence and current preventative management of Caseous lymphadenitis in Merino flocks in Australia." Animal Production Science 52, no. 7 (2012): 675. http://dx.doi.org/10.1071/an11271.
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The prevalence of Caseous lymphadenitis (CLA) in Australia was estimated to be 5.2% using 2009 abattoir surveillance data from all States supplied by Animal Health Australia involving 5029 lines comprising 1 339 463 sheep. This is a decrease from the 26% estimated in a similar study in 1995. There was a significant difference (P < 0.001) in CLA prevalence between all states except Tasmania and Victoria (P = 0.75) with prevalences of 12.8 and 12.9%, respectively. Western Australia recorded the lowest prevalence with 1.0%. The average CLA prevalence for New South Wales was 5.3% and within three surveyed Livestock Health and Pest Authority regions (Tablelands, Central North and Central West) was 2.9, 4.9 and 4.4%, respectively. The attitude of the majority of producers surveyed in these three Livestock Health and Pest Authority areas was that CLA was of little or no significance (75%) but were aware of the need for CLA control with ~68% using 6-in-1 vaccine, though only 39.9% as recommended. It appears that the prolonged use of CLA vaccination has been successful in reducing the prevalence of CLA across Australia and particularly in New South Wales. Further improvements in communication of information on preventative management practices associated with lice control, importance of using an approved vaccination program, plus increasing producers’ awareness of the importance of CLA control, are indicated.
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Lesslie, Robert G., Brendan G. Mackey, and Kathryn M. Preece. "A Computer-based Method of Wilderness Evaluation." Environmental Conservation 15, no. 3 (1988): 225–32. http://dx.doi.org/10.1017/s0376892900029362.
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With ever-increasing demands being made on remote and natural lands, planners and managers require more detailed information than hitherto to assist them in monitoring the status of this wilderness resource and developing appropriate and effective management prescriptions. These requirements are addressed by a computer-based wilderness evaluation procedure that has been developed for a national wilderness survey of Australia.The methodology, based on the wilderness continuum concept (Lesslie & Taylor, 1985), places emphasis on measuring variation in wilderness quality by using four indicators that represent the two essential attributes of remoteness and naturalness. This permits a precise assessment to be made of the wilderness resource, revealing those factors which contribute to or compromise wilderness quality. The computer-based storage and analysis of data enables surveys to be conducted over large, even continental, areas, yet at a relatively fine level of resolution that is appropriate to localized planning needs.Trial application to the State of Victoria, Australia, demonstrates that the survey procedure can be successfully adapted to a wide range of environments, use-patterns, data-base characteristics, and management objectives, which should be applicable and very widely useful elsewhere.
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Woodruff, Madeleine Eloise, Rebecca Doyle, Grahame Coleman, Lauren Hemsworth, and Carolina Munoz. "Knowledge and attitudes are important factors in farmers’ choice of lamb tail docking length." Veterinary Record 186, no. 10 (January 20, 2020): 319. http://dx.doi.org/10.1136/vr.105631.
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BackgroundTail docking is common practice in the sheep industry to prevent soiling of the breech and flystrike. To ensure optimal healing after tail docking and reduce the risk of arthritis, perineal cancers and prolapses, it is recommended to dock tails equivalent to the length of the vulva. However, recent studies have found that some tails are docked too short (24–86 per cent).MethodsTo address this issue, this study aimed to identify key drivers behind tail docking length decisions. Two focus groups, phone (n=30) and online surveys (n=21) were conducted in regional Victoria, Australia to examine farmer knowledge of and attitudes towards appropriate lamb tail length and barriers to best practice. The focus group data were analysed qualitatively, and the surveys were analysed qualitatively and quantitatively.ResultsIn total, 57 per cent of farmers were classed as docking tails short. Short tail docking appeared to be influenced by unawareness of the recommended length and docking at a length that shearers approve of. Other potential factors included lack of knowledge of negative health consequences associated with short tails, importance placed on dag and flystrike prevention, and impracticality of measuring where to dock.ConclusionAddressing these factors in future education and intervention programmes may improve tail docking practice and sheep welfare.
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Browne, Jennifer, Emily D'Amico, Sharon Thorpe, and Colin Mitchell. "Feltman: evaluating the acceptability of a diabetes education tool for Aboriginal health workers." Australian Journal of Primary Health 20, no. 4 (2014): 319. http://dx.doi.org/10.1071/py14040.
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There is an urgent need to address the lack of Aboriginal-specific diabetes prevention and management resources. Following consultation with Victorian Aboriginal health workers, the Victorian Aboriginal Community Controlled Health Organisation and Diabetes Australia – Victoria developed ‘Feltman’, a life-sized felt body showing the main organs involved in the digestion and metabolism of food, and the main parts of the body affected by diabetes. Feltman was distributed to all Victorian Aboriginal Community Controlled Health Organisations and an additional 32 Victorian organisations. In total, 276 people from 57 organisations were trained to use Feltman. An online evaluation survey was developed and sent to all people who were trained to use Feltman in Victoria. Sixty-six people completed the survey. All respondents agreed Feltman was an appropriate tool for the Aboriginal community, 89% of health workers felt more confident in their ability to discuss diabetes with their community but would like further training to maintain skills and confidence and 70% of workers had used Feltman with the community. Qualitative feedback noted its strength as a highly visual resource that was popular with the Aboriginal community. Workers reported that Feltman was a highly acceptable diabetes education resource, which they believed had increased knowledge and improved the management of diabetes among clients.
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Smith, Mary, Sue Atkins, Leon Worth, Michael Richards, and Noleen Bennett. "Infections and antimicrobial use in Australian residential aged care facilities: a comparison between local and international prevalence and practices." Australian Health Review 37, no. 4 (2013): 529. http://dx.doi.org/10.1071/ah12007.
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Introduction. In July 2011, 29 residential aged care facilities (RACF) located in the Grampians rural region, Victoria, participated in the Grampians healthcare-associated infection (HAI) and antimicrobial use point prevalence study. Methods. On a single day, trained infection control consultants collected data using two surveys. The RACF survey enabled collection of information (e.g. occupancy levels) about each RACF and its residents. The resident survey was completed for eligible high-level care residents who presented with signs and symptoms of a HAI and/or were prescribed an antimicrobial. A literature review was undertaken so comparisons could be made against similar studies. Results. The Grampians prevalence of residents presenting with ≥1 HAI (3.8%) was higher than the pooled prevalence (2.3%) for four international studies (P = 0.01). The Grampians prevalence of residents prescribed ≥1 antimicrobial (8.3%) was higher than the pooled prevalence (5.8%) for eight international studies (P = 0.009). Conclusion. The prevalence of the Grampians residents presenting with ≥1 HAI and residents prescribed ≥1 antimicrobial were both observed to be significantly higher than pooled data from similar international studies. What is known about this topic? RACF residents are vulnerable to HAI for a variety of reasons (e.g. comorbidities and functional disabilities). Inappropriate antimicrobial use for these HAI may lead to the emergence of antimicrobial resistance, adverse drug reactions and excessive costs. The literature does not extensively detail surveillance programs that measure HAI or antimicrobial use in Australian RACF. What does this paper add? In a sample of Australian RACF, the Grampians point prevalence study established a baseline prevalence of HAI and antimicrobial use. The rates calculated were shown to be significantly high when compared with similar studies. What are the implications for practitioners? Quality improvement initiatives that might decrease the prevalence of HAI and antimicrobial use in Australian RACF should be investigated and supported by key stakeholders.
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Hannah, Stephanie, Kingsley E. Agho, Milan K. Piya, Kristen Glenister, Lisa Bourke, Uchechukwu L. Osuagwu, and David Simmons. "Trends and Factors Associated with Obesity Prevalence in Rural Australian Adults—Comparative Analysis of the Crossroads Studies in Victoria over 15 Years." Nutrients 14, no. 21 (October 28, 2022): 4557. http://dx.doi.org/10.3390/nu14214557.
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This study examined the changes in the prevalence of obesity and associated lifestyle factors using data from repeated cross-sectional, self-reported surveys (Crossroads I: 2001–2003 and Crossroads II: 2016–2018, studies) and clinic anthropometric measurements collected from regional and rural towns in the Goulburn Valley, Victoria. Given that past community studies have only focused categorically on dietary intake, or assessed caloric energy intake, we examined the difference in broad dietary practices at two different times. Clinical assessments from randomly selected household participants aged ≥18 years were analyzed. Differences in obesity prevalence were calculated for each individual variable. Logistic regression was used to determine the odds ratios (95% confidence intervals (CI)) with and without adjustment for key lifestyle factors. There were 5258 participants in Crossroads I and 2649 in Crossroads II surveys. Obesity prevalence increased from 28.2% to 30.8% over 15 years, more among those who ate fried food, but decreased significantly among rural dwellers (31.7: 27.0, 36.8% versus 25.1: 22.9, 27.5%) and those who had adequate fruit intake (28.5: 25.0, 32.3% to 23.9: 21.8, 26.2%). Obesity was associated with older age (≥35 years), use of fat-based spreads for bread (adjusted odds ratio, aOR:1.26: 1.07, 1.48) and physical inactivity. The increase in obesity prevalence especially in the rural towns, was associated with unhealthy dietary behaviour which persisted over 15 years. Understanding and addressing the upstream determinants of dietary intake and choices would assist in the development of future health promotion programs.
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Perlstein, Robyn, Scott McCoombe, Susie Macfarlane, Andrew Colin Bell, and Caryl Nowson. "Nutrition Practice and Knowledge of First-Year Medical Students." Journal of Biomedical Education 2017 (August 27, 2017): 1–10. http://dx.doi.org/10.1155/2017/5013670.
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Objectives. To compare the knowledge of Australian dietary recommendations to the dietary practices of first-year medical students. Design. Over a period of four years, anonymous online surveys were completed by medical students attending a first-year nutrition lecture. Background. There is little information on the nutritional knowledge and dietary practices of medical students. Setting. First-year postgraduate university medical students, Geelong, Victoria, Australia. Participants. Between the years 2012 and 2016, 32%–61% of first-year students completed the survey. Phenomenon of Interest. Student’s knowledge of dietary guidelines and related practices. Analysis. The frequency of response was assessed across the different year cohorts using descriptive statistics. Results. Between 59% and 93% of first-year students correctly identified the recommended daily servings for fruit, and between 61% and 84% knew the vegetable recommendations. In contrast only 40%–46% met the guidelines for fruit and 12%–19% met the guidelines for vegetables. Conclusions and Implications. Discrepancies between students’ nutrition knowledge and behavior can provide learning opportunities. With low rates of fruit and vegetable consumption in medical students, increased awareness of links between nutrition and health, together with encouragement to make behavioral changes, may increase the skills of graduates to support patients in improving dietary intake.
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Reavley, Nicola J., Allison J. Milner, Angela Martin, Lay San Too, Alicia Papas, Katrina Witt, Tessa Keegel, and Anthony D. LaMontagne. "Depression literacy and help-seeking in Australian police." Australian & New Zealand Journal of Psychiatry 52, no. 11 (February 5, 2018): 1063–74. http://dx.doi.org/10.1177/0004867417753550.
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Objective: To assess depression literacy, help-seeking and help-offering to others in members of the police force in the state of Victoria, Australia. Methods: All staff in police stations involved in a cluster randomised controlled trial of an integrated workplace mental health intervention were invited to participate. Survey questions covered sociodemographic and employment information, recognition of depression in a vignette, stigma, treatment beliefs, willingness to assist co-workers with mental health problems, help-giving and help-seeking behaviours, and intentions to seek help. Using the baseline dataset associated with the trial, the paper presents a descriptive analysis of mental health literacy and helping behaviours, comparing police station leaders and lower ranks. Results: Respondents were 806 staff, comprising 618 lower-ranked staff and 188 leaders. Almost 84% of respondents were able to correctly label the problem described in the vignette. Among those who had helped someone with a mental health problem, both lower ranks and leaders most commonly reported ‘talking to the person’ although leaders were more likely to facilitate professional help. Leaders’ willingness to assist the person and confidence in doing so was very high, and over 80% of leaders appropriately rated police psychologists, general practitioners, psychologists, talking to a peer and contacting welfare as helpful. However, among both leaders and lower ranks with mental health problems, the proportion of those unlikely to seek professional help was greater than those who were likely to seek it. Conclusion: Knowledge about evidence-based interventions for depression was lower in this police sample than surveys in the general population, pointing to the need for education and training to improve mental health literacy. Such education should also aim to overcome barriers to professional help-seeking. Interventions that aim to improve mental health literacy and help-seeking behaviour appear to be suitable targets for better protecting police member mental health.
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Crawford, S., and J. Garrard. "A Combined Impact-Process Evaluation of a Program Promoting Active Transport to School: Understanding the Factors That Shaped Program Effectiveness." Journal of Environmental and Public Health 2013 (2013): 1–14. http://dx.doi.org/10.1155/2013/816961.
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This mixed methods study was a comprehensive impact-process evaluation of the Ride2School program in metropolitan and regional areas in Victoria, Australia. The program aimed to promote transport to school for primary school children. Qualitative and quantitative data were collected at baseline and followup from two primary schools involved in the pilot phase of the program and two matched comparison schools, and a further 13 primary schools that participated in the implementation phase of the program. Classroom surveys, structured and unstructured observations, and interviews with Ride2School program staff were used to evaluate the pilot program. For the 13 schools in the second phase of the program, parents and students completed questionnaires at baseline (N= 889) and followup (N= 761). Based on the quantitative data, there was little evidence of an overall increase in active transport to school across participating schools, although impacts varied among individual schools. Qualitative data in the form of observations, interviews, and focus group discussions with students, school staff, and program staff provided insight into the reasons for variable program impacts. This paper highlights the benefits of undertaking a mixed methods approach to evaluating active transport to school programs that enables both measurement and understanding of program impacts.
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Price, Anna M. H., Anna Zhu, Huu N. J. Nguyen, Diana Contreras-Suárez, Natalie Schreurs, Jade Burley, Kenny D. Lawson, et al. "Study protocol for the Healthier Wealthier Families (HWF) pilot randomised controlled trial: testing the feasibility of delivering financial counselling to families with young children who are identified as experiencing financial hardship by community-based nurses." BMJ Open 11, no. 5 (May 2021): e044488. http://dx.doi.org/10.1136/bmjopen-2020-044488.
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IntroductionPoverty and deprivation can harm children’s future health, learning, economic productivity and societal participation. The Australian Healthier Wealthier Families project seeks to reduce the childhood inequities caused by poverty and deprivation by creating a systematic referral pathway between two free, community-based services: universal, well-child nursing services, which provide health and development support to families with children from birth to school entry, and financial counselling. By adapting the successful Scottish ‘Healthier Wealthier Children’ model, the objectives of this Australian pilot are to test the (1) feasibility of systematising the referral pathway, and (2) short-term impacts on household finances, caregiver health, parenting efficacy and financial service use.Methods and analysisThis pilot randomised controlled trial will run in three sites across two Australian states (Victoria and New South Wales), recruiting a total of 180 participants. Nurses identify eligible caregivers with a 6-item, study-designed screening survey for financial hardship. Caregivers who report one or more risk factors and consent are randomised. The intervention is financial counselling. The comparator is usual care plus information from a government money advice website. Feasibility will be evaluated using the number/proportion of caregivers who complete screening, consent and research measures, and access financial counselling. Though powered to assess feasibility, impacts will be measured 6 months post-enrolment with qualitative interviews and questionnaires about caregiver-reported income, loans and costs (adapted from national surveys, for example, the Household, Income and Labour Dynamics in Australia Survey); health (General Health Questionnaire 1, EuroQol five-dimensional questionnaire, Depression, Anxiety, Stress Scale short-form); efficacy (from the Longitudinal Study of Australian Children); and financial service use (study-designed) compared between arms.Ethics and disseminationEthics committees of the Royal Children’s Hospital (HREC/57372/RCHM-2019) and South West Sydney Local Health District (2019/ETH13455) have approved the study. Participants and stakeholders will receive results through regular communication channels comprising meetings, presentations and publications.Trial registration numberACTRN12620000154909; prospectively registered. Pre-results.
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Rauw, Jennifer Marie, Sunil Parimi, Nikita Ivanov, Jessica Noble, Eugenia Wu, Monita Sundar, Jennifer Goulart, and Celestia S. Higano. "The evolution of the education module for men with metastatic prostate cancer (mPC) in the prostate cancer supportive care (PCSC) program." Journal of Clinical Oncology 39, no. 28_suppl (October 1, 2021): 279. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.279.
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279 Background: The PCSC Program was initiated in 2013 at the Vancouver Prostate Centre to provide a comprehensive program for patients and partners with prostate cancer. This program provides educational sessions (ES) and clinical services, including decision-making for primary therapy, sexual health, pelvic floor physiotherapy, hormone therapy, counseling, exercise, and nutrition for patients in BC, Canada. In 2016, the PCSC Program expanded to BC Cancer Victoria and in 2017 to other BC Cancer sites. In 2018, medical oncologists (MDs) in Victoria (JR, SP) developed an Education Module addressing treatment options for men with metastatic hormone sensitive (mHSPC) and metastatic castration resistant (mCRPC) disease. MDs delivered in-person ES in Victoria in 2018 and, in 2019, added a virtual platform (VP) option. From 3-5/2020, the ESs were on hold due to the COVID pandemic and parental leaves. In 6/2020, the ESs resumed only on VP, and the PCSC Oncology Nurse Practitioner (NP), NI, gave the presentations for the MDs on leave. In 10/2020, due to a changing standard of care for mHSPC, the PCSC team consolidated the two ESs into one. We report on the evolution of this Education Module in response to both the changing standard of care and the COVID pandemic. Methods: We prospectively collected attendance and patient characteristic metrics from all ES for men with mPC. We tracked presenter type (MD vs. NP) and prospectively collected anonymous patient satisfaction questionnaires. Results: From 1/2018 to 1/2021, 100 men registered for 27 ES; 81 men, 41 partners, and 2 family members actually attended. 48/75 (64%) men were white, 39/75 (52%) retired, and 56/75 (74.7%) married. 47 men attended 12 mHSPC ES, 13 men attended ten mCRPC ES, and 17 attended four consolidated ES. MDs presented 15 ES, and the NP presented 12 ES. Responses to questions on 70 satisfaction surveys were similar for MD vs. NP presenters. 9 responders to the recently added VP-specific questions said they agreed (4) or strongly agreed (5) that it was beneficial to watch the ES at home on a computer. The Table below shows attendance per site per year. Conclusions: The ESs for men with mPC were well-received. Although there was a VP option before COVID, attendance increased significantly after the lockdown as patients and providers became more familiar with VPs. Satisfaction surveys confirmed that an NP could deliver the ES rather than MD. Consolidation of the mHSPC and mCRPC ES reflected the changing standard of care and resulted in more efficient use of presenter time. Virtual delivery of the sessions provided greater access to those living in distant or remote areas of the province and those in lockdown during the COVID pandemic. [Table: see text]
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Thomas, Simone, Emma Sciberras, Kate Lycett, Nicole Papadopoulos, and Nicole Rinehart. "Physical Functioning, Emotional, and Behavioral Problems in Children With ADHD and Comorbid ASD: A Cross-Sectional Study." Journal of Attention Disorders 22, no. 10 (May 25, 2015): 1002–7. http://dx.doi.org/10.1177/1087054715587096.
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Objective: To examine (a) physical and daily functioning in children with ADHD and autism spectrum disorder (ASD) compared with ADHD alone and (b) whether decreased physical quality of life (QoL) is associated with increased emotional and behavioral problems in children with ADHD-ASD. Method: Cross-sectional study comprising 392 children with confirmed ADHD (ADHD-ASD, n = 93; ADHD alone, n = 299) recruited from 21 pediatric practices in Victoria, Australia. Data were collected via parent and teacher surveys. Key measures included the Strengths and Difficulties Questionnaire (SDQ) and Pediatric Quality of Life Inventory (PedsQL). Results: Children with ADHD-ASD had poorer QoL across both psychosocial and physical health domains, and also had greater parent-reported behavioral, emotional, and peer problems, compared with children with ADHD alone. Poorer physical QoL partially mediated the relationship between comorbid ASD status and poorer emotional and behavioral functioning. Conclusion:The comorbid overlay of ASD in ADHD appears to influence not only problems in physical functioning but also the severity of problems relating to areas of emotional and behavioral functioning.
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Ollis, Debbie, and Lyn Harrison. "Lessons in building capacity in sexuality education using the health promoting school framework." Health Education 116, no. 2 (February 1, 2016): 138–53. http://dx.doi.org/10.1108/he-08-2014-0084.
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Purpose – The health promoting school model is rarely implemented in relation to sexuality education. This paper reports on data collected as part of a five-year project designed to implement a health promoting and whole school approach to sexuality education in a five campus year 1-12 college in regional Victoria, Australia. Using a community engagement focus involving local and regional stakeholders and with a strong research into practice component, the project is primarily concerned with questions of capacity building, impact and sustainability as part of whole school change. The paper aims to discuss this issue. Design/methodology/approach – Using an action research design, data were collected from parents, students, teachers and key community stakeholders using a mixed methods approach involving surveys, interviews, document analysis and participant observation. Findings – Sexuality education has become a key school policy and has been implemented from years 1 to 9. Teachers and key support staff have engaged in professional learning, a mentor program has been set up, a community engagement/parent liaison position has been created, and parent forums have been conducted on all five campuses. Research limitations/implications – The translation of research into practice can be judged by the impact it has on teacher capacity and the students’ experience. Classroom observation and more longitudinal research would shed light on whether the espoused changes are happening in reality. Originality/value – This paper reports on lessons learned and the key enabling factors that have built capacity to ensure that sexuality education within a health promoting, whole school approach will remain sustainable into the future. These findings will be relevant to others interested in building capacity in sexuality education and health promotion more generally.
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Gao, Crystal, Zheng Jie Lim, Brendan Freestone, Kristy Austin, and Rob McManus. "Use of a Novel Electronic Patient Care Record System at Mass Gathering Events by St. John Ambulance Victoria." Prehospital and Disaster Medicine 34, s1 (May 2019): s88. http://dx.doi.org/10.1017/s1049023x19001845.
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Introduction:The growing number of mass gathering events (MGEs) in Victoria has seen an increase in demand for event health services and the need for real-time reporting of medical incidents at these events.Aim:Since 2016, St. John Ambulance Victoria has introduced an electronic patient care record (ePCR) system with the aim of improving patient care and satisfaction. It appears that this ePCR system is the first of its kind to be trialed at MGEs by a volunteer organization.Methods:A qualitative study was conducted to determine strengths and limitations of the ePCR system by compiling results of surveys and interviews and through anonymous feedback from volunteers and patrons (event organizers, patients). This study is ongoing.Results:It was found that the use of ePCR: 1.Allowed for collection of relevant data to assist in future planning of MGEs2.Aids the overall coordination of first aid delivery at MGEs -faster relaying of patient information to event commanders-reduction of paperwork-improved ability to locate first aid crews using GPS tracking3.Received positive feedback from first aiders, event organizers, and patrons4.Was deemed easy-to-use (4/5), acceptable (4.3/5), and helpful (4.1/5) by our membersDiscussion:These experiences demonstrate that ePCR is well-received, easy to use, and leads to improved patient satisfaction and treatment outcomes at MGEs. Furthermore, the ability to collect and analyze real-time data such as GPS location tracking, incidence heat maps, and patient demographics facilitate future event planning and resource allocation at MGEs. It is acknowledged that this study is preliminary, and the trialed use of an ePCR system has been limited to metropolitan areas and MGEs with <1 million patrons. The intent is to continue this study and explore the use of ePCRs at larger MGEs and events in rural or regional areas.
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Rizzo, Carmen, Antonella Conte, Maurizio Azzaro, Maria Papale, Alessandro C. Rappazzo, Dario Battistel, Marco Roman, Angelina Lo Giudice, and Mauro Guglielmin. "Cultivable Bacterial Communities in Brines from Perennially Ice-Covered and Pristine Antarctic Lakes: Ecological and Biotechnological Implications." Microorganisms 8, no. 6 (May 29, 2020): 819. http://dx.doi.org/10.3390/microorganisms8060819.
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The diversity and biotechnological potentialities of bacterial isolates from brines of three Antarctic lakes of the Northern Victoria Land (namely Boulder Clay and Tarn Flat areas) were first explored. Cultivable bacterial communities were analysed mainly in terms of bacterial response to contaminants (i.e., antibiotics and heavy metals) and oxidation of contaminants (i.e., aliphatic and aromatic hydrocarbons and polychlorobiphenyls). Moreover, the biosynthesis of biomolecules (antibiotics, extracellular polymeric substances and enzymes) with applications for human health and environmental protection was assayed. A total of 74 and 141 isolates were retrieved from Boulder Clay and Tarn Flat brines, respectively. Based on 16S rRNA gene sequence similarities, bacterial isolates represented three phyla, namely Proteobacteria (i.e., Gamma- and Alphaproteobacteria), Bacteroidetes and Actinobacteria, with differences encountered among brines. At genus level, Rhodobacter, Pseudomonas, Psychrobacter and Leifsonia members were dominant. Results obtained from this study on the physiological and enzymatic features of cold-adapted isolates from Antarctic lake brines provide interesting prospects for possible applications in the biotechnological field through future targeted surveys. Finally, findings on contaminant occurrence and bacterial response suggest that bacteria might be used as bioindicators for tracking human footprints in these remote polar areas.
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Begley, Ryan, Yogesan Kanagasingam, Chun Chan, Chandrashan Perera, Moya Vandeleur, and Paul Paddle. "Demonstration of Accuracy and Feasibility of Remotely Delivered Oximetry: A Blinded, Controlled, Real-World Study of Regional/Rural Children with Obstructive Sleep Apnoea." Healthcare 11, no. 2 (January 16, 2023): 278. http://dx.doi.org/10.3390/healthcare11020278.
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Objectives: Evaluate diagnostic accuracy and feasibility of a mail-out home oximetry kit. Design: Patients were referred for both the tertiary/quaternary-centre hospital-delivered oximetry (HDO) and for the mail-out remotely-delivered oximetry (RDO). Quantitative and qualitative data were collected. The COVID-19 pandemic began during this study; therefore, necessary methodological adjustments were implemented. Setting: Patients were first evaluated in Swan Hill, Victoria. RDO kits were sent to home addresses. For the HDO, patients travelled to the Melbourne city area, received the kit, stayed overnight, and returned the kit the following morning. Participants: All consecutive paediatric patients (aged 2–18), diagnosed by a specialist in Swan Hill with obstructive sleep apnoea (OSA) on history/examination, and booked for tonsillectomy +/− adenoidectomy, were recruited. Main outcome measures: Diagnostic accuracy (i.e., comparison of RDO to HDO results) and test delivery time (i.e., days from consent signature to oximetry delivery) were recorded. Patient travel distances for HDO collection were calculated using home/delivery address postcodes and Google® Maps data. Qualitative data were collected with two digital follow-up surveys. Results: All 32 patients that had both the HDO and RDO had identical oximetry results. The HDO mean delivery time was 87.7 days, while the RDO mean delivery time was 23.6 days (p value: <0.001). Qualitatively, 3/28 preferred the HDO, while 25/28 preferred the RDO (n = 28). Conclusions: The remote option is as accurate as the hospital option, strongly preferred by patients, more rapidly completed, and also an ideal investigation delivery method during certain emergencies, such as the COVID-19 pandemic.
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Cornes, Isabel Clare, and Brian Cook. "Localising climate change: heatwave responses in urban households." Disaster Prevention and Management: An International Journal 27, no. 2 (April 3, 2018): 159–74. http://dx.doi.org/10.1108/dpm-11-2017-0276.
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Purpose The purpose of this paper is to provide empirical insights into urban household perceptions and (in)action towards the perceived impacts of climate change, based on a case study in Kensington, Victoria, Australia. This case utilises households as sites of active agency, rather than as passive recipients of climate change or associated governance. Design/methodology/approach This research trialled an approach to engaging a community in the context of disaster risk reduction (DRR). It involved a two-stage quantitative door-knocking survey (reported elsewhere), followed by a qualitative interview with interested households. In total, 76 quantitative surveys contextualise 15 qualitative interviews, which are the focus of this analysis. The findings are presented comparatively alongside the current literature. Findings Heatwaves are understood to be the most concerning hazard for the households in this sample who associate their increasing frequency and severity with climate change. However, subsequent (in)action is shown to be situated within the complexities of day-to-day activities and concerns. While respondents did not consider themselves to have “expert” knowledge on climate change, or consider their actions to be a direct response to climate change, most had undertaken actions resulting from experience with heatwaves. These findings suggest there may be an under-representation of DRR, which includes climate change adaptation actions, within the existing research. Research limitations/implications While this sample justifies the arguments and conclusions, it is not a representative sample and therefore requires follow-up. It does however challenge traditional approaches to risk management, which focus on awareness raising and education. The research highlights the unique contexts in which households perceive and act on risk, and the need for risk “experts” to consider such contexts. Originality/value This research provides empirical evidence of urban household responses to perceived climate change-related risk, an often-neglected dimension of heatwave and adaptation studies in Australia. The findings also suggest promise for the methodological approach.
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McDougall, Rosalind, Barbara Hayes, Marcus Sellars, Bridget Pratt, Anastasia Hutchinson, Mark Tacey, Karen Detering, Cade Shadbolt, and Danielle Ko. "'This is uncharted water for all of us': challenges anticipated by hospital clinicians when voluntary assisted dying becomes legal in Victoria." Australian Health Review 44, no. 3 (2020): 399. http://dx.doi.org/10.1071/ah19108.
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ObjectiveThe aim of this study was to identify the challenges anticipated by clinical staff in two Melbourne health services in relation to the legalisation of voluntary assisted dying in Victoria, Australia. MethodsA qualitative approach was used to investigate perceived challenges for clinicians. Data were collected after the law had passed but before the start date for voluntary assisted dying in Victoria. This work is part of a larger mixed-methods anonymous online survey about Victorian clinicians’ views on voluntary assisted dying. Five open-ended questions were included in order to gather text data from a large number of clinicians in diverse roles. Participants included medical, nursing and allied health staff from two services, one a metropolitan tertiary referral health service (Service 1) and the other a major metropolitan health service (Service 2). The data were analysed thematically using qualitative description. ResultsIn all, 1086 staff provided responses to one or more qualitative questions: 774 from Service 1 and 312 from Service 2. Clinicians anticipated a range of challenges, which included burdens for staff, such as emotional toll, workload and increased conflict with colleagues, patients and families. Challenges regarding organisational culture, the logistics of delivering voluntary assisted dying under the specific Victorian law and how voluntary assisted dying would fit within the hospital’s overall work were also raised. ConclusionsThe legalisation of voluntary assisted dying is anticipated to create a range of challenges for all types of clinicians in the hospital setting. Clinicians identified challenges both at the individual and system levels. What is known about the topic?Voluntary assisted dying became legal in Victoria on 19 June 2019 under the Voluntary Assisted Dying Act 2017. However there has been little Victorian data to inform implementation. What does this paper add?Victorian hospital clinicians anticipate challenges at the individual and system levels, and across all clinical disciplines. These challenges include increased conflict, emotional burden and workload. Clinicians report concerns about organisational culture, the logistics of delivering voluntary assisted dying under the specific Victorian law and effects on hospitals’ overall work. What are the implications for practitioners?Careful attention to the breadth of staff affected, alongside appropriate resourcing, will be needed to support clinicians in the context of this legislative change.