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1.
Food Chem ; 462: 140900, 2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-39213973

RESUMO

Australian honey samples from four botanical genera (Lophostemon, Eucalyptus, Macadamia and Corymbia) were investigated for their phenolic content. An improved phenolic extraction and high-performance liquid chromatography-diode array detection (HPLC-DAD) analysis method allowed for the rapid and reliable identification of phenolic compounds. A concentrated liquid-liquid extraction method with an acidified aqueous solution and acetonitrile was optimised to isolate phenolic compounds from the honey matrix. The concentrated extraction method improved sensitivity and permitted the identification of phenolics present at low concentrations (LOD: 0.012-0.25 mg/kg and LOQ: 0.040-2.99 mg/kg). The optimised HPLC-DAD chromatographic conditions gave stable retention times, improved peak separation and allowed for the inexpensive detection of each of the 109 phenolic compounds at their maximum absorbance wavelength. Out of the 109 phenolic compounds included in this study, 49 were identified in the Australian honeys tested. Furthermore, 25 of the 49 compounds were determined to be markers specific to honey floral origin.


Assuntos
Eucalyptus , Mel , Fenóis , Mel/análise , Cromatografia Líquida de Alta Pressão , Fenóis/análise , Fenóis/química , Eucalyptus/química , Austrália , Flores/química
2.
Child Abuse Negl ; 156: 107022, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39243584

RESUMO

BACKGROUND: Childhood Maltreatment (CM) is linked to adverse outcomes, including Borderline Personality Disorder (BPD) and increased propensity for offending behaviors. However, research on the specific role that BPD plays between the two is limited and highly relevant given the high prevalence of CM in Australia. OBJECTIVE: The present study aimed to investigate (1) the relationship between CM and subsequent offending behaviors, (2) whether BPD mediates the relation between CM and offending behaviors, and (3) which type of CM (physical, sexual, emotional abuse, neglect, exposure to domestic violence, multitype maltreatment) predicts BPD. PARTICIPANTS: The sample comprised 106 self-identified Australian female survivors of interpersonal violent crimes. METHODS: Participants completed an online survey consisting of the Adverse Childhood Events Questionnaire, the McLean Screening Instrument for BPD, and a self-created questionnaire to measure offending behaviors. Regression, mediation analysis, and logistic regression were conducted. RESULTS: CM significantly predicted offending behaviors (path c, B = 1.39, p <. 001) with BPD partially mediating the relationship (path c', B = 1.04, 95 % CI [0.31, 1.77], p = .006; path a, B = 0.47, 95 % CI [0.12, 0.83], p = .009, path b, B = 0.34, 95 % CI [0.07, 0.61], p = .014). Emotional abuse and multitype exposure were identified as predictors of BPD symptom development (OR = 9.42, 95 % CI OR [2.58, 34.40]; OR = 3.81, 95 % CI OR [1.41; 10.28], respectively). CONCLUSION: These findings indicate the necessity of early interventions addressing CM, with a particular focus on emotional abuse and exposure to more than one type of maltreatment, to reduce the risk of developing BPD symptomatology and mitigate future offending behaviors.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis , Transtorno da Personalidade Borderline , Humanos , Transtorno da Personalidade Borderline/psicologia , Transtorno da Personalidade Borderline/epidemiologia , Feminino , Adulto , Austrália/epidemiologia , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Adulto Jovem , Pessoa de Meia-Idade , Inquéritos e Questionários , Adolescente , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Criança , Criminosos/psicologia , Criminosos/estatística & dados numéricos
3.
Sci Rep ; 14(1): 21241, 2024 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-39261541

RESUMO

Health equity is a fast emerging priority for most healthcare systems around the world. Factors impacting health equity include education level, geographical location, age, gender, employment status and income. However, research examining the effect of these demographic variables on health service utilisation among mid-aged and older post-stroke adults is limited. Data was obtained from a sub-study of the Sax Institute's 45 and Up Study, which is conducted in Australia. The sub-study survey collected demographic, health service utilisation and health status information from 576 participants who had a previous stroke diagnosis. Poisson regression was used to examine the association between demographic characteristics and number of consultations with a doctor and/or an allied health practitioner over a 12 month period. All demographic measures were significantly associated with the number of consultations with doctors and/or allied health practitioners. The number of doctor consultations increased for those who struggled to live on their available income (IRR = 1.41), but decreased for females (IRR = 0.81), those who reside in an inner regional area (IRR = 0.83), those who were separated, divorced or widowed (IRR = 0.61), and for those who completed a trade, apprenticeship or diploma (IRR = 0.83). The number of allied health practitioner consultations increased for those who completed a trade, apprenticeship or diploma (IRR = 1.27), and for those who struggled to live on their available income (IRR = 1.38), but decreased for increasing age (IRR = 0.87), females (IRR = 0.78), and for those who reside in an outer regional or remote area (IRR = 0.49). We identified several demographic factors associated with a lower frequency and type of health care services used by post-stroke adults. These possible barriers need to be explored further, as reduced use of healthcare services may lead to poorer stroke outcomes in these demographics. Specifically, researching strategies to best support individuals facing these additional challenges is necessary to ensure equitable healthcare for all Australians.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Acidente Vascular Cerebral , Humanos , Feminino , Masculino , Austrália , Pessoa de Meia-Idade , Idoso , Acidente Vascular Cerebral/terapia , Acidente Vascular Cerebral/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Sobreviventes , Demografia , Fatores Socioeconômicos , Idoso de 80 Anos ou mais
4.
BMC Health Serv Res ; 24(1): 1067, 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39272078

RESUMO

BACKGROUND: The COVID-19 pandemic disrupted health systems around the globe. Lessons from health systems responses to these challenges may help design effective and sustainable health system responses for future challenges. This study aimed to 1/ identify the broad types of health system challenges faced during the pandemic and 2/ develop a typology of health system response to these challenges. METHODS: Semi-structured one-on-one online interviews explored the experience of 19 health professionals during COVID-19 in a large state health system in Australia. Data were analysed using constant comparative analysis utilising a sociotechnical system lens. RESULTS: Participants described four overarching challenges: 1/ System overload, 2/ Barriers to decision-making, 3/ Education or training gaps, and 4/ Limitations of existing services. The limited time often available to respond meant that specific and well-designed strategies were often not possible, and more generic strategies that relied on the workforce to modify solutions and repair unexpected gaps were common. For example, generic responses to system overload included working longer hours, whilst specific strategies utilised pre-existing technical resources (e.g. converting non-emergency wards into COVID-19 wards). CONCLUSION: During the pandemic, it was often not possible to rely on mature strategies to frame responses, and more generic, emergent approaches were commonly required when urgent responses were needed. The degree to which specific strategies were ready-to-hand appeared to dictate how much a strategy relied on such generic approaches. The workforce played a pivotal role in enabling emergent responses that required dealing with uncertainties.


Assuntos
COVID-19 , Pandemias , Pesquisa Qualitativa , COVID-19/epidemiologia , Humanos , Austrália/epidemiologia , SARS-CoV-2 , Atenção à Saúde/organização & administração , Pessoal de Saúde/psicologia , Entrevistas como Assunto , Feminino , Masculino
5.
Nutrients ; 16(17)2024 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-39275264

RESUMO

No Money No Time (NMNT) is a culinary nutrition website designed to optimize diet quality. The primary aim was to evaluate the impact of an online targeted nutrition challenge email campaign that encouraged engagement with NMNT and goal setting to improve diet quality and weekly food expenditure. A secondary aim was to assess NMNT engagement. Australian adults ≥18 years were recruited to the eHealth nutrition challenge delivered via weekly emails. Diet quality was assessed using the Healthy Eating Quiz (HEQ) diet quality tool. Engagement was assessed using email open and click-through rates. Intention-to-treat (ITT) analysis was conducted using mixed effects linear regression. Of 481 adults (49.7 ± 13.9 years, 84% female) who enrolled 79 (16%) completed the challenge. ITT results indicated statistically significant 6-week increases in diet quality score (+3.8 points p ≤ 0.001, d = 0.58) with sub-scale improvements in vegetables (+0.9 points, p = 0.01, d = 0.32), fruit (+1.2 points, p ≤ 0.001, d = 0.55), and dairy (+0.9 points, p ≤ 0.001, d = 0.58). There were significant post-challenge reductions in household spending on takeaway/snacks/coffee of AUD 8.9 per week (p = 0.01, d = 0.29), body weight reduction (-0.6 kg, p = 0.03, d = 0.26), and BMI (-0.2 kg/m2p = 0.02, d = 0.28). The email open rate remained constant at around 67% (56% to 75%), with an average click-through rate of 18% (7.1% to 37.9%). The eHealth nutrition challenge significantly improved diet quality while reducing BMI and money spent on discretionary foods. Strategies to scale the challenge should be tested as an innovative population strategy for improving diet quality, health indicators, and managing household food budgets.


Assuntos
Dieta Saudável , Telemedicina , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Adulto , Dieta Saudável/economia , Telemedicina/economia , Austrália , Internet , Dieta/economia , Promoção da Saúde/métodos , Promoção da Saúde/economia , Idoso
6.
Nutrients ; 16(17)2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39275293

RESUMO

Dietary patterns contribute to overall health and diseases of ageing but are understudied in older adults. As such, we first aimed to develop dietary indices to quantify Mediterranean Diet Score (MDS) utilisation and Ultra-processed Food (UPF) intake in a well-characterised cohort of relatively healthy community-dwelling older Australian adults. Second, we aimed to understand the relationship between these scores and the association of these scores with prevalent cardiometabolic disease and frailty. Our major findings are that in this population of older adults, (a) pre-frailty and frailty are associated with reduced MDS and increased UPF intake; (b) adherence to MDS eating patterns does not preclude relatively high intake of UPF (and vice versa); and (c) high utilisation of an MDS eating pattern does not prevent an increased risk of frailty with higher UPF intakes. As such, the Mediterranean Diet pattern should be encouraged in older adults to potentially reduce the risk of frailty, while the impact of UPF intake should be further explored given the convenience these foods provide to a population whose access to unprocessed food may be limited due to socioeconomic, health, and lifestyle factors.


Assuntos
Dieta Mediterrânea , Fragilidade , Humanos , Dieta Mediterrânea/estatística & dados numéricos , Idoso , Masculino , Feminino , Fragilidade/epidemiologia , Fragilidade/prevenção & controle , Austrália/epidemiologia , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Fast Foods , Comportamento Alimentar , Idoso Fragilizado/estatística & dados numéricos , Alimento Processado
7.
Nurs Open ; 11(9): e70029, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39275909

RESUMO

AIM: Explore Australian-Chinese immigrants' health literacy and preferences and engagement with translated diabetes self-management patient education materials. DESIGN: The cross-sectional survey was conducted with Australian-Chinese immigrants at risk or with type 2 diabetes recruited via health services, and diabetes and community organisations. METHODS: The survey had three parts: (1) diabetes screening; (2) sociodemographic information, clinical characteristics and preferences for translated materials; and (3) Functional, Communicative and Critical Health Literacy (FCCHL) Scale. RESULTS: Of 381 participants, 54.3% reported diabetes (n = 207), the remainder pre-diabetes or at risk (45.7%, n = 174); 34.1% male; mean age 64.1 years. Average total health literacy (FCCHL) scores were 35.3/56 (SD = 8.7). Participants with greater English proficiency reported higher health literacy (p < 0.001). This pattern also existed for functional (p < 0.001), communicative (p = 0.007) and critical (p = 0.041) health literacy subdomains. Health literacy scores did not differ significantly based on years of residence in Australia (all p > 0.05). Although the majority of participants (75.6%, N = 288) were willing to receive translated diabetes information, only a small proportion (19.7%, N = 75) reporting receiving such materials. CONCLUSION: There is a clear need for co-designed diabetes patient education materials that meet the needs and adequately reach Australian-Chinese immigrants. In particular, these materials must support people with limited English-language proficiency. IMPLICATIONS FOR NURSING PRACTICE: This study highlights important considerations for nurses seeking to improve diabetes care for Chinese immigrants when incorporating patient education materials as part of their nursing education.


Assuntos
Diabetes Mellitus Tipo 2 , Emigrantes e Imigrantes , Letramento em Saúde , Humanos , Estudos Transversais , Masculino , Feminino , Austrália , Pessoa de Meia-Idade , Emigrantes e Imigrantes/psicologia , Diabetes Mellitus Tipo 2/psicologia , Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/terapia , Idoso , China/etnologia , Inquéritos e Questionários , Educação de Pacientes como Assunto , Preferência do Paciente/psicologia , Preferência do Paciente/etnologia , Preferência do Paciente/estatística & dados numéricos , Adulto , Povo Asiático/psicologia , Povo Asiático/estatística & dados numéricos , População do Leste Asiático
8.
BMJ Open ; 14(9): e085335, 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39277199

RESUMO

INTRODUCTION: Communication failings may compromise the diagnostic process and pose a risk to quality of care and patient safety. With a focus on emergency care settings, this project aims to examine the critical role and impact of communication in the diagnostic process, including in diagnosis-related health and research policy, and diagnostic patient-clinician interactions in emergency departments (EDs). METHODS AND ANALYSIS: This project uses a qualitatively driven multimethod design integrating findings from two research studies to gain a comprehensive understanding of the impact of context and communication on diagnostic excellence from diverse perspectives. Study 1 will map the diagnostic policy and practice landscape in Australia, New Zealand and the USA through qualitative expert interviews and policy analysis. Study 2 will investigate the communication of uncertainty in diagnostic interactions through a qualitative ethnography of two metropolitan Australian ED sites incorporating observations, field notes, video-recorded interactions, semistructured interviews and written medical documentation, including linguistic analysis of recorded diagnostic interactions and written documentation. This study will also feature a description of clinician, patient and carer perspectives on, and involvement in, interpersonal diagnostic interactions and will provide crucial new insights into the impact of communicating diagnostic uncertainty for these groups. Project-spanning patient and stakeholder involvement strategies will build research capacity among healthcare consumers via educational workshops, engage with community stakeholders in analysis and build consensus among stakeholders. ETHICS AND DISSEMINATION: The project has received ethical approvals from the Human Research Ethics Committee at ACT Health, Northern Sydney Local Health District and the Australian National University. Findings will be disseminated to academic peers, clinicians and healthcare consumers, health policy-makers and the general public, using local and international academic and consumer channels (journals, evidence briefs and conferences) and outreach activities (workshops and seminars).


Assuntos
Comunicação , Serviço Hospitalar de Emergência , Pesquisa Qualitativa , Humanos , Serviço Hospitalar de Emergência/normas , Austrália , Incerteza , Nova Zelândia , Projetos de Pesquisa , Formulação de Políticas , Relações Médico-Paciente , Política de Saúde , Estados Unidos
9.
BMJ Open ; 14(9): e088281, 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39277208

RESUMO

INTRODUCTION: Aboriginal and Torres Strait Islander peoples are the First Peoples of Australia. Up to 45% of dementia in these populations is due to potentially modifiable risk factors. The Dementia Prevention and Risk Management Program for Aboriginal Australians (DAMPAA) is an Aboriginal Health Practitioner led programme that aims to reduce cognitive decline and functional impairment in older Aboriginal people. METHODS: Design: DAMPAA is a multisite, randomised controlled trial aiming to deliver and evaluate a culturally appropriate risk factor management programme. POPULATION: Community-dwelling Aboriginal people aged 45-90 years. INTERVENTION: Participants will be randomly assigned to either usual care (control) or to a group programme comprising exercise and health education yarning sessions and pharmacist-delivered medication reviews delivered over a 12-month period. PRIMARY OUTCOME: Cognitive function (Kimberley Indigenous Cognitive Assessment (KICA)-Cog score), daily function (KICA-Activities of Daily Living (ADL) score) and quality of life (Good Spirit, Good Life and EQ-5D-5L scores). SECONDARY OUTCOMES: Process evaluation interviews, cardiovascular risk factors, falls and death. Process evaluation will be conducted with qualitative methods. Quantitative outcomes will be analysed with generalised linear mixed models. ETHICS AND DISSEMINATION: The study was approved by the Western Australian Aboriginal Health Ethics Committee and the University of Western Australia Human Research Ethics Committee. Study results will be published in peer-reviewed journals and presented at scientific meetings. We will also develop and disseminate a comprehensive DAMPAA toolkit for health services. The study's findings will guide future prevention strategies and outline a comprehensive process evaluation that may be useful in other Aboriginal health research to contextualise findings.


Assuntos
Demência , Havaiano Nativo ou Outro Ilhéu do Pacífico , Humanos , Demência/prevenção & controle , Demência/etnologia , Austrália , Idoso , Idoso de 80 Anos ou mais , Serviços de Saúde do Indígena/organização & administração , Gestão de Riscos/métodos , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Qualidade de Vida , Feminino , Masculino , Atividades Cotidianas , Fatores de Risco , Povos Aborígenes Australianos e Ilhéus do Estreito de Torres
10.
Food Res Int ; 195: 114970, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39277267

RESUMO

Lupins, and other legumes, have attained international interest due to their reported remarkable health benefits. Currently, the seed coats are discarded as waste or animal feed. The research presented here summarizes the potential for incorporating the seed coats into 'whole grain' foods. We aimed to identify metabolites found in the seed coats of nine commercial Australian cultivars of lupin (Lupinus angustifolius and L. albus species), and to evaluate and compare their functional, nutritional, antioxidant, and antidiabetic properties, along with in silico exploration of mechanisms of action for selected identified secondary metabolites. The seed coats were found to contain 79 to 90% dietary fibers and substantial quantity of essential macrometals. LC-QTOF MS-based, untargeted bioactive metabolite profiling explored a total of 673 chemical entities, and identified 63 bioactive secondary metabolites including: biophenols, unsaturated fatty acids, triterpenoids, alkaloids, and dietary prebiotics (insoluble fibers). The seed coats from these nine cultivars show substantial antioxidant activity. The cultivars of L. angustifolius inhibit α-amylase and α-glucosidase significantly in vitro. Moreover, in silico docking and dynamic simulation along with ADME/T analysis suggest that quercetin 3-methyl ether and 8-C-methylquercetin 3-methyl ether as molecules, novel in lupin seed coats, are responsible for the α-amylase and α-glucosidase inhibition. The findings indicated that lupin seed coats might be beneficial food components, rather than be discarded as 'mill waste'.


Assuntos
Antioxidantes , Hipoglicemiantes , Lupinus , Sementes , Antioxidantes/análise , Sementes/química , Lupinus/química , Hipoglicemiantes/análise , Simulação por Computador , Fibras na Dieta/análise , Valor Nutritivo , Austrália , alfa-Amilases/metabolismo , alfa-Amilases/antagonistas & inibidores , Cromatografia Líquida/métodos , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Simulação de Acoplamento Molecular , Inibidores de Glicosídeo Hidrolases/farmacologia , Espectrometria de Massas/métodos
11.
Nat Commun ; 15(1): 8076, 2024 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-39277590

RESUMO

N. gonorrhoeae, which causes the sexually transmissible infection gonorrhoea, remains a significant public health threat globally, with challenges posed by increasing transmission and antimicrobial resistance (AMR). The COVID-19 pandemic introduced exceptional circumstances into communicable disease control, impacting the transmission of gonorrhoea and other infectious diseases. Through phylogenomic and phylodynamic analysis of 5881 N. gonorrhoeae genomes from Australia, we investigated N. gonorrhoeae transmission over five years, including a time period during the COVID-19 pandemic. Using a novel cgMLST-based genetic threshold, we demonstrate persistence of large N. gonorrhoeae genomic clusters over several years, with some persistent clusters associated with heterosexual transmission. We observed a decline in both N. gonorrhoeae transmission and genomic diversity during the COVID-19 pandemic, suggestive of an evolutionary bottleneck. The longitudinal, occult transmission of N. gonorrhoeae over many years further highlights the urgent need for improved diagnostic, treatment, and prevention strategies for gonorrhoea.


Assuntos
COVID-19 , Genoma Bacteriano , Genômica , Gonorreia , Neisseria gonorrhoeae , Filogenia , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/efeitos dos fármacos , Humanos , Gonorreia/transmissão , Gonorreia/epidemiologia , Gonorreia/microbiologia , Austrália/epidemiologia , Masculino , Feminino , COVID-19/transmissão , COVID-19/epidemiologia , Estudos Longitudinais , Adulto , SARS-CoV-2/genética , Adulto Jovem
12.
BMC Health Serv Res ; 24(1): 1068, 2024 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-39277712

RESUMO

BACKGROUND: The recent crises of bushfires, floods, and the COVID-19 pandemic on the southeast coast of Australia were unprecedented in their extent and intensity. Few studies have investigated responses to cumulative disasters in First Nations communities, despite acknowledgement that these crises disproportionately impact First Nations people. This study was conducted by Aboriginal and non-Aboriginal researchers in partnership with Waminda, South Coast Women's Health and Wellbeing Aboriginal Corporation, an Aboriginal Community Controlled Health Organisation (ACCHO). It investigated the collective experiences of people affected by cumulative disasters to identify the practices that support healing, and recovery for Aboriginal communities. The study addresses a knowledge gap of how Waminda, designs, manages and delivers responses to address complex health and social issues in the context of cumulative disasters. METHODS: Underpinned by practice theory this study employed Indigenous-informed, narrative inquiry. Culturally-appropriate, multiple interpretive methods were used to collect data including: observations; yarns with Aboriginal community members, yarns with Waminda practitioners, management and board members; interviews-to-the-double, visual images and documentation. The data were collated and analysed using the phases of reflexive thematic analysis. RESULTS: The paper articulates a suite of culturally safe and place-based practices that enhance social, emotional and spiritual well-being following cumulative disasters. These practice bundles include: adopting a Country-centred conception of local communities; being community-led; viewing care as a collective, relational, sociomaterial accomplishment and having fluid boundaries. These practice bundles 'hang together' through organising practices including the Waminda Model of Care, staff wellbeing framework and emergency management plan which orient action and manage risks. The paper demonstrates the need for disaster responses to be community-led and culturally situated. ACCHOs are shown to play a crucial role, and their local responses to immediate community needs are grounded in contextual knowledge and use existing resources rather than relying on mainstream system-wide interventions. CONCLUSIONS: The paper suggests crafting responses that focus on assisting communities (re)gain their sense of belonging, hope for the future, control over their lives and their capacities to care for and to be cared for by Country, are key to both enhancing healing, health and well-being and harnessing the strengths of communities.


Assuntos
COVID-19 , Serviços de Saúde do Indígena , Havaiano Nativo ou Outro Ilhéu do Pacífico , Humanos , Havaiano Nativo ou Outro Ilhéu do Pacífico/psicologia , Feminino , COVID-19/epidemiologia , Serviços de Saúde do Indígena/organização & administração , Austrália , Desastres , Masculino , SARS-CoV-2 , Adulto
13.
Child Abuse Negl ; 156: 106977, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39217741

RESUMO

BACKGROUND: An important element of reducing the sexual abuse and exploitation of children is to understand the behaviors of individuals who consume child sexual abuse material (CSAM), including the predictors of continued use. OBJECTIVE: To investigate predictors of 'ever viewing' CSAM and subsequent intentional use among individuals in the community. METHOD: This study used multivariate logistic regression analysis to identify significant predictors of ever viewing CSAM (n = 742) in an anonymous survey of 5512 Internet users in the community, and of subsequent intentional CSAM use among a subset of 459 CSAM viewers. RESULTS: The characteristics of respondents that were significantly associated with ever viewing CSAM were being male, older in age (25-34 and 55+ years cf. 18-24 years), residing in Australia, New Zealand, or Canada (cf. the United Kingdom), earlier exposure to adult pornography (<14 years), experiencing childhood physical abuse or neglect, viewing bestiality pornography featuring adults, viewing bondage/S&M (BDSM) pornography featuring adults, being likely (self-reported) to have sexual contact with a child, and visiting pedophilic chat forums online. In the subset sample, almost half (218, 47.5 %) viewed CSAM again intentionally after first exposure. Predictors of subsequent intentional viewing of CSAM after adjusting for age and country of residence were being male, ever experiencing loneliness, searching for CSAM intentionally at first exposure, being likely (self-reported) to have sexual contact with a child, and visiting pedophilic chat forums online. CONCLUSIONS: The findings have strong implications for prevention of first exposure to CSAM, and of continued CSAM use after exposure does occur.


Assuntos
Abuso Sexual na Infância , Literatura Erótica , Internet , Humanos , Masculino , Feminino , Adulto , Abuso Sexual na Infância/estatística & dados numéricos , Abuso Sexual na Infância/psicologia , Pessoa de Meia-Idade , Literatura Erótica/psicologia , Criança , Adolescente , Adulto Jovem , Austrália/epidemiologia , Nova Zelândia , Canadá/epidemiologia , Inquéritos e Questionários , Modelos Logísticos , Idoso , Pedofilia/psicologia
14.
Aust J Prim Health ; 302024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39270058

RESUMO

Background General practice training in outer metropolitan (OM) areas contributes to patients' access to care. Differences in clinical practice and training in rural versus urban areas have been established, but less is known about OM versus inner metropolitan (IM) differences - whether they offer a trainee learning experience of populations with distinct demographics and healthcare characteristics. This study sought to identify the characteristics and associations of general practice training in New South Wales and Australian Capital Territory OM areas, compared to IM and rural areas. Methods Cross-sectional analyses of data (2016-2020) from the Registrar Clinical Encounters in Training (ReCEnT) study, an ongoing cohort study of Australian GP registrars' in-consultation clinical and educational experience and behaviours, were performed. Multinomial logistic regression assessed associations of rural/OM/IM practice location with registrar and practice factors, patient factors, consultation content factors and consultation action factors. Results Overall, 1308 registrars provided data from 177,026 consultations. For several variables, there was a pattern in the differences of associations across rural/OM/IM areas. Experience of care of older patients and Aboriginal and/or Torres Strait Islander health were more likely in OM than IM areas. Care of patients from non-English speaking background was more likely in OM than in rural areas. Possible markers of healthcare access (specialist referrals, and pathology and imaging requests) were less likely in OM than in both IM and rural areas. Conclusions OM areas are distinct (and educationally rich) clinical learning environments, with distinct demographic characteristics and seeming healthcare access limitations. This finding has implications for workforce support and health resource allocation.


Assuntos
Medicina Geral , Serviços de Saúde Rural , Humanos , Estudos Transversais , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Serviços de Saúde Rural/estatística & dados numéricos , Medicina Geral/estatística & dados numéricos , New South Wales , Idoso , Serviços Urbanos de Saúde/estatística & dados numéricos , Adolescente , Adulto Jovem , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Austrália , População Rural/estatística & dados numéricos , Criança , Território da Capital Australiana , Pré-Escolar , Lactente
15.
Environ Health Perspect ; 132(9): 97007, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39269729

RESUMO

BACKGROUND: While some evidence has potentially linked climate change to carcinogenic factors, the long-term effect of climate change on liver cancer risk largely remains unclear. OBJECTIVES: Our objective is to evaluate the long-term relationship between temperature increase and liver cancer incidence in Australia. METHODS: We mapped the spatial distribution of liver cancer incidence from 2001 to 2019 in Australia. A Bayesian spatial conditional autoregressive (CAR) model was used to estimate the relationships between the increase in temperature at different lags and liver cancer incidence in Australia, after controlling for chronic hepatitis B prevalence, chronic hepatitis C prevalence, and the Index of Relative Socio-economic Disadvantage. Spatial random effects obtained from the Bayesian CAR model were also mapped. RESULTS: The research showed that the distribution of liver cancer in Australia is spatially clustered, most areas in Northern Territory and Northern Queensland have higher incidence and relative risk. The increase in temperature at the lag of 30 years was found to correlate with the increase in liver cancer incidence in Australia, with a posterior mean of 30.57 [95% Bayesian credible interval (CrI): 0.17, 58.88] for the univariate model and 29.50 (95% CrI: 1.27, 58.95) after controlling for confounders, respectively. The results were not highly credible for other lags. DISCUSSION: Our Bayesian spatial analysis suggested a potential relationship between temperature increase and liver cancer. To our knowledge, this research marks the first attempt to assess the long-term effect of global warming on liver cancer. If the relationship is confirmed by other studies, these findings may inform the development of prevention and mitigation strategies based on climate change projections. https://doi.org/10.1289/EHP14574.


Assuntos
Teorema de Bayes , Mudança Climática , Neoplasias Hepáticas , Humanos , Neoplasias Hepáticas/epidemiologia , Austrália/epidemiologia , Incidência , Análise Espacial , Temperatura , Temperatura Alta
16.
PLoS One ; 19(9): e0307018, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39269955

RESUMO

This study aims to address and improve the low physical activity levels among people with mild dementia by implementing a novel shared decision-making and motivational support program, named "Changing the Focus". It will utilise a pre-post mixed methods approach, aiming to recruit 60 community living older people with mild dementia and their care-partners. The shared decision-making process will involve the person living with dementia, their care-partner, and a research therapist, using a purpose-designed discussion tool including factors such as preferred physical activities, health status, local opportunities and program accessibility. This process aims to identify personalised local physical activity opportunities. Participants will be supported with the help of a research therapist to engage in targeted community-based physical activities for 12-months, to progress towards the recommended physical activity guidelines of 150 minutes per week. The intervention provided by the research therapist will include three home visits (baseline, 6- and 12-months) and seven motivational support phone calls (within the first six months). Research therapists may provide additional home visits and support calls as needed. Primary outcomes include program participation (participants living with dementia continuing with the program after 12-months), total physical activity time per week (measured using the Active Australia Survey at baseline, 6- and 12- months) and program acceptability (assessed through semi-structured interviews with participants, care-partners, referrers, and physical activity providers). Secondary outcomes include physical performance, mental health, wellbeing measures, and impact on care-partners (evaluated through physical tests or validated scales at baseline, 6- and 12-months). Other implementation aspects include reach, maintenance, safety (falls, other adverse events) and an economic evaluation. Results will inform feasibility, potential benefits, and challenges associated with this innovative shared decision-making and supported physical activity program for people living with mild dementia. Findings will guide future large-scale studies and contribute to enhancing physical activity opportunities for this population.


Assuntos
Demência , Exercício Físico , Estudos de Viabilidade , Humanos , Demência/terapia , Demência/reabilitação , Demência/psicologia , Idoso , Motivação , Masculino , Feminino , Austrália , Vida Independente , Tomada de Decisão Compartilhada , Idoso de 80 Anos ou mais
17.
Physiol Rep ; 12(17): e70045, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39252180
18.
Aust J Prim Health ; 302024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39265059

RESUMO

Background Australia's commitment to eliminate hepatitis C by 2030 is underpinned by the mobilisation of the primary care sector. Primary care nurses are well placed to contribute to achieving elimination given their unique access to people with/at risk of hepatitis C and their person-centred approach to care delivery. This study examines the enablers to primary care nurse involvement in elimination efforts. Methods Primary care nurses involved in the care of people with/at risk of hepatitis C were recruited through two national nursing organisations. Participants provided verbal consent to participate in an electronically recorded, semi-structured interview. Interview data were transcribed verbatim, coded and analysed using a thematic analysis. Results Sixteen interviews were conducted with nurses working in general practice, community health, alcohol and other drug services, and custodial settings, with the findings framed using a social-ecological model. The study identified individual attributes, such as empathy and advocacy for clients deemed 'too hard for everyone else'. Interpersonal enablers included participants' ability to effectively communicate with clients and colleagues, and using trusted professional relationships to improve client access to care. Public policy that addressed community factors, including stigma and confidentiality, were seen as supportive. Conclusions This study identified the critical and varied role primary care nurses play in hepatitis C elimination. Effective scale up of hepatitis C care involves recognising the pivotal role of primary care nurses, which will help to create an enabling environment that supports nurses to work to their full scope of practice and enhance their contribution to the elimination response.


Assuntos
Hepatite C , Entrevistas como Assunto , Papel do Profissional de Enfermagem , Humanos , Austrália , Hepatite C/prevenção & controle , Feminino , Masculino , Enfermagem de Atenção Primária/métodos , Pesquisa Qualitativa , Adulto , Erradicação de Doenças/métodos , Atenção Primária à Saúde , Pessoa de Meia-Idade
19.
Reprod Fertil Dev ; 362024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39265061

RESUMO

sion="1.0" encoding="utf-8"?> RD Reproduction, Fertility and Development Reprod. Fertil. Dev. 1031-3613 1448-5990 CSIRO Publishing 36 Gardiner Road Clayton 3168 Victoria Australia RD24134 10.1071/RD24134 Foreword Dedication to Jim Cummins Spermatology and testis biology - honouring the contributions of James M. Cummins M. Yeste and G. B. Martin https://orcid.org/0000-0002-2209-340X Yeste Marc A * https://orcid.org/0000-0002-1905-7934 Martin Graeme B. B Department of Biology, Faculty of Sciences, University of Girona , Girona , Spain . Faculty of Agriculture and Natural Sciences, University of Western Australia , Stirling Highway , Crawley , WA , Australia . * Correspondence to: Marc Yeste Department of Biology, Faculty of Sciences, University of Girona, Girona, Spain Email: marc.yeste@udg.edu 12 September 2024 36 15 Collection: Dedication to Jim Cummins RD24134 17 August 2024 Received: 17 August 2024 20 August 2024 Accepted: 20 August 2024 12 September 2024 Published: 12 September 2024 © 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing 2024 The Author(s) (or their employer(s)). This collection celebrates the important contributions James (Jim) Michael Cummins made to the field of reproductive biology. It covers a variety of topics but with a clear focus on spermatology where Jim's impact, as a scientist and teacher, was most profound. As a core member of the Editorial Board of Reproduction, Fertility and Development , for a series of Editors-in-Chief, he was a font of wisdom for all aspects of the field, including reproductive technology in humans, and acted as a guardian of editorial principles and ethics. This article belongs to the Collection Dedication to Jim Cummins.


Assuntos
Testículo , Masculino , Testículo/fisiologia , Humanos , História do Século XX , História do Século XXI , Espermatogênese/fisiologia , Austrália , Animais
20.
J Parasitol ; 110(5): 428-439, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39266006

RESUMO

This paper provides a summary of new and revised records of pentastomes published since 1985 and also presents a checklist of all pentastome records from Australian reptiles and amphibians. The need to identify pentastome species, through both morphological and molecular characterization, is highlighted to enable a determination of the true diversity of pentastome species and their distribution within amphibians and reptiles in Australia.


Assuntos
Anfíbios , Répteis , Animais , Anfíbios/parasitologia , Répteis/parasitologia , Austrália , Lista de Checagem
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