Non-linear effects of non-host diversity on the removal of free-living infective stages of parasites.

Among the ecological functions and services of biodiversity is the potential buffering of diseases through dilution effects where increased biodiversity results in a reduction in disease risk for humans and wildlife hosts. Whether such effects are a universal phenomenon is still under intense debate and diversity effects are little studied in cases when non-host organisms remove free-living parasite stages during their transmission from one host to the next by consumption or physical obstruction. Here, we investigated non-host diversity effects on the removal of cercarial stages of trematodes, ubiquitous parasites in aquatic ecosystems. In laboratory experiments using response surface designs, varying both diversity and density at same time, we compared three combinations of two non-hosts at four density levels: predatory crabs that actively remove cercariae from the water column via their mouth parts and gills, filter feeding oysters that passively filter cercariae from the water column while not becoming infected themselves, and seaweed which physically obstructs cercariae. The addition of a second non-host did not generally result in increased parasite removal but neutralised, amplified or reduced the parasite removal exerted by the first non-host, depending on the density and non-host combination. These non-linear non-host diversity effects were probably driven by intra- and interspecific interactions and suggest the need to integrate non-host diversity effects in understanding the links between community diversity and infection risk.

Participant characteristics and reasons for non-consent to health information linkage for research: experiences from the ATHENA COVID-19 study.

BACKGROUND: The linkage of primary care, hospital and other health registry data is a global goal, and a consent-based approach is often used. Understanding the attitudes of why participants take part is important, yet little is known about reasons for non-participation. The ATHENA COVID-19 feasibility study investigated: 1) health outcomes of people diagnosed with COVID-19 in Queensland, Australia through primary care health data linkage using consent, and 2) created a cohort of patients willing to be re-contacted in future to participate in clinical trials. This report describes the characteristics of participants declining to participate and reasons for non-consent. METHODS: Patients diagnosed with COVID-19 from January 1st, 2020, to December 31st, 2020, were invited to consent to having their primary healthcare data extracted from their GP into a Queensland Health database and linked to other data sets for ethically approved research. Patients were also asked to consent to future recontact for participation in clinical trials. Outcome measures were proportions of patients consenting to data extraction, permission to recontact, and reason for consent decline. RESULTS: Nine hundred and ninety-five participants were approached and 842(85%) reached a consent decision. 581(69%), 615(73%) and 629(75%) consented to data extraction, recontact, or both, respectively. Mean (range) age of consenters and non-consenters were 50.6(22-77) and 46.1(22-77) years, respectively. Adjusting for age, gender and remoteness, older participants were more likely to consent than younger (aOR 1.02, 95%CI 1.01 to 1.03). The least socio-economically disadvantaged were more likely to consent than the most disadvantaged (aOR 2.20, 95% 1.33 to 3.64). There was no difference in consent proportions regarding gender or living in more remote regions. The main reasons for non-consent were 'not interested in research' (37%), 'concerns about privacy' (15%), 'not registered with a GP' (8%) and 'too busy/no time' (7%). 'No reason' was given in 20%. CONCLUSION: Younger participants and the more socio-economically deprived are more likely to non-consent to primary care data linkage. Lack of patient interest in research, time required to participate and privacy concerns, were the most common reasons cited for non-consent. Future health care data linkage studies addressing these issues may prove helpful.

Educational composition effect on the sex gap in life expectancy: A research note based on evidence from Australia.

Life expectancy for females has exceeded that of males globally this century. There is considerable within-country variation in life expectancy related to education. Sex gaps in life expectancy can be decomposed into two components: sex differences in education-specific mortality and sex differences in educational composition. We illustrate this using Australian data for 2016, when the sex gap in life expectancy at age 25 was 3.8 years. The sex gap would be as large as 4.5 years if males and females had the same educational composition; however, it is reduced by 0.7 years, given the lower levels of education among women than men. In a hypothetical scenario accounting for recent increases in females' educational achievement (holding the educational composition at all ages constant at that observed at ages 25-39 for both sexes), we estimate a potential increase in the sex gap (to 4.1 years) in favour of females.

The political and security dimensions of the humanitarian health response to violent conflict.

The nature of armed conflict throughout the world is intensely dynamic. Consequently, the protection of non-combatants and the provision of humanitarian services must continually adapt to this changing conflict environment. Complex political affiliations, the systematic use of explosive weapons and sexual violence, and the use of new communication technology, including social media, have created new challenges for humanitarian actors in negotiating access to affected populations and security for their own personnel. The nature of combatants has also evolved as armed, non-state actors might have varying motivations, use different forms of violence, and engage in a variety of criminal activities to generate requisite funds. New health threats, such as the COVID-19 pandemic, and new capabilities, such as modern trauma care, have also created new challenges and opportunities for humanitarian health provision. In response, humanitarian policies and practices must develop negotiation and safety capabilities, informed by political and security realities on the ground, and guidance from affected communities. More fundamentally, humanitarian policies will need to confront a changing geopolitical environment, in which traditional humanitarian norms and protections might encounter wavering support in the years to come.

Physical, mental, and social wellbeing and their association with death by suicide and self-harm in older adults: a community-based cohort study.

OBJECTIVE: To assess associations between physical, mental, and social well-being and suicide and self-harm in a community-based sample of older adults. METHODS: Using a cohort design, questionnaire data from 102,880 individuals aged 65 years or older living in New South Wales, Australia during 2006-2009 were linked to hospital and cause-of-death databases until 2017. Poisson regressions obtained adjusted incidence rate ratios (IRRs). RESULTS: One hundred nine suicides and 191 deliberate self-harm (DSH) events occurred. Compared to those reporting excellent/good overall health, older adults reporting fair overall health had higher suicide rates (IRR = 2.8, 95% confidence interval: 1.8-4.4). Also, suffering from physical limitations was associated with higher rates of suicide. A fair versus excellent/good memory was associated with higher rates of suicide (IRR = 2.0, 1.3-3.3). Male erectile dysfunction was linked to self-harm (IRR = 2.8, 1.0-7.7). Suicide rates were elevated with baseline Kessler-10 scores of 20-50 versus 10-15 (IRR = 5.0, 2.9-8.9); the corresponding IRR for DSH was 2.9 (1.8-4.8). Elevated rates were observed for both self-reported depression and anxiety. Poor versus excellent/good quality of life was associated with suicide (IRR = 4.3, 1.7-10.7) and achieving less than desired to due to emotional problems was linked to self-harm (IRR = 1.8 1.3-2.4). Rates of suicide ande DSH were lower in those with ≥5 people to depend on versus one (suicide: IRR = 0.5, 0.3-0.9; DSH: IRR = 0.5, 0.3-0.7). CONCLUSIONS: Older adults experiencing health problems, including those relating to overall health or memory, and those with psychological distress had elevated rates of suicidal behavior. Rates of subsequent self-harm and/or death by suicide were elevated in participants with small social networks.

The association between living in socially fragmented neighbourhoods and psychological distress among immigrant and non-immigrant people aged 45 and over in NSW, Australia.

OBJECTIVE: Immigrants' mental health is a growing public health concern. Neighbourhood characteristics in the host society may contribute to the poor mental health observed among immigrants. In this study, we aimed to investigate the association between neighbourhood-level social fragmentation and socioeconomic characteristics with psychological distress among immigrants and non-immigrants living in Australia. METHODOLOGY: We conducted cross-sectional secondary data analysis of 228,039 participants from the Sax Institute's 45 and Up Study, with psychological distress measured with the Kessler 10 (K10) and area-level social fragmentation and economic advantage/disadvantage measured at the statistical area level 1 (areas containing approximately 400 people). Multilevel logistic models were used to examine the extent to which differences across the least and most fragmented and economic advantage/disadvantage neighbourhoods contributed to the prevalence of high psychological distress (K10 score ⩾ 22). RESULTS: Immigrants accounted for about 23% of the sample. Slightly more immigrants (34.8%) compared to non-immigrants (32.9%) lived in fragmented areas. Although immigrants were over represented in areas with socioeconomic advantage (40% vs 33.9%), the prevalence of high psychological distress in neighbourhoods with higher social fragmentation and socioeconomic disadvantage was higher in immigrants than non-immigrants. Immigrants had 17% (95% confidence interval = [12%, 22%]) higher odds of having high psychological distress compared to non-immigrants. There was no evidence of an interaction between social fragmentation or socioeconomic disadvantage and immigrant status. Living in fragmented or socioeconomically disadvantaged areas was associated with higher psychological distress among immigrants and non-immigrants. English as a second language and low annual income were significant predictors of psychological distress in immigrants over and above area-level characteristics. CONCLUSION: Immigrants are vulnerable to mental health issues, but the characteristics of the area they live in are also important. Helping immigrants settle into well-integrated and economically advantaged areas may decrease the possibility of mental health issues.

Measures of mental, physical, and social wellbeing and their association with death by suicide and self-harm in a cohort of 266,324 persons aged 45 years and over.

PURPOSE: The aim of this study was to examine the relation of mental, physical, and social wellbeing measures to death by suicide and self-harm (SH). METHODS: Using a cohort design, questionnaire data on 266,324 responders aged ≥ 45 years, living in NSW, Australia were linked to hospital and death databases during 2006-2017. Adjusted incidence rate ratios (IRR) were calculated. RESULTS: Overall, 212 suicides and 723 SH episodes were observed. A dose-response relationship with suicidal behaviour was found for Kessler-10 Psychological Distress Scale; IRRs of 4.5 (95% CI 2.4-8.3) for suicide and 8.3 (95% CI 6.5-10.7) for SH were observed for scores of high versus low distress. Elevated rates were also observed for those reporting poor versus good or excellent health (suicide, IRR: 3.8, 95% CI 2.2-6.9; SH, IRR: 4.5 95% CI 3.4-6.1); being dependent versus not dependent on help with daily tasks (suicide, IRR: 2.4 95% CI 1.5-3.7; SH, IRR: 2.6 95% CI 2.0-3.3); being a current smoker (suicide, IRR: 1.8, 95% CI 1.1-2.9; SH, IRR: 2.9 95% CI 2.3-3.5) having versus not having male erectile problems (SH, IRR: 1.9 95% CI 1.4-2.5). Participants with ≥ 5 people versus one person to depend on had reduced suicidal behaviour (suicide, IRR: 0.5 95% CI 0.3-0.7, SH, IRR: 0.5 95% CI 0.4-0.6). CONCLUSIONS: An active social network was linked to lower rates of suicide and self-harm. Adverse health, dependence on help, psychological distress were associated with higher rates of suicide and self-harm, while erectile problems were linked to an elevated rate of self-harm.

Education-related variation in coronary procedure rates and the contribution of private health care in Australia: a prospective cohort study.

BACKGROUND: Contemporary Australian evidence on socioeconomic variation in secondary cardiovascular disease (CVD) care, a possible contributor to inequalities in cardiovascular disease outcomes, is lacking. This study examined the relationship between education, an individual-level indicator of socioeconomic position, and receipt of angiography and revascularisation procedures following incident hospitalisation for acute myocardial infarction (AMI) or angina, and the role of private care in this relationship. METHODS: Participants aged ≥45 from the New South Wales population-based 45 and Up Study with no history of prior ischaemic heart disease hospitalised for AMI or angina were followed for receipt of angiography or revascularisation within 30 days of hospital admission, ascertained through linked hospital records. Education attainment, measured on baseline survey, was categorised as low (no school certificate/qualifications), intermediate (school certificate/trade/apprenticeship/diploma) and high (university degree). Cox regression estimated the association (hazard ratios [HRs]) between education and coronary procedure receipt, adjusting for demographic and health-related factors, and testing for linear trend. Private health insurance was investigated as a mediating variable. RESULTS: Among 4454 patients with AMI, 68.3% received angiography within 30 days of admission (crude rate: 25.8/person-year) and 48.8% received revascularisation (rate: 11.7/person-year); corresponding figures among 4348 angina patients were 59.7% (rate: 17.4/person-year) and 30.8% (rate: 5.3/person-year). Procedure rates decreased with decreasing levels of education. Comparing low to high education, angiography rates were 29% lower among AMI patients (adjusted HR = 0.71, 95% CI: 0.56-0.90) and 40% lower among angina patients (0.60, 0.47-0.76). Patterns were similar for revascularisation among those with angina (0.78, 0.61-0.99) but not AMI (0.93, 0.69-1.25). After adjustment for private health insurance status, the HRs were attenuated and there was little evidence of an association between education and angiography among those admitted for AMI. CONCLUSIONS: There is a socioeconomic gradient in coronary procedures with the most disadvantaged patients being less likely to receive angiography following hospital admission for AMI or angina, and revascularisation procedures for angina. Unequal access to private health care contributes to these differences. The extent to which the remaining variation is clinically appropriate, or whether angiography is being underused among people with low socioeconomic position or overused among those with higher socioeconomic position, is unclear.

Consumer and host body size effects on the removal of trematode cercariae by ambient communities.

Parasite transmission can be altered via the removal of parasites by the ambient communities in which parasite-host interactions take place. However, the mechanisms driving parasite removal remain poorly understood. Using marine trematode cercariae as a model system, we investigated the effects of consumer and host body size on parasite removal rates. Laboratory experiments revealed that consumer or host body size significantly affected cercarial removal rates in crabs, oysters and cockles but not in shrimps. In general, cercarial removal rates increased with consumer (crabs and oysters) and host (cockles) body size. For the filter feeding oysters and cockles, the effects probably relate to their feeding activity which is known to correlate with bivalve size. Low infection levels found in cockle hosts suggest that parasite removal by hosts also leads to significant mortality of infective stages. The size effects of crab and shrimp predators on cercarial removal rates were more complex and did not show an expected size match-mismatch between predators and their cercarial prey, suggesting that parasite removal rates in predators are species-specific. We conclude that to have a comprehensive understanding of parasite removal by ambient communities, more research into the various mechanisms of cercarial removal is required.

Socioeconomic variation in absolute cardiovascular disease risk and treatment in the Australian population.

Cardiovascular disease (CVD), preventable through appropriate management of absolute CVD risk, disproportionately affects socioeconomically disadvantaged individuals. The aim of this study was to estimate absolute and relative socioeconomic inequalities in absolute CVD risk and treatment in the Australian population using cross-sectional representative data on 4751 people aged 45-74 from the 2011-12 Australian Health Survey. Poisson regression was used to calculate prevalence differences (PD) and ratios (PR) for prior CVD, high 5-year absolute risk of a primary CVD event and guideline-recommended medication use, in relation to socioeconomic position (SEP, measured by education). After adjusting for age and sex, the prevalence of high absolute risk of a primary CVD event among those of low, intermediate and high SEP was 12.6%, 10.9% and 7.7% (PD, low vs. high = 5.0 [95% CI: 2.3, 7.7], PR = 1.6 [1.2, 2.2]) and for prior CVD was 10.7%, 9.1% and 6.7% (PD = 4.0 [1.4, 6.6], PR = 1.6 [1.1, 2.2]). The proportions using preventive medication use among those with high primary risk were 21.3%, 19.5% and 29.4% for low, intermediate and high SEP and for prior CVD, were 37.8%, 35.7% and 17.7% (PD = 20.1 [9.7, 30.5], PR = 2.1 [1.3, 3.5]). Proportions at high primary risk and not using medications among those of low, intermediate and high SEP were 10.6%, 8.8% and 4.7% and with prior CVD and not using medications were 8.5%, 6.3% and 4.1%. Findings indicate substantial potential to prevent CVD and reduce inequalities through appropriate management of high absolute risk in the population.

Absolute cardiovascular disease risk and lipid-lowering therapy among Aboriginal and Torres Strait Islander Australians.

OBJECTIVE: To quantify absolute cardiovascular disease (CVD) risk in Aboriginal and Torres Strait Islander people and their use of lipid-lowering therapies. DESIGN, PARTICIPANTS: Cross-sectional analysis of nationally representative data from 2820 participants aged 18-74 years who provided biomedical data for the National Aboriginal and Torres Strait Islander Health Measures Survey component of the 2012-13 Australian Aboriginal and Torres Strait Islander Health Survey. MAIN OUTCOME MEASURES: Prior CVD and use of lipid-lowering medications were ascertained at interview. 5-year absolute risk of a primary CVD event was calculated with the Australian National Vascular Disease Prevention Alliance algorithm, with categories low (< 10%), moderate (10-15%) and high risk (> 15%). RESULTS: Among participants aged 35-74 years, 9.6% (95% CI, 7.2-12.0%) had prior CVD; 15.7% (95% CI, 13.0-18.3%) were at high, 4.9% (95% CI, 3.3-6.6%) at moderate, and 69.8% (95% CI, 66.8-72.8%) at low absolute primary CVD risk. 82.6% of those at high primary risk were identified on the basis of clinical criteria. High primary absolute risk affected 1.1% (95% CI, 0.0-2.5%) of 18-24-year-olds, 4.7% (95% CI, 2.0-7.5%) of 25-34-year-olds, and 44.2% (95% CI, 33.1-55.3%) of 65-74-year-olds. Lipid-lowering therapy was being used by 52.9% (95% CI, 38.2-67.6%) of people aged 35-74 years with prior CVD and by 42.2% (95% CI, 30.5-53.8%) of those at high primary CVD risk. CONCLUSION: Absolute CVD risk is high among Aboriginal and Torres Strait Islander people, and most of those at high risk are undertreated. Substantial proportions of people under 35 years of age are at high risk, but are not targeted by current guidelines for absolute CVD risk assessment, compromising CVD prevention in this population.

Social capital dynamics and health in mid to later life: findings from Australia.

PURPOSE: The influence of social capital has been shown to improve health and wellbeing. This study investigates the relationship between changes in social capital and health outcomes during a 6-year follow-up in mid to later life in Australia. METHODS: Nationally representative data from the Household, Income and Labour Dynamics in Australia (HILDA) survey included participants aged 45 years and over who responded in 2006, 2010 and 2012 (N = 3606). Each of the three components of social capital (connectedness, trust and participation) was measured in Waves 2006 and 2010 and categorised as: 'never low', 'transitioned to low', 'transitioned out of low' and 'consistently low'. Health outcomes in 2012 included self-rated overall health, physical functioning, and mental health based on the Short Form 36-item health survey (SF-36). Multivariable logistic regression assessed changes in social capital (measured in 2006 and 2010) predicted poor health (measured in 2012), adjusting for covariates. RESULTS: Consistently low trust was significantly associated with higher odds of transitions into poor physical functioning (AOR 1.54; 95% Confidence Interval 1.06-1.22), poor mental health (AOR 1.59; 95% CI 1.08-2.36) and poor self-rated health (AOR 1.86; 95% CI 1.27-2.72). Transition into low trust was also a predictor of poor self-rated health after adjusting for covariates (AOR 1.74; 95% CI 1.11-2.73). Changes in social connectedness in both directions (transitioned out of and into low) were statistically associated with poor self-rated health (AORs 1.40; 95% CI 1.00-1.97 and 1.61; 95% CI 1.11-2.34, respectively) after adjusting for confounders as well as other social capital components. CONCLUSIONS: Our longitudinal findings reveal social capital dynamics and effects on health in mid to later life. Social trust and connectedness could be important enablers for older persons to be more active in the community and potentially benefit their health and wellbeing over time.

Intergenerational policy and workforce participation in Australia: using health as a metric.

Like many nations, population ageing is challenging Australia's economic future; increasing the workforce participation of mothers and mature-aged adults are two policy strategies to address it. Drawing on a Health in All Policies (HiAPs) framework, our study aims to supply longitudinal evidence on connections between this policy strategy and health. Considering physical inactivity, poor mental health, overweight and obesity we estimate associations with the level of participation (not employed compared with part- or full-time employed). Using eight waves of data from the Household, Income and Labour Dynamics in Australia survey, a series of random intercept logistic models estimate the odds for mothers (n = 2105) and Australians aged 55-64 years (n = 3201) on each health outcome. We find that there are health benefits as well as risks linked to level of participation. Mothers who worked >20 h/wk had higher odds of physical inactivity, as did mature-aged Australians working either part - or full-time. Working part- or full-time was unrelated to overweight or obesity over the span of our study. Level of participation was unrelated to mental health among mature-age Australians, although part-time (but not full-time) work benefited mothers'. In terms of health, working more may offer mixed blessings to these two target populations; part-time work appears to be optimal. By using health as a metric, our study adds to the case for a HiAPs approach.

Parasites as prey: the effect of cercarial density and alternative prey on consumption of cercariae by four non-host species.

In parasites with complex life cycles the transmission of free-living infective stages can be influenced by ambient community diversity, in particular via predation. Here, we experimentally investigated whether parasite density and the presence of alternative prey can alter predation rates on free-living cercarial stages of a marine trematode by several non-host predators. All four predator species consumed increasing numbers of cercariae with an increase in cercarial density, indicating that the removal of cercariae by predators is effective over a range of natural densities as well as in the presence of alternative prey for a number of predators typical of marine ecosystems. However, the relative removal rates and the effects of cercarial density and alternative prey differed among predator species. In barnacles and shrimps, significant interactive effects of cercarial density and alternative prey on cercarial predation occurred while in oysters and crabs cercarial removal rates were unaffected by both factors. As changes in cercarial densities directly translate into changes in infection levels in down-stream hosts in this parasite-host system, the observed predator-specific responses suggest that cercarial predation effects on disease risks will depend on the specific species composition of ambient communities and not on non-host biodiversity per se.

Effect of dose and frequency of exposure to infectious stages on trematode infection intensity and success in mussels.

Marine parasites such as trematodes often compromise the fitness of their hosts. Such effects are generally considered to be density-dependent, i.e. the greater the infection intensity in the host, the greater the detrimental impact on host fitness. However, the mechanisms determining infection in marine hosts are still poorly understood. Here, we investigated the effect of cercarial dose and exposure frequency (single vs. trickle infections) of a marine trematode parasite, Himasthla elongata (Trematoda: Echinostomatidae), on infection intensity and success in its second intermediate host, the blue mussel Mytilus edulis, an abundant and widely distributed bivalve in European coastal waters. In our laboratory experiment, we tested 4 levels of parasite doses and showed that mussels faced higher parasite infection intensity at higher doses of cercarial exposure and that they acquired more infections when repeatedly exposed to smaller doses compared to a single high dose. However, the infection success of cercariae did not differ among 4 dose levels but was only significantly different between trickle and single exposures. This indicates that cercariae were not subjected to a dose-dependent regulation of their infectivity, suggesting that infection intensity in mussels is largely driven by factors mediating the abundance of infective stages. With the combined investigation of the effect of cercarial dose and exposure frequency at realistic dose levels, our study contributes to our currently very limited understanding of the determinants of infection intensity in marine hosts and highlights the usefulness of experimental studies in advancing our knowledge in this field.

Health or harm? A cohort study of the importance of job quality in extended workforce participation by older adults.

BACKGROUND: As people are living longer, they are being encouraged to work longer. While it is assumed that extended employment will be good for health, the evidence has been mixed. This study considers whether employment and job quality exert an influence on four indicators of health status in older workers. METHODS: Data for this study came from 836 older workers (440 men and 396 women) aged 50-59 years at baseline who participated in the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Using linear regression, we examine within-person change in self-rated, physical and mental health and one health behaviour (physical activity) at two time points over a nine year follow-up period. RESULTS: There were minimal differences in the way health changed for older adults who continued working compared to those who retired voluntarily. However, when we decomposed employment in terms of job quality, health outcomes diverged. Compared to voluntary retirees, older workers who had worked in good quality jobs reported marginally better self-rated health (0.14,-0.02-0.29); but did not differ in their physical (2.31,-1.09-5.72) or mental health (0.51,-1.84-2.87). In contrast, older workers who held poor quality jobs for most of the follow-up period declined in their self-rated (-1.13,-0.28 - -0.02), physical (-4.90, 8.52- - 1.29) and mental health (-4.67, 7.69- - 1.66) relative to voluntary retirees. Older workers who held poor quality jobs for just some of the follow-up period did not differ from voluntary retirees in terms of their health. However there was evidence of a linear relationship between length of exposure to poor quality jobs and decline in health outcomes. CONCLUSION: Extended working lives mean that people will be 'exposed' to work for longer, and this exposure will occur at a life stage characterised by declining health for many. Our findings show that ensuring older workers have access to secure jobs which allow for control over work time, skill use and fair rewards will be essential if policy goals to boost participation and productivity, as well as reduce the health and care costs of the elderly, are to be met.

Not all hours are equal: could time be a social determinant of health?

Time can be thought of as a resource that people need for good health. Healthy behaviour, accessing health services, working, resting and caring all require time. Like other resources, time is socially shaped, but its relevance to health and health inequality is yet to be established. Drawing from sociology and political economy, we set out the theoretical basis for two measures of time relevant to contemporary, market-based societies. We measure amount of time spent on care and work (paid and unpaid) and the intensity of time, which refers to rushing, effort and speed. Using data from wave 9 (N = 9177) of the Household, Income and Labour Dynamics of Australia Survey we found that time poverty (> 80 h per week on care and work) and often or always rushing are barriers to physical activity and rushing is associated with poorer self-rated and mental health. Exploring their social patterning, we find that time-poor people have higher incomes and more time control. In contrast, rushing is linked to being a woman, lone parenthood, disability, lack of control and work-family conflicts. We supply a methodology to support quantitative investigations of time, and our findings underline time's dimensionality, social distribution and potential to influence health.

Promoting equity in the mental wellbeing of children and young people: a scoping review.

There is increasing emphasis on wellbeing as a target for mental health promotion, especially during the formative period of childhood. Despite growing research on the importance of mental wellbeing, there is little information on how to effectively promote it or how to promote it equitably. This article presents a scoping review of interventions which seek to promote mental wellbeing and reduce inequities in children and young people living in high income countries. We used Fair Foundations: The VicHealth framework for health equity (VicHealth (2013) Melbourne, Australia: The Victorian Health Promotion Foundation) to identify points of entry at three layers of influence: (i) socioeconomic, cultural and political contexts, (ii) daily living conditions, and (iii) individual and family health-related factors. We identified more than 1000 interventions which aimed to prevent or treat childhood mental illness, but there were far fewer that aimed to promote children's or young people's mental wellbeing. The interventions we studied were either universal or specifically targeted children from disadvantaged families: none explicitly used an equity framework to guide their design or evaluation or addressed social gradients in wellbeing. Most interventions remained focused on proximate factors, although we also identified a handful of interventions that sought to address children's access to services and their educational and neighbourhood environments. However, we found encouraging evidence that interventions in family and educational settings were successful in building children's strengths and supporting positive parenting, universally and within disadvantaged groups. Such positive programme evaluations signal the potential for using a proportionate universalism approach that emphasizes equity in the promotion of mental wellbeing.

Pathological and physiological effects of nicking on brown crab (Cancer pagurus) in the Irish crustacean fishery.

Nicking is used in fisheries to immobilize claws of brown crab (Cancer pagurus) in order to prevent cannibalism and fighting during storage. Nicking fractures the apodemes creating an open wound and damage to the internal claw tissues, which is the most valuable product of brown crab. In turn, this results in a reduction of quality of product and possibly compromises the host's defence mechanisms to other physiological challenges experienced throughout the post-harvest process. This study assessed the effects of nicking on the physiology and pathology of brown crab from the Irish fishery over 7 days. Results showed significantly elevated levels of muscle necrosis (P=0.005), total pathologies (P=0.022) and encirculating granulocytes in nicked crab compared to non-nicked crab. Mean glucose (212.0 µg/mL±108.4), lactate (36.52 µg/mL±38.74) and RI (11.05n±1.78) levels were higher in nicked crab indicating increased stress levels. Overall, histology results showed a significantly higher (P=0.022) occurrence of pathologies, such as melanised nodules, in nicked animals. In addition to an observed reduction in the quality of claw muscle, nicked crab also showed significantly higher (P=0.005) levels of necrosis in claw muscle. From the results of this study it is recommended that alternative retention methods are used.

National estimates of occupation-related inequalities in all-cause mortality using linked Census-mortality data.

OBJECTIVE: This report aims to provide national estimates of occupation-related inequalities in all-cause mortality for Australian residents aged 25-64 years. METHOD: Data came from the 2016 Census linked to Deaths Registrations, available via the Multi-Agency Data Integration Project. Using negative binomial regression, we estimated age-adjusted relative and absolute inequalities in all-cause mortality rates in the 13 months following Census according to occupation, defined using the Australian and New Zealand Standard Classification of Occupations (eight major groups), using managers as the reference group. RESULTS: Among 10.8M people, there were 20,987 deaths. Age-adjusted mortality rates were lowest among managers and professionals and were generally highest for manual occupations, for example, among men, relative risks (RR) for labourers ranged across age groups from 1.44 (95% CI 1.19-1.75, age 54-64) to 2.99 (1.93-4.65, age 25-34); among women, the RR for machine operators and drivers were 3.95 (1.39-11.21 in age 25-24 and 2.73 (1.66-4.49) in age 45-54, but there was relatively little variation by occupation in women aged 35-44 and 55-64. Around one in five deaths (23% for men, 17% for women) were associated with being in an occupation other than manager. CONCLUSION: These findings highlight that there is benefit in documenting national mortality inequalities according to occupation in addition to other measures of socioeconomic position. They provide further insights into socioeconomic inequalities in mortality. IMPLICATIONS FOR PUBLIC HEALTH: Methods that aim to reduce mortality for those in manual occupations, particularly among young men, will reduce inequalities and improve population health.