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1.
Med J Aust ; 221(1): 55-60, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38946642

RESUMO

OBJECTIVE: To assess the effectiveness of the Cultural, Social and Emotional Wellbeing Program for reducing psychological distress and enhancing the social and emotional wellbeing of Aboriginal women preparing for release from prison. STUDY DESIGN: Mixed methods; qualitative study (adapted reflexive thematic analysis of stories of most significant change) and assessment of psychological distress. SETTING, PARTICIPANTS: Aboriginal and Torres Strait Islander women at the Boronia Pre-release Centre for Women, Perth, Western Australia, May and July 2021. INTERVENTION: Cultural, Social and Emotional Wellbeing Program (two days per week for six weeks). The Program involves presentations, workshops, activities, group discussions, and self-reflections designed to enhance social and emotional wellbeing. MAIN OUTCOME MEASURES: Themes and subthemes identified from reflexive thematic analysis of participants' stories of most significant change; change in mean psychological distress, as assessed with the 5-item Kessler Scale (K-5) before and after the Program. RESULTS: Fourteen of 16 invited women completed the Program; ten participated in its evaluation. They reported improved social and emotional wellbeing, reflected as enhanced connections to culture, family, and community. Mean psychological distress was lower after the Program (mean K-5 score, 11.3; 95% confidence interval [CI], 9.0-13.6) than before the Program (9.0; 95% CI, 6.5-11.5; P = 0.047). CONCLUSION: The women who participated in the Program reported personal growth, including acceptance of self and acceptance and pride in culture, reflecting enhanced social and emotional wellbeing through connections to culture and kinship. Our preliminary findings suggest that the Program could improve the resilience of Aboriginal and Torres Strait Islander in contact with the justice system.


Assuntos
Saúde Mental , Havaiano Nativo ou Outro Ilhéu do Pacífico , Humanos , Feminino , Havaiano Nativo ou Outro Ilhéu do Pacífico/psicologia , Adulto , Saúde Mental/etnologia , Austrália Ocidental , Avaliação de Programas e Projetos de Saúde , Angústia Psicológica , Pesquisa Qualitativa , Pessoa de Meia-Idade , Emoções , Prisioneiros/psicologia , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia , Adulto Jovem
2.
Front Public Health ; 12: 1392208, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38983266

RESUMO

Introduction: Western Australia has one of the highest rates of Aboriginal children entering out-of-home care in Australia. Kinship care is the preferred culturally safe out-of-home care option for Aboriginal children, yet all jurisdictions, including Western Australia, are far from meeting best-practice national standards. Intersectoral collaboration is a key primary healthcare principle and internationally recognized for improving health systems and outcomes. This paper presents findings from a qualitative research project investigating Aboriginal primary healthcare workers' experiences of intersectoral collaboration challenges and strengthening opportunities. Methods: Constructivist grounded theory guided this research involving 55 semi-structured interviews and four focus group discussions with Aboriginal primary healthcare workers. The research was guided by Indigenous methodologies and led by Indigenous researchers Participants were recruited from seven Aboriginal Community Controlled Health Organisations located across Perth metro, Pilbara, Midwest/Gascoyne and Southwest regions in Western Australia. Results: Key themes identified around intersectoral collaboration challenges were communication, including information sharing and interagency meetings, and the relationship with the government sector, including trust and the importance of the perception of Aboriginal health service independence. Key themes around strengthening areas to improve intersectoral collaboration included strengthening service resourcing and coverage, including the availability of services, and addressing high program turnover. The need for a shift in approach, including more emphasis on Aboriginal-led care and aligning approaches between sectors, was another area for strengthening. Discussion: This study addresses a significant research gap concerning out-of-home care, kinship care, and intersectoral collaboration in an Australian Aboriginal context. Findings highlighted the need to review the out-of-home and kinship models of care to strengthen the system, including creating more formal and structured modes of collaborating and better resourcing family support and kinship care.


Assuntos
Serviços de Saúde do Indígena , Colaboração Intersetorial , Havaiano Nativo ou Outro Ilhéu do Pacífico , Pesquisa Qualitativa , Humanos , Austrália Ocidental , Serviços de Saúde do Indígena/organização & administração , Grupos Focais , Criança , Masculino , Feminino , Cuidados no Lar de Adoção , Entrevistas como Assunto , Teoria Fundamentada
3.
Int J Speech Lang Pathol ; 26(3): 334-345, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38962971

RESUMO

PURPOSE: Within Australia, some families face challenges in accessing paediatric speech-language pathology services. This research sought to investigate the factors that impact access to paediatric speech-language pathology services within Western Australia. METHOD: Researchers used constructivist grounded theory to investigate the construct of access, as experienced and perceived by service decision-makers, namely caregivers of children with communication needs and speech-language pathologists who provide communication services. Eleven speech-language pathologists and 16 caregivers took part in 32 semi-structured in-depth interviews. Researchers used layers of coding of interviews transcripts and the constant comparative method to investigate data. RESULT: Findings outline the factors that impact access to speech-language pathology services, as organised into the seven categories of the Model of Access to Speech-Language Pathology Services (MASPS). The categories and properties of this model are grounded within experiences and perspectives that participants contributed to the dataset. CONCLUSION: MASPS provides a theoretical structure that has been constructed using inductive and abductive reasoning. This model can be used by service designers and decision-makers to reflect upon and improve experiences of service for a range of consumers. MASPS can also be used as a basis for further investigation into aspects of service access.


Assuntos
Acessibilidade aos Serviços de Saúde , Patologia da Fala e Linguagem , Humanos , Patologia da Fala e Linguagem/métodos , Austrália Ocidental , Criança , Feminino , Cuidadores , Masculino , Teoria Fundamentada , Entrevistas como Assunto , Adulto
4.
Nutrients ; 16(13)2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38999842

RESUMO

BACKGROUND: Probiotic supplementation in preterm neonates is standard practice in many centres across the globe. The impact of probiotic supplementation in the neonatal age group on the risk of hospitalisation in infancy has not been reported previously. METHODS: Infants born < 32 + 6 weeks of gestation in Western Australia were eligible for inclusion. We conducted a retrospective cohort study comparing data from before probiotic supplementation (Epoch 1: 1 December 2008-30 November 2010, n = 1238) versus after (Epoch 2: 1 June 2012-30 May 2014, n = 1422) on the risks of respiratory- and gastrointestinal infection-related hospitalisation. A subgroup analysis of infants born < 28 weeks of gestation was analysed separately for similar outcomes. RESULTS: Compared to Epoch 1, an 8% reduction in incidence of hospitalisation up to 2 years after birth was observed in Epoch 2 (adjusted incidence rate ratio (IRR) of 0.92; 95% confidence interval (CI); 0.87-0.98), adjusted for gestational age, smoking, socioeconomic status, and maternal age. The rate of hospitalisation for infants born < 28 weeks of gestation was comparable in epochs 1 and 2. CONCLUSION: Infants exposed to probiotic supplementation in the neonatal period experience a reduced risk of hospitalisation in the first two years after discharge from the neonatal unit.


Assuntos
Suplementos Nutricionais , Hospitalização , Probióticos , Humanos , Austrália Ocidental/epidemiologia , Recém-Nascido , Probióticos/administração & dosagem , Probióticos/uso terapêutico , Hospitalização/estatística & dados numéricos , Estudos Retrospectivos , Feminino , Masculino , Lactente , Idade Gestacional , Recém-Nascido Prematuro , Incidência , Fatores de Risco , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/prevenção & controle
5.
Int J Tuberc Lung Dis ; 28(7): 322-327, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38961550

RESUMO

SETTINGThis was a retrospective chart review in Western Australia, Australia.OBJECTIVETo describe the diagnosis, management, and treatment outcomes of ocular TB in Western Australia (WA).DESIGNThis was a retrospective review of ocular TB cases in WA from 2007 to 2018 with a minimum 2-year follow-up upon completion of anti-TB therapy (ATT).RESULTSA total of 44 patients were referred to WA TB clinic. Ten were excluded from the analysis of treatment response; 34 met the inclusion criteria, of whom 97.1% were born overseas. No patients had symptomatic extraocular TB. Chest X-ray showed prior pulmonary TB in 11.7% of patients (n = 4). All patients were treated with three or four ATT drugs. The most common ocular TB manifestation was retinal vasculitis (23.5%). Full resolution of ocular inflammation following ATT occurred in 66.7% (n = 22), and reduced ocular inflammation requiring only topical steroid treatment was seen in 21.2% (n = 7). Treatment failure occurred in 12.1% (n = 4). Side effects were reported in 45.6% of patients, with gastrointestinal symptoms most common (27.2%).CONCLUSIONOur study is the first Australian study examining the management of ocular TB. Our study highlights the challenges in diagnosing TB ocular disease in a low-endemicity setting and the importance of the collaboration between uveitis and TB subspecialists..


Assuntos
Antituberculosos , Tuberculose Ocular , Humanos , Austrália Ocidental/epidemiologia , Estudos Retrospectivos , Feminino , Masculino , Antituberculosos/administração & dosagem , Tuberculose Ocular/tratamento farmacológico , Tuberculose Ocular/diagnóstico , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Resultado do Tratamento , Adolescente , Vasculite Retiniana/diagnóstico , Vasculite Retiniana/tratamento farmacológico , Seguimentos
6.
Clin Exp Dent Res ; 10(4): e906, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38970251

RESUMO

OBJECTIVES: This study aimed to explore the dental staff knowledge of simulated patient methodology and support for its use to investigate dental staffs' triaging ability. MATERIAL AND METHODS: Staff at dental practices in Western Australia were invited to participate in a cross-sectional online questionnaire, consisting of demographic questions, questions on triaging, and knowledge of simulated patient methodology. Descriptive and parametric tests were undertaken for quantitative data; qualitative responses were thematically analyzed. RESULTS: Of the 100 participants, most were female (71%), aged 25-39 years (57%), dentists (46%), and worked in private practices (60%). While 82% of participants triaged dental appointment enquiries, only 26% had heard of simulated patient studies. The majority (66%) of participants spent 1-5 min when triaging appointments and less than half (29%) asked about medical history, aggravating or alleviating factors. Although there was a general positive attitude toward use of simulated patient methodology to investigate practice, some concerns were identified. CONCLUSIONS: The findings of our exploratory study suggests that there may be a potential for utilizing simulated patient studies to improve the care of patients by dental receptionists in general dental practices.


Assuntos
Clínicas Odontológicas , Simulação de Paciente , Humanos , Feminino , Projetos Piloto , Adulto , Estudos Transversais , Masculino , Clínicas Odontológicas/organização & administração , Austrália Ocidental , Inquéritos e Questionários/estatística & dados numéricos , Atitude do Pessoal de Saúde , Triagem/métodos , Triagem/normas , Pessoa de Meia-Idade , Agendamento de Consultas , Recursos Humanos em Odontologia
7.
J Vis Exp ; (208)2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38975765

RESUMO

Infants at risk of HIE require early identification and initiation of therapeutic hypothermia (TH). Earlier treatment with TH is associated with better outcomes. aEEG is frequently used when making the decision whether to commence TH. As this is often limited to tertiary centers, TH may be delayed if the infant requires transport to a center that provides it. We aimed to provide a method for the application of amplitude-integrated electroencephalogram (aEEG) and to determine the feasibility of acquiring clinically meaningful information during transport. All infants ≥35 weeks, at risk of HIE at referral, were eligible for inclusion. Scalp electrodes were placed in the C3-C4; P3-P4 position on the infant's scalp and connected to the aEEG amplifier. The aEEG amplifier was, in turn, connected to a clinical tablet computer with EEG software to collect and analyze aEEG information. Recordings were reviewed by the chief principal investigator and two independent reviewers (blinded) for background trace and artifact. Predefined criteria for data quality were set to movement artifacts and software impedance notifications. Surveys were completed by healthcare staff and parents for acceptability and ease of use.


Assuntos
Eletroencefalografia , Estudos de Viabilidade , Hipóxia-Isquemia Encefálica , Humanos , Hipóxia-Isquemia Encefálica/diagnóstico , Eletroencefalografia/métodos , Lactente , Austrália Ocidental , Recém-Nascido , Hipotermia Induzida/métodos , Resgate Aéreo
8.
BMC Health Serv Res ; 24(1): 770, 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38943091

RESUMO

BACKGROUND: Current processes collecting cancer stage data in population-based cancer registries (PBCRs) lack standardisation, resulting in difficulty utilising diverse data sources and incomplete, low-quality data. Implementing a cancer staging tiered framework aims to improve stage collection and facilitate inter-PBCR benchmarking. OBJECTIVE: Demonstrate the application of a cancer staging tiered framework in the Western Australian Cancer Staging Project to establish a standardised method for collecting cancer stage at diagnosis data in PBCRs. METHODS: The tiered framework, developed in collaboration with a Project Advisory Group and applied to breast, colorectal, and melanoma cancers, provides business rules - procedures for stage collection. Tier 1 represents the highest staging level, involving complete American Joint Committee on Cancer (AJCC) tumour-node-metastasis (TNM) data collection and other critical staging information. Tier 2 (registry-derived stage) relies on supplementary data, including hospital admission data, to make assumptions based on data availability. Tier 3 (pathology stage) solely uses pathology reports. FINDINGS: The tiered framework promotes flexible utilisation of staging data, recognising various levels of data completeness. Tier 1 is suitable for all purposes, including clinical and epidemiological applications. Tiers 2 and 3 are recommended for epidemiological analysis alone. Lower tiers provide valuable insights into disease patterns, risk factors, and overall disease burden for public health planning and policy decisions. Capture of staging at each tier depends on data availability, with potential shifts to higher tiers as new data sources are acquired. CONCLUSIONS: The tiered framework offers a dynamic approach for PBCRs to record stage at diagnosis, promoting consistency in population-level staging data and enabling practical use for benchmarking across jurisdictions, public health planning, policy development, epidemiological analyses, and assessing cancer outcomes. Evolution with staging classifications and data variable changes will futureproof the tiered framework. Its adaptability fosters continuous refinement of data collection processes and encourages improvements in data quality.


Assuntos
Estadiamento de Neoplasias , Neoplasias , Sistema de Registros , Humanos , Austrália Ocidental/epidemiologia , Neoplasias/patologia , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Coleta de Dados/métodos , Coleta de Dados/normas , Benchmarking
9.
Pharmacoepidemiol Drug Saf ; 33(6): e5845, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38825961

RESUMO

PURPOSE: Medications are commonly used during pregnancy to manage pre-existing conditions and conditions that arise during pregnancy. However, not all medications are safe to use in pregnancy. This study utilized privacy-preserving record linkage (PPRL) to examine medications dispensed under the national Pharmaceutical Benefits Scheme (PBS) to pregnant women in Western Australia (WA) overall and by medication safety category. METHODS: In this retrospective, cross-sectional, population-based study, state perinatal records (Midwives Notification Scheme) were linked with national PBS dispensing data using PPRL. Live and stillborn neonates born between 2012 and 2019 in WA were included. The proportion of pregnancies during which the mother was dispensed a PBS medication was calculated, overall and by medication safety category. Factors associated with PBS medication dispensing were examined using logistic regression. RESULTS: PPRL linkage identified matching records for 97.4% of women with perinatal records. A total of 271 739 pregnancies were identified, with 158 585 (58.4%) pregnancies involving the dispensing of at least one PBS medication. Category A medications (those considered safe in pregnancy) were the most commonly dispensed (n = 119 126, 43.8%) followed by B3 (n = 51 135, 18.8%) and B1 (n = 42 388, 15.6%) medication (those with unknown safety). Over the study period, the dispensing of PBS medications in pregnancy increased (OR: 1.06, 95%CI: 1.06, 1.07). The strongest predictor of medication dispensing in pregnancy was pre-pregnancy dispensing (OR: 3.61, 95%CI: 3.54, 3.68). Other factors associated with medication use in pregnancy were smoking, older maternal age, obesity, and prior pregnancies. CONCLUSION: Privacy preserving record linkage provides a way to link cross-jurisdictional data while preserving patient confidentiality and data security. The dispensing of PBS medication in pregnancy was common and increased over time, with approximately 60% of women dispensed at least one medication during pregnancy.


Assuntos
Registro Médico Coordenado , Humanos , Feminino , Gravidez , Austrália Ocidental , Estudos Retrospectivos , Adulto , Estudos Transversais , Adulto Jovem , Seguro de Serviços Farmacêuticos/estatística & dados numéricos , Adolescente , Recém-Nascido
10.
Int Ophthalmol ; 44(1): 280, 2024 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-38922477

RESUMO

PURPOSE: The purpose of this study was to analyse the contamination rate of corneal samples stored in OCM at Lions Eye Bank of Western Australia over a 12-year period. METHODS: All OCM samples used to preserve corneas from 2011 to 2022 (inclusive) underwent microbiological testing. Samples were collected into aerobic and anaerobic culture bottles on day 3-5 of corneal preservation and 24 h after transfer to thinning medium. Samples were tested for 7 days using the BACTEC FX system. Corneas remained in quarantine until clearance was obtained. RESULTS: From 2011 to 2022, 3009 corneas were retrieved and 2756 corneas were stored in OCM. Thirty one (1.1%) positive samples were reported, with 20 growths of bacterial origin and 11 fungal. Microbial contamination was mostly identified on day 1 of culture (77.5%). Donors of contaminated samples had a mean age of 55 years, with 17 male and 14 female donors. The highest incidence of contamination came from donors whose cause of death was cancer. Death to enucleation times of contaminated samples ranged from 3.5 to 25.5 h (mean = 13.5 ± 7.3) and death to preservation time ranged from 4.1 to 27.5 h (mean = 14.8 ± 7.2). These did not significantly differ from the average time from death to enucleation (mean = 13.9 ± 3) and death to preservation (mean = 16.3 ± 4.2) of non-contaminated samples. CONCLUSION: Microbiological screening of corneas stored in OCM at LEBWA showed a very low rate of positive cultures with no predictive donor characteristics.


Assuntos
Bactérias , Córnea , Bancos de Olhos , Preservação de Órgãos , Doadores de Tecidos , Bancos de Olhos/estatística & dados numéricos , Humanos , Córnea/microbiologia , Feminino , Masculino , Pessoa de Meia-Idade , Austrália Ocidental/epidemiologia , Preservação de Órgãos/métodos , Doadores de Tecidos/estatística & dados numéricos , Adulto , Idoso , Bactérias/isolamento & purificação , Técnicas de Cultura de Órgãos , Transplante de Córnea , Idoso de 80 Anos ou mais , Estudos Retrospectivos , Fungos/isolamento & purificação , Adulto Jovem
11.
Proc Natl Acad Sci U S A ; 121(25): e2305948121, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38857400

RESUMO

For over a century, the evolution of animal play has sparked scientific curiosity. The prevalence of social play in juvenile mammals suggests that play is a beneficial behavior, potentially contributing to individual fitness. Yet evidence from wild animals supporting the long-hypothesized link between juvenile social play, adult behavior, and fitness remains limited. In Western Australia, adult male bottlenose dolphins (Tursiops aduncus) form multilevel alliances that are crucial for their reproductive success. A key adult mating behavior involves allied males using joint action to herd individual females. Juveniles of both sexes invest significant time in play that resembles adult herding-taking turns in mature male (actor) and female (receiver) roles. Using a 32-y dataset of individual-level association patterns, paternity success, and behavioral observations, we show that juvenile males with stronger social bonds are significantly more likely to engage in joint action when play-herding in actor roles. Juvenile males also monopolized the actor role and produced an adult male herding vocalization ("pops") when playing with females. Notably, males who spent more time playing in the actor role as juveniles achieved more paternities as adults. These findings not only reveal that play behavior provides male dolphins with mating skill practice years before they sexually mature but also demonstrate in a wild animal population that juvenile social play predicts adult reproductive success.


Assuntos
Golfinho Nariz-de-Garrafa , Reprodução , Comportamento Sexual Animal , Comportamento Social , Animais , Masculino , Golfinho Nariz-de-Garrafa/fisiologia , Feminino , Reprodução/fisiologia , Comportamento Sexual Animal/fisiologia , Austrália Ocidental , Vocalização Animal/fisiologia , Jogos e Brinquedos
12.
Health Promot Int ; 39(3)2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38943525

RESUMO

Farming is a challenging, stressful and rewarding occupation involving many factors that are beyond farmers' control. The aim of this study was to investigate correlates associated with the anxiety, depression and stress of farmers in Western Australia. Farmers and farm residents (N = 124) completed an online survey assessing anxiety, depression, stress, farming stressors, social supports, coping strategies and sense of belonging. Higher financial/external trade and societal pressures, family/relationship tension, use of coping strategies such as self-blame, venting, disengagement and planning, lack of succession planning and considering selling the farm, and lower social support and sense of belonging, were associated with higher anxiety, depression and/or stress. The findings highlight the specific impacts of financial and family pressures on poorer mental health status among farmers. Clinical and community interventions that build on naturally occurring strengths, such as family support and community connectedness, are needed.


Assuntos
Adaptação Psicológica , Ansiedade , Depressão , Fazendeiros , Apoio Social , Estresse Psicológico , Humanos , Masculino , Fazendeiros/psicologia , Feminino , Depressão/psicologia , Austrália Ocidental , Pessoa de Meia-Idade , Ansiedade/psicologia , Adulto , Estresse Psicológico/psicologia , Inquéritos e Questionários , Família/psicologia , Agricultura , Idoso
13.
Environ Monit Assess ; 196(7): 592, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38829468

RESUMO

Freshwater aquatic ecosystems are threatened globally. Biological monitoring is required to deliver rapid and replicable assessment of changes in habitat quality. The Ephemeroptera, Plectoptera, Trichoptera (EPT) index is a globally recognised rapid bioassessment that measures taxa richness of three insect orders whose larvae are considered sensitive to freshwater habitat degradation. South-western Australia contains threatened freshwater ecosystems but has depauperate EPT fauna and high endemism, potentially reducing the capacity of the EPT index to track degradation. This study investigated if EPT species richness, composition or individual species tracked physical or chemical river degradation in three catchments in south-western Australia. We sampled EPT fauna and measured water chemistry, erosion, sedimentation, riparian vegetation cover and instream habitat at 98 sites in the winters of 2007 and 2023. We found 35 EPT taxa across the study area with a median number of species per site of two. EPT species richness had weak positive associations with a composite water quality index and dissolved oxygen and weak negative associations with electrical conductivity and total nitrogen. No association was found between physical and fringing zone degradation measures and EPT species richness. EPT community structure generally did not distinguish between sites with high or low degradation levels. The presence of the mayfly Nyungara bunni tracked salinity, dissolved oxygen and nitrogen levels, but its usefulness as a bioindicator could be limited by its restricted range. This study suggests that the EPT index would need modification or combination with other indices to be a useful rapid bioassessment in south-western Australia.


Assuntos
Biodiversidade , Ecossistema , Monitoramento Ambiental , Rios , Animais , Rios/química , Monitoramento Ambiental/métodos , Austrália Ocidental , Insetos , Ephemeroptera
14.
Proc Biol Sci ; 291(2024): 20240435, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38835280

RESUMO

Extensive research has investigated the relationship between the social environment and cognition, suggesting that social complexity may drive cognitive evolution and development. However, evidence for this relationship remains equivocal. Group size is often used as a measure of social complexity, but this may not capture intraspecific variation in social interactions. Social network analysis can provide insight into the cognitively demanding challenges associated with group living at the individual level. Here, we use social networks to investigate whether the cognitive performance of wild Western Australian magpies (Gymnorhina tibicen dorsalis) is related to group size and individual social connectedness. We quantified social connectedness using four interaction types: proximity, affiliative, agonistic and vocal. Consistent with previous research on this species, individuals in larger groups performed better on an associative learning task. However, social network position was also related to cognitive performance. Individuals receiving aggressive interactions performed better, while those involved in aggressive interactions with more group members performed worse. Overall, this suggests that cognitive performance is related to specific types of social interaction. The findings from this study highlight the value of considering fine-grained metrics of sociality that capture the challenges associated with social life when testing the relationship between the social environment and cognition.


Assuntos
Agressão , Cognição , Comportamento Social , Animais , Austrália Ocidental , Masculino , Passeriformes/fisiologia , Feminino
15.
BMC Public Health ; 24(1): 1514, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840254

RESUMO

BACKGROUND: Mandates provide a relatively cost-effective strategy to increase vaccinate rates. Since 2014, five Australian states have implemented No Jab No Play (NJPlay) policies that require children to be fully immunised to attend early childhood education and childcare services. In Western Australia, where this study was conducted, NJNPlay legislation was enacted in 2019. While most Australian families support vaccine mandates, there are a range of complexities and unintended consequences for some families. This research explores the impact on families of the NJNPlay legislation in Western Australia (WA). METHODS: This mixed-methods study used an online parent/carer survey (n = 261) representing 427 children and in-depth interviews (n = 18) to investigate: (1) the influence of the NJNPlay legislation on decision to vaccinate; and (2) the financial and emotional impacts of NJNPlay legislation. Descriptive and bivariate tests were used to analyse the survey data and open-ended questions and interviews were analysed using reflexive thematic analysis to capture the experience and the reality of participants. RESULTS: Approximately 60% of parents intended to vaccinate their child. Parents who had decided not to vaccinate their child/ren were significantly more likely to experience financial [p < 0.001] and emotional impacts [p < 0.001], compared to those who chose to vaccinate because of the mandate. Qualitative data were divided with around half of participants supporting childhood immunisation and NJNPlay with others discussing concerns. The themes (a) belief in the importance of vaccination and ease of access, (b) individual and community protection, and (c) vaccine effectiveness, safety and alternatives help understand how parents' beliefs and access may influence vaccination uptake. Unintended impacts of NJNPlay included: (a) lack of choice, pressure and coercion to vaccinate; (b) policy and community level stigma and discrimination; (c) financial and career impacts; and (d) loss of education opportunities. CONCLUSIONS: Parents appreciation of funded immunisation programs and mandates which enhance individual and community protection was evident. However for others unintended consequences of the mandate resulted in significant social, emotional, financial and educational impacts. Long-term evidence highlights the positive impact of immunisation programs. Opinions of impacted families should be considered to alleviate mental health stressors.


Assuntos
Pais , Humanos , Austrália Ocidental , Pais/psicologia , Feminino , Masculino , Adulto , Pré-Escolar , Inquéritos e Questionários , Pesquisa Qualitativa , Criança , Vacinação/legislação & jurisprudência , Vacinação/psicologia , Vacinação/estatística & dados numéricos , Lactente , Pessoa de Meia-Idade
16.
Health Promot Int ; 39(3)2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38902981

RESUMO

This research aimed to inform approaches to increase access to secure housing and improve mental health outcomes for migrants from culturally and linguistically diverse backgrounds (hereafter migrants) who are generally invisible in health and social policy and service provision in Western Australia. We used semi-structured, in-depth interviews (n = 11) and interpretative phenomenological analysis to explore service provider experiences and perspectives of issues impacting service provision and the needs of migrants in this context. Five superordinate themes reveal complex experiences for both service providers and the migrants with whom they work. Findings reflect tensions between contemporary notions of choice and control and a social service system that is difficult to navigate, reflects systemic racism and appears to rely heavily on the non-government sector. Insights have important and practical implications for health promotion policy, practice and research. Recommendations include improvements to housing access, provision, funding and policies; addressing service barriers via staff training and more accessible community resources; and co-design and community outreach approaches.


Assuntos
Habitação , Entrevistas como Assunto , Humanos , Austrália Ocidental , Feminino , Masculino , Migrantes/psicologia , Pesquisa Qualitativa , Acessibilidade aos Serviços de Saúde , Promoção da Saúde/métodos , Adulto , Racismo
17.
Int J Colorectal Dis ; 39(1): 91, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38867089

RESUMO

PURPOSE: Surgery wait times after diagnosis of appendicitis are an important factor influencing the success of a patient's treatment. The proposed study will be a quantitative multicenter retrospective cohort design with the primary aim of assessing the difference between appendicectomy wait times between rural and urban hospitals in Western Australia and the effect of this on operative outcomes. Selected outcome measures will be examined by time from initial presentation at an emergency department to the patient being diagnosed and then time of diagnosis to surgery being performed. The secondary aim is to compare rates of negative appendicectomies between hospitals. METHODS: Appendicectomy patients will be identified from operating room register by medical student data collectors; then, each respective hospital's emergency room data collection will subsequently be accessed to complete case report forms based on demographics and clinical findings, pre-operative investigations, and management and follow-up. Case report forms with > 95% completeness will be accepted for pooled analysis. The expected duration of retrospective data collection will be 8 months. This study RGS6483 has received HREC approval by the Royal Perth Hospital HREC Ethics Committee, with a waiver of consent obtained and the HREC was notified of amendments to the protocol made on April 21, 2024. Dissemination of results. Data will be collected and stored online through a secure server running the Research Electronic Data Capture (REDCap) web application. No patient-identifiable data will be entered into the system. Results will subsequently be shared via scientific journal publication and presentation at relevant meetings.


Assuntos
Apendicectomia , Humanos , Apendicectomia/estatística & dados numéricos , Austrália Ocidental , Resultado do Tratamento , Apendicite/cirurgia , Geografia , Listas de Espera , Fatores de Tempo , Tempo para o Tratamento/estatística & dados numéricos , População Rural/estatística & dados numéricos , Hospitais Urbanos/estatística & dados numéricos , Estudos Retrospectivos
18.
Br J Anaesth ; 133(2): 334-343, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38702238

RESUMO

BACKGROUND: Recent studies report conflicting results regarding the relationship between labour epidural analgesia (LEA) in mothers and neurodevelopmental disorders in their offspring. We evaluated behavioural and neuropsychological test scores in children of mothers who used LEA. METHODS: Children enrolled in the Raine Study from Western Australia and delivered vaginally from a singleton pregnancy between 1989 and 1992 were evaluated. Children exposed to LEA were compared with unexposed children. The primary outcome was the parent-reported Child Behaviour Checklist (CBCL) reporting total, internalising, and externalising behavioural problem scores at age 10 yr. Score differences, an increased risk of clinical deficit, and a dose-response based on the duration of LEA exposure were assessed. Secondary outcomes included language, motor function, cognition, and autistic traits. RESULTS: Of 2180 children, 850 (39.0%) were exposed to LEA. After adjustment for covariates, exposed children had minimally increased CBCL total scores (+1.41 points; 95% confidence interval [CI] 0.09 to 2.73; P=0.037), but not internalising (+1.13 points; 95% CI -0.08 to 2.34; P=0.066) or externalising (+1.08 points; 95% CI -0.08 to 2.24; P=0.068) subscale subscores. Increased risk of clinical deficit was not observed for any CBCL score. For secondary outcomes, score differences were inconsistently observed in motor function and cognition. Increased exposure duration was not associated with worse scores in any outcomes. CONCLUSIONS: Although LEA exposure was associated with slightly higher total behavioural scores, there was no difference in subscores, increased risk of clinical deficits, or dose-response relationship. These results argue against LEA exposure being associated with consistent, clinically significant neurodevelopmental deficits in children.


Assuntos
Analgesia Epidural , Testes Neuropsicológicos , Efeitos Tardios da Exposição Pré-Natal , Humanos , Feminino , Gravidez , Analgesia Epidural/efeitos adversos , Criança , Masculino , Analgesia Obstétrica/efeitos adversos , Analgesia Obstétrica/métodos , Adulto , Austrália Ocidental/epidemiologia , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/etiologia , Comportamento Infantil/efeitos dos fármacos , Pré-Escolar , Transtornos do Neurodesenvolvimento/epidemiologia
19.
Burns ; 50(6): 1536-1543, 2024 08.
Artigo em Inglês | MEDLINE | ID: mdl-38705776

RESUMO

BACKGROUND: The hypermetabolic response after a burn predisposes patients to hypothermia due to dysfunction of thermoregulation. Traditionally, hypothermia is avoided actively in burn care due to reported complications associated with low body temperature. The likelihood of hypothermia with acute burn surgery is compounded by general anesthesia, exposure of wound areas and prolonged operation times. However, we find limited studies exploring the effects of perioperative hypothermia on length of stay in the adult burn population. OBJECTIVE: To determine associations between postoperative hypothermia and hospital length of stay in adult burns patients. METHOD: This retrospective cohort study involved patients admitted to the State Adult Burn Unit in Western Australia between 1st January 2015 to 28th February 2021. All adults who underwent surgery for acute burn, and had postoperative recovery room body temperature recorded, were included in the study. In this study, we defined normothermia as >36.5C and hypothermia as < 36.0 °C with mild, moderate, and severe hypothermia being 35.0-35.9 °C, 34.0-34.9 °C and < 34.0 °C, respectively. Patients with hyperthermia were excluded. Multivariable general linear models explored if hypothermia was independently associated with length of stay. RESULTS: Among 1486 adult patients, 1338 (90%) were normothermic postoperatively, with temperatures >36.0C. We included 148 (10%) patients with hypothermia (temperature <36.0 °C) postoperatively. Most burns in the study population were minor: 96% had burns < 15% TBSA. Data modelling demonstrated that hypothermia was associated with a shorter length of hospital stay (coefficient = -0.129, p = 0.041). CONCLUSION: In adult acute burn patients, postoperative hypothermia was associated with reduced length of stay after surgery. The positive results of this study indicate that a review of the core temperature targets with acute burn surgery, and timing of burn patient cooling practices in general is warranted.


Assuntos
Queimaduras , Hipotermia , Tempo de Internação , Complicações Pós-Operatórias , Humanos , Queimaduras/cirurgia , Hipotermia/epidemiologia , Hipotermia/etiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Feminino , Adulto , Estudos Retrospectivos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Sobreviventes/estatística & dados numéricos , Idoso , Austrália Ocidental/epidemiologia , Temperatura Corporal , Estudos de Coortes , Adulto Jovem , Modelos Lineares
20.
Cancer Epidemiol ; 90: 102580, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38701695

RESUMO

BACKGROUND: Evidence is emerging that melanoma has distinct aetiologic pathways and subtypes, characterized by factors like anatomic site of the tumour. To explore genetic influences on anatomic subtypes, we examined the extent to which melanomas in first-degree relatives shared the same body site of occurrence. METHODS: Population-level linked data was used to identify the study population of over 1.5 million individuals born in Western Australia between 1945 and 2014, and their first-degree relatives. There were 1009 pairs of invasive tumours from 677 family pairs, each categorised by anatomic site. Greater than expected representation of site-concordant pairs would suggest the presence of genetic factors that predispose individuals to site-specific melanoma. RESULTS: Comparing observed versus expected totals, we observed a modest increase in site concordance for invasive head/neck and truncal tumours (P=0.02). A corresponding analysis including in situ tumours showed a similar concordance (P=0.05). No further evidence of concordance was observed when stratified by sex. CONCLUSION: In conclusion, modest evidence of aggregation was observed but with inconsistent patterns between sites. Results suggest that further investigation into the familial aggregation of melanoma by tumour site is warranted, with the inclusion of genetic data in order to disentangle the relative contributions of genetic and environmental factors.


Assuntos
Melanoma , Neoplasias Cutâneas , Humanos , Melanoma/genética , Melanoma/epidemiologia , Melanoma/patologia , Feminino , Masculino , Austrália Ocidental/epidemiologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Pessoa de Meia-Idade , Adulto , Predisposição Genética para Doença , Família , Idoso
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