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1.
Artigo em Inglês | MEDLINE | ID: mdl-32664828

RESUMO

Notified cases of COVID-19 and associated deaths reported to the National Notifiable Diseases Surveillance System (NNDSS) to 5 July 2020. Cumulative confirmed cases in Australia notified up to 5 July 2020: notifications = 8,566, deaths = 106. Over the past fortnightly reporting period (22 June to 5 July), 897 cases were notified, with 4 deaths. The national incidence of COVID-19 remained low, with very few cases reported by most jurisdictions in this reporting period. The majority of the current cases reported over this fortnight are from Victoria, with an increasing number and proportion of cases reported as being locally acquired. Total case numbers have increased with an average of 54 cases reported on any one day, more than twice the average number reported in the previous reporting period. The number and proportion of deaths associated with COVID-19 remains low and it appears that vulnerable populations have not been disproportionately affected by COVID-19 overall. Testing rates continue to be high across all jurisdictions, with the nationwide positivity rate remaining very low at less than 0.3%. In this reporting period, the number of cases reported nationally has increased from 214 (8 June to 21 June) to 897 (22 June to 5 July). Of the cases notified in this reporting period, 87% (781 cases) were notified from Victoria and 89% of these cases were acquired locally. Of the remaining 116 cases reported from other jurisdictions only 6% were locally acquired. The increase in Victoria is attributable to multiple epidemiologically linked outbreaks across a range of settings and locations. A small proportion of cases have experienced severe disease, requiring hospitalisation or intensive care, with some fatalities. The crude case fatality rate amongst Australian cases is 1.2%. People who are older and have one or more comorbidities are more likely to experience severe disease.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Betacoronavirus/isolamento & purificação , Criança , Pré-Escolar , Técnicas de Laboratório Clínico , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Prevalência , Viagem , Vitória/epidemiologia , Adulto Jovem
2.
Am Surg ; 86(6): 591-595, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32683969

RESUMO

An informal workgroup of 9 hepatopancreaticobiliary (HPB) surgeons from 6 different countries on 4 continents shifted the focus of their quarterly tumor board discussions to their responses to the current COVID-19 pandemic. Just as they had discussing HPB cases, they share their experiences and ideas in dealing with the outbreak that faced their hospitals and communities. Their efforts to improve care proved that professionalism in surgery, like the global pandemic, has no boundaries.


Assuntos
Infecções por Coronavirus/terapia , Pandemias , Papel do Médico , Pneumonia Viral/terapia , Cirurgiões , Austrália/epidemiologia , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Cuidados Críticos , Procedimentos Cirúrgicos Eletivos , Inglaterra/epidemiologia , Gastroenterologia , Humanos , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Mianmar/epidemiologia , Nepal/epidemiologia , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Isolamento Social , Sri Lanka/epidemiologia , Texas/epidemiologia
3.
Subst Abus ; 41(3): 269-274, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32697171

RESUMO

Medications for opioid use disorder (MOUD), such as methadone and buprenorphine, are effective strategies for treatment of opioid use disorder (OUD) and reducing overdose risk. MOUD treatment rates continue to be low across the US, and currently, some evidence suggests access to evidence-based treatment is becoming increasingly difficult for those with OUD as a result of the 2019 novel corona virus (COVID-19). A major underutilized source to address these serious challenges in the US is community pharmacy given the specialized training of pharmacists, high levels of consumer trust, and general availability for accessing these service settings. Canadian, Australian, and European pharmacists have made important contributions to the treatment and care of those with OUD over the past decades. Unfortunately, US pharmacists are not permitted to prescribe MOUD and are only currently allowed to dispense methadone for the treatment of pain, not OUD. US policymakers, regulators, and practitioners must work to facilitate this advancement of community pharmacy-based through research, education, practice, and industry. Advancing community pharmacy-based MOUD for leading clinical management of OUD and dispensation of treatment medications will afford the US a critical innovation for addressing the opioid epidemic, fallout from COVID-19, and getting individuals the care they need.


Assuntos
Analgésicos Opioides/uso terapêutico , Serviços Comunitários de Farmácia , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Farmacêuticos , Âmbito da Prática , Austrália , Betacoronavirus , Buprenorfina/uso terapêutico , Canadá , Infecções por Coronavirus , Assistência à Saúde , Acesso aos Serviços de Saúde , Humanos , Metadona/uso terapêutico , Pandemias , Pneumonia Viral , Reino Unido , Estados Unidos
4.
J Environ Manage ; 270: 110795, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32721290

RESUMO

The role of cyanobacteria from soil biocrusts in restoring degraded land is gaining interest in recent years because of their critical role in enhancing soil fertility and preventing erosion. However, soil restoration through cyanobacterial inoculation remains a challenge for large-scale restoration efforts and new methodologies for effective cyanobacterial application need to be developed. Here, we propose a bioenvironmental approach to inoculate soils with pelletized cyanobacteria from soil biocrusts. Fresh cultures of three soil native cyanobacteria strains from two representative N-fixing genera (Nostoc and Scytonema) and a non-heterocystous filamentous genus (Leptolyngbya) were added into a substrate composed of commercial bentonite powder and sand (1:10 wt ratio) and extruded into pellets. Then, in two multifactorial microcosm experiments under glasshouse conditions, we evaluated (i) the survival and establishment over time of the cyanobacteria encapsulated in pellets, and ii) the viability of pelletized cyanobacteria after drying and storing for 30 d, on soils from three arid regions in Australia. Our results showed that pellets can dissolve completely and spread out in all treatments. Scytonema and the consortium of the three cyanobacteria species showed significant (P < 0.001) deeper CR680 peaks, higher chlorophyll a contents and lower albedo compared to the other inoculation treatments. Storing the pellets for 30 d significantly affected the viability of the cyanobacteria inoculum with reductions of approximately 50% in chlorophyll a content (a proxy for cyanobacteria biomass). Overall, our results showed that some cyanobacteria species can be successfully incorporated into extruded pellets and survive on degraded soils. This technology opens a wide range of opportunities for application in large scale restoration programs although further testing and refining through field trials is recommended.


Assuntos
Cianobactérias , Microbiologia do Solo , Austrália , Clorofila A , Clima Desértico , Ecossistema , Solo
7.
Public Health Res Pract ; 30(2)2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32601650

RESUMO

Although there has been consistent evidence indicating that school closures have only limited efficacy in reducing community transmission of coronavirus disease 2019 (COVID-19), the question of whether children should be kept home from school has attracted extensive and often divisive public debate in Australia. In this article we analyse the factors that drove high levels of concern among parents, teachers and the public and led to both demands for school closures in late March 2020, and to many parents' reluctance to return their children to school in May 2020. We discuss how the use of well-established principles of risk communication might have reduced much of this community concern. Then we set out a range of practical suggestions for communication practices that build trust and hence diminish concerns in relation to managing schools over the long term of the COVID-19 pandemic.


Assuntos
Relações Comunidade-Instituição , Infecções por Coronavirus/psicologia , Pais/psicologia , Pneumonia Viral/psicologia , Instituições Acadêmicas/organização & administração , Austrália , Criança , Infecções por Coronavirus/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Humanos , Pandemias , Relações Pais-Filho , Pneumonia Viral/epidemiologia , Prática de Saúde Pública/normas
8.
Public Health Res Pract ; 30(2)2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32601651

RESUMO

The effects of the coronavirus disease 2019 (COVID-19) pandemic upon human health, economic activity and social engagement have been swift and far reaching. Emerging evidence shows that the pandemic has had dramatic mental health impacts, bringing about increased anxiety and greater social isolation due to the physical distancing policies introduced to control the disease. In this context, it is possible to more deeply appreciate the health consequences of loneliness and social isolation, which researchers have argued are enduring experiences for many people and under-recognised contributors to public health. In this paper, we examine the social and psychological consequences of the COVID-19 pandemic, with a focus on what this has revealed about the need to better understand and respond to social isolation and loneliness as public health priorities. Social isolation and loneliness are understood to be distinct conditions, yet each has been found to predict premature mortality, depression, cardiovascular disease and cognitive decline. Estimates of the prevalence and distribution of social isolation and loneliness vary, possibly ranging from one-in-six to one-in-four people, and the lack of knowledge about the extent of these conditions indicates the need for population monitoring using standardised methods and validated measures. Reviews of the evidence relating to social isolation and loneliness interventions have found that befriending schemes, individual and group therapies, various shared activity programs, social prescription by healthcare providers, and diverse strategies using information and communication technologies have been tried. There remains uncertainty about what is effective for different population groups, particularly for prevention and for addressing the more complex condition of loneliness. In Australia, a national coalition - Ending Loneliness Together - has been established to bring together researchers and service providers to facilitate evidence gathering and the mobilisation of knowledge into practice. Research-practice partnerships and cross-disciplinary collaborations of this sort are essential for overcoming the public health problems of loneliness and social isolation that have pre-existed and will endure beyond the COVID-19 pandemic.


Assuntos
Redes Comunitárias , Infecções por Coronavirus/psicologia , Solidão/psicologia , Pneumonia Viral/psicologia , Quarentena/psicologia , Isolamento Social/psicologia , Austrália , Humanos , Saúde Mental , Pandemias , Autoeficácia , Apoio Social
9.
Public Health Res Pract ; 30(2)2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32601652

RESUMO

OBJECTIVES: Our objective is to assess the potential contribution of the Australian Government's mobile smartphone tracing app (COVIDSafe) to the sustained control of coronavirus disease 2019 (COVID-19). STUDY TYPE: Development and analysis of a system dynamics model. METHODS: To define the pandemic context and specify model-building parameters, we searched for literature on COVID-19, its epidemiology in Australia, case finding processes, and factors that might affect community acceptance of the COVIDSafe smartphone app for contact tracing. We then developed a system dynamics model of COVID-19 based on a modified susceptible-exposed-infected-recovered compartmental model structure, using initial pandemic data and published information on virus behaviour to determine parameter values. We applied the model to examine factors influencing the projected trends: the extent of viral testing, community participation in social distancing, and the level of uptake of the COVIDSafe app. RESULTS: Modelling suggests that a second COVID-19 wave will occur if social distancing declines (i.e. if the average number of contacts made by each individual each day increases) and the rate of testing declines. The timing and size of the second wave will depend on the rate of decrease in social distancing and the decline in testing rates. At the app uptake level of approximately 27% (current at 20 May 2020), with a monthly 50% reduction in social distancing (i.e. the average number of contacts per day doubling every 30 days until they reach pre-social distancing rates) and a 5% decline in testing, the app would reduce the projected total number of new cases during April-December 2020 by one-quarter. If uptake reaches the possible maximum of 61%, the reduction could be more than half. CONCLUSIONS: Maintenance of a large-scale testing regimen for COVID-19 and widespread community practice of social distancing are vital. The COVIDSafe smartphone app has the potential to be an important adjunct to testing and social distancing. Depending on the level of community uptake of the app, it could have a significant mitigating effect on a second wave of COVID-19 in Australia.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Smartphone/estatística & dados numéricos , Austrália , Infecções por Coronavirus/diagnóstico , Humanos , Relações Interpessoais , Aplicativos Móveis/estatística & dados numéricos , Modelos Teóricos , Pneumonia Viral/diagnóstico , Saúde Pública , Medição de Risco , Distância Social
10.
Artigo em Inglês | MEDLINE | ID: mdl-32600222

RESUMO

Notified cases of COVID-19 and associated deaths reported to the National Notifiable Diseases Surveillance System (NNDSS) to 21 June 2020. Confirmed cases in Australia notified up to 7 June 2020: notifications = 7,491; deaths = 102. The incidence of COVID-19 has markedly reduced since a peak in mid-March. A combination of early case identification, physical distancing, public health measures and a reduction in international travel have been effective in slowing the spread of disease in Australia. Of the 215 cases notified between 8 and 21 June, 75% (163 cases) were notified from Victoria. Most of these cases were acquired locally. In contrast, cases notified from other states (NSW, Qld and WA) over this period were mostly overseas-acquired. Of locally-acquired cases in Victoria in this period, 51% were associated with contacts of a confirmed case or in a known outbreak, while 49% were unable to be linked to another case or were under investigation at the time of reporting. There are several clusters across a range of settings, including extended families, hotel quarantine facilities and a retail store, with most cases limited in geographic spread to a number of Local Government Areas around Melbourne. In response, the Victorian Government has re-introduced restrictions for household and outdoor gatherings, has delayed plans to ease other restrictions and has implemented enhanced public health response activities, particularly with regard to testing and contact tracing. A small proportion of overall cases have experienced severe disease, requiring hospitalisation or intensive care, with some fatalities. The crude case fatality rate amongst Australian cases is 1.4%. People who are older and have one or more comorbidities are more likely to experience severe disease. The highest rate of COVID-19 continues to be among people aged 65-79 years. Three-quarters of all cases in this age group have been associated with overseas travel, including several outbreaks linked to cruise ships. The lowest rate of disease is in children under 18 years, a pattern reflected in international reports. Internationally, as of 21 June 2020, the largest numbers of both cases and deaths have been reported in the United States. Of the confirmed cases reported globally, the case fatality rate is approximately 5.3%. Other countries in the Americas region, such as Brazil and Chile, are seeing rapid growth in case numbers. Case numbers in Europe remain relatively steady, while there is significant growth in the South East Asia region, including in India and Bangladesh. Reported cases are increasing in Africa, although the numbers are much smaller. In the Pacific region there are few new cases reported daily.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Betacoronavirus/isolamento & purificação , Criança , Pré-Escolar , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Monitoramento Epidemiológico , Hospitalização/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Vigilância da População , Quarentena/legislação & jurisprudência , Vitória/epidemiologia , Adulto Jovem
11.
J Ment Health Policy Econ ; 23(2): 55-60, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32621725

RESUMO

BACKGROUND: The approach to care for persons with an acute illness is different from that for a person with a chronic disease. Whilst the goal of treatment for an acute illness is to cure the disease, a chronic condition has no cure as such, and hence management requires a team approach that is aimed at achieving goals that are jointly set by service users and providers. Severe and persistent mental illness (SPMI) is a chronic disease. However, in many mental health services, the approach to care for persons with SPMI is similar to those who have an acute mental illness. AIM: The aims of this paper are twofold: (i) to make an argument for recovery oriented services to focus on meeting clients' needs rather than on symptom reduction, (ii) to propose a model of service provision where clinical mental health services form a part rather than the mainstay of care for people with SPMI. RESULTS: Using examples from Australia's Partner's in Recovery initiative and other recovery literature, we start by describing how SPMI should be treated as a chronic disease that focuses on recovery. We then highlight how mental health services continue to monitor outcomes based on clinical rather than personal recovery. Next, we diagrammatically illustrate how needs can be aligned with the recovery process and illustrate how care coordination can be the hub of service delivery in a hub and spoke model. We conclude with comments on workforce requirements and costs of a needs-based recovery oriented service. DISCUSSION: In a needs based model, the role of the specialist mental health service will move from being at the centre of care to being one of the components of care and the role of the care coordinator will become central. Although, there are as yet no randomised controlled trials to show that meeting needs of persons with SPMI will significantly contribute to their recovery, preliminary studies show that it is possible. IMPLICATIONS FOR HEALTHCARE PROVISION AND USE: The role of the care coordinator becomes the hub of service provision collaborating with agencies such as family practices, specialist mental health services, legal, housing, employment, education, and community services. IMPLICATIONS FOR HEALTH POLICIES: A shift from the current model of care to a needs based approach requires a revolutionary change in the way we do business and will have to be the largest shake up of the mental health service system since deinstitutionalisation. IMPLICATIONS FOR FURTHER RESEARCH: It is a long journey from the status quo to a needs based approach. The first step would be to gather more evidence on the usefulness of addressing people's needs in achieving recovery.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Transtornos Mentais/reabilitação , Serviços de Saúde Mental/organização & administração , Equipe de Assistência ao Paciente , Austrália , Doença Crônica , Comportamento Cooperativo , Habitação , Humanos , Transtornos Mentais/psicologia
13.
Euro Surveill ; 25(25)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32613939

RESUMO

Sentinel surveillance of acute hospitalisations in response to infectious disease emergencies such as the 2009 influenza A(H1N1)pdm09 pandemic is well described, but recognition of its potential to supplement routine public health surveillance and provide scalability for emergency responses has been limited. We summarise the achievements of two national paediatric hospital surveillance networks relevant to vaccine programmes and emerging infectious diseases in Canada (Canadian Immunization Monitoring Program Active; IMPACT from 1991) and Australia (Paediatric Active Enhanced Disease Surveillance; PAEDS from 2007) and discuss opportunities and challenges in applying their model to other contexts. Both networks were established to enhance capacity to measure vaccine preventable disease burden, vaccine programme impact, and safety, with their scope occasionally being increased with emerging infectious diseases' surveillance. Their active surveillance has increased data accuracy and utility for syndromic conditions (e.g. encephalitis), pathogen-specific diseases (e.g. pertussis, rotavirus, influenza), and adverse events following immunisation (e.g. febrile seizure), enabled correlation of biological specimens with clinical context and supported responses to emerging infections (e.g. pandemic influenza, parechovirus, COVID-19). The demonstrated long-term value of continuous, rather than incident-related, operation of these networks in strengthening routine surveillance, bridging research gaps, and providing scalable public health response, supports their applicability to other countries.


Assuntos
Hospitais Pediátricos/estatística & dados numéricos , Programas de Imunização/normas , Admissão do Paciente/estatística & dados numéricos , Vigilância da População/métodos , Vacinação/efeitos adversos , Vacinas/administração & dosagem , Austrália/epidemiologia , Canadá/epidemiologia , Criança , Pré-Escolar , Confiabilidade dos Dados , Política de Saúde , Hospitalização/estatística & dados numéricos , Humanos , Programas Nacionais de Saúde/normas , Vigilância em Saúde Pública , Vacinação/estatística & dados numéricos
14.
BMC Public Health ; 20(1): 1038, 2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32605547

RESUMO

BACKGROUND: Institutions are a recommended setting for dietary interventions and nutrition policies as these provide an opportunity to improve health by creating healthy food environments. In Australia, state and territory governments encourage or mandate institutions in their jurisdiction to adopt nutrition policies. However, no work has analysed the policy design across settings and jurisdictions. This study aimed to compare the design and components of government-led institutional nutrition policies between Australian states and territories, determine gaps in existing policies, and assess the potential for developing stronger, more comprehensive policies. METHODS: Government-led institutional nutrition policies, in schools, workplaces, health facilities and other public settings, were identified by searching health and education department websites for each Australian state and territory government. This was supplemented by data from other relevant stakeholder websites and from the Food Policy Index Australia website. A framework for monitoring and evaluating nutrition policies in publicly-funded institutions was used to extract data and a qualitative analysis of the design and content of institutional nutrition policies was performed. Comparative analyses between the jurisdictions and institution types were conducted, and policies were assessed for comprehensiveness. RESULTS: Twenty-seven institutional nutrition policies were identified across eight states and territories in Australia. Most policies in health facilities and public schools were mandatory, though most workplace policies were voluntary. Twenty-four included nutrient criteria, and 22 included guidelines for catering/fundraising/advertising. While most included implementation guides or tools and additional supporting resources, less than half included tools/timelines for monitoring and evaluation. The policy design, components and nutrient criteria varied between jurisdictions and institution types, though all were based on the Australian Dietary Guidelines. CONCLUSIONS: Nutrition policies in institutions present an opportunity to create healthy eating environments and improve population health in Australia. However, the design of these policies, including lack of key components such as accountability mechanisms, and jurisdictional differences, may be a barrier to implementation and prevent the policies having their intended impact.


Assuntos
Governo , Política Nutricional , Austrália , Instalações de Saúde , Humanos , Pesquisa Qualitativa , Instituições Acadêmicas , Local de Trabalho
15.
BMC Public Health ; 20(1): 1037, 2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32605552

RESUMO

BACKGROUND: Australia, like other nations, has experienced a shift in dietary patterns away from home cooking of nutritious foods, towards a reliance on pre-prepared convenience meals. These are typically energy-dense, nutrient-poor and contribute to the rising prevalence of obesity and chronic disease burden. The aims of this study were to evaluate whether a community-based cooking program instigated a change to participants' skills, attitudes, knowledge, enjoyment and satisfaction of cooking and cooking confidence (self-efficacy). METHODS: The pseudo-random, pre-post study design consisted of an intervention and a control group. Participant recruitment and group allocation was based on their program start dates. Intervention participants were surveyed three times (baseline, 7 weeks and 6 months) and the control group were surveyed at baseline and 5 weeks. All participants were registered via an online website and were 18 years or over. Upon consent, participants were offered four levels of commitment, defined by different assessments. The minimum participation level included an online survey and levels 2, 3 and 4 involved attendance at a clinic with increasing functional, anthropometric and biomarker measurements. Primary endpoints were participants' cooking confidence as a proxy for self-efficacy. Secondary endpoints were dietary intake, physical activity levels, body composition, anthropometry, blood, urine and faecal biomarkers of systemic, physical and mental health. DISCUSSION: The community cooking program provided participants with information and advice on food sourcing, preparation and nutrition to improve home cooking skills. The study was designed to explore whether food literacy programs are efficacious in improving participant physical health and well-being in order to combat the rise in obesity and diet-related disease. It will support future use of public health cooking program initiatives aimed at improving food literacy, self-efficacy and physical and mental health. The extensive data collected will inform future research into the relationship between diet, the gut-microbiota and human health. TRIAL REGISTRATION: Retrospectively registered on 16.08.2019 with the Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12619001144101 . Protocol version 4.


Assuntos
Culinária , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Autoeficácia , Adulto , Austrália , Biomarcadores , Doença Crônica , Dieta/efeitos adversos , Dieta/estatística & dados numéricos , Feminino , Humanos , Estilo de Vida , Masculino , Obesidade/epidemiologia , Obesidade/prevenção & controle , Satisfação Pessoal , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa , Inquéritos e Questionários , Austrália Ocidental/epidemiologia
16.
Intern Med J ; 50(7): 798-804, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32656985

RESUMO

The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has emerged as a public health emergency and challenged healthcare systems globally. In a minority of patients, SARS-CoV-2 manifests with a severe acute respiratory illness and currently there is insufficient data regarding the virulence of COVID-19 in inflammatory bowel disease patients taking immunosuppressive therapy. This review aims to summarise the current literature and provide guidance on the management of inflammatory bowel disease patients in the context of the COVID-19 pandemic in the Australasian setting.


Assuntos
Infecções por Coronavirus , Gastroenterologia , Fatores Imunológicos/farmacologia , Doenças Inflamatórias Intestinais , Pandemias , Administração dos Cuidados ao Paciente , Pneumonia Viral , Austrália , Betacoronavirus/isolamento & purificação , Gestão de Mudança , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Gerenciamento Clínico , Gastroenterologia/organização & administração , Gastroenterologia/tendências , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/imunologia , Doenças Inflamatórias Intestinais/terapia , Pandemias/prevenção & controle , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/tendências , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Gestão de Riscos
18.
BMC Infect Dis ; 20(1): 486, 2020 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-32641070

RESUMO

BACKGROUND: Asymptomatic screening for gonorrhoea in heterosexual men is currently not recommended in many countries including Australia, given the prevalence is relatively low in the heterosexual population. We aimed to determine the proportion of urethral gonorrhoea cases among heterosexual men attending a sexual health clinic that was asymptomatic and symptomatic, the time since last sexual contact to the onset of symptoms and the time to clinic presentation following the onset of symptoms. METHODS: This was a cross-sectional study that included heterosexual men aged 16 years or above attending the Melbourne Sexual Health Centre (MSHC) in Australia between August 2017 and August 2018. Gonorrhoea cases were diagnosed by nucleic acid amplification testing (NAAT) and/or culture. Descriptive analyses were conducted for all gonorrhoea cases including demographic characteristics, recent sexual practices, reported urethral symptoms and duration, sexual contact with a person diagnosed with gonorrhoea, investigations performed and laboratory results. RESULTS: There were 116 confirmed cases of urethral gonorrhoea in heterosexual men over the study period of which 6.0% (95% CI: 2.7-12.1%) were asymptomatic. Typical urethral discharge was present in 80.2% (95% CI: 71.9-86.5%) of men. The mean time between last sexual contact and the onset of symptoms was 7.0 days, and between the onset of symptoms to presentation to the clinic was 5.6 days. CONCLUSIONS: A small proportion of heterosexual men with urethral gonorrhoea do not have any symptoms. Heterosexual men with urethral symptoms usually seek for healthcare within a week, prompting rapid healthcare-seeking behaviour.


Assuntos
Infecções Assintomáticas/epidemiologia , Gonorreia/diagnóstico , Gonorreia/epidemiologia , Heterossexualidade , Neisseria gonorrhoeae/genética , Saúde Sexual , Doenças Uretrais/diagnóstico , Doenças Uretrais/epidemiologia , Adolescente , Adulto , Austrália/epidemiologia , Estudos Transversais , Gonorreia/microbiologia , Gonorreia/fisiopatologia , Humanos , Masculino , Técnicas de Amplificação de Ácido Nucleico/métodos , Prevalência , Doenças Uretrais/microbiologia , Adulto Jovem
19.
J Laryngol Otol ; 134(6): 519-525, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32613920

RESUMO

OBJECTIVE: To present our data evaluating the feasibility of simultaneous cochlear implantation with resection of acoustic neuroma. METHODS: This paper describes a case series of eight adult patients with a radiologically suspected acoustic neuroma, treated at a tertiary referral centre in Newcastle, Australia, between 2012 and 2015. Patients underwent cochlear implantation concurrently with removal of an acoustic neuroma. The approach was translabyrinthine, with facial nerve monitoring and electrically evoked auditory brainstem response testing. Standard post-implant rehabilitation was employed, with three and six months' follow-up data collected. The main outcome measures were: hearing, subjective benefit of implant, operative complications and tumour recurrence. RESULTS: Eight patients underwent simultaneous cochlear implantation with resection of acoustic neuroma over a 3-year period, and had 25-63 months' follow up. There were no major complications. All patients except one gained usable hearing and were daily implant users. CONCLUSION: Simultaneous cochlear implantation with resection of acoustic neuroma has been shown to be a safe treatment option, which will be applicable in a wide range of clinical scenarios as the indications for cochlear implantation continue to expand.


Assuntos
Implante Coclear/métodos , Terapia Combinada/métodos , Audição/fisiologia , Neuroma Acústico/cirurgia , Adolescente , Idoso , Austrália/epidemiologia , Terapia Combinada/estatística & dados numéricos , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Nervo Facial/cirurgia , Estudos de Viabilidade , Seguimentos , Testes Auditivos/métodos , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Neuroma Acústico/diagnóstico por imagem , Neuroma Acústico/patologia , Neuroma Acústico/reabilitação , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Centros de Atenção Terciária , Resultado do Tratamento
20.
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