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1.
Artículo en Inglés | MEDLINE | ID: mdl-33805343

RESUMEN

In early 2020 from April to early June, the metropolitan area of Sydney as well as the rest of New South Wales (NSW, Australia) experienced a period of lockdown to prevent the spread of COVID-19 virus in the community. The effect of reducing anthropogenic activities including transportation had an impact on the urban environment in terms of air quality which is shown to have improved for a number of pollutants, such as Nitrogen Dioxides (NO2) and Carbon Monoxide (CO), based on monitoring data on the ground and from a satellite. In addition to primary pollutants CO and NOx emitted from mobile sources, PM2.5 (primary and secondary) and secondary Ozone (O3) during the lockdown period will also be analyzed using both statistical methods on air quality data and the modelling method with emission and meteorological data input to an air quality model. By estimating the decrease in traffic volume in the Sydney region, the corresponding decrease in emission input to the Weather Research and Forecasting-Community Multiscale Air Quality Modelling System (WRF-CMAQ) air quality model is then used to estimate the effect of lockdown on the air quality especially CO, NO2, O3, and PM2.5 in the Greater Metropolitan Region (GMR) of Sydney. The results from both statistical and modelling methods show that NO2, CO, and PM2.5 levels decreased during the lockdown, but O3 instead increased. However, the change in the concentration levels are small considering the large reduction of ~30% in traffic volume.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Australia , Control de Enfermedades Transmisibles , Monitoreo del Ambiente , Humanos , Nueva Gales del Sur , Pandemias , Material Particulado/análisis
2.
J Law Med ; 28(2): 346-369, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33768746

RESUMEN

During the COVID-19 pandemic in Australia, governments in all jurisdictions (except New South Wales) have declared states of emergency and exercised powers under their public health emergency legislation. Highly restrictive measures have been introduced pursuant to the exercise of such powers. Extraordinary government action demands strong accountability. This section piece reviews the public health emergency legislation in all Australian jurisdictions and finds that inadequate accountability mechanisms are embedded in the statutes. This section piece demonstrates that there is insufficient transparency around the decisions being made by the Executive under the public health emergency powers. The section piece also reveals that there are very few options built into the public health emergency legislation for review of executive action for its legality, meritoriousness and fairness.


Asunto(s)
Salud Pública , Australia , Humanos , Nueva Gales del Sur , Pandemias , Responsabilidad Social
3.
J Law Med ; 28(2): 389-420, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33768748

RESUMEN

Australia is obliged under the Convention on the Rights of Persons with Disabilities to provide decision-making support to people with cognitive impairment. While there has been considerable recent activity looking at how the law should respond to the challenges raised by the Convention, there has been little discussion in Australia of how these changes will impact upon the care of people with dementia (the largest class of person with cognitive impairment in Australia). This section examines current Australian legal approaches to decision-making for people with dementia in four jurisdictions (New South Wales, South Australia, Victoria and Western Australia) through an analysis of reported tribunal decisions in each of these jurisdictions. It notes the scope for informal supported decision-making and the basis for the invocation of guardianship orders, including the new Victorian supportive guardianship order, and compares the new standards raised by the Convention. The section considers legal reforms which could improve the implementation of supported decision-making for people living with dementia.


Asunto(s)
Demencia , Competencia Mental , Toma de Decisiones , Humanos , Nueva Gales del Sur , Victoria , Australia Occidental
4.
Epidemiol Psychiatr Sci ; 30: e22, 2021 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-33750482

RESUMEN

AIMS: Mental health (MH) service users have increased prevalence of chronic physical conditions such as cardio-respiratory diseases and diabetes. Potentially Preventable Hospitalisations (PPH) for physical health conditions are an indicator of health service access, integration and effectiveness, and are elevated in long term studies of people with MH conditions. We aimed to examine whether PPH rates were elevated in MH service users over a 12-month follow-up period more suitable for routine health indicator reporting. We also examined whether MH service users had increased PPH rates at a younger age, potentially reflecting the younger onset of chronic physical conditions. METHODS: A population-wide data linkage in New South Wales (NSW), Australia, population 7.8 million. PPH rates in 178 009 people using community MH services in 2016-2017 were compared to population rates. Primary outcomes were crude and age- and disadvantage-standardised annual PPH episode rate (episodes per 100 000 population), PPH day rate (hospital days per 100 000) and adjusted incidence rate ratios (AIRR). RESULTS: MH service users had higher rates of PPH admission (AIRR 3.6, 95% CI 3.5-3.6) and a larger number of hospital days (AIRR 5.2, 95% CI 5.2-5.3) than other NSW residents due to increased likelihood of admission, more admissions per person and longer length of stay. Increases were greatest for vaccine-preventable conditions (AIRR 4.7, 95% CI 4.5-5.0), and chronic conditions (AIRR 3.7, 95% CI 3.6-3.7). The highest number of admissions and relative risks were for respiratory and metabolic conditions, including chronic obstructive airways disease (AIRR 5.8, 95% CI 5.5-6.0) and diabetic complications (AIRR 5.4, 95% CI 5.1-5.8). One-quarter of excess potentially preventable bed days in MH service users were due to vaccine-related conditions, including vaccine-preventable respiratory illness. Age-related increases in risk occurred earlier in MH service users, particularly for chronic and vaccine-preventable conditions. PPH rates in MH service users aged 20-29 were similar to population rates of people aged 60 and over. These substantial differences were not explained by socio-economic disadvantage. CONCLUSIONS: PPHs for physical health conditions are substantially increased in people with MH conditions. Short term (12-month) PPH rates may be a useful lead indicator of increased physical morbidity and less accessible, integrated or effective health care. High hospitalisation rates for vaccine-preventable respiratory infections and hepatitis underline the importance of vaccination in MH service users and suggests potential benefits of prioritising this group for COVID-19 vaccination.


Asunto(s)
/epidemiología , Servicios Comunitarios de Salud Mental/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Adulto , Anciano , Australia , Enfermedad Crónica/epidemiología , Comorbilidad , Estado de Salud , Humanos , Persona de Mediana Edad , Nueva Gales del Sur/epidemiología , Prevalencia , Adulto Joven
5.
Int J Prison Health ; ahead-of-print(ahead-of-print)2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33709638

RESUMEN

PURPOSE: New South Wales (NSW) correctional system houses 30% of prisoners in Australia and at this time has only had a single documented case of COVID-19 amongst its prisoner population. The coordinated response by Justice Health and Forensic Mental Health Network (The Network) undertaken with the support of NSW Ministry of Health, in partnership with Corrective Services NSW (CSNSW), Youth Justice and private jails has ensured that the NSW correctional system has remained otherwise COVID-free. DESIGN/METHODOLOGY/APPROACH: A research study of how a range of partners which support the operations of NSW Correctional System developed an effective approach for the prevention a COVID-19 epidemic amongst its inmates. FINDINGS: Establishment of effective partnerships, early coordination of representatives from all aspects of the NSW correctional system, limited access to the correctional environment, reduced prison population and strict isolation of all new receptions have all contributed to maintaining this COVID-free status despite other NSW settings with similar risk profiles, such as aged care facilities and cruise ship arrivals, experiencing serious outbreaks. RESEARCH LIMITATIONS/IMPLICATIONS: Although Australia/New Zealand context of suppressed community infection rates for COVID-19 (which are approaching elimination in some jurisdictions) is in contrast to the situation in other parts of the world, the principles described in this paper will be useful to most other correctional systems. PRACTICAL IMPLICATIONS: Modelling was used to underline our approach and reinforced the veracity of following this approach. ORIGINALITY/VALUE: The Network and CSNSW has been able to mount an effective, integrated response to the COVID-19 pandemic, which has been sustainable through the first peak of COVID-19 cases. This case study catalogues the process of developing this response and details each intervention implemented with inventive use of tables to demonstrate the impact of the range of interventions used.


Asunto(s)
/epidemiología , Control de Infecciones/organización & administración , Prisiones/organización & administración , Adulto , Femenino , Humanos , Masculino , Nueva Gales del Sur/epidemiología , Estudios de Casos Organizacionales , Pandemias
6.
Australas J Ageing ; 40(1): 84-89, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33682315

RESUMEN

OBJECTIVE: To investigate the impact of the COVID-19 pandemic on the quality of life and social networks of older adults receiving community care services. METHODS: Quality of life and social network questionnaires were completed by older adults (n = 21) receiving home care services at three time points (2018, 2019, and during the first Australian COVID-19 lockdown in 2020). Additional questions about technology use were included in 2020. RESULTS: Older adults' quality of life significantly decreased during the pandemic compared to the prior year. During the pandemic, over 80% used technology to maintain contact with family and friends, and social networks did not change. CONCLUSION: Government messages and support initiatives directed towards technology adoption among older adults receiving home care may assist with maintaining social connection during COVID-19. Our findings add to the relatively limited understanding of the impact of the COVID-19 pandemic on the socio-emotional well-being of older people.


Asunto(s)
/epidemiología , Calidad de Vida , Red Social , Comunicación por Videocoferencia , Anciano , Anciano de 80 o más Años , Computadores , Femenino , Servicios de Atención de Salud a Domicilio , Humanos , Relaciones Interpersonales , Estudios Longitudinales , Masculino , Nueva Gales del Sur/epidemiología , Pandemias , Teléfono Inteligente , Encuestas y Cuestionarios
7.
Harm Reduct J ; 18(1): 20, 2021 02 17.
Artículo en Inglés | MEDLINE | ID: mdl-33596940

RESUMEN

The COVID-19 crisis has had profound impacts on health service provision, particularly those providing client facing services. Supervised injecting facilities and drug consumption rooms across the world have been particularly challenged during the pandemic, as have their client group-people who consume drugs. Several services across Europe and North America closed due to difficulties complying with physical distancing requirements. In contrast, the two supervised injecting facilities in Australia (the Uniting Medically Supervised Injecting Centre-MSIC-in Sydney and the North Richmond Community Health Medically Supervised Injecting Room-MSIR-in Melbourne) remained open (as at the time of writing-December 2020). Both services have implemented a comprehensive range of strategies to continue providing safer injecting spaces as well as communicating crucial health information and facilitating access to ancillary services (such as accommodation) and drug treatment for their clients. This paper documents these strategies and the challenges both services are facing during the pandemic. Remaining open poses potential risks relating to COVID-19 transmission for both staff and clients. However, given the harms associated with closing these services, which include the potential loss of life from injecting in unsafe/unsupervised environments, the public and individual health benefits of remaining open are greater. Both services are deemed 'essential health services', and their continued operation has important benefits for people who inject drugs in Sydney and Melbourne.


Asunto(s)
/prevención & control , Reducción del Daño , Control de Infecciones/métodos , Programas de Intercambio de Agujas , Trastornos Relacionados con Opioides/rehabilitación , Equipo de Protección Personal , Abuso de Sustancias por Vía Intravenosa/rehabilitación , Australia , Prestación de Atención de Salud , Sobredosis de Droga/terapia , Vivienda , Humanos , Máscaras , Naloxona/uso terapéutico , Antagonistas de Narcóticos/uso terapéutico , Nueva Gales del Sur , Tratamiento de Sustitución de Opiáceos , Derivación y Consulta , Resucitación/métodos , Trastornos Relacionados con Sustancias , Victoria
8.
Aust N Z J Public Health ; 45(1): 59-64, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33559961

RESUMEN

OBJECTIVES: To identify and describe chronic disease prevention programs offered by Aboriginal Community Controlled Health Services (ACCHSs) in New South Wales (NSW), Australia. METHODS: ACCHSs were identified through the Aboriginal Health and Medical Research Council of NSW website. Chronic disease programs were identified from the Facebook page and website of each ACCHS. Characteristics, including regions, target population, condition, health behaviour, modality and program frequency were extracted and summarised. RESULTS: We identified 128 chronic disease programs across 32 ACCHSs. Of these, 87 (68%) programs were broad in their scope, 20 (16%) targeted youth, three (2%) targeted Elders, 16 (12%) were for females only and five (4%) were for males only. Interventions included physical activity (77, 60%), diet and nutrition (74, 58%), smoking (70, 55%), and the Aboriginal and Torres Strait Islander Health Check (44, 34%), with 93 programs (73%) of ongoing duration. CONCLUSIONS: Chronic disease prevention programs address chronic conditions by promoting physical activity, diet and nutrition, smoking cessation and health screening. Most target the general Aboriginal community, a few target specific groups based on gender and age, and more than one-quarter are time-limited. Implications for public health: Chronic disease programs that are co-produced with specific groups, based on age and gender, may be needed.


Asunto(s)
Enfermedad Crónica/prevención & control , Conductas Relacionadas con la Salud/etnología , Promoción de la Salud/métodos , Servicios de Salud del Indígena/estadística & datos numéricos , Estilo de Vida Saludable , Grupo de Ascendencia Oceánica/psicología , Cese del Hábito de Fumar/estadística & datos numéricos , Adolescente , Anciano , Australia/epidemiología , Femenino , Humanos , Masculino , Nueva Gales del Sur , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Fumar/epidemiología , Cese del Hábito de Fumar/etnología
9.
Artículo en Inglés | MEDLINE | ID: mdl-33540747

RESUMEN

Strong and healthy futures for Aboriginal and Torres Strait Islander people requires engagement in meaningful decision making which is supported by evidence-based approaches. While a significant number of research publications state the research is co-designed, few describe the research process in relation to Indigenous ethical values. Improving the health and wellbeing of Aboriginal and Torres Strait Islander mothers and babies is crucial to the continuation of the oldest living culture in the world. Developing meaningful supports to empower Aboriginal and Torres Strait Islander mothers to quit smoking during pregnancy is paramount to addressing a range of health and wellbeing outcomes. Aboriginal and Torres Strait Islander women have called for non-pharmacological approaches to smoking cessation during pregnancy. We describe a culturally responsive research protocol that has been co-designed and is co-owned with urban and regional Aboriginal communities in New South Wales. The project has been developed in line with the AH&MRC's (Aboriginal Health & Medical Research Council) updated guidelines for ethical research with Aboriginal and Torres Strait Islander communities. Ethics approvals have been granted by AH&MRC #14541662 University of Newcastle HREC H-2020-0092 and the Local Health District ethics committee 2020/ETH02095. Results will be disseminated through peer reviewed articles, community reports, infographics, and online social media content.


Asunto(s)
Servicios de Salud del Indígena , Cese del Hábito de Fumar , Femenino , Humanos , Nueva Gales del Sur , Grupo de Ascendencia Oceánica , Embarazo , Fumar
10.
Artículo en Inglés | MEDLINE | ID: mdl-33632090

RESUMEN

Abstract: The key issues with Neisseria gonorrhoeae infections, in Australia and elsewhere, are coincident increases in disease rates and in antimicrobial resistance (AMR), although these factors have not been shown to be correlated. Despite advances in diagnosis, control of this disease remains elusive, and incidence in Australia continues to increase. Of the Australian jurisdictions, New South Wales (NSW) has the highest N. gonorrhoeae notifications, and over the five-year period 2015-2019, notifications in NSW have increased above the national average (by 116% versus 85%, respectively). Gonococcal disease control is reliant on effective antibiotic regimens. However, escalating AMR in N. gonorrhoeae is a global health priority, as the collateral injury of untreated infections has substantive impacts on sexual and newborn health. Currently, our first-line therapy for gonorrhoea is also our last line, with no ideal alternative identified. Despite some limitations, gentamicin is licensed and readily available in Australia, and is proposed for treatment of resistant N. gonorrhoeae in national guidelines; however, supportive published microbiological data are lacking. Analysis of gonococcal resistance patterns within Australia for the period 1991-2019, including 35,000 clinical isolates from NSW, illustrates the establishment and spread of population-level resistance to all contemporaneous therapies. An analysis of gentamicin susceptibility on 2,768 N. gonorrhoeae clinical isolates from NSW, for the period 2015-2020, demonstrates that the median minimum inhibitory concentration (MIC) for gentamicin in NSW has remained low, at 4.0 mg/L, and resistance was not detected in any isolate. There has been no demonstration of MIC drift over time (p = 0.91, Kruskal-Wallis test), nor differences in MIC distributions according to patients' sex or site of specimen collection. This is the first large-scale evaluation of gentamicin susceptibility in N. gonorrhoeae in Australia. No gentamicin resistance was detected in clinical isolates, 2015-2020, hence this is likely to be an available treatment option for resistant gonococcal infections in NSW.


Asunto(s)
Gentamicinas/uso terapéutico , Gonorrea/tratamiento farmacológico , Neisseria gonorrhoeae/efectos de los fármacos , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana , Femenino , Gentamicinas/farmacología , Gonorrea/microbiología , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Nueva Gales del Sur , Factores Sexuales
11.
Environ Pollut ; 274: 116498, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33524649

RESUMEN

Poor air quality is an emerging problem in Australia primarily due to ozone pollution events and lengthening and more severe wildfire seasons. A significant deterioration in air quality was experienced in Australia's most populous cities, Melbourne and Sydney, as a result of fires during the so-called Black Summer which ran from November 2019 through to February 2020. Following this period, social, mobility and economic restrictions to curb the spread of the COVID-19 pandemic were implemented in Australia. We quantify the air quality impact of these contrasting periods in the south-eastern states of Victoria and New South Wales (NSW) using a meteorological normalisation approach. A Random Forest (RF) machine learning algorithm was used to compute baseline time series' of nitrogen dioxide (NO2), ozone (O3), carbon monoxide CO and particulate matter with diameter < 2.5 µm (PM2.5), based on a 19 year, detrended training dataset. Across Victorian sites, large increases in CO (188%), PM2.5 (322%) and ozone (22%) were observed over the RF prediction in January 2020. In NSW, smaller pollutant increases above the RF prediction were seen (CO 58%, PM2.5 80%, ozone 19%). This can be partly explained by the RF predictions being high compared to the mean of previous months, due to high temperatures and strong wind speeds, highlighting the importance of meteorological normalisation in attributing pollution changes to specific events. From the daily observation-RF prediction differences we estimated 249.8 (95% CI: 156.6-343.) excess deaths and 3490.0 (95% CI 1325.9-5653.5) additional hospitalisations were likely as a result of PM2.5 and O3 exposure in Victoria and NSW. During April 2019, when COVID-19 restrictions were in place, on average NO2 decreased by 21.5 and 8% in Victoria and NSW respectively. O3 and PM2.5 remained effectively unchanged in Victoria on average but increased by 20 and 24% in NSW respectively, supporting the suggestion that community mobility reduced more in Victoria than NSW. Overall the air quality change during the COVID-19 lockdown had a negligible impact on the calculated health outcomes.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Fuego , Afroamericanos , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Ciudades , Control de Enfermedades Transmisibles , Monitoreo del Ambiente , Humanos , Nueva Gales del Sur , Pandemias , Material Particulado/análisis , Estaciones del Año , Victoria
12.
Nutr Metab Cardiovasc Dis ; 31(3): 950-960, 2021 03 10.
Artículo en Inglés | MEDLINE | ID: mdl-33546942

RESUMEN

BACKGROUND & AIMS: Vascular function, blood pressure and inflammation are involved in the pathogenesis of major chronic diseases, including both cardiovascular disease (CVD) and mild cognitive impairment (MCI). This study investigated the effects of food anthocyanins on microvascular function, 24-h ambulatory blood pressure (ABP) and inflammatory biomarkers in older adults with MCI. METHODS AND RESULTS: Thirty-one participants with MCI [19 female, 12 male, mean age 75.3 (SD 6.9) years and body mass index 26.1 (SD 3.3) kg/m2], participated in a randomized, controlled, double-blind clinical trial (Australian New Zealand Clinical Trials Registry: ACTRN12618001184268). Participants consumed 250 mL fruit juice daily for 8 weeks, allocated into three groups: a) high dose anthocyanins (201 mg); b) low dose anthocyanins (47 mg); c) control. Microvascular function (Laser Speckle Contrast Imaging combined with a post-occlusive reactive hyperaemia test), 24h ABP and serum inflammatory biomarkers were assessed before and after the nutritional intervention. RESULTS: Participants in the high anthocyanins group had a reduction in serum tumor necrosis factor alpha (TNF-α) (P = 0.002) compared to controls and the low anthocyanins group (all P's > 0.05). Serum IL-6, IL-1ß, c-reactive protein, and parameters of microvascular function and 24h ABP were not altered by any treatment. CONCLUSION: A daily high dose of fruit-based anthocyanins for 8 weeks reduced concentrations of TNF-α in older adults with MCI. Anthocyanins did not alter other inflammatory biomarkers, microvascular function or blood pressure parameters. Further studies with a larger sample size and longer period of follow-up are required to elucidate whether this change in the immune response will alter CVD risk and progression of cognitive decline.


Asunto(s)
Antocianinas/administración & dosificación , Presión Sanguínea , Cognición , Disfunción Cognitiva/dietoterapia , Jugos de Frutas y Vegetales , Mediadores de Inflamación/sangre , Factor de Necrosis Tumoral alfa/sangre , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Disfunción Cognitiva/sangre , Disfunción Cognitiva/fisiopatología , Disfunción Cognitiva/psicología , Método Doble Ciego , Regulación hacia Abajo , Femenino , Humanos , Masculino , Microcirculación , Nueva Gales del Sur , Factores de Tiempo , Resultado del Tratamiento
14.
Nutr Metab Cardiovasc Dis ; 31(4): 1102-1112, 2021 04 09.
Artículo en Inglés | MEDLINE | ID: mdl-33549432

RESUMEN

BACKGROUND AND AIMS: The role of antioxidant intake in cardiovascular disease remains inconclusive. This study evaluates the association between antioxidant intake and the risk of major adverse cardiovascular events (MACE) among older Australian men. METHODS AND RESULTS: 794 men aged ≥75 years participated in the 3rd wave of the Concord Health and Ageing in Men Project. Dietary adequacy of antioxidant intake was assessed by comparing participants' intake of vitamins A, E, C and zinc to the Nutrient Reference Values (NRV) for Australia. Attainment of NRVs of antioxidants was categorised into a dichotomised variable 'inadequate' (meeting≤2 of 4 antioxidants) or 'adequate' (meeting≥3 of 4 antioxidants). The usage of antioxidant supplements was assessed. The outcome measure was MACE. The composite MACE endpoint was defined as having one of the following: death, myocardial infarction, ischemic stroke, congestive cardiac failure (CCF), and revascularization during the period of observation. There was no significant association between dietary (HR: 1.03, 95% CI: 0.71, 1.48) or supplemental antioxidant intake (HR: 1.10, 95% CI: 0.75, 1.63) and overall MACE. However, a significant association was observed between inadequate antioxidant intake and CCF (HR: 1.32; 95% CI: 1.16, 1.50). The lowest quartile of zinc intake (<11.00 mg/d) was significantly associated with CCF (HR 2.36; 95% CI: 1.04, 5.34). None of the other antioxidants were significantly associated with CCF or other MACE components. CONCLUSION: Inadequate dietary antioxidant intake, particularly zinc, is associated with increased risk of CCF in older Australian men but not associated with overall MACE.


Asunto(s)
Antioxidantes/administración & dosificación , Enfermedades Cardiovasculares/prevención & control , Dieta Saludable , Suplementos Dietéticos , Envejecimiento Saludable , Salud del Hombre , Conducta de Reducción del Riesgo , Factores de Edad , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Humanos , Masculino , Nueva Gales del Sur/epidemiología , Estado Nutricional , Pronóstico , Estudios Prospectivos , Factores Protectores , Ingesta Diaria Recomendada , Medición de Riesgo , Factores Sexuales , Factores de Tiempo , Zinc/administración & dosificación
15.
Artículo en Inglés | MEDLINE | ID: mdl-33573537

RESUMEN

Background: The current COVID-19 pandemic is not the first time New South Wales prisons have faced contagion. This paper examines the current responses in New South Wales prisons to the threat of COVID-19 to prisoner health, by contrasting contemporary activities with actions and policy developed during two historical epidemics: the influenza epidemic of 1860 and pandemic of 1919. Method: Epidemiological information relating to cases of disease in NSW prisons during the 1860 and 1919 influenza epidemics was obtained from the Comptroller-General's reports for the specific outbreak years and for the preceding and succeeding five-year periods. Additional archival sources such as digitised newspaper reports and articles available through the National Library of Australia were analysed for closer detail. The management of these outbreaks was compared to current strategies to mitigate against risk from the COVID-19 pandemic in the NSW prison system. Results: Interesting similarities were discovered in relation to the management of the historic influenza outbreaks in NSW prisons and in the management of the current COVID-19 pandemic. An outbreak of influenza in mid-1860 impacted seven penal institutions in Sydney and Parramatta. Infection rates at these institutions were between 3.1% and 100%; the mean rate was 41.8%. The public health measures employed at the time included allowing 'air circulation freely night and day', and treatments that were 'tonical and stimulatory'. Discussion: While the past 100 or more years have brought huge progress in scientific knowledge, public health approaches remain the mainstay of outbreak management in prisons; and, as in 1919, the opportunity for Australia to observe the rest of the world and plan for action has not been wasted. Prisons pose a potential risk for pandemic spread but they also present a unique opportunity for reducing disease risk by ironic virtue of the 'separate system' that was recognised even 100 years ago as characteristic of these institutions.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/métodos , Gripe Humana/historia , Prisiones/historia , Salud Pública , Control de Enfermedades Transmisibles/historia , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Gripe Humana/epidemiología , Nueva Gales del Sur/epidemiología , Prisiones/organización & administración , Prisiones/normas
17.
BMC Public Health ; 21(1): 225, 2021 01 27.
Artículo en Inglés | MEDLINE | ID: mdl-33504347

RESUMEN

BACKGROUND: The first COVID-19 cases were diagnosed in Australia on 25 January 2020. Initial epidiemiology showed that the majority of cases were in returned travellers from overseas. One aspect of Public Health response was to introduce compulsory 14 day quarantine for all travellers returning to New South Wales (NSW) by air or sea in Special Health Accommodation (SHA). We aim to outline the establishment of a specialised health quarantine accommodation service in the context of the COVID-19 pandemic, and describe the first month of COVID-19 screening. METHODS: The SHA was established with a comprehensive governance structure, remote clinical management through Royal Prince Alfred Virtual Hospital (rpavirtual) and site management with health care workers, NSW Police and accommodation staff. RESULTS: From 29 March to 29 April 2020, 373 returning travellers were admitted to the SHA from Sydney Airport. 88 (26.1%) of those swabbed were positive for SARS-CoV 2. The day of diagnosis of COVID-19 varied from Day 1 to Day 13, with 63.6% (n = 56) of these in the first week of quarantine. 50% of the people in the SHA were referred to rpavirtual for ongoing clinical management. Seven people required admission to hospital for ongoing clinical care. CONCLUSION: The Public Health response to COVID-19 in Australia included early and increased case detection through testing, tracing of contacts of confirmed cases, social distancing and prohibition of gatherings. In addition to these measures, the introduction of mandated quarantine for travellers to Australia was integral to the successful containment of COVID-19 in NSW and Australia through the prevention of transmission locally and interstate from returning travellers.


Asunto(s)
/prevención & control , Enfermedades Transmisibles Importadas/prevención & control , Servicios de Salud , Salud Pública , Cuarentena/legislación & jurisprudencia , Viaje/legislación & jurisprudencia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Australia/epidemiología , Niño , Preescolar , Enfermedades Transmisibles Importadas/epidemiología , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Nueva Gales del Sur/epidemiología , Adulto Joven
18.
J Environ Manage ; 283: 111979, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33482453

RESUMEN

Droughts are slow-moving natural hazards that gradually spread over large areas and capable of extending to continental scales, leading to severe socio-economic damage. A key challenge is developing accurate drought forecast model and understanding a models' capability to examine different drought characteristics. Traditionally, forecasting techniques have used various time-series approaches and machine learning models. However, the use of deep learning methods have not been tested extensively despite its potential to improve our understanding of drought characteristics. The present study uses a deep learning approach, specifically the Long Short-Term Memory (LSTM) to predict a commonly used drought measure, the Standard Precipitation Evaporation Index (SPEI) at two different time scales (SPEI 1, SPEI 3). The model was compared with other common machine learning method, Random Forests, Artificial Neural Networks and applied over the New South Wales (NSW) region of Australia, using hydro-meteorological variables as predictors. The drought index and predictor data were collected from the Climatic Research Unit (CRU) dataset spanning from 1901 to 2018. We analysed the LSTM forecasted results in terms of several drought characteristics (drought intensity, drought category, or spatial variation) to better understand how drought forecasting was improved. Evaluation of the drought intensity forecasting capabilities of the model were based on three different statistical metrics, Coefficient of Determination (R2), Root Mean Square Error (RMSE), and Mean Absolute Error (MAE). The model achieved R2 value of more than 0.99 for both SPEI 1 and SPEI 3 cases. The variation in drought category forecasted results were studied using a multi-class Receiver Operating Characteristic based Area under Curves (ROC-AUC) approach. The analysis revealed an AUC value of 0.83 and 0.82 for SPEI 1 and SPEI 3 respectively. The spatial variation between observed and forecasted values were analysed for the summer months of 2016-2018. The findings from the study show an improvement relative to machine learning models for a lead time of 1 month in terms of different drought characteristics. The results from this work can be used for drought mitigation purposes and different models need to be tested to further enhance our capabilities.


Asunto(s)
Sequías , Memoria a Corto Plazo , Australia , Predicción , Redes Neurales de la Computación , Nueva Gales del Sur
20.
Aust Vet J ; 99(4): 124-129, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33442892

RESUMEN

BACKGROUND: Sheep producers reported elevated ewe mortality following a wetter-than-average season on the tablelands of New South Wales in 2010. We conducted a survey of local producers to determine the extent and cause of ewe losses, as well as associated risk factors. METHODS: A questionnaire was designed and posted to sheep producers running at least 1000 sheep. Data from questionnaires were analysed using linear mixed models to identify risk factors associated with ewe mortality. Data on the likely causes of deaths, particularly those associated with foot abscess, were analysed by ordinal generalised linear mixed models to determine the most prevalent causes of ewe death. RESULTS: The mean annual ewe mortality was 5.4% (range 0.1%-28.6%). Higher mortality was associated with older ewes and lambing in paddocks with longer pastures. The two most important causes of ewe death reported by farmers were 'died during lambing' and 'foot abscess'. Mortality due to foot abscess was more commonly reported in adult ewes than maiden ewes (odds ratio and 95% confidence interval: 5.61; 3.52, 8.94), when lambing on pasture longer than 5 cm than ≤5 cm (2.96; 1.54, 5.70) and when lambing in spring than in autumn (4.87; 1.36, 17.41). CONCLUSIONS: The level of ewe mortality observed was at the upper end of that reported previously in Australia. Risk factor analysis suggested that, in wet years, losses due to foot abscess could be reduced by lambing older heavier ewes in autumn on pasture swards less than 5 cm high.


Asunto(s)
Enfermedades de las Ovejas , Animales , Australia , Femenino , Nueva Gales del Sur/epidemiología , Ovinos , Enfermedades de las Ovejas/epidemiología , Oveja Doméstica , Encuestas y Cuestionarios
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