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1.
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
2.
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
3.
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
4.
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
5.
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
6.
Emerg Med Australas ; 33(2): 343-348, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33387421

RESUMEN

OBJECTIVE: The study aims to determine whether ED presentation volume or hospital occupancy had a greater impact on ED performance before and during the COVID-19 health response at a tertiary referral hospital in Sydney, Australia. METHODS: Single centre time series analysis using routinely collected hospital and ED data from January 2019 to September 2020. The primary outcome was ED access block measured by emergency treatment performance (ETP; i.e. percentage of patients who were discharged or transferred to a ward from ED within 4 h of ED arrival time). Secondary outcomes were hospital occupancy, elective theatre cases and ambulance ramping. Multivariate time series analysis was performed using vector autoregression, to model effects of changes in various endogenous and correlated variables on ETP. RESULTS: There was an increase in ETP, drop in ED presentations and decrease in hospital occupancy between April and June 2020. Elective surgery and hospital occupancy had significant effects up to 2 days prior on ETP, while there were no significant effects of either ED or ambulance presentations on ETP. Hospital occupancy itself increased with ED presentations after 2-4 days and decreased with elective surgery after 1 day. Shocks (a one standard deviation increase) in hospital occupancy had a peak impact nearly two times greater compared to ED presentations (-1.43, 95% confidence interval -1.92, -0.93 vs -0.73, 95% confidence interval -1.21, -0.25). CONCLUSION: The main determinants of the reduction of ED overcrowding and access block during the pandemic were associated with reductions in hospital occupancy and elective surgery levels, and more research is required to assess more complex associations beyond the scope of this manuscript.


Asunto(s)
Ocupación de Camas/estadística & datos numéricos , Aglomeración , Servicio de Urgencia en Hospital/organización & administración , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Humanos , Análisis de Series de Tiempo Interrumpido , Nueva Gales del Sur/epidemiología , Pandemias
7.
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
8.
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
10.
Intern Med J ; 50(10): 1271-1273, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32945610

RESUMEN

Ambulatory care is an important service for patients with the COVID-19 infection especially in a regional area where most of the patients underwent home isolation. Escalation of treatment and timely transition to inpatient care are critical when COVID-19 patients deteriorate. Equally important is ensuring transfer into facility is carried out in a well-planned, safe manner to prevent exposure to health care professionals as well as other inpatients. This study is a summary of our COVID Hospital-in-the-Home (HITH) service and clinical presentation of COVID-19 patients.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Servicios de Atención de Salud a Domicilio/organización & administración , Transferencia de Pacientes/organización & administración , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Anciano , Anciano de 80 o más Años , Betacoronavirus , Infecciones por Coronavirus/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva Gales del Sur/epidemiología , Pandemias , Neumonía Viral/fisiopatología , Riesgo
11.
Artículo en Inglés | MEDLINE | ID: mdl-32981492

RESUMEN

Cumulatively to 13 September there have been 26,753 case notifications and 674 deaths. The number of new cases reported nationally this fortnight was 764, a 61% decrease from the previous fortnight (1,948). On average this represented 55 cases diagnosed each day over the reporting period, a decrease from 125 cases per day over the previous reporting period. 84% of all cases (640/764) were reported in Victoria, with a smaller number of cases reported from New South Wales (95), Queensland (22), Western Australia (4) and South Australia (3). In Victoria, 97% of cases (621) were locally acquired and were mostly reported from residential aged care facilities; and 3% of cases (19) were reported as under investigation at the date of extract this reporting period. Excluding Victoria, 124 cases were reported nationally, 32% (40) were overseas acquired; 65% (81) were locally acquired, predominantly in New South Wales (62); and 2% (3) of cases were under investigation at this time, all reported in Queensland. The continued decrease in new cases observed this fortnight in Victoria is likely associated with the enhanced public health measures that are currently in place in Victoria. Locally-acquired cases which were predominantly associated with several interconnected clusters continued to be reported in New South Wales. In Queensland, 82% of cases (18/22) were reported as locally acquired from two clusters associated with immigration centres or correctional facilities. A total of 6 deaths were reported from cases diagnosed in this reporting period-all from Victoria, all aged 50 years or older, three male and three female. Although testing rates have declined gradually over the past month they remain high at 14.5 tests per 1,000 population per week. The overall positivity rate for the reporting period was 0.13%. Victoria reported a positivity rate of 0.39% for this reporting period while in all other jurisdictions the positivity rate was 0.05% or lower. For this report, "In focus" is paediatric inflammatory multisystem syndrome temporally associated with SARS-COV-2 (PIMS-TS). A review of Australia's public health response to COVID-19 (as at 13 September 2020) is at Appendix A.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Síndrome de Respuesta Inflamatoria Sistémica/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Infecciones Asintomáticas , Australia/epidemiología , Betacoronavirus , Niño , Preescolar , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/transmisión , Femenino , Hogares para Ancianos , Hospitalización , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Nueva Gales del Sur/epidemiología , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Neumonía Viral/transmisión , Queensland/epidemiología , Australia del Sur/epidemiología , Victoria/epidemiología , Australia Occidental/epidemiología , Adulto Joven
13.
Emerg Med Australas ; 32(6): 1046-1051, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32959477

RESUMEN

OBJECTIVE: To estimate the personal protective equipment (PPE) required in a paediatric ED during the COVID-19 pandemic comparing the use per patient to use per patient zone, based on the NSW Clinical Excellence Commission (CEC) guidelines in place at the time of the study. METHODS: A retrospective case note review of all patients and staff present in the ED of The Children's Hospital at Westmead, Sydney, Australia in the 24 h period of Sunday 5 April 2020. The primary outcome of PPE estimates was generated from identifying the number of patient contacts and aerosol generating procedures (AGPs) performed per patient as well as the number of staff on shift. RESULTS: One hundred patients attended the ED (50% of usual) and all were included in the study. For a low-risk community environment allocating PPE per patient contact required 48 face shields, 382 surgical masks, 48 N95 masks and 430 gowns for the day, increasing to 430 face shields, 331 surgical masks, 430 N95 masks and 761 gowns in a high-risk community environment. Allocating PPE using zoning reduces the requirement to 48 face shields, 192 surgical masks, 48 N95 masks and 204 gowns, increasing to 196 face shields, 96 surgical masks, 196 N95 masks and 292 gowns per day in a high-risk community environment. CONCLUSION: This study has demonstrated the considerable requirement for PPE in a paediatric ED, which varies according to presentation type and the background prevalence of COVID-19 in the community.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Servicio de Urgencia en Hospital/estadística & datos numéricos , Hospitales Pediátricos/estadística & datos numéricos , Pandemias/prevención & control , Equipo de Protección Personal/estadística & datos numéricos , Neumonía Viral/prevención & control , Niño , Preescolar , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Lactante , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Masculino , Evaluación de Necesidades , Nueva Gales del Sur/epidemiología , Equipo de Protección Personal/provisión & distribución , Neumonía Viral/epidemiología , Estudios Retrospectivos
14.
Aust Vet J ; 98(10): 486-490, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32794196

RESUMEN

Encephalomyocarditis virus (EMCV) infection was detected by real-time reverse transcription PCR (qRT-PCR) in four adult alpacas (Vicugna pacos) from two properties on the Far North Coast of New South Wales (NSW) in April and May 2018 and in two adult alpacas from a third property on the Central Coast of NSW in October 2018. Viral RNA was detected in a range of samples, including blood, fresh body organs and mucosal swabs. EMCV was isolated from the blood and body organs of five of these alpacas. These animals displayed a range of clinical signs, including inappetence, colic, recumbency and death. Necropsy findings included multifocal to coalescing areas of myocardial pallor, pulmonary congestion and oedema, hepatic congestion and serosal effusion. Histopathological changes comprised acute, multifocal myocardial degeneration and necrosis, with mild, neutrophilic and lymphocytic inflammation (5/5 hearts) and mild, perivascular neutrophilic meningoencephalitis (1/3 brains). This is the first report of disease due to EMCV in alpacas under farm conditions, and it identifies EMCV infection as a differential diagnosis for acute disease and death in this camelid species. In addition to the samples traditionally preferred for EMCV isolation (fresh heart, brain and spleen), blood samples are also appropriate for EMCV detection by qRT-PCR assay.


Asunto(s)
Camélidos del Nuevo Mundo , Infecciones por Cardiovirus/epidemiología , Infecciones por Cardiovirus/veterinaria , Infecciones/veterinaria , Animales , Virus de la Encefalomiocarditis/genética , Corazón , Nueva Gales del Sur/epidemiología
16.
Aust Vet J ; 98(11): 546-549, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32743841

RESUMEN

To determine the extent to which wild deer are contributing in the transmission of Fasciola hepatica (liver fluke) livers from deer shot by hunters, farmers undertaking population control on their farms and vertebrate pest controllers were collected and frozen. The livers were later thawed, sliced and examined for the presence of adult flukes or evidence of past infection. Livers from 19 deer were examined (18 fallow [Dama dama] and one sambar [Rusa unicolor]). Seventeen of the fallow deer were animals collected on farms near Jindabyne, New South Wales. The remaining fallow deer was collected in the Australian Capital Territory and one sambar deer was collected in north-eastern Victoria. Nine of the 17 deer (53%) from the Jindabyne area were either infected with Fasciola hepatica (liver fluke) or had thickened bile ducts indicating past infection. Infection levels in the infected animals varied widely from 3 liver fluke to over 50 per liver. No sign of infection was present in the deer from the Australian Capital Territory or Victoria. Fallow deer are wide-spread in the Jindabyne area and their population is increasing. It is likely their contribution to the maintenance and distribution of F. hepatica to livestock in the Jindabyne area, and in other livestock rearing areas of south-eastern Australia, is important and increasing.


Asunto(s)
Ciervos , Fasciola hepatica , Animales , Nueva Gales del Sur/epidemiología , Australia del Sur , Victoria
17.
Artículo en Inglés | MEDLINE | ID: mdl-32829705

RESUMEN

Confirmed cases in Australia this reporting period (20 July to 2 August): 6,121 notifications, 71 deaths. Cumulative: 18,367 notifications, 240 deaths. Over the past fortnightly reporting period (20 July to 2 August), the number of new cases reported nationally increased from 3,462 in the previous fortnight to 6,121. The large increase in numbers is due to multiple epidemiologically-linked outbreaks across a range of settings and locations in Victoria (97%; 5,914 cases) with very few (207) cases reported by other jurisdictions in this reporting period. Of the 5,914 cases reported in Victoria, all were locally acquired. Of the remaining 207 cases nationally reported, only 23% were reported as locally acquired. ACT is the only jurisdiction reporting 0 cases, with its last case reported on 9 July. A total of 71 deaths were reported, all from Victoria. On average, 437 cases were reported each day over the reporting period, an increase from 247 cases per day over the previous fortnight. Testing rates remain high across all jurisdictions, with an overall positivity rate for the reporting period of 0.7%. Victoria reported a positivity rate of 1.7% for this reporting period; in all other jurisdictions the positivity rate was 0.07% or lower. Overall, syndromic surveillance of respiratory illness trends continues to show very low levels compared to previous years. 12% of cases have required hospitalisation or intensive care.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Australia/epidemiología , Betacoronavirus , Niño , Preescolar , Comorbilidad , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/fisiopatología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Nueva Gales del Sur/epidemiología , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/fisiopatología , Índice de Severidad de la Enfermedad , Distribución por Sexo , Adulto Joven
18.
BMC Public Health ; 20(1): 1294, 2020 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-32847576

RESUMEN

BACKGROUND: Mild to moderate road traffic injury (RTI) in people of working age is associated with limited recovery. Less is known about RTI recovery in older age. This study explored the perspectives and factors associated with recovery and health-related quality of life following mild to moderate RTI in older age in New South Wales, Australia. METHODS: A qualitative study using content analysis was undertaken. Participants aged 65 or more years were purposively selected from a larger inception cohort study of health outcomes following mild to moderate RTI conducted in New South Wales, Australia. Semi-structured interviews were undertaken at approximately 12 or 24 months post-injury. Content analysis was used to code and analyse the data, with methodological rigour obtained by double-coding and discussing findings to reach consensus. Results were reported using the consolidated criteria for reporting qualitative research (COREQ). RESULTS: Nineteen participants were invited to participate in the study of which 12 completed interviews. Data saturation was reached at the twelfth interview. Recovery experiences were diverse. Five main themes were identified: recovery is regaining independence; injury and disability in older age; the burden of non-obvious disability; the importance of support; and positive personal approaches. Key facilitators of recovery were: regaining independence; support from family and friends; and positive personal approaches. Key barriers were: threats to independence; passive coping behaviours; non-obvious disabilities (chronic pain, psychological impacts); and reluctance to raise ongoing issues with General Practitioners. Threats to independence, especially not driving and self-care, appeared to have a more profound effect on recovery than physical functioning. CONCLUSION: Older people view injury as a threat to independent functioning. This is somewhat different to what younger people report. Regaining independence is key to older people's recovery and health-related quality of life following RTI, and should be a key consideration for health professionals, services and supports working with this unique cohort. Greater efforts to help older people regain their independence following RTI are needed and can be facilitated by health professionals and appropriate service provision. TRIAL REGISTRATION: Australia New Zealand clinical trial registry identification number ACTRN12613000889752 .


Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Personas con Discapacidad/psicología , Heridas y Traumatismos/epidemiología , Heridas y Traumatismos/rehabilitación , Adaptación Psicológica , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Personas con Discapacidad/estadística & datos numéricos , Femenino , Humanos , Vida Independiente/psicología , Masculino , Nueva Gales del Sur/epidemiología , Investigación Cualitativa , Calidad de Vida/psicología
20.
Artículo en Inglés | MEDLINE | ID: mdl-32726917

RESUMEN

The aim of this study was to report on breastfeeding duration up to 24 months and determine the predictors of breastfeeding duration among women in South Western Sydney, one of the most culturally diverse and socioeconomically disadvantaged regions of New South Wales (NSW), Australia. Mother-infant dyads (n = 1035) were recruited to the Healthy Smiles Healthy Kids birth cohort study. Study data were collected through telephone interviews at 2, 4, 8, 12, and 24 months postpartum. Cox proportional hazards models were used to determine factors associated with the risk of stopping full breastfeeding at six months and any breastfeeding at 12 and 24 months. The majority of mothers (92.3%) had initiated breastfeeding. At six months, 13.5% of infants were fully breastfed, while 49.9% received some breast milk. Only 25.5% and 2.9% of infants received some breast milk at 12 and 24 months, respectively. Lower maternal education level, lower socioeconomic status, full-time employment, maternal smoking during pregnancy, and caesarean delivery were associated with increased risk of stopping full breastfeeding at six months and any breastfeeding at 12 and 24 months. Older maternal age and partner's preference for breastfeeding were associated with an increased likelihood of continuing any breastfeeding at 12 and 24 months. These findings present a number of opportunities for prolonging breastfeeding duration in disadvantaged communities in NSW.


Asunto(s)
Lactancia Materna , Cesárea , Leche Humana , Australia , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Nueva Gales del Sur/epidemiología , Embarazo , Clase Social
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