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1.
BMC Health Serv Res ; 24(1): 558, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38693520

RESUMEN

BACKGROUND: Project ECHO® networks at Children's Health Queensland Hospital and Health Service (CHQHHS) are communities of practice designed to mitigate services and systems fragmentation by building collaborative partnerships addressing priority child and youth health needs. Aboriginal and Torres Strait Islander people experience the negative impacts of fragmentation in addition to historical challenges of absent or culturally inappropriate health services. Access to culturally safe and responsive services can be improved by engaging Aboriginal and Torres Strait Islander Health Workers and similar roles in an online community of practice, supporting the integration of cultural and clinical knowledge and self-determination of Aboriginal and Torres Strait Islander consumers in decisions affecting their health. Analysing professional support networks and knowledge sharing patterns helps identify enablers and barriers to partnerships. Using social network research, the multilevel network inclusive of ECHO network members and their colleagues was studied to identify interdisciplinary and cross-sector advice exchange patterns, explore the position of cultural brokers and identify common relational tendencies. METHODS: Social network theories and methods informed the collection of network data and analysis of advice-seeking relationships among ECHO network members and their nominees. Registered members from two ECHO networks were invited to complete the Qualtrics survey. Networks analysed comprised 398 professionals from mainstream health, Aboriginal and Torres Strait Islander Community Controlled Health Organisation, education, disability and child safety service settings. RESULTS: Brokers were well represented, both those who hold knowledge brokerage positions as well as cultural brokers who incorporate clinical and cultural knowledge enabling holistic care for Aboriginal and Torres Strait Islander patients (38 individuals, 17% of network). Professionals who occupy brokerage positions outside the ECHO network tend to be more connected with co-members within the network. CONCLUSIONS: This study is the first application of contemporary social network theories and methods to investigate an ECHO network. The findings highlight the connectivity afforded by brokers, enabling the coordination and collaboration necessary for effective care integration. Inclusion of cultural brokers in an ECHO network provides sustained peer group support while also cultivating relationships that facilitate the integration of cultural and clinical knowledge.


Asunto(s)
Servicios de Salud del Indígena , Nativos de Hawái y Otras Islas del Pacífico , Humanos , Servicios de Salud del Indígena/organización & administración , Femenino , Queensland , Competencia Cultural , Masculino , Red Social , Adulto , Análisis de Redes Sociales , Comunidad de Práctica
2.
Aust J Gen Pract ; 53(5): 321-325, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38697066

RESUMEN

BACKGROUND AND OBJECTIVES: Q fever (QF) is a zoonotic disease caused by Coxiella burnetii, often associated with abattoir workers and farmers. Recent analysis suggests that QF might occur more frequently in urban areas. This study ascertains the knowledge of, and attitudes towards, QF and behaviours in the management of QF among general practitioners (GPs) across rural and urban areas. METHOD: This cross-sectional survey study targeted GPs working in regional Queensland. GPs were asked to complete a 59-item questionnaire. Logistic regression was used to compare respondent demographics with attitude ratings and knowledge scores. RESULTS: Diagnosing a patient with QF was significantly related to practitioner age, years in practice and practising in a rural area. DISCUSSION: This study shows gaps in GP QF knowledge, particularly around QF management. With increased urbanisation of rural areas potentially leading to increases in acute QF cases, GPs need to improve their knowledge of this disease.


Asunto(s)
Médicos Generales , Conocimientos, Actitudes y Práctica en Salud , Fiebre Q , Humanos , Fiebre Q/psicología , Fiebre Q/diagnóstico , Queensland , Estudios Transversales , Médicos Generales/psicología , Médicos Generales/estadística & datos numéricos , Femenino , Encuestas y Cuestionarios , Masculino , Persona de Mediana Edad , Adulto , Actitud del Personal de Salud , Población Rural/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos
3.
PLoS One ; 19(5): e0303877, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38771828

RESUMEN

Coxiella burnetii, the causative agent of Q fever, is a zoonotic bacteria of global public health significance. The organism has a complex, diverse, and relatively poorly understood animal reservoir but there is increasing evidence that macropods play some part in the epidemiology of Q fever in Australia. The aim of this cross-sectional survey was to estimate the animal- and tissue-level prevalence of coxiellosis amongst eastern grey (Macropus giganteus) and red (Osphranter rufus) kangaroos co-grazing with domestic cattle in a Q fever endemic area in Queensland. Serum, faeces and tissue samples from a range of organs were collected from 50 kangaroos. A total of 537 tissue samples were tested by real-time PCR, of which 99 specimens from 42 kangaroos (84% of animals, 95% confidence interval [CI], 71% to 93%) were positive for the C. burnetii IS1111 gene when tested in duplicate. Twenty of these specimens from 16 kangaroos (32%, 95% CI 20% to 47%) were also positive for the com1 or htpAB genes. Serum antibodies were present in 24 (57%, 95% CI 41% to 72%) of the PCR positive animals. There was no statistically significant difference in PCR positivity between organs and no single sample type consistently identified C. burnetii positive kangaroos. The results from this study identify a high apparent prevalence of C. burnetii amongst macropods in the study area, albeit seemingly with an inconsistent distribution within tissues and in relatively small quantities, often verging on the limits of detection. We recommend Q fever surveillance in macropods should involve a combination of serosurveys and molecular testing to increase chances of detection in a population, noting that a range of tissues would likely need to be sampled to confirm the diagnosis in a suspect positive animal.


Asunto(s)
Anticuerpos Antibacterianos , Coxiella burnetii , Macropodidae , Fiebre Q , Animales , Coxiella burnetii/genética , Coxiella burnetii/inmunología , Macropodidae/microbiología , Queensland/epidemiología , Fiebre Q/epidemiología , Fiebre Q/veterinaria , Fiebre Q/microbiología , Fiebre Q/inmunología , Anticuerpos Antibacterianos/sangre , Anticuerpos Antibacterianos/inmunología , Ganado/microbiología , Bovinos , Estudios Transversales
4.
BMC Ecol Evol ; 24(1): 67, 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38773413

RESUMEN

BACKGROUND: The ecology and biology of oysters (Ostreidae) across the tropics is poorly understood. Morphological plasticity and shared characteristics among oysters have resulted in the misidentification of species, creating challenges for understanding basic species-specific biological information that is required for restoration and aquaculture. Genetic barcoding has proven essential for accurate species identification and understanding species geographic ranges. To reduce the costs of molecular species identification we developed multiplex assays using the cytochrome c oxidase subunit I (COI or cox1) barcoding gene for the rapid identification of five species of oysters within the genus Saccostrea that are commonly found in Queensland, Australia: Saccostrea glomerata, Saccostrea lineage B, Saccostrea lineage F, Saccostrea lineage G, and Saccostrea spathulata (lineage J). RESULTS: Multiplex assays were successful in species-specific amplification of targeted species. The practical application of these primers was tested on wild spat collected from a pilot restoration project in Moreton Bay, Queensland, with identified species (S. glomerata, lineage B and lineage G) validated by Sanger sequencing. DNA sampling by extraction of oyster pallial fluid was also tested on adult oysters collected from the Noosa estuary in Queensland to assess whether oysters were able to be identified non-destructively. DNA concentrations as low as 1 ng/ µL still amplified in most cases, allowing for identification, and mortality at 6 weeks post pallial fluid collection was low (3 out of 104 sampled oysters). CONCLUSION: These multiplex assays will be essential tools for species identification in future studies, and we successfully demonstrate their practical application in both restoration and aquaculture contexts in Queensland. The multiplex assays developed in this study outline easily replicable methods for the development of additional species-specific primer sets for the rapid identification of other species of Saccostrea found across the Indo-Pacific, which will be instrumental in unravelling the taxonomic ambiguities within this genus in tropical regions.


Asunto(s)
Acuicultura , Código de Barras del ADN Taxonómico , Complejo IV de Transporte de Electrones , Reacción en Cadena de la Polimerasa Multiplex , Ostreidae , Animales , Reacción en Cadena de la Polimerasa Multiplex/métodos , Acuicultura/métodos , Código de Barras del ADN Taxonómico/métodos , Complejo IV de Transporte de Electrones/genética , Ostreidae/genética , Queensland , Especificidad de la Especie , Conservación de los Recursos Naturales/métodos
5.
Trials ; 25(1): 293, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38693590

RESUMEN

BACKGROUND: Distressing symptoms are common in advanced cancer. Medicinal cannabinoids are commonly prescribed for a variety of symptoms. There is little evidence to support their use for most indications in palliative care. This study aims to assess a 1:20 delta-9-tetrahydrocannabinol/cannabidiol (THC/CBD) cannabinoid preparation in the management of symptom distress in patients with advanced cancer undergoing palliative care. METHODS AND DESIGN: One hundred and fifty participants will be recruited across multiple sites in Queensland, Australia. A teletrial model will facilitate the recruitment of patients outside of major metropolitan areas. The study is a pragmatic, multicenter, randomised, placebo-controlled, two-arm trial of escalating doses of an oral 1:20 THC/CBD medicinal cannabinoid preparation (10 mg THC:200 mg CBD/mL). It will compare the efficacy and safety outcomes of a titrated dose range of 2.5 mg THC/50mgCBD to 30 mg THC/600 mg CBD per day against a placebo. There is a 2-week patient-determined titration phase, to reach a dose that achieves symptom relief or intolerable side effects, with a further 2 weeks of assessment on the final dose. The primary objective is to assess the effect of escalating doses of a 1:20 THC/CBD medicinal cannabinoid preparation against placebo on change in total symptom distress score, with secondary objectives including establishing a patient-determined effective dose, the effect on sleep quality and overall quality of life. Some patients will be enrolled in a sub-study which will more rigorously evaluate the effect on sleep. DISCUSSION: MedCan-3 is a high-quality, adequately powered, placebo-controlled trial which will help demonstrate the utility of a THC:CBD 1:20 oral medicinal cannabis product in reducing total symptom distress in this population. Secondary outcomes may lead to new hypotheses regarding medicinal cannabis' role in particular symptoms or in particular cancers. The sleep sub-study will test the feasibility of using actigraphy and the Insomnia Severity Index (ISI) in this cohort. This will be the first large-scale palliative care randomised clinical trial to utilise the teletrial model in Australia. If successful, this will have significant implications for trial access for rural and remote patients in Australia and internationally. TRIAL REGISTRATION: ANZCTR ACTRN12622000083796 . Protocol number 001/20. Registered on 21 January 2022. Recruitment started on 8 August 2022.


Asunto(s)
Cannabidiol , Dronabinol , Marihuana Medicinal , Neoplasias , Cuidados Paliativos , Humanos , Administración Oral , Cannabidiol/administración & dosificación , Cannabidiol/efectos adversos , Cannabidiol/uso terapéutico , Método Doble Ciego , Dronabinol/uso terapéutico , Dronabinol/administración & dosificación , Combinación de Medicamentos , Marihuana Medicinal/uso terapéutico , Marihuana Medicinal/efectos adversos , Marihuana Medicinal/administración & dosificación , Estudios Multicéntricos como Asunto , Neoplasias/tratamiento farmacológico , Neoplasias/complicaciones , Cuidados Paliativos/métodos , Calidad de Vida , Queensland , Ensayos Clínicos Controlados Aleatorios como Asunto , Carga Sintomática , Factores de Tiempo , Resultado del Tratamiento
6.
BMJ Open ; 14(5): e081680, 2024 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-38772583

RESUMEN

OBJECTIVE: People with post-stroke aphasia (language/communication impairment) and their supporters report mixed satisfaction with stroke and aphasia care. To date, however, their journey of care and the key service interactions that shape their experience have not been comprehensively explored. We aimed to investigate the lived experience of post-stroke aphasia care, across the continuum of care and by geographical location, to establish priorities for service design. DESIGN: This is the first stage of an experience-based co-design study. We purposively sampled people with aphasia (PWA) and significant others (SOs) across 21 hospital and health service sites, community groups and by self-referral. Participants shared experiences of care in online interviews and focus groups. Touchpoints (key moments that shape experience) and unmet needs were identified using qualitative thematic analysis. Priorities for service design were established using an adapted nominal group technique. SETTING: Sites spanned remote, regional and metropolitan areas in Queensland, Australia. PARTICIPANTS: PWA (n=32; mild=56%; moderate=31%; severe=13%) and SOs (n=30) shared 124 experiences of acute, rehabilitation and community-based care in 23 focus groups and 13 interviews. RESULTS: Both positive and negative healthcare experiences occurred most frequently in hospital settings. Negative experiences regularly related to communication with health professionals, while positive experiences related to the interpersonal qualities of healthcare providers (eg, providing hope) for PWA, or witnessing good rapport between a PWA and their health professional for SOs. To improve services, PWA prioritised communicatively accessible education and information and SOs prioritised access to psychological and peer support. CONCLUSIONS: We identified key aspects of post-stroke aphasia care that shape experience. The needs of PWA and SOs may be better met through health professional training in supported communication, increased service availability in regional and remote areas, communication-accessible hospital environments, increased access to psychological and peer support, and meaningful involvement of SOs in rehabilitation.


Asunto(s)
Afasia , Grupos Focales , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Humanos , Afasia/etiología , Afasia/rehabilitación , Afasia/terapia , Femenino , Masculino , Persona de Mediana Edad , Anciano , Accidente Cerebrovascular/complicaciones , Rehabilitación de Accidente Cerebrovascular/métodos , Queensland , Adulto , Investigación Cualitativa , Necesidades y Demandas de Servicios de Salud , Anciano de 80 o más Años , Satisfacción del Paciente
7.
Commun Biol ; 7(1): 611, 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38773323

RESUMEN

Human impacts lead to widespread changes in the abundance, diversity and traits of shark assemblages, altering the functioning of coastal ecosystems. The functional consequences of shark declines are often poorly understood due to the absence of empirical data describing long-term change. We use data from the Queensland Shark Control Program in eastern Australia, which has deployed mesh nets and baited hooks across 80 beaches using standardised methodologies since 1962. We illustrate consistent declines in shark functional richness quantified using both ecological (e.g., feeding, habitat and movement) and morphological (e.g., size, morphology) traits, and this corresponds with declining ecological functioning. We demonstrate a community shift from targeted apex sharks to a greater functional richness of non-target species. Declines in apex shark functional richness and corresponding changes in non-target species may lead to an anthropogenically induced trophic cascade. We suggest that repairing diminished shark populations is crucial for the stability of coastal ecosystems.


Asunto(s)
Biodiversidad , Tiburones , Tiburones/fisiología , Animales , Queensland , Ecosistema , Dinámica Poblacional , Australia , Océanos y Mares
8.
BMJ Case Rep ; 17(4)2024 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-38594194

RESUMEN

We present the first published case of simultaneous pneumonitis and immune thrombocytopenic purpura secondary to primary cytomegalovirus (CMV) infection in an immunocompetent patient. Treatment with oral valganciclovir for 2 weeks successfully led to complete clinical recovery. CMV is traditionally associated with infection in immunocompromised patients and neonates; however, evidence of severe CMV infections in immunocompetent hosts is emerging. It is important to highlight the broad range of clinical presentations of CMV infections to prevent diagnostic delay and associated morbidity and expense.


Asunto(s)
Infecciones por Citomegalovirus , Neumonía , Púrpura Trombocitopénica Idiopática , Femenino , Recién Nacido , Humanos , Citomegalovirus , Púrpura Trombocitopénica Idiopática/complicaciones , Púrpura Trombocitopénica Idiopática/diagnóstico , Púrpura Trombocitopénica Idiopática/tratamiento farmacológico , Ganciclovir/uso terapéutico , Diagnóstico Tardío , Queensland , Infecciones por Citomegalovirus/complicaciones , Infecciones por Citomegalovirus/diagnóstico , Infecciones por Citomegalovirus/tratamiento farmacológico , Neumonía/complicaciones , Neumonía/diagnóstico , Neumonía/tratamiento farmacológico , Antivirales/uso terapéutico
9.
Health Place ; 87: 103245, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38631216

RESUMEN

This study examined associations between changes in neighbourhood walkability and body mass index (BMI) among 1041 residents who relocated within Brisbane, Australia between 2007 and 2016 over five waves of the HABITAT study. Measures included spatially-derived neighbourhood walkability (dwelling density, street connectivity, and land use mix) and self-reported height and weight. No associations were found between any neighbourhood walkability characteristics and BMI. Examining these associations over the life course, and the impact of residential relocation in the younger years, remains a priority for future research.


Asunto(s)
Índice de Masa Corporal , Características de la Residencia , Caminata , Humanos , Caminata/estadística & datos numéricos , Femenino , Masculino , Características de la Residencia/estadística & datos numéricos , Estudios Longitudinales , Adulto , Persona de Mediana Edad , Australia , Planificación Ambiental , Anciano , Queensland , Dinámica Poblacional
10.
Brain Impair ; 252024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38566286

RESUMEN

Background Cognitive rehabilitation of people with traumatic brain injury is a complex and challenging area of practice. Practitioners working in cognitive rehabilitation require ongoing training to stay abreast of new research and best practice interventions. A needs analysis was conducted to inform the development of a capacity building program for cognitive rehabilitation providers. Methods A cross-sectional online survey of providers of cognitive rehabilitation services in Queensland collected data on demographic information, perceptions of knowledge, skills and confidence in cognitive rehabilitation, previously completed training, desired training opportunities and delivery methods, and barriers and facilitators to engaging in training. Results The 103 respondents included 67 occupational therapists, 17 speech pathologists, 12 psychologists and seven social workers with a broad range of practice experience. Participants perceived a need for further training, with executive function and functional cognition the most desired topics. The number of topics previously trained on was significantly correlated with levels of knowledge, skills and confidence (P Conclusion Cognitive rehabilitation providers in Queensland reported a need for further training, delivered flexibly, with a focus on managing complex cognitive impairments.


Asunto(s)
Creación de Capacidad , Entrenamiento Cognitivo , Humanos , Queensland , Estudios Transversales , Encuestas y Cuestionarios
11.
Aust J Rural Health ; 32(2): 249-262, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38646861

RESUMEN

INTROUDCTION: There is increased risk of skin cancer in patients with gloermular disease or those with renal transplant. OBJECTIVES: To compare the risk of skin cancer between kidney recipients (KTRs) and patients with glomerular disease (GD). DESIGN: The cohort comprised patients with KTRs (n = 61) and GD (n = 51) in Central and Central West Queensland, Australia. A quantitative cohort study was undertaken to study the risk of skin cancer in rural communities between two subgroups of patients with kidney diseases in relationship to immunosuppression. Statistical analyses of the differences in incidence of skin cancers between the two groups were done by chi-square test, Fisher's exact test, independent t-test and McNemar's test. FINDINGS: KTRs with non-melanoma skin carcinoma (NMSC) increased significantly after treatment with immunosuppressants (pre-transplantation, n = 11 [18.0%], post-transplantation, n = 28 [45.9%]; p < 0.001). There were no differences in number of patients with NMSC observed in the GD group (pre-diagnosis, n = 6 [11.8%], post-diagnosis, n = 7 [13.7%]; p = 1.000). Compared to the risks at 1 year post-immunosuppressants, the incidence of NMSC of KTRs increased significantly at 3 years (20.3% vs. 35.4%, p < 0.001) and 5 years (20.3% vs. 62.2%, p < 0.001) post-immunosuppressants, whereas the increased incidence of NMSC was observed only at 5 years (2.1% vs. 11.8%, p = 0.012) in the GD cohort. The mean cumulative number of NMSC in KTRs increased significantly at 3 years (p = 0.011), and 5 years (p = 0.001) post-immunosuppressants, compared to the risks at 1 year post-immunosuppressants, however, no differences were noted in the GD cohort. DISCUSSION: Immunosuppressants increased the risk of NMSC in KTRs. The increased risk is likely dependent on the intensity and duration of immunosuppressants. CONCLUSION: In patients with a high risk of NMSC, reducing skin cancer risk should be considered in conjunction with the optimisation of treatment.


Asunto(s)
Trasplante de Riñón , Neoplasias Cutáneas , Humanos , Queensland/epidemiología , Femenino , Masculino , Persona de Mediana Edad , Neoplasias Cutáneas/epidemiología , Adulto , Población Rural/estadística & datos numéricos , Anciano , Estudios de Cohortes , Incidencia , Inmunosupresores/uso terapéutico , Inmunosupresores/efectos adversos , Factores de Riesgo , Receptores de Trasplantes/estadística & datos numéricos
12.
PeerJ ; 12: e17180, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38618562

RESUMEN

Skeletal remains of sauropod dinosaurs have been known from Australia for over 100 years. Unfortunately, the classification of the majority of these specimens to species level has historically been impeded by their incompleteness. This has begun to change in the last 15 years, primarily through the discovery and description of several partial skeletons from the Cenomanian-lower Turonian (lower Upper Cretaceous) Winton Formation in central Queensland, with four species erected to date: Australotitan cooperensis, Diamantinasaurus matildae, Savannasaurus elliottorum, and Wintonotitan wattsi. The first three of these appear to form a clade (Diamantinasauria) of early diverging titanosaurs (or close relatives of titanosaurs), whereas Wintonotitan wattsi is typically recovered as a distantly related non-titanosaurian somphospondylan. Through the use of 3D scanning, we digitised numerous specimens of Winton Formation sauropods, facilitating enhanced comparison between type and referred specimens, and heretofore undescribed specimens. We present new anatomical information on the holotype specimen of Diamantinasaurus matildae, and describe new remains pertaining to twelve sauropod individuals. Firsthand observations and digital analysis enabled previously proposed autapomorphic features of all four named Winton Formation sauropod species to be identified in the newly described specimens, with some specimens exhibiting putative autapomorphies of more than one species, prompting a reassessment of their taxonomic validity. Supported by a specimen-level phylogenetic analysis, we suggest that Australotitan cooperensis is probably a junior synonym of Diamantinasaurus matildae, but conservatively regard it herein as an indeterminate diamantinasaurian, meaning that the Winton Formation sauropod fauna now comprises three (rather than four) valid diamantinasaurian species: Diamantinasaurus matildae, Savannasaurus elliottorum, and Wintonotitan wattsi, with the latter robustly supported as a member of the clade for the first time. We refer some of the newly described specimens to these three species and provide revised diagnoses, with some previously proposed autapomorphies now regarded as diamantinasaurian synapomorphies. Our newly presented anatomical data and critical reappraisal of the Winton Formation sauropods facilitates a more comprehensive understanding of the mid-Cretaceous sauropod palaeobiota of central Queensland.


Asunto(s)
Dinosaurios , Humanos , Animales , Queensland , Filogenia , Australia , Restos Mortales
13.
Influenza Other Respir Viruses ; 18(4): e13280, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38623599

RESUMEN

BACKGROUND: The 'PenCS Flu Topbar' app was deployed in Central Queensland (CQ), Australia, medical practices through a pilot programme in March 2021. METHODS: We evaluated the app's user experience and examined whether the introduction of 'PenCS Flu Topbar' in medical practices could improve the coverage of NIP-funded influenza vaccinations. We conducted a mixed-method study including a qualitative analysis of in-depth interviews with key end-users and a quantitative analysis of influenza vaccine administrative data. RESULTS: 'PenCS Flu Topbar' app users reported positive experiences identifying patients eligible for NIP-funded seasonal influenza vaccination. A total of 3606 NIP-funded influenza vaccinations was administered in the eight intervention practices, 14% higher than the eight control practices. NIP-funded vaccination coverage within practices was significantly higher in the intervention practices (31.2%) than in the control practices (27.3%) (absolute difference: 3.9%; 95% CI: 2.9%-5.0%; p < 0.001). The coverage was substantially higher in Aboriginal and Torres Strait Islander people aged more than 6 months, pregnant women and children aged 6 months to less than 5 years for the practices where the app was introduced when compared to control practices: incidence rate ratio (IRR) 2.4 (95% CI: 1.8-3.2), IRR 2.7 (95% CI: 1.8-4.2) and IRR 2.3 (1.8-2.9) times higher, respectively. CONCLUSIONS: Our evaluation indicated that the 'PenCS Flu Topbar' app is useful for identifying the patients eligible for NIP-funded influenza vaccination and is likely to increase NIP-funded influenza vaccine coverage in the eligible populations. Future impact evaluation including a greater number of practices and a wider geographical area is essential.


Asunto(s)
Vacunas contra la Influenza , Gripe Humana , Aplicaciones Móviles , Niño , Humanos , Femenino , Embarazo , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Queensland/epidemiología , Estaciones del Año , Vacunación , Australia/epidemiología
14.
BMC Health Serv Res ; 24(1): 475, 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38627700

RESUMEN

BACKGROUND: More than 80 countries, including Australia, have made commitments to deliver climate-resilient and low carbon healthcare. Understanding how healthcare workers view their own and their organization's efforts to achieve sustainable and climate-resilient healthcare practice is vital to inform strategies to accelerate that transition. METHODS: We conducted an online staff survey in a large state government hospital-and-health-service organisation in Queensland, Australia, to ascertain attitudes and practices towards environmentally sustainable, climate-resilient healthcare, and views about the organizational support necessary to achieve these goals in their workplace. RESULTS: From 301 participants showed staff strongly support implementing sustainable and climate-resilient healthcare but require significantly more organizational support. Participants identified three categories of organizational support as necessary for the transition to environmentally sustainable and climate-resilient health services and systems: (1) practical support to make sustainability easier in the workplace (e.g. waste, energy, water, procurement, food, transport etc.); (2) training and education to equip them for 21st century planetary health challenges; and (3) embedding sustainability as 'business as usual' in healthcare culture and systems. CONCLUSIONS: The research provides new insight into health workforce views on how organizations should support them to realize climate and sustainability goals. This research has implications for those planning, managing, implementing, and educating for, the transition to environmentally sustainable and climate-resilient health services and systems in Queensland, Australia, and in similar health systems internationally.


Asunto(s)
Atención a la Salud , Servicios de Salud , Humanos , Australia , Queensland , Hospitales Públicos
15.
Aust N Z J Public Health ; 48(2): 100147, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38613931

RESUMEN

OBJECTIVE: The purpose of this article is to evaluate the COVID-19 Care in the Home (CCITH) program during the first COVID-19 omicron wave across Torres Strait and Cape York region of Far North Queensland in 2022. METHODS: A mixed-method study: An online survey and semi-structured interviews of CCITH internal and external stakeholders and participants was utilised to develop a greater understanding of perspectives of the program. RESULTS: Survey participants n=140. Most survey respondents did not attend hospital, emergency, or primary healthcare centre during isolation for medical assistance (82%, 115/140) and most strongly agreed/agreed (87%, 122/140) that the CCITH program cared for their health needs. Interview participants n=14. Thematic analysis of interviews verified survey responses and identified successes of this program including improved community relationships and primary healthcare centres and community members felt supported. Limitations included rapid changes to policies and roles and limited food availability during isolation. CONCLUSIONS: The CCITH program highlights the resilience and self-determination of First Nations communities and primary health staff across the Torres Strait and Cape York throughout the first COVID-19 outbreak in the region. IMPLICATIONS FOR PUBLIC HEALTH: This virtual model of care could be employed in similar settings to improve service provision in both primary and public health to increase community safety and achieve good health outcomes.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiología , Queensland/epidemiología , Masculino , Femenino , Adulto , Salud Pública , Encuestas y Cuestionarios , Persona de Mediana Edad , Servicios de Atención de Salud a Domicilio , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico/psicología , Pandemias
16.
BMJ Open ; 14(4): e081793, 2024 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-38653507

RESUMEN

OBJECTIVE: The 2022 Australian winter was the first time that COVID-19, influenza and respiratory syncytial virus (RSV) were circulating in the population together, after two winters of physical distancing, quarantine and borders closed to international travellers. We developed a novel surveillance system to estimate the incidence of COVID-19, influenza and RSV in three regions of Queensland, Australia. DESIGN: We implemented a longitudinal testing-based sentinel surveillance programme. Participants were provided with self-collection nasal swabs to be dropped off at a safe location at their workplace each week. Swabs were tested for SARS-CoV-2 by PCR. Symptomatic participants attended COVID-19 respiratory clinics to be tested by multiplex PCR for SARS-CoV-2, influenza A and B and RSV. Rapid antigen test (RAT) results reported by participants were included in the analysis. SETTING AND PARTICIPANTS: Between 4 April 2022 and 3 October 2022, 578 adults were recruited via their workplace. Due to rolling recruitment, withdrawals and completion due to positive COVID-19 results, the maximum number enrolled in any week was 423 people. RESULTS: A total of 4290 tests were included. Participation rates varied across the period ranging from 25.9% to 72.1% of enrolled participants. The total positivity of COVID-19 was 3.3%, with few influenza or RSV cases detected. Widespread use of RAT may have resulted in few symptomatic participants attending respiratory clinics. The weekly positivity rate of SARS-CoV-2 detected during the programme correlated with the incidence of notified cases in the corresponding communities. CONCLUSION: This testing-based surveillance programme could estimate disease trends and be a useful tool in settings where testing is less common or accessible. Difficulties with recruitment meant the study was underpowered. The frontline sentinel nature of workplaces meant participants were not representative of the general population but were high-risk groups providing early warning of disease.


Asunto(s)
COVID-19 , Gripe Humana , Infecciones por Virus Sincitial Respiratorio , SARS-CoV-2 , Vigilancia de Guardia , Humanos , COVID-19/epidemiología , COVID-19/diagnóstico , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Incidencia , Queensland/epidemiología , Masculino , Femenino , Gripe Humana/epidemiología , Gripe Humana/diagnóstico , Adulto , Persona de Mediana Edad , Estudios Longitudinales , Anciano , Adulto Joven , Estaciones del Año , Adolescente
17.
Diagn Microbiol Infect Dis ; 109(2): 116286, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38574445

RESUMEN

BACKGROUND: Although Proteus species are occasional causes of serious infections, their epidemiology has not been well defined. The objective was to describe the overall and species-specific occurrence and determinants of Proteus species bloodstream infection (BSI) in a large Australian population. METHODS: All Queensland residents with Proteus species BSI identified within the publicly funded healthcare system between 2000 and 2019 were included. RESULTS: A total of 2,143 incident episodes of Proteus species BSI were identified among 2,079 Queensland residents. The prevalence of comorbid illness differed with higher Charlson comorbidity scores observed with P. penneri and P. vulgaris, and higher prevalence of liver disease with P. penneri, higher comorbid cancer with P. vulgaris, and lower diabetes and renal disease prevalence with P. mirabilis BSIs. CONCLUSION: This study provides novel information on the epidemiology of Proteus species BSI.


Asunto(s)
Bacteriemia , Infecciones por Proteus , Proteus , Humanos , Bacteriemia/epidemiología , Bacteriemia/microbiología , Masculino , Persona de Mediana Edad , Femenino , Infecciones por Proteus/epidemiología , Infecciones por Proteus/microbiología , Anciano , Queensland/epidemiología , Proteus/clasificación , Proteus/aislamiento & purificación , Prevalencia , Adulto , Comorbilidad , Anciano de 80 o más Años , Adulto Joven , Proteus mirabilis/aislamiento & purificación , Proteus mirabilis/clasificación
18.
Obes Res Clin Pract ; 18(2): 147-153, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38575407

RESUMEN

BACKGROUND: This prospective cohort study aimed to investigate the associations between gestational weight gain (GWG) and long-term postpartum maternal weight gain, body mass index (BMI), waist circumference (WC), and the risk of general and abdominal obesity, beyond motherhood (some 27 y after childbirth). METHODS: Participants were 1953 women enrolled in the Mater-University of Queensland Study of Pregnancy cohort study that started in the early 1980 s, with the most recent follow-up at 27 y postpartum. We examined the prospective associations of GWG in pregnancy with weight, BMI, and WC and the risk of adiposity 27 y after the index pregnancy. We used linear and multinomial logistic regressions to examine the independent effect of GWG on each outcome, adjusting for potential confounders and mediators. RESULTS: The average GWG during pregnancy was 14.88 kg (SD 5.24). One in four women (25.50%) gained below the Institute of Medicine (IOM) recommendations and one in three (34.00%) gained excess weight during pregnancy. Every 100 g/week increment of GWG was associated with 2.0 (95% CI: 1.5, 2.6) kg, 0.7 (0.5, 0.9) kg/m2, 1.3 (0.8, 1.8) cm greater body weight, BMI, and WC, respectively 27 y postpartum. Women who gained inadequate weight in pregnancy had significantly lower odds of general obesity (OR; 0.70, 95% CI:0.53,0.94) or abdominal obesity (0.73; 0.56,0.96), whereas those who gained excess gestational weight had much higher odds of general obesity (4.49; 3.36,6.00) and abdominal obesity (3.09; 2.29,4.16). These associations were independent of potential confounders. CONCLUSION: Maternal GWG in pregnancy independently and strongly predicted beyond motherhood weight gain trajectory. GWG within IOM recommendation may prevent long-term development of both general and central obesity.


Asunto(s)
Índice de Masa Corporal , Ganancia de Peso Gestacional , Obesidad Abdominal , Periodo Posparto , Circunferencia de la Cintura , Aumento de Peso , Humanos , Femenino , Embarazo , Obesidad Abdominal/epidemiología , Estudios Prospectivos , Ganancia de Peso Gestacional/fisiología , Adulto , Aumento de Peso/fisiología , Factores de Riesgo , Queensland/epidemiología
19.
Sci Rep ; 14(1): 9677, 2024 04 27.
Artículo en Inglés | MEDLINE | ID: mdl-38678077

RESUMEN

In the field of population health research, understanding the similarities between geographical areas and quantifying their shared effects on health outcomes is crucial. In this paper, we synthesise a number of existing methods to create a new approach that specifically addresses this goal. The approach is called a Bayesian spatial Dirichlet process clustered heterogeneous regression model. This non-parametric framework allows for inference on the number of clusters and the clustering configurations, while simultaneously estimating the parameters for each cluster. We demonstrate the efficacy of the proposed algorithm using simulated data and further apply it to analyse influential factors affecting children's health development domains in Queensland. The study provides valuable insights into the contributions of regional similarities in education and demographics to health outcomes, aiding targeted interventions and policy design.


Asunto(s)
Algoritmos , Teorema de Bayes , Humanos , Análisis por Conglomerados , Queensland , Niño
20.
Epidemiol Infect ; 152: e67, 2024 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-38606586

RESUMEN

Ross River virus (RRV), the most medically and economically important arbovirus in Australia, has been the most prevalent arbovirus infections in humans for many years. Infected humans and horses often suffer similar clinical symptoms. We conducted a prospective longitudinal study over a 3.5-year period to investigate the exposure dynamics of RRV in three foal cohorts (n = 32) born in a subtropical region of South East Queensland, Australia, between 2020 and 2022. RRV-specific seroconversion was detected in 56% (n = 18) of foals with a median time to seroconversion, after waning of maternal antibodies, of 429 days (95% CI: 294-582). The median age at seroconversion was 69 weeks (95% CI: 53-57). Seroconversion events were only detected between December and March (Southern Hemisphere summer) over the entire study period. Cox proportion hazards regression analyses revealed that seroconversions were significantly (p < 0.05) associated with air temperature in the month of seroconversion. Time-lags in meteorological variables were not significantly (p > 0.05) associated with seroconversion, except for relative humidity (p = 0.036 at 2-month time-lag). This is in contrast to research results of RRV infection in humans, which peaked between March and May (Autumn) and with a 0-3 month time-lag for various meteorological risk factors. Therefore, horses may be suitable sentinels for monitoring active arbovirus circulation and could be used for early arbovirus outbreak detection in human populations.


Asunto(s)
Infecciones por Alphavirus , Enfermedades de los Caballos , Virus del Río Ross , Animales , Virus del Río Ross/aislamiento & purificación , Caballos , Enfermedades de los Caballos/epidemiología , Enfermedades de los Caballos/virología , Infecciones por Alphavirus/epidemiología , Infecciones por Alphavirus/veterinaria , Infecciones por Alphavirus/virología , Queensland/epidemiología , Estudios Prospectivos , Estudios Longitudinales , Femenino , Seroconversión , Masculino , Estaciones del Año , Anticuerpos Antivirales/sangre
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