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OBJECTIVE: To adapt 'fishplots' to describe real-time evolution of SARS-CoV-2 genomic clusters. RESULTS: This novel analysis adapted the fishplot to depict the size and duration of circulating genomic clusters over time in New South Wales, Australia. It illuminated the effectiveness of interventions on the emergence, spread and eventual elimination of clusters and distilled genomic data into clear information to inform public health action.
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COVID-19 , Austrália , Genômica , Humanos , New South Wales , SARS-CoV-2RESUMO
PROBLEM: There are significant inequalities in oral health status between Aboriginal and non-Aboriginal children in Australia, particularly where the children have insufficient access to various forms of fluoride. There has been a growing interest in seeing fluoride varnish programs used more widely for Aboriginal children due to proven effectiveness. Despite this, there has been limited scale-up of these programs in Australia. This study investigates the feasibility of using Aboriginal dental assistants to provide regular fluoride varnish applications for Aboriginal children in the primary school setting. DESIGN: A mixed-methods approach including auditing the number of Aboriginal dental assistants were trained and then approved by the NSW Chief Health Officer to apply fluoride varnish, and collection and reporting of participant data on the each of the fluoride varnish days in the local patient management system. SETTING: Six Aboriginal Community Controlled Health Services from regional NSW were invited to participate in the study. They also nominated a primary school and an Aboriginal dental assistant to participate in the study. KEY MEASURES FOR IMPROVEMENT: Data were obtained from four 'fluoride varnish days' held at the schools over a 12-month period between December 2017 and December 2018. The number of Aboriginal dental assistants were trained and then approved by the NSW Chief Health Officer to apply fluoride varnish is also reported. STRATEGIES FOR CHANGE: In total, 8 Aboriginal dental assistants were trained to apply fluoride varnish during the study. Overall, students participating in the study received three or more fluoride varnish applications. EFFECTS OF CHANGE: Results showed that Aboriginal dental assistants are able to safely and effectively apply fluoride varnish in a school setting with remote supervision. LESSONS LEARNT: This program can be scaled at the state level in NSW, and this could provide the basis for a nationally consistent program. Initial discussions have been held with several jurisdictions to lead this process via the Australian Health Ministers Advisory Council (AHMAC) based on the results of this study and the support of key stakeholders. The Poche Centre as part of its scale-up planning for the Fluoride Varnish Program is examining the feasibility of including the apply fluoride varnish skillset in its existing Aboriginal Dental Assistant Scholarship Program.
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Competência Clínica , Assistentes de Odontologia , Fluoretos Tópicos , Criança , Fluoretos Tópicos/administração & dosagem , Serviços de Saúde do Indígena , Humanos , Havaiano Nativo ou Outro Ilhéu do Pacífico , New South Wales , Instituições AcadêmicasRESUMO
In January 2020, a novel betacoronavirus (family Coronaviridae), named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified as the etiological agent of a cluster of pneumonia cases occurring in Wuhan City, Hubei Province, China1,2. The disease arising from SARS-CoV-2 infection, coronavirus disease 2019 (COVID-19), subsequently spread rapidly causing a worldwide pandemic. Here we examine the added value of near real-time genome sequencing of SARS-CoV-2 in a subpopulation of infected patients during the first 10 weeks of COVID-19 containment in Australia and compare findings from genomic surveillance with predictions of a computational agent-based model (ABM). Using the Australian census data, the ABM generates over 24 million software agents representing the population of Australia, each with demographic attributes of an anonymous individual. It then simulates transmission of the disease over time, spreading from specific infection sources, using contact rates of individuals within different social contexts. We report that the prospective sequencing of SARS-CoV-2 clarified the probable source of infection in cases where epidemiological links could not be determined, significantly decreased the proportion of COVID-19 cases with contentious links, documented genomically similar cases associated with concurrent transmission in several institutions and identified previously unsuspected links. Only a quarter of sequenced cases appeared to be locally acquired and were concordant with predictions from the ABM. These high-resolution genomic data are crucial to track cases with locally acquired COVID-19 and for timely recognition of independent importations once border restrictions are lifted and trade and travel resume.
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Betacoronavirus/genética , Infecções por Coronavirus/genética , Genoma Viral/genética , Pandemias , Pneumonia Viral/genética , Betacoronavirus/patogenicidade , COVID-19 , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Humanos , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , SARS-CoV-2 , Análise de Sistemas , Sequenciamento Completo do GenomaRESUMO
The SARS-CoV-2 epidemic has rapidly spread outside China with major outbreaks occurring in Italy, South Korea, and Iran. Phylogenetic analyses of whole-genome sequencing data identified a distinct SARS-CoV-2 clade linked to travellers returning from Iran to Australia and New Zealand. This study highlights potential viral diversity driving the epidemic in Iran, and underscores the power of rapid genome sequencing and public data sharing to improve the detection and management of emerging infectious diseases.
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INTRODUCTION: This study compares the workplace decisions from University of Sydney (USYD) dental graduates who participated in a 1-month voluntary Rural Clinical Placement Program (RCPP), USYD graduates who did not participate in the RCPP (non-RCPP), and with graduates who qualified from a dental Rural Clinical School (RCS) at Charles Sturt University (CSU). METHODOLOGY: From mid-2015, USYD students who graduated between 2009 and 2013, and CSU graduates from 2013 to 2014, were requested to complete a telephone interview related to employment choices. For USYD, 135 interviews were completed (63% of contactable graduates) and for CSU, 39 interviews (68%). Mixed methods were applied to analyse the data. RESULTS: For USYD, 33% of RCPP participants were working rurally compared with 18% of the non-RCPP, whilst 54% of CSU graduates were working rurally. For USYD, the self-reported influence of the RCPP on the graduates' employment decisions was a significant predictor of rural employment. For CSU, country of birth and employment status were weakly associated with rural employment. Across the three cohorts, key employment factors were as follows: job availability, family, personal relationships, good mentorship, clinical training, partner factor and lifestyle. In addition, both the RCPP and CSU graduates showed greater interest and awareness of rural employment than the non-RCPP. CONCLUSION: The CSU RCS and USYD RCPP are leading to positive rural employment outcomes, and it is clear that the provision of a rural experience is influencing graduates to work rurally. Further investigation of the CSU program is required to fully assess its impact and to provide longitudinal workforce information.
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Área de Atuação Profissional , Serviços de Saúde Rural , Escolha da Profissão , Humanos , População Rural , Recursos HumanosRESUMO
INTRODUCTION: As part of an oral health service for Aboriginal people in central northern New South Wales (NSW), Australia, oral health promotion was identified as a priority by the local Aboriginal community. The objective of this study was to collaborate with local Aboriginal communities to determine (1) the oral health needs of Aboriginal children aged 5-12 years, (2) the oral health knowledge and attitudes towards oral health of parents/guardians and (3) the perceived barriers and enablers towards oral health promotion for school children by local school staff and community health workers. The results of this collaboration will inform a community-owned oral health promotion program. METHODS: Aboriginal children aged 5-12 years enrolled in local schools received a dental screening by a single examiner. The number of decayed, missing and filled teeth of primary and permanent dentition (dmft/DMFT), plaque and gingivitis were recorded. Children completed a questionnaire assessing current oral hygiene practices, dental history and information on their diet. Parents/guardians completed a questionnaire assessing oral health knowledge and attitudes towards oral health. School staff and community health workers completed a questionnaire assessing attitudes, barriers and enablers towards implementing an oral health promotion program in schools. RESULTS: Eighty-eight children, representing 94% of those eligible, were screened, and 78 (82%) completed a questionnaire. The mean dmft/DMFT score was 5.3. Risk factors for dental caries identified included lack of toothbrush ownership (35%), minimal fluoride toothpaste use (24%), limited daily tooth brushing (51%) and frequent consumption of sugary foods (72%) and soft drinks (64%). Questionnaires were completed by 32 parents/guardians and 39 school and community health workers. Parents/guardians had limited oral health knowledge. School and health staff were willing to support a health promotion program to improve dental health of children. CONCLUSION: Aboriginal children living in rural and remote communities in NSW experience high rates of dental caries. Oral health promotion is urgently required to reduce the burden of dental caries and should address oral hygiene behaviours, fluoride use and access to healthy foods and drinks. Note: This article uses the term 'Aboriginal people' when referring to the first peoples of Australia. This term is inclusive of Australian Aboriginal and Torres Strait Islander people.
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Promoção da Saúde/organização & administração , Havaiano Nativo ou Outro Ilhéu do Pacífico , Saúde Bucal/etnologia , Serviços de Saúde Rural/organização & administração , Serviços de Saúde Escolar/organização & administração , Adulto , Criança , Pré-Escolar , Agentes Comunitários de Saúde , Comportamento Cooperativo , Assistência Odontológica/métodos , Cárie Dentária/etnologia , Inquéritos de Saúde Bucal , Açúcares da Dieta , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales , Higiene Bucal , Fatores de Risco , Adulto JovemRESUMO
OBJECTIVE: This systematic review analyzes existing literature on the clinical efficacy of air polishing devices (APDs), discussing the evidence-based data available for justifying their use as an alternative to conventional periodontal debridement in supportive periodontal therapy. The main objective of the review was to assess whether APD was as equally efficient or superior in obtaining successful treatment outcomes when compared with conventional methods. DATA SOURCES: Following PRISMA guidelines, a systematic literature search of articles in English, up to December 2016, was conducted using PubMed, Cochrane, and Medline. Relevant articles were selected based on specific criteria. Seven studies were selected for the final assessment. One more study was added after a manual search of the literature. Due to considerable heterogeneity in study designs and outcome variables measured, only clinical parameters (probing depth, bleeding on probing, and clinical attachment level) were selected for meta-analysis. CONCLUSION: The studies selected for this systematic review provide some evidence that APDs as monotherapy could be an alternative to conventional debridement of single- and multi-rooted teeth with no furcation involvement, during supportive periodontal therapy. Comparing clinical and microbiologic outcomes, APDs seem to be as effective as conventional treatments. The primary advantage for the use of APDs in supportive periodontal therapy seems to be their ability to efficiently remove biofilm, without causing damage to the periodontal soft tissues or tooth and root structure. There may also be an advantage regarding patient comfort and time consumed.
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Abrasão Dental por Ar/métodos , Doenças Periodontais/terapia , Humanos , Desbridamento PeriodontalRESUMO
OBJECTIVE: To compare the cost of a basket of staple foods, together with the availability and quality of fresh fruit and vegetables, by supermarket store type in high and low socioeconomic suburbs of Sydney. METHODS: A food basket survey was undertaken in 100 supermarkets in the 20 highest and 20 lowest socioeconomic suburbs of Sydney. We assessed the cost of 46 foods, the range of 30 fresh fruit and vegetables and the quality of ten fresh fruit and vegetables. Two major supermarket retailers, a discount supermarket chain and independent grocery stores were surveyed. RESULTS: The food basket was significantly cheaper in low compared to high socioeconomic suburbs ($177 vs $189, p<0.01). Discount supermarkets were at least 30% cheaper than other supermarket stores. There were fewer varieties and poorer quality fruit and vegetables in stores in low socioeconomic suburbs. CONCLUSIONS: Food basket prices and the availability and quality of fruit and vegetables varied significantly by store type and socioeconomic status of suburb. Implications for public health: A nationwide food and nutrition surveillance system is required to inform public health policy and practice initiatives. In addition to the food retail environment, these initiatives must address the underlying contributors to inequity and food insecurity for disadvantaged groups.
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Comércio , Abastecimento de Alimentos/economia , Alimentos/economia , Frutas/provisão & distribuição , Características de Residência , Fatores Socioeconômicos , Verduras/provisão & distribuição , Custos e Análise de Custo , Frutas/economia , Disparidades nos Níveis de Saúde , Humanos , Inquéritos Nutricionais , Classe Social , Inquéritos e Questionários , Verduras/economiaRESUMO
OBJECTIVE: Whether patients with type 2 diabetes change their lifestyle in response to their diagnosis and maintain behavior changes is unclear. This study aimed to 1) compare changes in lifestyle behaviors among participants who were newly diagnosed with type 2 diabetes and those never diagnosed with type 2 diabetes and 2) investigate changes in lifestyle behaviors in relation to the duration of newly diagnosed type 2 diabetes. METHODS: We used self-reported information from the New South Wales 45 and Up Study and a follow-up study. Changes in body weight; amount of walking, moderate to vigorous physical activity (MVPA), and sitting; fruit and vegetable consumption; and smoking status and number of cigarettes smoked were used as measures of health behavior change. These variables were compared between participants in a "new type 2 diabetes" group and a "no type 2 diabetes" group. RESULTS: The new type 2 diabetes group had a smaller decrease in vegetable consumption, lost more weight, and were more likely to quit smoking than the no type 2 diabetes group. MVPA, fruit consumption, and number of cigarettes smoked did not change significantly for either group. Although no significant changes were found in any of the health behaviors based on time since diagnosis, the magnitude of changes in weight and walking increased as duration of diagnosis increased, whereas changes in MVPA, number of cigarettes smoked, and proportion of participants who quit smoking decreased. CONCLUSION: In this population-based study, participants with incident type 2 diabetes reported only minimal changes in their lifestyle factors after receiving their diagnosis.
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BACKGROUND: Lifetime access to fluoridated water (FW) is associated with lower caries experience. However, assessing this association in adults is likely affected by age. Cohort stratification and categorization of per cent lifetime access to fluoridated water (% LAFW) within cohorts are current approaches to this assessment. These approaches require an examination of the % LAFW and caries experience variation within and across age groups and their association to inform future analyses. OBJECTIVE: This secondary analysis aimed to examine the age group variation in % LAFW and caries experience; and the association of % LAFW with caries within and across age groups of adults. METHODS: A secondary analysis was undertaken using the Australian National Survey of Adult Oral Health 2004-2006 data on 4090 persons aged 15-91 years randomly sampled by a stratified, multistage probability method. Study participants underwent an interview, an oral examination by trained and standardized dentists to determine decayed, missing or filled tooth surfaces (DMFS) and a mailed self-complete questionnaire which collected residential history to calculate % LAFW. Variations in % LAFW and DMFS across age groups (15-34; 35-44; 45-54; 55+) were examined. Multivariable regression log-link models were generated for DMFS score within each age group. RESULTS: The age groups varied in values and distribution of % LAFW. Caries experience was strongly associated with age. % LAFW was significantly associated with DMFS score in the two younger age groups, but not in the others. Multivariable regression models showed that the highest % LAFW quartile had significantly lower DMFS count than the lowest quartile in the two younger age groups (mean ratios: 0.67 and 0.78, respectively), controlling for other covariates. CONCLUSION: Access to FW was associated with caries experience in Australian adults. The magnitude of associations varied between age groups, dependent on the natural history of caries and its measurement by DMFS.
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Cárie Dentária/prevenção & controle , Fluoretação , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Índice CPO , Cárie Dentária/epidemiologia , Feminino , Fluoretação/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Adulto JovemRESUMO
BACKGROUND: The aim was to investigate the association between distant green space and physical activity modified by local green space. METHODS: Information about physical activity, demographic and socioeconomic background at the individual level was extracted from the New South Wales Population Health Survey. The proportion of a postcode that was parkland was used as a proxy measure for access to parklands and was calculated for each individual. RESULTS: There was a significant relationship between distant green space and engaging in moderate-to-vigorous physical activity (MVPA) at least once a week. No significant relationship was found between adequate physical activity and distant green space. No significant relationships were found between adequate physical activity, engaging in MVPA, and local green space. However, if respondents lived in greater local green space (≥25%), there was a significant relationship between engaging in MVPA at least once a week and distance green space of ≥20%. CONCLUSION: This study highlights the important effect of distant green space on physical activity. Our findings also suggest that moderate size of local green space together with moderate size of distant green space are important levers for participation of physical activity.
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Planejamento Ambiental/estatística & dados numéricos , Exercício Físico , Adolescente , Adulto , Idoso , Atitude Frente a Saúde , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales , Razão de Chances , Características de Residência , Adulto JovemRESUMO
BACKGROUND: Advances in geographic information systems (GIS) and increased availability of routinely collected data have the potential to contribute to public health and health services research. The aim of this feasibility study was to explore the use of GIS to measure access to general practices and its relationship to selected antenatal behaviours. METHODS: We obtained the Perinatal Data Collection, 2004-2008, for South Western Sydney Local Health District from the New South Wales Ministry of Health. Using a GIS, we generated circular and polygon-based 1 km and 2 km road network buffers from a maternal residential address and then calculated the number of general practices within those buffers (density measures). Distances to general practices from maternal residences were also calculated in the GIS as another measure of geographic access to general practices (proximity measures). We used generalised estimating equations logistic regression to examine associations between access to general practices, and smoking during pregnancy and late first antenatal visit. RESULTS: The numbers of general practices within circular buffers were significantly greater than within polygon-based road network buffers. The average distance to the five closest general practices from a mother's residence was 2.3 km ± 3.0 km (median 1.4 km, range 0.05 km to 40.0 km). For two of the five measures of access, a higher number of general practices was associated with increased risk for late first antenatal visit. However, the associations were weak, with odds ratios very close to unity. Choice of metrics of geographic access to general practices did not alter the associations with smoking during pregnancy or late first antenatal visit. CONCLUSION: GIS can be used to quantify measures of geographic access to health services for public health and health services research. Geographic access to general practices was generally not associated with smoking during pregnancy or late first antenatal visit. GIS and routinely collected health data can be used to answer novel questions in public health and health services research.
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Acessibilidade aos Serviços de Saúde , Pesquisa sobre Serviços de Saúde/métodos , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Fumar/epidemiologia , Adulto , Coleta de Dados , Estudos de Viabilidade , Feminino , Medicina Geral , Sistemas de Informação Geográfica , Humanos , New South Wales , Saúde Pública , Prevenção do Hábito de Fumar , Adulto JovemRESUMO
OBJECTIVE: To monitor the changes in dental caries prevalence of 5- to 7-year-old children living in a fluoridated area, a newly fluoridated area and in an area without water fluoridation, in NSW, Australia. METHODS: Dental caries prevalence was recorded for 5- to 7-year-old children, living in the three study locations, by six trained and calibrated examiners in 2008, 2010 and 2012. A questionnaire recorded demographic data, toothbrushing behaviour and sugary drink consumption. Caries experience was measured using the decayed, missing, and filled teeth (dmft) index for primary teeth, the percentage of children who were caries free and the significant caries index. Univariate analysis was undertaken to determine independent predictors of caries. RESULTS: The caries prevalence changed over time. In 2008, the mean dmft index was 1.40 for the fluoridated area, 2.02 for the area about to fluoridate and 2.09 for the unfluoridated control. By 2012, these mean dmft scores were 0.69, 0.72 and 1.21, respectively. In the two areas where children received fluoridated water, the significant caries index was 2.30 for the fluoridated area and 2.40 for the newly fluoridated area. The significant caries score for children in the unfluoridated location was 3.93. Multivariate analysis showed that over time the differences in dental caries prevalence between the established fluoride area and the newly fluoridated area diminished. However, children in the unfluoridated control area continued to demonstrate significant differences in the mean number of decayed teeth compared with children in the fluoridated comparator sites, and the proportions of children free from decay were significantly higher in the fluoridated areas than in the unfluoridated area. CONCLUSION: Fluoridation of public water supplies in Gosford and Wyong offers young children better dental health than those children who do not have access to this public health measure.
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Cárie Dentária/epidemiologia , Fluoretação/estatística & dados numéricos , Bebidas/estatística & dados numéricos , Bebidas Gaseificadas/estatística & dados numéricos , Criança , Pré-Escolar , Índice CPO , Sacarose Alimentar/administração & dosagem , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Estudos Longitudinais , Masculino , New South Wales/epidemiologia , Prevalência , Dente Decíduo/patologia , Escovação Dentária/estatística & dados numéricosRESUMO
BACKGROUND: The Local Government Area of Gosford implemented a water fluoridation scheme in 2008. Therefore the opportunity was taken to record the dental health of primary school children aged 5-7 years prior to the fluoridation and compare the results with other communities in NSW with different access to fluoridated water. The aim was to compare the oral health of New South Wales (Australia)s 5-7 year olds living in fluoridated, and non- fluoridated communities. One of the areas was due to implement water fluoridation and is termed the pre-fluoridation site. METHODS: Pupils in the first year of Public and Catholic Schools in three areas of NSW were recruited. Class lists were used to draw a sample of approximately 900 per area. This number allowed for a non-response rate of up to 30 per cent and would give a sample sufficient numbers to allow statistical inferences to be drawn. Children whose parents consented received a dental examination and the clinical data was collected on mark sense cards. RESULTS: In the 3 areas the proportion of children who received a dental examination varied; 77.5% (n = 825) for the fluoridated area, 80.1% (n = 781) for the pre-fluoridated area and 55.3% (n = 523) for the non-fluoridated area. The mean dmft was 1.40 for the fluoridated area, 2.02 for the pre-fluoridated area and 2.09 for the non-fluoridated area. These differences were statistically significant (p < 0.01). Differences were also noted in the proportion of children who were caries free, 62.6% fluoridated area, 50.8% for the pre-fluoride area and 48.6% for the non-fluoride location. CONCLUSION: The children living in the well-established fluoridated area had less dental caries and a higher proportion free from disease when compared with the other two areas which were not fluoridated. Fluoridation demonstrated a clear benefit in terms of better oral health for young children.
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Saúde da Criança/estatística & dados numéricos , Cárie Dentária/epidemiologia , Fluoretação/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Fatores Etários , Criança , Pré-Escolar , Índice CPO , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Havaiano Nativo ou Outro Ilhéu do Pacífico/etnologia , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , New South Wales/epidemiologia , Prevalência , Saúde da População Rural/estatística & dados numéricos , Classe Social , Dente Decíduo/patologia , Saúde da População Urbana/estatística & dados numéricosRESUMO
AIM: To describe the prevalence and risk factors for markers of poor oral health in Aboriginal and non-Aboriginal young people in custody in Australia. METHODS: All incarcerated youth, aged 13-21 years, in New South Wales Juvenile Custodial Centres between August and October 2009 were invited to participate and undertake a dental exam. The main outcome measures were an assessment of moderate/abundant plaque, periodontal disease, dental caries experience, mean decayed and/or filled and/or missing teeth (DMFT) index and untreated decay. RESULTS: Two hundred ninety-four participants (91% male, 46% Aboriginal) underwent a dental exam. Markers of poor oral health were common - 49.4% with moderate/abundant plaque, 34.4% with periodontal disease, mean DMFT 3.56 and 54% having untreated decay. Risk factors independently associated with poor oral health were geographical remoteness and non-fluoridation of the water supply of the usual residence, a shorter incarceration time and dental treatment outside of custody. CONCLUSIONS: Young people entering custody have poor oral health, with those from geographically remote areas without water fluoridation at highest risk. The incarceration period is an opportunity for oral health improvements in these young people through access to dental treatment services. Better triaging systems are needed to identify those of greatest priority, and prevention services are needed.
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OBJECTIVES: Early colonisation of oral surfaces by periodontal pathogens presents a significant risk factor for subsequent development of destructive disease affecting tissues that support the dentition. The aims of the present study were to establish the age-dependent relationship between sub-gingival profiles of 22 Prevotella species/phylotypes in children, adolescents and adults from an isolated Aboriginal community and, further, to use this information to identify Prevotella species that could serve as microbial risk indicators. MATERIALS AND METHODS: DNA isolated from sub-gingival plaque samples (three healthy sites and three inflamed/diseased sites) from adults, adolescents and children was screened for Porphyromonas gingivalis load and 22 Prevotella species/phylotypes by species-specific PCR. RESULTS: A noticeable feature in adolescents was the marked increase in colonisation by P. gingivalis across all test sites. The mean number of Prevotella species/phylotypes colonising inflamed/diseased sub-gingival sites increased with age. Progressive partitioning of selected Prevotella species/phylotypes to healthy or inflamed/diseased sites was evident. Prevalence of Prevotella intermedia, Prevotella oral clone P4PB_24 and Prevotella oris increased significantly with age in diseased sites. Similarly, significant age-dependent increase in colonisation of healthy as well as inflamed/diseased sub-gingival sites was apparent for Prevotella oralis, Prevotella multiformis, Prevotella denticola, Prevotella strain P4P_53 and Prevotella oral clone BR014. CONCLUSION: Early colonisation of children by P. gingivalis, P. intermedia and Prevotella oral clone P4PB_24 provides indication of risk for subsequent development of periodontal disease. CLINICAL RELEVANCE: In the present study, the complexity of Prevotella species within gingival sites is explored as a basis for evaluating contribution of Prevotella species to disease.
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Gengiva/microbiologia , Doenças Periodontais/microbiologia , Porphyromonas gingivalis/genética , Prevotella/genética , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Estudos de Coortes , DNA Bacteriano/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Havaiano Nativo ou Outro Ilhéu do Pacífico , New South Wales , Reação em Cadeia da Polimerase , Adulto JovemRESUMO
OBJECTIVE: To investigate the potential social and behavioural risk factors influencing the oral health of teenagers aged 14 and 15 years living in New South Wales Australia. METHODS: Quantitative and qualitative methodologies were used in this research project. Data were obtained from both the clinical and questionnaire components of the NSW Teen Dental Survey 2010 and were analysed in SAS 9.2. The analyses allowed for various demographic and behavioural risk factors to be assessed using caries experience, severe caries and DMFT (decayed, missing or filled teeth) counts as the key outcome variables. RESULTS: Of the 1,256 14- and 15-year-olds who had a dental examination, 1,199 (95.5%) provided questionnaire data. The clinical examinations found that 44.4% of teenagers overall had caries experience in at least one tooth, while 10.6% of the sample had experienced severe caries. Severe dental caries was found to be significantly related to a variety of factors, including family income, fluoridation status, tooth brushing behaviour and sugary drink consumption. CONCLUSIONS: The oral health of 14- and 15-year-olds in NSW is influenced by social and dietary factors as well as access to fluoridated water supplies. There was also a strong relationship between self-rated oral health status with DMFT and with caries experience. IMPLICATIONS: The findings of this study will assist policy makers by highlighting the current caries risk factors that should be part of future health promotion programs.
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Saúde do Adolescente , Cárie Dentária/epidemiologia , Fluoretação/estatística & dados numéricos , Saúde Bucal , Adolescente , Índice CPO , Feminino , Inquéritos Epidemiológicos , Humanos , Entrevistas como Assunto , Masculino , New South Wales/epidemiologia , Pesquisa Qualitativa , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Late antenatal care and smoking during pregnancy are two important factors that are amenable to intervention. Despite the adverse health impacts of smoking during pregnancy and the health benefits of early first antenatal visit on both the mother and the unborn child, substantial proportions of women still smoke during pregnancy or have their first antenatal visit after 10 weeks gestation. This study was undertaken to assess the usefulness of geospatial methods in identifying communities at high risk of smoking during pregnancy and timing of the first antenatal visit, for which targeted interventions may be warranted, and more importantly, feasible. METHODS: The Perinatal Data Collection, from 1999 to 2008 for south-western Sydney, were obtained from the New South Wales Ministry of Health. Maternal addresses at the time of delivery were georeferenced. A spatial scan statistic implemented in SaTScan was then used to identify statistically significant spatial clusters of women who smoked during pregnancy or women whose first antenatal care visit occurred at or after 10 weeks of pregnancy. RESULTS: Four spatial clusters of maternal smoking during pregnancy and four spatial clusters of first antenatal visit occurring at or after 10 weeks were identified in our analyses. In the maternal smoking during pregnancy clusters, higher proportions of mothers, were aged less than 35 years, had their first antenatal visit at or after 10 weeks and a lower proportion of mothers were primiparous. For the clusters of increased risk of late first antenatal visit at or after 10 weeks of gestation, a higher proportion of mothers lived in the most disadvantaged areas and a lower proportion of mothers were primiparous. CONCLUSION: The application of spatial analyses provides a means to identify spatial clusters of antenatal risk factors and to investigate the associated socio-demographic characteristics of the clusters.
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Intervenção Médica Precoce/métodos , Sistemas de Informação Geográfica , Mapeamento Geográfico , Vigilância da População/métodos , Cuidado Pré-Natal/métodos , Fumar/epidemiologia , Adolescente , Adulto , Análise por Conglomerados , Feminino , Humanos , New South Wales/epidemiologia , Gravidez , Prevenção do Hábito de Fumar , Adulto JovemRESUMO
INTRODUCTION: Dental decay (caries) can cause pain, infection and tooth loss, negatively affecting eating, speaking and general health. People living in rural and regional Australian communities have more caries, more severe caries and more untreated caries than those in the city. The unique environmental conditions and population groups in these communities may contribute to the higher caries burden. In particular, some towns lack community water fluoridation, and some have a high proportion of Aboriginal people, who have significantly worse oral health than their non-Aboriginal counterparts. Because of these and other unique circumstances, mainstream research on caries risk factors may not apply in these settings. This study aimed to gather contemporary oral health data from small rural or regional Australian communities, and investigate caries risk factors in these communities. METHODS: A cross-sectional survey consisting of a standardized dental examination and questionnaire was used to measure the oral health of 434 children (32% Aboriginal) aged 3-12 years in three small rural or regional areas. Oral health was determined as the deciduous and permanent decayed, missing and filled teeth (dmft/DMFT), and the proportion of children without caries. Risk factors were investigated by logistic regression. RESULTS: The dmft/DMFT for children in this study was 1.5 for 5-6 year olds and 1.0 for 11-12 year olds (index groups reported). Independent predictors of having caries (Yes/No) were age group, holding a concession card (OR=2.45, 95%CI=1.58-3.80) and tooth-brushing less than twice per day (OR=2.11, 95% CI=1.34-3.34). Aboriginal status also became a significant variable under sensitivity analyses (OR 1.9, CI 1.12-3.24) when the tooth-brushing variable was removed. Gender, water fluoridation and parental education were not significant predictors of caries in these communities. CONCLUSIONS: The rural/remote children in this study had worse oral health than either state or national average in both the 5-6 year old and 11-12 year age group. Socioeconomic status, tooth-brushing and Aboriginal status were significantly associated with caries in these communities. To close the substantial gap in oral health outcomes between rural and metropolitan residents, approaches that target rural areas, Aboriginal people and those from low socioeconomic backgrounds are needed.
Assuntos
Cárie Dentária/epidemiologia , População Rural/estatística & dados numéricos , Fatores Etários , Austrália/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Fluoretação/estatística & dados numéricos , Humanos , Masculino , Higiene Bucal/estatística & dados numéricos , Fatores de Risco , Fatores Sexuais , Fatores SocioeconômicosRESUMO
BACKGROUND: The aim of this study was to investigate how perceived neighbourhood safety and area deprivation influenced the relationship between parklands and mental health. METHODS: Information about psychological distress, perceptions of safety, demographic and socio-economic background at the individual level was extracted from New South Wales Population Health Survey. The proportion of a postcode that was parkland was used as a proxy measure for access to parklands and was calculated for each individual. Generalized Estimating Equations logistic regression analyses were performed to account for correlation between participants within postcodes, and with controls for socio-demographic characteristics and socio-economic status at the area level. RESULTS: In areas where the residents reported perceiving their neighbourhood to be "safe" and controlling for area levels of socio-economic deprivation, there were no statistically significant associations between the proportion of parkland and high or very high psychological distress. In the most disadvantaged neighbourhoods which were perceived as unsafe by residents, those with greater proportions of parkland, over 20%, there was greater psychological distress, this association was statistically significant (20-40% parkland: OR=2.27, 95% CI=1.45-3.55; >40% parkland: OR=2.53, 95% CI=1.53-4.19). CONCLUSION: Our study indicates that perceptions of neighbourhood safety and area deprivation were statistically significant effect modifiers of the association between parkland and psychological distress.