Blood, guts and knife cuts: reducing the risk of swine brucellosis in feral pig hunters in north-west New South Wales, Australia.

INTRODUCTION: Humans who have close contact with livestock, wild or feral animals can risk acquiring zoonotic infections such as brucellosis, Q fever, and leptospirosis. Human infection with Brucella suis (swine brucellosis) usually follows occupational or recreational exposure to infected animals. Worldwide, many cases of human infection follow contact with infected feral pigs. In Australia there is a growing market for the export of 'wild boar' and a considerable number of people are involved in feral pig hunting. However, feral pig hunters are often hard to reach with health strategies. According to Australian authorities the most important means of preventing disease in humans includes covering cuts; wearing gloves; washing hands; and avoiding blood when coming into contact with feral pigs. There has not been an evaluation of the acceptability of these recommended risk-reduction strategies in the settings where feral pig hunting and evisceration occurs. METHODS: Semi-structured interviews and small focus groups were conducted with feral pig hunters in north-west New South Wales (NSW), Australia, to explore their hunting experiences and views on the brucellosis prevention strategies. Interview and focus group notes were thematically analysed. RESULTS: There was a range of experiences of feral pig hunting, from a very professional approach to a purely recreational approach. The main domains that emerged from participants' experiences during their most recent feral pig hunting activity and their reflections on current swine brucellosis risk reduction strategies were: 'you've gotta be tough to be a feral pig hunter'; 'most of the suggested strategies won't work as they are'; 'reducing risk in the scrub'; and 'how to let pig hunters know'. The recreational nature and prevailing macho perspective of participants demand a pragmatic approach to risk reduction if it is going to prove acceptable to feral pig hunters. The 'you've gotta be tough to be a feral pig hunter' context of the activity and the reality that many feral pig hunters participate with little preparation and a 'just keep going' approach, may counteract currently recommended risk-reduction strategies. The alternate strategies that emerged from the interviews need to be tested in the real activity, especially evisceration 'in the scrub' (at the site of slaughter). But the following ideas were grounded in the participants' experiences: take more time and watch your hands when making cuts; have good lighting; take care when cutting near a sow's uterus; use latex gloves to cover cuts on hands. CONCLUSIONS: Swine brucellosis is a zoonosis of concern for feral pig hunters in many parts of Australia, including north-west NSW. Many of the current strategies to reduce the risk of brucellosis did not appear appropriate or acceptable to the feral pig hunters interviewed. More acceptable strategies when eviscerating, such as taking more time, watching hands when cutting, ensuring good lighting, being careful in the vicinity of the uterus and using a latex glove to cover cuts and abrasions on hands need to be field tested. Further development of the food safety regulations is required to also support zoonosis risk reduction strategies.

Implementation of the Australian core public health functions in rural Western Australia.

OBJECTIVE: To assess the implementation of the Australian core functions of public health in rural Western Australia. METHODS: Cross-sectional surveys (n=26) and semi-structured key informant interviews (n=64) with public health practitioners throughout each of the eight rural health regions in Western Australia. A scoring system was utilised to categorise responses that were frequently part of current practice (score=2), sometimes undertaken (score=1) and rare or not undertaken at all (score=0). RESULTS: Functions with reasonably good coverage (mean score 1.0) included: preventing and controlling communicable and non-communicable diseases; promoting and supporting healthy lifestyles; planning, funding, managing and evaluating health gain; ensuring safe and healthy environments; and contributing to healthy growth and development through all life stages. Lower levels of coverage were found for: assessing health needs; developing healthy public policy and fiscal measures; strengthening communities; and improving health for Aboriginal people and other vulnerable groups. CONCLUSIONS: There are limitations in the capacity of the rural public health workforce in Western Australia to implement the core public health functions. While some areas were defined as being adequately addressed, gaps in implementation appeared across all nine functions. IMPLICATIONS: The Australian core functions can be utilised to broadly assess current public health practice, however further development of the functions and their measurement, plus methods to align accountability measures for current public health practice with the core functions, are required.

Agricultural motorcycle injuries in WA adolescents.

OBJECTIVE: To determine and compare the prevalence, nature and predictors of agricultural motorcycle injuries (2, 3 & 4 wheels) in a high-risk cohort of Western Australian adolescents. METHODS: A cross-sectional survey of 326 students (Years 11 and 12) was drawn from the six designated agricultural colleges, in Western Australia. The survey instrument was assessed as reliable and measured riding exposure, vehicle type and maintenance, use of protective equipment, training and injury experience. RESULTS: For those subjects with access to an agricultural motorcycle (n = 240), a total of 53% (n = 127) had incurred an injury. Of these, 73% (n = 92) resulted from two wheelers and 24% (n = 31) from ATVs, with 3% (n = 4) not specified. No significant differences in the nature of injury or body parts injured was observed. Approximately one-third of those injured required medical treatment. Predictors of injury were maximum travelling speed exceeding 101 km/hour (OR 4.53) and only sometimes wearing a helmet (OR 4.10). CONCLUSIONS: Agricultural motorcycle injuries are a significant issue in rural areas, with potential intervention points relating to improving rider training and reducing specific risk-taking behaviours. IMPLICATIONS: Further work to investigate the efficacy of rider training interventions for agricultural motorcycles are warranted.

Farm injury in Tasmania.

The aim of the study was to provide information about the type and severity of farming injury. Data were collected from industrial members of the Tasmanian Farmers and Graziers Association, using a valid and reliable self administered retrospective questionnaire covering the previous 2 years. A total of 506 responses were obtained, with 38% indicating there had been at least one injury sustained on their farm during this period. Of those reporting an injury, 18% were admitted, 30% attended an Emergency Department, 43% of injuries were seen by GPs at their surgery, 4% received first aid on the farm, 4% reported no treatment and 2% utilised another source. The results suggest that the sheep industries bear a disproportionate amount of the injury burden (30.5%) within Tasmanian agriculture. Information from this study can be used by other agricultural and health stakeholders to provide direction about the development of appropriate farm injury prevention strategies within rural communities in Tasmania.

Changes in Expanded Program for Immunization coverage for mother and child in Krakor, Cambodia 1996--1998.

We evaluated a training intervention aimed at enhancing the roles of health centre staff, Village Health Volunteers (VHVs) and Traditional Birth Attendants (TBAs) within the Expanded Program for Immunization (EPI) in the district of Krakor, Cambodia. We conducted population-based surveys to determine the coverage of the EPI at baseline (1996) and after the intervention (1998), using data from health cards for mothers and their children and history data. Statistically significant changes over the 2-year period were apparent for tetanus, BCG, polio and DTP, supporting the positive impact the training intervention had on immunization coverage in the district.

'Weddings, parties, anythingellipsis', a qualitative analysis of ecstasy use in Perth, Western Australia.

This study investigates the patterns of use, the meanings associated with use, the perception of risk and the strategies adopted to reduce these risks for a sample of ecstasy users in Perth, Western Australia. The sample was purposively chosen to represent the heterogeneous nature of ecstasy users in Perth. Data were collected from 31 ecstasy users and 157 h of participant observation in a variety of settings. The study found that users exhibited a reasonable degree of control over their consumption, incorporating a series of risk reduction strategies. Application of these strategies was inconsistent, with a large percentage of the sample indulging in occasional binges, spontaneous purchases, polydrug use and purchasing from unknown individuals in clubs/pubs. As users became more experienced, they tended to become less concerned about the risks associated with use and exhibited greater risk taking behaviour. Understanding the beliefs and events that influence the adoption (or non-adoption) of harm reduction strategies and the heterogeneous nature of ecstasy users is important for future health promotion interventions and policy.

Use of low-density foams as pressure amplifiers in equation-of-state experiments with laser-driven shock waves.

The applicability of foams to equation of state experiments with laser-produced shocks has been studied. The pressure increase due to impedance mismatch at the payload-foam interface was measured experimentally using sub-ns laser pulses smoothed with phase zone plates. Foams of density in the range 5-900 mg/cm(3) and of thicknesses of 50-150 microm were used. A model has been developed to study pressure amplification and the conditions under which the shock is stationary. Two-step two-material targets, allowing simultaneous measurements of the shock velocities in the two materials, were then used to obtain relative equation of state data. Pressures higher than 100 Mbar were achieved in gold.

Changes in ante-natal care and family planning in Krakor, Pursat, Cambodia, 1996-1998.

This study examines variations in ante-natal care (ANC) and family planning in Krakor, Pursat, Cambodia between 1996 and 1998. Population-based survey interviews were conducted with a total of 291 women in 1996 and 211 women in 1998. An intervention strategy designed to enhance the skills and roles of Health Centre staff, Village Health Volunteers (VHVs) and Traditional Birth Attendants (TBAs) was conducted. Over this timeframe, reported ANC access increased from 37% to 47%. Most women delivered their last child at home, usually assisted by a TBA. Few women practiced family planning, despite the fact that most reported that they did not want any further children. A range of reasons for not practicing family planning were found to be highly significant, including the lack of available services (p<0.01). The fear of side-effects decreased significantly (p<0.01), with the community education provided by the VHVs and TBAs, potentially being one contributing factor. The results of this study suggest that continual support of VHVs and TBAs will further improve the health of women in Cambodia.

Process evaluation of an on-site water testing program in remote Aboriginal communities in Western Australia.

A unique public health intervention introduced on-site water test kits into 19 communities in Western Australia in order to improve the frequency of water testing in remote Aboriginal communities. Resources, training and support were provided by the Health Department of Western Australia to enable the communities to conduct fortnightly water testing over a 12-month period. This study assesses how effective and appropriate the training and support strategies were, and the extent of acceptance of the program by the community 'water samplers'. A written survey of the participants (community water samplers), enabled their knowledge of the principles and the application of the test regime, and their satisfaction with both the training strategies and the resources to be evaluated. A structured phone survey was conducted mid-trial to re-assess participant knowledge, to ascertain the use of training resources and to identify barriers to regular testing. Details of the support that was provided, was documented systematically during the trial by the Health Department. The participants were satisfied with the format and content of the training workshops. Support services documentation disclosed that contact with the participants throughout the trial was limited. The acceptance of the program by the water samplers varied. Those who participated in the trial expressed the need for more feedback and support. A major reason for not participating in the trial was due to the water sampler leaving the community. The specific outcomes of the program and directions for future programs are discussed.

Foam-induced smoothing studied through laser-driven shock waves

The influence of foams on the uniformity of laser energy deposition has been studied by measuring laser-driven shock waves breakout from foam-aluminum layered targets. Well characterized laser nonuniformities have been produced first by using phase zone plates to get a smooth beam and then by inserting different opaque grids before the foam. Smoothing has been studied as a function of foam density and grid materials (producing different radiative effects).

How valid is adolescents' self-report as a way of assessing sun protection practices?

BACKGROUND: The accurate assessment of sun protective behaviors can assist in the effective targeting of preventive strategies. METHODS: This study explored the validity of self-report by adolescents in relation to parental/guardian reports using a scale to determine whether adolescents were accurately classified as adequately protected or not during the preceding weekend. The study sample was drawn from a school population and provided 53 matched adolescent and parental/guardian responses from 115 subjects (consent rate 46%). The validity of self-reports in relation to the level of protection afforded to a range of body parts (face, neck, shoulders, torso, etc.) was calculated. Calculations of sensitivity, which represented the proportion of cases in which the body part was classified as adequately protected by both the criterion reference and the self-report, and specificity, in which inadequate protection was confirmed by both the criterion reference and the self-report, were completed. In instances in which fewer than five observations fell into a cell, thereby limiting the accuracy of results, no measures were calculated. RESULTS: Measures of sensitivity for the use of sun protection were legs (59%), neck (79%), feet (79%), face (92%), and shoulders, torso, and upper arms (98%). In contrast measures of specificity were face (61%), legs (80%), and neck (87%). CONCLUSIONS: Although further studies of self-report methodologies with larger samples are required to verify these findings, the results suggest that adolescent self-report of solar protection is relatively valid and has the potential to be utilized with a degree of confidence to assess behavior.

The prevalence and predictors of solar protection use among adolescents.

BACKGROUND: Adolescence has been identified as a critical period in the etiology of subsequent melanoma and nonmelanocytic skin cancer. This study examines the prevalence and predictors of solar protection use among adolescents. METHODS: A total of 3,642 adolescents between the ages of 11 and 16 years were recruited from a random sample of 27 schools in an Australian state. The participants completed a validated survey that provided information on a range of demographic, knowledge, attitudinal, and behavioral factors. Sun protection practices adopted during the preceding weekend were assessed using a validated self-report diary. A formula that quantifies protection status was then employed to categorize adolescents into those who were using adequate versus low levels of solar protection. RESULTS: Overall 54% of males and 44% of females were classified as adequately protected during the preceding weekend. Logistic regression analyses identified the following as significant predictors of having an adequate level of sun protection--gender (males more likely to be protected), age (11 to 13 year olds more likely to be protected than 14 to 16 years olds), ownership of a broad-brimmed hat or cap, attitudes relating to the discomfort associated with wearing a hat, image to peers, "hassle" associated with the use of sun protective measures, school attended, and sun protective policies of the school. CONCLUSIONS: Implications of these findings for future preventive strategies are discussed and include improved targeting of sun protection programs to non-adopters, modification of attitudes relating to suntans and image to peers, reducing the level of perceived difficulty associated with utilizing sunscreen, and the potential role that schools may play in fostering sun protection.

Sport injury patterns in urban and rural accident and emergency units.

Sport injuries are a common yet an unwanted aspect of participation in sports. Previous studies have indicated disparities between urban and rural injury patterns. This study examines sport injuries specifically. Although similar in many features, there were major variations in the patterns of rural and urban sports injuries. Rural injuries appeared to revolve around football codes while the urban pattern reflected involvement in a wider variety of sport. The results confirm that injury data can be used to determine specific priorities within different communities. Consequently local data are seen as imperative to initiate appropriate preventive action in rural areas.

Injury data collection in the rugby codes.

A large number of studies into injuries in rugby union and league have been conducted. This review analysed published reports on rugby injuries in relation to their methodological rigour. Desirable criteria for sports injury data collection were identified from the literature. Each study was then analysed in respect to the criteria. Results indicated that no studies met all of the desirable criteria. Recommendations for sports injury methodological design are given.