Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 156
Filtrar
1.
Crit Care ; 25(1): 253, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34281609

RESUMO

BACKGROUND: Drowning is a cause of significant global mortality. The mechanism of injury involves inhalation of water, lung injury and hypoxia. This systematic review addressed the following question: In drowning patients with lung injury, what is the evidence from primary studies regarding treatment strategies and subsequent patient outcomes? METHODS: The search strategy utilised PRISMA guidelines. Databases searched were MEDLINE, EMBASE, CINAHL, Web of Science and SCOPUS. There were no restrictions on publication date or age of participants. Quality of evidence was evaluated using GRADE methodology. RESULTS: Forty-one papers were included. The quality of evidence was very low. Seventeen papers addressed the lung injury of drowning in their research question and 24 had less specific research questions, however included relevant outcome data. There were 21 studies regarding extra-corporeal life support, 14 papers covering the theme of ventilation strategies, 14 addressed antibiotic use, seven papers addressed steroid use and five studies investigating diuretic use. There were no clinical trials. One retrospective comparison of therapeutic strategies was found. There was insufficient evidence to make recommendations as to best practice when supplemental oxygen alone is insufficient. Mechanical ventilation is associated with barotrauma in drowning patients, but the evidence predates the practice of lung protective ventilation. There was insufficient evidence to make recommendations regarding adjuvant therapies. CONCLUSIONS: Treating the lung injury of drowning has a limited evidentiary basis. There is an urgent need for comparative studies of therapeutic strategies in drowning.


Assuntos
Afogamento/fisiopatologia , Lesão Pulmonar/etiologia , Resultado do Tratamento , Antibacterianos/normas , Antibacterianos/uso terapêutico , Barotrauma/etiologia , Barotrauma/terapia , Oxigenação por Membrana Extracorpórea/métodos , Oxigenação por Membrana Extracorpórea/normas , Humanos , Lesão Pulmonar/terapia , Respiração Artificial/métodos , Respiração Artificial/normas
3.
BMC Public Health ; 21(1): 1072, 2021 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090385

RESUMO

BACKGROUND: Drowning is a significant public health issue, with females accounting for one third of global drowning deaths. The rate of female drowning has not decreased within high-income countries and presentations to hospital have increased. This scoping review aimed to explore adult female unintentional drowning, including risk factors, clinical treatment and outcomes of females hospitalised for drowning. METHODS: A systematic search of the literature following the PRISMA-ScR framework was undertaken. The databases OVID MEDLINE, Embase, CINAHL, OVID Emcare, Web of Science, Informit and Scopus were accessed. Study locations of focus were Australia, Canada, New Zealand, the United Kingdom, and the United States. Studies from January 2003 to April 2019 were included. The quality of evidence of included studies was assessed using GRADE guidelines. RESULTS: The final search results included 14 studies from Australia (n = 4), Canada (n = 1), New Zealand (n = 1), United States (n = 6), United Kingdom (n = 1), and one study reporting data from both Australia and United States. Nine studies reported risk factors for female drowning including age, with the proportion of female drowning incidence increasing with age. Although females are now engaging in risk-taking behaviours associated with drowning that are similar to males, such as consuming alcohol and swimming in unsafe locations, their exposure to risky situations and ways they assess risk, differ. Females are more likely to drown from accidental entry into water, such as in a vehicle during a flood or fall into water. This review found no evidence on the clinical treatment provided to females in hospital after a drowning incident, and only a small number of studies reported the clinical outcomes of females, with inconsistent results (some studies reported better and some no difference in clinical outcomes among females). CONCLUSION: Adult females are a group vulnerable to drowning, that have lacked attention. There was no single study found which focused solely on female drowning. There is a need for further research to explore female risk factors, the clinical treatment and outcomes of females hospitalised for drowning. This will not only save the lives of females, but also contribute to an overall reduction in drowning.


Assuntos
Afogamento , Adulto , Austrália/epidemiologia , Canadá , Países Desenvolvidos , Afogamento/epidemiologia , Feminino , Humanos , Masculino , Nova Zelândia , Reino Unido
4.
Aust N Z J Public Health ; 45(3): 255-262, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33900674

RESUMO

OBJECTIVE: This study aimed to describe the epidemiology and risk factors contributing to drowning among migrants in Australia. METHODS: A total population retrospective epidemiological study of unintentional drowning deaths in Australia between 1 July 2009 and 30 June 2019 of people born outside Australia (migrants). Cases were extracted from the National Coronial Information System. Descriptive statistics, chi-square and relative risk were calculated. Crude drowning rates were based on country of birth and population in Australia. RESULTS: There were 572 migrant deaths over the study period, 28.9% of total drowning deaths, 82.9% were male. Twenty-one per cent were aged 25-34 years and 40.8% had lived in Australia for 20+ years. Migrants at highest risk of drowning were from: South Korea (2.63/100,000 95%CI: 0.85-8.25), Taiwan (2.29/100,000 95%CI: 0.27-13.44), and Nepal (2.15/100,000 95%CI: 0.23-11.55). Migrants were more likely to drown when around rocks (p<0.001) compared with Australian-born people, who most frequently drowned in rivers (p<0.001). CONCLUSIONS: Migrants are not over-represented in drowning statistics. However, unique trends were found for drowning among migrants based on country of birth and length of time in Australia. Implications for public health: Holistic drowning prevention strategies and policies are required to effectively lower drowning risk among migrant communities.


Assuntos
Acidentes/mortalidade , Afogamento/mortalidade , Adolescente , Adulto , Distribuição por Idade , Idoso , Austrália/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Migrantes
5.
Travel Med Infect Dis ; 40: 101973, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33450405

RESUMO

Aircrew fitness-to-fly is among the elements that make aviation the safest form of long-distance transport. The health of cabin crew is a crucial determinant in carrying out safety-related duties. 'Fitness-to-fly' is associated with defined workplace conditions, for which airlines have a legal duty to ensure fitness for employment. We explored the literature on fitness-to-fly to obtain a pragmatic assessment of the challenges for aeromedical examinations. Regulations promulgated by aviation regulatory authorities and airline-internal policies have similar status and meaning, yet there is no harmonised approach internationally, and an inability to conform periodic medical assessments to actual operational fitness. The COVID-19 pandemic has highlighted the need to better understand fitness-to-fly criteria. Fitness-to-fly measures are mainly based on self-reported data and there is a need for a 'safety' factor for self-reports. Aeromedical evaluations should evolve from meeting medical standards to include pandemics as an element of the overall risk of aircraft operations. Re-evaluating criteria for fitness-to-fly assessment will further the goal of linking research to the actual needs of public health decisionmakers. If airlines are to resume operations at pre-pandemic levels, they must demonstrate to the public and public health agencies that fitness-to-fly assessment is appropriate and effective.


Assuntos
Aeronaves/normas , Aviação/normas , COVID-19/epidemiologia , Local de Trabalho/normas , COVID-19/prevenção & controle , COVID-19/transmissão , Teste para COVID-19 , Conhecimentos, Atitudes e Prática em Saúde , Mão de Obra em Saúde , Humanos , Saúde do Trabalhador/normas , Pandemias/prevenção & controle , Políticas , SARS-CoV-2/isolamento & purificação , Autorrelato
7.
Health Promot J Austr ; 32 Suppl 1: 49-60, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32803829

RESUMO

ISSUE ADDRESSED: Drowning is a global public health challenge with a need to ensure equity to drowning prevention information and interventions. In Australia, people born overseas are identified as being at greater risk of drowning. This paper presents findings from a community-based qualitative evaluation of swimming and water safety (SWS) programs delivered to adults from migrant backgrounds in Sydney, Australia. METHODS: A qualitative study was conducted in November-December 2019 among 35 female participants of SWS programs targeted to adult migrants. While offered to all SWS program participants, no males took part in the study. Focus groups and interviews were recorded, transcribed and thematically analysed using a deductive approach. The domains of enquiry were guided by the health belief model and the theory of planned behaviour. RESULTS: Study participants were ≥25 years, first generation and most had lived in Australia for ≥10 years. Most were nonswimmers and were fearful of water prior to the program. Key themes were: direct SWS program outcomes, health and well-being; enablers and barriers to participation including: motivation, a program coordinator, fear and settlement priorities. CONCLUSION: Findings suggest that in order to increase SWS participation among migrant communities, the broader determinants of health need to be considered. Culturally appropriate strategies are required to enable both men and women equal opportunities to access SWS programs. SO WHAT: SWS programs provide multiple benefits for adult migrants; however, the impact on reducing inequities is limited, with broader multi-strategic health promotion approaches and policies required for inclusion and sustainability.


Assuntos
Afogamento , Migrantes , Adulto , Austrália , Afogamento/prevenção & controle , Feminino , Humanos , Masculino , Natação , Água
8.
Emerg Med Australas ; 33(1): 34-44, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32633088

RESUMO

OBJECTIVE: Aeromedical services are an essential part of the healthcare system. Centralised coordination of aeromedical retrieval tasking offers benefits for safety, timeliness and efficiency in service delivery. The aim of the present study is to review aeromedical retrievals in Queensland exploring patient demographics, temporal patterns and usage characteristics. METHODS: This is a retrospective cases series for the period 1 January 2010 to 31 December 2014 incorporating data from Retrieval Services Queensland and Queensland Newborn Emergency Transport Service. Ethics approval was obtained (JCU-HREC H6137 and Public Health Act #RD005673). Descriptive analysis of the de-identified data was undertaken included patient demographics, referral and receiving locations, retrieval platform and acuity of transport request. RESULTS: There were 73 042 aeromedical retrievals undertaken during the period, with an average of 40 cases per day (range 16-89). The majority (95%) of retrievals were for Queensland residents. Overall 23.1% of cases were cardiology-related and 12.7% were injury-related. Older adults aged 75-84 years had the highest rate of retrievals relative to the population with a crude rate of 942.4 per 100 000 per annum. Overall 14.9% of cases were Priority 1, which represents the tasking with the highest acuity but majority were Priority 4 (41.6%). One third (37.6%) of all patients were from inner regional locations. CONCLUSIONS: Potential investments in health service planning may alleviate the burden on aeromedical services, particularly related to cardiology services in inner and outer regional Queensland. Aeromedical services are pivotal in enabling all sick and injured residents' access to the highest quality of care regardless of the remoteness of their residence.


Assuntos
Resgate Aéreo , Serviços Médicos de Emergência , Idoso , Humanos , Recém-Nascido , Queensland , Encaminhamento e Consulta , Estudos Retrospectivos
9.
Trop Med Infect Dis ; 5(2)2020 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-32316470

RESUMO

The deployment of United States (US) Armed Forces personnel into the central Pacific islands of Samoa and Tonga, which is highly-endemic for lymphatic filariasis (LF), resulted in thousands of cases of the acute form of this disease and greatly reduced their ability to carry out their mission. The major driving factor for the intensity of transmission was the aggressiveness and efficiency of the Aedes species mosquito vectors, especially the day-biting Ae. Polynesiensis. The paper reminds us of the danger that tropical diseases can pose for troops sent into endemic areas and constant and careful surveillance that is required to prevent rapid resurgence of Aedes-transmitted LF in populations, where the LF elimination program has been successful.

10.
Diving Hyperb Med ; 50(1): 34-42, 2020 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-32187616

RESUMO

INTRODUCTION: Divers with suspected decompression illness require high concentration oxygen (O2). There are many different O2 delivery devices, with few data comparing their performance. This study evaluated O2 delivery, using tissue O2 partial pressure (PtcO2), in healthy divers breathing O2 via three different delivery devices. METHODS: Twelve divers had PtcO2 measured at six limb sites. Participants breathed O2 from: a demand valve using an intraoral mask with a nose clip (NC); a medical O2 rebreathing system (MORS) with an oronasal mask and with an intraoral mask; and a non-rebreather mask (NRB) at 15 or 10 L·min⁻¹ O2 flow. In-line inspired O2 FIO2) and nasopharyngeal FIO2 were measured. Participants provided subjective ratings of device comfort, ease of breathing, and overall ease of use. RESULTS: PtcO2 values and nasopharyngeal FIO2 were similar with the demand valve with intraoral mask, MORS with both masks and the NRB at 15 L·min⁻¹. PtcO2 and nasopharyngeal FIO2 values were significantly lower with the NRB at 10 L·min⁻¹. The NRB was rated as the most comfortable to wear, easiest to breathe with, and overall the easiest to use. CONCLUSION: Of the commonly available devices promoted for O2 delivery to injured divers, similar PtcO2 and nasopharyngeal FIO2 values were obtained with the three devices tested: MORS with an oronasal or intraoral mask, demand valve with an intraoral mask and NRB at a flow rate of 15 L·min⁻¹. PtcO2 and nasopharyngeal FIO2 values were significantly lower when the flow rate using the NRB was decreased to 10 L·min⁻¹.


Assuntos
Oxigênio/análise , Adulto , Monitorização Transcutânea dos Gases Sanguíneos , Doença da Descompressão , Feminino , Humanos , Masculino , Máscaras , Oxigenoterapia , Respiração
11.
Inj Prev ; 26(3): 279-288, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31907207

RESUMO

INTRODUCTION: Some populations have been less susceptible to reductions in drowning than others. It has been hypothesised that this is due to prevention strategies failing to account for the influence of social determinants (such as ethnicity, socioeconomic status). Populations such as ethnic minorities have been over-represented in injury statistics, however this is not well explored in drowning. This study aims to identify high-risk populations for drowning, risk factors and prevention strategies. METHODS: A literature review undertaken systematically using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach was conducted of peer-reviewed literature in English, published between 1990 and 2018 from high-income countries. Search terms included drowning, water safety, ethnic minority, migrant, and culturally diverse. RESULTS: In total, 35 articles were included. High-risk populations identified were: ethnic minorities, First Nations/Aboriginal people, migrants and rural residents. Over half (51%) focused on children (0-18 years). Risk factors included social determinants, swimming ability and knowledge, attitudes and behaviour. Four intervention studies were found; two focused on upskilling adults from high-risk populations to increase employment opportunities within the aquatic industry; an evaluation of a 10-year rock fishing safety education project and a learn-to-swim programme for minority children. Proposed prevention strategies included education, practical skills, research, policy and engagement. DISCUSSION: Limited literature exists pertaining to drowning among adults from high-risk populations. There is a need to increase the sophistication of drowning prevention strategies addressing the disparities in drowning from a culturally appropriate perspective. Acknowledging the role of the social determinants of health in drowning prevention is essential in order to improve drowning outcomes for high-risk populations globally.


Assuntos
Afogamento/epidemiologia , Afogamento/prevenção & controle , Grupos Étnicos/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Prevenção de Acidentes/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Grupos Populacionais/estatística & dados numéricos , Fatores de Risco , População Rural/estatística & dados numéricos , Classe Social , Determinantes Sociais da Saúde/estatística & dados numéricos , Natação/estatística & dados numéricos , Migrantes/estatística & dados numéricos
12.
Inj Prev ; 26(3): 240-247, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-30928913

RESUMO

INTRODUCTION: Internationally, rivers are a leading drowning location, yet little evidence exists evaluating river drowning prevention strategies. This study aims to use expert opinion to identify strategies more likely to be effective. METHODS: Using a modified Delphi process, a virtual panel of 30 experts from 12 countries considered, grouped and prioritised strategies for river drowning prevention. Proposed strategies were assessed against known evidence and suitability in high-income countries (HICs) as well as low-income and middle-income countries (LMICs) using expert opinion. The final phase consolidated a list of strategies whose effectiveness was assessed against 10 evidence-based river drowning scenarios. RESULTS: An initial list of 424 prevention strategies was refined to 22. After being assessed against the 10 scenarios, a final list of 13 strategies was derived. Strategies addressed alcohol consumption around rivers, flood mitigation, improving child supervision, learning to swim, increased lifejacket wear and achieving community-wide resuscitation skills. DISCUSSION: While all 13 strategies were assessed as being effective in both LMICs and HICs by at least 60% of the respondents, further work is required to define river drowning at a country level and therefore allow for effective solutions to be developed, particularly in LMICs. No strategy will be effective in isolation and must be implemented alongside policy and behaviour change, public awareness and education. Evaluation should be incorporated as part of any future implementation of strategies. CONCLUSION: This Delphi process identified 13 drowning prevention strategies for rivers. Further research is required to validate the efficacy of these findings through implementation and evaluation.


Assuntos
Prevenção de Acidentes/métodos , Afogamento/prevenção & controle , Rios , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Criança , Pré-Escolar , Técnica Delfos , Feminino , Inundações/estatística & dados numéricos , Humanos , Renda , Lactente , Masculino , Pessoa de Meia-Idade , Ressuscitação/estatística & dados numéricos , Fatores de Risco , Natação/estatística & dados numéricos , Adulto Jovem
13.
Health Promot J Austr ; 31(1): 93-103, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31002469

RESUMO

ISSUE ADDRESSED: Cycling participation rates in Australia and Queensland remain low. Rural residents typically do not have distinct cycling infrastructure available for use. Investigating current cycling participation and barriers to cycling engagement will inform future work to promote cycling engagement. METHODS: Data were collected through the inclusion of cycling-related questions in the 2012 Queensland Social Survey. RESULTS: The majority of the sample had not cycled in the previous 12 months (66%; n = 831). Significantly more rural residents reported not cycling due to environmental concerns (P < 0.05) and preferring other modes of transport or exercise (P < 0.01). Rural cyclists (31.4%; n = 113) had higher levels of cycling engagement in the previous week (41.6% to 32.6% urban; χ2  = 7.83; n = 420; P < 0.05) but lower cycling durations than urban cyclists (41.6% rural residents cycling for 30+ minutes vs 57.4% urban residents; χ2  = 8.25; n = 418; P < 0.01). Rural cycling engagement was independently associated with being male (OR = 2.34; 95% CI = 1.40-3.91); sufficient physical activity engagement (OR = 1.86; 95% CI = 1.10-3.15); and having children at place of residence (1-2 children: OR = 3.21; 95% CI = 1.88-5.49; 3+ children: OR = 3.01; 95% CI = 1.17-7.75). CONCLUSIONS: One-third of all adults cycled in the previous 12 months irrespective of location; however reasons for not cycling varied by urban/rural location. Results indicate that environmental factors appear to be inhibiting cycling participation in rural areas. Advocating for government commitment for infrastructure development to support safe cycling across Queensland including outside of metropolitan areas is required. SO WHAT?: This research explores self-reported cycling engagement amongst a sample of urban and rural dwelling Queenslanders. Differences in cycling exposure and reasons for lack of engagement offer insights into what may encourage greater cycling participation.


Assuntos
Ciclismo , População Rural , População Urbana , Adolescente , Adulto , Idoso , Exercício Físico , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Queensland , Características de Residência , Autorrelato , Adulto Jovem
14.
Travel Med Infect Dis ; 33: 101463, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31376464

RESUMO

BACKGROUND: Millions of tourists visit Malaysia annually while a large number of Malaysians travel overseas. Taking care of travellers' healthcare needs is important aspect of the healthcare system. Community pharmacies are ideally positioned to provide travel health-related services. However, studies are lacking in this area. Therefore, this study aims to explore the nature and type of travel health-related services provided by Malaysian community pharmacies. METHODS: A survey was carried out at 135 community pharmacies in nine districts of Selangor, Malaysia, from November 2017 to February 2018, using a self-administered standardized questionnaire. RESULTS: The majority (n = 95, 85%) of community pharmacies reported to have provided services to both international travellers and outbound Malaysian travellers. The common healthcare services provided to international travellers were monitoring of chronic diseases including hypertension and diabetes, and advice on minor ailments, supplements and medical devices. The key health services provided to outbound Malaysian travellers were advice on vaccination requirements, better management of chronic diseases and necessary medications to manage illness during travel. Most of the respondents supported the provision of travel health-related services through the community pharmacies. CONCLUSION: The study findings showed that Malaysian community pharmacies provided several travel health-related services to both international and Malaysian outbound travellers. Pharmacists in Malaysia are ideally positioned to have an increased role in travel medicine. They have the training to advise on complex medication issues especially with regard to interactions and polypharmacy. However, further training and courses should be provided that are tailored specifically for the needs of this professional group.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Medicina de Viagem/métodos , Medicina de Viagem/estatística & dados numéricos , Atitude do Pessoal de Saúde , Estudos Transversais , Humanos , Malásia , Farmacêuticos/psicologia , Papel Profissional , Inquéritos e Questionários , Viagem
15.
Emerg Med Australas ; 31(6): 916-929, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31729193

RESUMO

Primary aeromedical retrievals are a direct scene response to patients with a critical injury or illness using a medically equipped aircraft. They are often high-acuity taskings. In Australia, information on primary retrieval taskings is housed by service providers, of which there are many across the country. This exploratory literature review aims to explore the contemporary peer-reviewed literature on primary aeromedical retrievals in Australia. The focus is on adult primary aeromedical retrievals undertaken in Australia and clinical tools used in this pre-hospital setting. Included articles were reviewed for research theme (clinical and equipment, systems and/or outcomes), data coverage and appraisal of the evidence. Of the 37 articles included, majority explored helicopter retrievals (n = 32), retrieval systems (n = 21), compared outcomes within a service (n = 10) and explored retrievals in the state of New South Wales (n = 19). Major topics of focus included retrieval of trauma patients and airway management. Overall, the publications had a lower strength of evidence because of the preponderance of cross-sectional and case-study methodology. This review provides some preliminary but piecemeal insight into primary retrievals in Australia through a localised systems lens. However, there are several areas for research action and service outcome improvements suggested, all of which would be facilitated through the creation of a national pre-hospital and retrieval registry. The creation of a registry would enable consideration of the frequency and context of retrievals, comparison across services, more sophisticated data interrogation. Most importantly, it can lead to service and pre-hospital and retrieval system strengthening.


Assuntos
Resgate Aéreo/estatística & dados numéricos , Serviços Médicos de Emergência/organização & administração , Transporte de Pacientes/estatística & dados numéricos , Austrália , Humanos
16.
Aust N Z J Public Health ; 43(5): 477-483, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31180612

RESUMO

OBJECTIVE: To examine fatal drowning associated with aquatic rescues and prior self-reported experience of undertaking an aquatic rescue in Australia. METHODS: Previous aquatic rescue experience was sourced through the 2013 Queensland Computer Assisted Telephone Instrument Survey and compared to data on rescue-related fatal unintentional drowning between 1 January 2006 and 31 December 2015. RESULTS: Twenty-three per cent (n=294/1291) of survey respondents had previously performed an aquatic rescue. Males (X2 =35.2; p<0.001) were more likely to have performed a rescue; commonly at a beach/ocean/harbour location (X2 =13.5; p<0.001). Females were more likely to have rescued a child (0-4 years of age) (X2 =29.2; p<0.001) from a swimming pool (X2 =34.3; p<0.001). Fifty-one people drowned while performing an aquatic rescue (Males=82.4%; 25-44 years of age=53.0%; beaches=54.9%). CONCLUSIONS: Drownings are prevented by bystanders; this is not without risk to the rescuer. Most people perform only one rescue in their life, often at a younger age, on an altruistic basis, of family members or young children. Community-wide rescue skills, taught at a young age, with consideration for coastal, inland and swimming pool environments, may prevent drowning. Implications for public health: There is a need to train people early in their life on how to undertake a safe rescue and provide resuscitation, including promoting regular updates, in particular if supervising children.


Assuntos
Afogamento/mortalidade , Conhecimentos, Atitudes e Prática em Saúde , Trabalho de Resgate/estatística & dados numéricos , Piscinas , Adolescente , Adulto , Idoso , Austrália/epidemiologia , Criança , Pré-Escolar , Afogamento/epidemiologia , Afogamento/prevenção & controle , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Queensland/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
17.
Prehosp Disaster Med ; 34(3): 241-250, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31079592

RESUMO

INTRODUCTION: Natural disasters often damage or destroy the protective public health service infrastructure (PHI) required to maintain the health and well-being of people with noncommunicable diseases (NCDs). This interruption increases the risk of an acute exacerbation or complication, potentially leading to a worse long-term prognosis or even death. Disaster-related exacerbations of NCDs will continue, if not increase, due to an increasing prevalence and sustained rise in the frequency and intensity of disasters, along with rapid unsustainable urbanization in flood plains and storm-prone coastal zones. Despite this, the focus of disaster and health systems preparedness and response remains on communicable diseases, even when the actual risk of disease outbreaks post-disaster is low, particularly in developed countries. There is now an urgent need to expand preparedness and response beyond communicable diseases to include people with NCDs.Hypothesis/Problem:The developing evidence-base describing the risk of disaster-related exacerbation of NCDs does not incorporate the perspectives, concerns, and challenges of people actually living with the conditions. To help address this gap, this research explored the key influences on patient ability to successfully manage their NCD after a natural disaster. METHODS: A survey of people with NCDs in Queensland, Australia collected data on demographics, disease, disaster experience, and primary concern post-disaster. Descriptive statistics and chi-square tests with a Bonferroni-adjustment were used to analyze data. RESULTS: There were 118 responses to the survey. Key influences on the ability to self-manage post-disaster were access to medication, medical services, water, treatment and care, power, and food. Managing disease-specific symptoms associated with cardiovascular disease, diabetes, mental health, and respiratory diseases were primary concerns following a disaster. Stress and anxiety, loss of sleep, weakness or fatigue, and shortness of breath were common concerns for all patients with NCDs. Those dependent on care from others were most worried about shortness of breath and slow healing sores. Accessing medication and medical services were priorities for all patients post-disaster. CONCLUSION: The key influences on successful self-management post-disaster for people with NCDs must be reflected in disaster plans and strategies. Achieving this will reduce exacerbations or complications of disease and decrease demand for emergency health care post-disaster.


Assuntos
Planejamento em Desastres/organização & administração , Serviços Médicos de Emergência/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Doenças não Transmissíveis/prevenção & controle , Autogestão/métodos , Austrália , Gerenciamento Clínico , Feminino , Humanos , Masculino , Desastres Naturais , Saúde Pública , Queensland , Medição de Risco , Inquéritos e Questionários
18.
Prehosp Disaster Med ; 34(2): 155-160, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30968817

RESUMO

INTRODUCTION: First aid, particularly bystander cardiopulmonary resuscitation (CPR), is an important element in the chain of survival. However, little is known about what influences populations to undertake first aid/CPR training, update their training, and use of the training. OBJECTIVES: The aim of this study was to explore the characteristics of people who have first aid/CPR training, those who have updated their training, and use of these skills. METHODS: As part of the 2011 state-wide, computer-assisted telephone interviewing (CATI) survey of people over 18 years of age living in Queensland, Australia, stratified by gender and age group, three questions about first aid training, re-training, and skill uses were explored. RESULTS: Of the 1,277 respondents, 73.2% reported having undertaken some first aid/CPR training and 39.5% of those respondents had used their first aid/CPR skills. The majority of respondents (56.7%) had not updated their first aid/CPR skills in the past three years, and an additional 2.5% had never updated their skills. People who did not progress beyond year 10 in school and those in lower income groups were less likely to have undertaken first aid/CPR training. Males and people in lower income groups were less likely to have recently updated their first aid/CPR training. People with chronic health problems were in a unique demographic sub-group; they were less likely to have undertaken first aid/CPR training but more likely to have administered first aid/CPR. CONCLUSION: Training initiatives that target people on the basis of education level, income group, and the existence of chronic health problems might be one strategy for improving bystander CPR rates when cardiac arrest occurs in the home.Franklin RC, Watt K, Aitken P, Brown LH, Leggat PA. Characteristics associated with first aid and cardiopulmonary resuscitation training and use in Queensland, Australia. Prehosp Disaster Med. 2019;34(2):155-160.


Assuntos
Reanimação Cardiopulmonar , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Parada Cardíaca/terapia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Queensland , Inquéritos e Questionários , Adulto Jovem
19.
Inj Prev ; 25(5): 392-399, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-29875291

RESUMO

INTRODUCTION: Globally, rivers are a common drowning location. In Australia, rivers are the leading location for fatal drowning. Limited information exists on exposure and impact on river drowning risk. METHODS: Australian unintentional fatal river drowning data (sourced from coronial records) and nationally representative survey data on river visitation were used to estimate river drowning risk based on exposure for adults (18 years and older). Differences in river drowning rates per 100 000 (population and exposed population) were examined by sex, age group, activity prior to drowning, alcohol presence and watercraft usage. RESULTS: Between 1 January 2014 and 31 December 2016, 151 people drowned in Australian rivers; 86% male and 40% aged 18-34 years. Of survey respondents, 73% had visited a river within the last 12 months. After adjusting for exposure: males were 7.6 times more likely to drown at rivers; female drowning rate increased by 50% (0.06-0.09 per 100 000); males aged 75+ years and females aged 55-74 years were at highest risk of river drowning; and swimming and recreating pose a high risk to both males and females. After adjusting for exposure, males were more likely to drown with alcohol present (RR=8.5; 95% CI 2.6 to 27.4) and in a watercraft-related incident (RR=25.5; 95% CI 3.5 to 186.9). CONCLUSIONS: Calculating exposure for river drowning is challenging due to diverse usage, time spent and number of visits. While males were more likely to drown, the differences between males and females narrow after adjusting for exposure. This is an important factor to consider when designing and implementing drowning prevention strategies to effectively target those at risk.


Assuntos
Afogamento/etiologia , Afogamento/prevenção & controle , Rios , Adulto , Distribuição por Idade , Idoso , Austrália/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recreação , Fatores de Risco , Distribuição por Sexo , Natação/estatística & dados numéricos , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...