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1.
BMJ Open ; 11(6): e048109, 2021 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-34103321

RESUMO

OBJECTIVES: We integrated an established participant-centred active vaccine safety surveillance system with a cloud-based pharmacy immunisation-recording program in order to measure adverse events following immunisation (AEFI) reported via the new surveillance system in pharmacies, compared with AEFI reported via an existing surveillance system in non-pharmacy sites (general practice and other clinics). DESIGN: A prospective cohort study. PARTICIPANTS AND SETTING: Individuals >10 years receiving influenza immunisations from 22 pharmacies and 90 non-pharmacy (general practice and other clinic) sites between March and October 2020 in Western Australia. Active vaccine safety surveillance was conducted using short message service and smartphone technology, via an opt-out system. OUTCOME MEASURES: Multivariable logistic regression was used to assess the primary outcome: differences in proportions of AEFI between participants immunised in pharmacies compared with non-pharmacy sites, adjusting for confounders of age, sex and influenza vaccine brand. A subgroup analysis of participants over 65 years was also performed. RESULTS: Of 101 440 participants (6992 from pharmacies; 94 448 from non-pharmacy sites), 77 498 (76.4%) responded; 96.1% (n=74 448) within 24 hours. Overall, 4.8% (n=247) pharmacy participants reported any AEFI, compared with 6% (n=4356) non-pharmacy participants (adjusted OR: 0.87; 95% CI: 0.76 to 0.99; p=0.039). Similar proportions of AEFIs were reported in pharmacy (5.8%; n=31) and non-pharmacy participants (6; n=1617) aged over 65 years (adjusted OR: 0.94; 95% CI: 0.65 to 1.35; p=0.725). The most common AEFIs in pharmacy were: pain (2%; n=104), tiredness (1.9%; n=95) and headache (1.7%; n=88); and in non-pharmacy sites: pain (2.3%; n=1660), tiredness (1.9%; n=1362) and swelling (1.5%; n=1121). CONCLUSIONS: High and rapid response rates demonstrate good participant engagement with active surveillance in both pharmacy and non-pharmacy participants. Significantly fewer AEFIs reported after pharmacist immunisations compared with non-pharmacy immunisations, with no difference in older adults, may suggest different cohorts attend pharmacy versus non-pharmacy immunisers. The integrated pharmacy system is rapidly scalable across Australia with global potential.


Assuntos
Vacinas contra Influenza , Influenza Humana , Farmácias , Sistemas de Notificação de Reações Adversas a Medicamentos , Idoso , Austrália/epidemiologia , Humanos , Vacinas contra Influenza/efeitos adversos , Influenza Humana/prevenção & controle , Estudos Prospectivos , Estações do Ano , Vacinação , Austrália Ocidental/epidemiologia
2.
BMJ Open ; 11(5): e040600, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33975864

RESUMO

OBJECTIVE: To retrospectively assess a cohort of mothers for characteristics of injuries that they have suffered as a result of family and domestic violence (FDV) and which have required admission to a hospital during both the intrapartum and postpartum periods. DESIGN AND SETTING: Retrospective, whole-population linked data study of FDV in Western Australia using the Western Australia birth registry from 1990 to 2009 and Hospital Morbidity Data System records from 1970 to 2013. MAIN OUTCOME MEASURES: Number of hospitalisations, and mode, location and type of injuries recorded, with particular focus on the head and neck area. RESULTS: There were 11 546 hospitalisations for mothers due to FDV. 8193 hospitalisations recorded an injury code to the head and/or neck region. The upper and middle thirds of the face and scalp were areas most likely to receive superficial injuries (58.7% or 4158 admissions), followed by the mouth and oral cavity (9.7% or 687 admissions). Fracture to the mandible accounted for 479 (4.2%) admissions and was almost equal to the sum of the next three most common facial fractures (nasal, maxillary and orbital floor). Mothers more likely to be hospitalised due to a head injury from FDV included those with more than one child (OR=1.17, 95% CI 1.03 to 1.30) and those with infants (<1 year old) (OR=1.40, 95% CI 1.04 to 1.90) and young children (<7 years old) (OR=1.15, 95% CI 1.01 to 1.30). CONCLUSIONS: FDV is a serious and ongoing problem and front-line clinicians are in need of evidence-based guidelines to recognise and assist victims of FDV. Mothers with children in their care are a particularly vulnerable group.


Assuntos
Violência Doméstica , Mães , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Estudos Retrospectivos , Web Semântica , Austrália Ocidental/epidemiologia
3.
J Med Microbiol ; 70(4)2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33856292

RESUMO

Introduction. The evolving SARS-CoV-2 coronavirus pandemic presents a series of challenges to clinical diagnostic services. Many proprietary PCR platforms deployed outside centralised laboratories have limited capacity to upscale when public health demands increase. We set out to develop and validate an open-platform mobile laboratory for remote area COVID-19 diagnosis, with a subsequent field trial.Gap Statement. In regional Western Australia, molecular diagnostic support is limited to near point-of-care devices. We therefore aimed to demonstrate open-platform capability in a rapidly deployable format within the context of the COVID-19 pandemic.Methodology. We compared, selected and validated components of a SARS-CoV-2 RT-PCR assay in order to establish a portable molecular diagnostics laboratory. The optimal combination of PCR assay equipment, reagents and consumables required for operation to national standards in regional laboratories was identified. This comprised RNA extraction and purification (QuickGene-480, Kurabo, Japan), a duplex RT-PCR assay (Logix Smart COVID-19, Co-Diagnostics, USA), a Myra liquid handling robot (Biomolecular Systems, Australia) and a magnetic induction thermal cycler (MIC, Biomolecular Systems).Results The 95 and 99% limits of detection were 1.01 copies µl-1 (5.05 copies per reaction) and 2.80 copies µl-1 (14.00 copies per reaction) respectively. The Co-Diagnostics assay amplified both SARS-CoV-1 and -2 RNA but showed no other cross reactivity. Qualitative results aligned with the reference laboratory SARS-CoV-2 assay (sensitivity 100% [95 % CI 96.48-100%], specificity 100% [95% CI 96.52-100%]). In field trials, the laboratory was operational within an hour of arrival on-site, can process up to 36 samples simultaneously, produces results in two and a half hours from specimen reception, and performed well during six consecutive runs during a 1 week deployment.Conclusion. Our mobile laboratory enables an adaptive response to increased test demand, and unlike many proprietary point-of-care PCR systems, rapid substitution with an alternative assay if gene targets change or reagent supply chains fail. We envisage operation of this RT-PCR assay as a standby capability to meet varying regional test demands under public health emergency operations guidance.


Assuntos
Teste de Ácido Nucleico para COVID-19 , COVID-19/diagnóstico , Unidades Móveis de Saúde , SARS-CoV-2/isolamento & purificação , COVID-19/epidemiologia , Reações Cruzadas , Humanos , Limite de Detecção , Sistemas Automatizados de Assistência Junto ao Leito , RNA Viral/genética , RNA Viral/isolamento & purificação , SARS-CoV-2/genética , Sensibilidade e Especificidade , Austrália Ocidental/epidemiologia
4.
ANZ J Surg ; 91(6): 1154-1158, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33905619

RESUMO

BACKGROUND: In Western Australia, the media has reported on an increase in the purchasing, repairs and use of bicycles during the COVID-19 period. The study aimed to investigate for a relationship in bicycle related injuries in the paediatric population during the time of COVID-19 restrictions. METHODS: A retrospective study of the incident of motorized and non-motorized bicycle related injuries and trauma presentations during the COVID-19 'shutdown' period from March to June 2020. Data were collected from the Emergency Department Information System, discharge summaries, operation and radiology reports. The data presented is from Perth Children's Hospital, the only tertiary paediatric hospital and the only referral centre for childhood trauma in the state of Western Australia. Participants were children aged 15 years and younger attending the emergency department (ED) at Perth Children's Hospital during the designated time period. The primary outcomes included total ED presentations, bicycle related presentations and bicycle related admissions during the COVID-19 period. RESULTS: Bicycle related presentations to the ED increased by 42.7% over the COVID-19 period from 1.4% to 3.0% of all children attending the ED. Children admitted to the hospital with bicycle related injuries or trauma increased by 48.7% from 76 to 113 children in comparison to the same period in 2019. CONCLUSION: During the period of COVID-19 restrictions, paediatric ED presentations decreased dramatically, but bicycle related injuries and trauma increased substantially. Safety equipment including helmets and protective gear should be worn for all children riding bicycles, and social distancing should be maintained.


Assuntos
Ciclismo , COVID-19 , Criança , Serviço Hospitalar de Emergência , Dispositivos de Proteção da Cabeça , Humanos , Estudos Retrospectivos , SARS-CoV-2 , Austrália Ocidental/epidemiologia
5.
Emerg Infect Dis ; 27(5): 1279-1287, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33900170

RESUMO

Onboard quarantining has been only partially effective to control outbreaks of coronavirus disease on cruise ships. We describe the successful use of the ship as a quarantine facility during the response to the outbreak on the MS Artania, which docked in Western Australia, Australia. The health-led 14-day quarantine regime was based on established principles of outbreak management and experiences of coronavirus disease outbreaks on cruise ships elsewhere. The attack rate in the crew was 3.3% (28/832) before quarantine commencement and 4.8% (21/441) during quarantine on board. No crew members became symptomatic after completion of quarantine. Infection surveillance involved telephone correspondence, face-to-face visits, and testing for severe acute respiratory syndrome coronavirus 2. No serious health issues were reported, no response staff became infected, and only 1 quarantine breach occurred among crew. Onboard quarantine could offer financial and operational advantages in outbreak response and provide reassurance to the shore-based wider community regarding risk for infection.


Assuntos
COVID-19 , Quarentena , Austrália/epidemiologia , Surtos de Doenças/prevenção & controle , Humanos , SARS-CoV-2 , Navios , Austrália Ocidental/epidemiologia
6.
Front Public Health ; 9: 636921, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33692984

RESUMO

Introduction: Amidst the evolving COVID-19 pandemic, understanding the transmission dynamics of the SARS-CoV-2 virus is key to providing peace of mind for the community and informing policy-making decisions. While available data suggest that school-aged children are not significant spreaders of SARS-CoV-2, the possibility of transmission in schools remains an ongoing concern, especially among an aging teaching workforce. Even in low-prevalence settings, communities must balance the potential risk of transmission with the need for students' ongoing education. Through the roll out of high-throughput school-based SARS-CoV-2 testing, enhanced follow-up for individuals exposed to COVID-19 and wellbeing surveys, this study investigates the dynamics of SARS-CoV-2 transmission and the current psychosocial wellbeing impacts of the pandemic in school communities. Methods: The DETECT Schools Study is a prospective observational cohort surveillance study in 79 schools across Western Australia (WA), Australia. To investigate the incidence, transmission and impact of SARS-CoV-2 in schools, the study comprises three "modules": Module 1) Spot-testing in schools to screen for asymptomatic SARS-CoV-2; Module 2) Enhanced surveillance of close contacts following the identification of any COVID-19 case to determine the secondary attack rate of SARS-CoV-2 in a school setting; and Module 3) Survey monitoring of school staff, students and their parents to assess psycho-social wellbeing following the first wave of the COVID-19 pandemic in WA. Clinical Trial Registration: Trial registration number: ACTRN12620000922976.


Assuntos
Teste para COVID-19/estatística & dados numéricos , COVID-19/diagnóstico , COVID-19/psicologia , Pais/psicologia , Instituições Acadêmicas/estatística & dados numéricos , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Adolescente , Adulto , Austrália , COVID-19/epidemiologia , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pandemias/estatística & dados numéricos , Prevalência , Estudos Prospectivos , SARS-CoV-2 , Austrália Ocidental/epidemiologia
7.
BMJ Open ; 11(3): e043315, 2021 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-33664075

RESUMO

OBJECTIVE: This study aimed to examine trends in number of CT scans requested by tertiary emergency department (ED) physicians in Western Australia (WA) from 2003 to 2015 across broad demographic and presentation characteristics, anatomical areas and presented symptoms. DESIGN: An observational cross-sectional study over study period from 2003 to 2015. SETTING: Linked administrative health service data at individual level from WA. PARTICIPANTS: A total of 1 666 884 tertiary hospital ED presentations of people aged 18 years or older were included in this study MAIN OUTCOME MEASURE: Number of CT scans requested by tertiary ED physicians in an ED presentation. METHODS: Poisson regression models were used to assess variation and trends in number of CT scans requested by ED physicians across demographic characteristics, clinical presentation characteristics and anatomical areas. RESULTS: Over the entire study duration, 71 per 1000 ED episodes had a CT requested by tertiary ED physicians. Between 2003 and 2015, the rate of CT scanning almost doubled from 58 to 105 per 1000 ED presentations. After adjusted for all observed characteristics, the rate of CT scans showed a downward trend from 2009 to 2011 and subsequent increase. Males, older individuals, those attending ED as a result of pain, those with neurological symptoms or injury or with higher priority triage code were the most likely to have CT requested by tertiary ED physicians. CONCLUSIONS: Noticeable changes in the number of CTs requested by tertiary ED physicians corresponded to the time frame of major health reforms happening within WA and nationally.


Assuntos
Serviço Hospitalar de Emergência , Médicos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Centros de Atenção Terciária , Tomografia Computadorizada por Raios X , Austrália Ocidental/epidemiologia , Adulto Jovem
8.
BMJ Open ; 11(3): e045319, 2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33757954

RESUMO

OBJECTIVE: To investigate the associations between interpregnancy intervals (IPIs) and developmental vulnerability in children's first year of full-time school (age 5). DESIGN: Retrospective cohort study using logistic regression. ORs were estimated for associations with IPIs with adjustment for child, parent and community sociodemographic variables. SETTING: Western Australia (WA), 2002-2015. PARTICIPANTS: 34 574 WA born singletons with a 2009, 2012 or 2015 Australian Early Development Census (AEDC) record. MAIN OUTCOME MEASURE: The AEDC measures child development across five domains; Physical Health and Wellbeing, Social Competence, Emotional Maturity, Language and Cognitive Skills (school-based) and Communication Skills and General Knowledge. Children with scores <10th percentile were classified as developmentally vulnerable on, one or more domains (DV1), or two or more domains (DV2). RESULTS: 22.8% and 11.5% of children were classified as DV1 and DV2, respectively. In the adjusted models (relative to the reference category, IPIs of 18-23 months), IPIs of <6 months were associated with an increased risk of children being classified as DV1 (adjusted OR (aOR) 1.17, 95% CI 1.08 to 1.34), DV2 (aOR 1.31, 95% CI 1.10 to 1.54) and an increased risk of developmental vulnerability for the domains of Physical Health and Wellbeing (aOR 1.25, 95% CI 1.06 to 1.48) and Emotional Maturity (aOR 1.36, 95% CI 1.12 to 1.66). All IPIs longer than the reference category were associated with and increased risk of children being classified as DV1 and DV2 (aOR >1.15). IPIs of 60-119 months and ≥120 months, were associated with an increased risk of developmental vulnerability on each of the five AEDC domains, with greater odds for each domain for the longer IPI category. CONCLUSIONS: IPIs showed independent J-shaped relationships with developmental vulnerability, with short (<6 months) and longer (≥24 months) associated with increased risks of developmental vulnerability.


Assuntos
Intervalo entre Nascimentos , Desenvolvimento Infantil , Austrália , Pré-Escolar , Humanos , Armazenamento e Recuperação da Informação , Estudos Retrospectivos , Austrália Ocidental/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-33562413

RESUMO

Asbestos-related diseases (ARDs)-mesothelioma, lung cancer, and asbestosis-are well known as occupational diseases. As industrial asbestos use is eliminated, ARDs within the general community from para-occupational, environmental, and natural exposures are more prominent. ARD clusters have been studied in communities including Broni, Italy; Libby, Montana; Wittenoom, Western Australia; Karain, Turkey; Ambler, Pennsylvania; and elsewhere. Community ARDs pose specific public health issues and challenges. Community exposure results in higher proportions of mesothelioma in women and a younger age distribution than occupational exposures. Exposure amount, age at exposure, fiber type, and genetic predisposition influence ARD expression; vulnerable groups include those with social and behavioral risk, exposure to extreme events, and genetic predispositions. To address community exposure, regulations should address all carcinogenic elongated mineral fibers. Banning asbestos mining, use, and importation will not reduce risks from asbestos already in place. Residents of high-risk communities are characteristically exposed through several pathways differing among communities. Administrative responsibility for controlling environmental exposures is more diffuse than for workplaces, complicated by diverse community attitudes to risk and prevention and legal complexity. The National Mesothelioma Registries help track the identification of communities at risk. High-risk communities need enhanced services for screening, diagnosis, treatment, and social and psychological support, including for retired asbestos workers. Legal settlements could help fund community programs. A focus on prevention, public health programs, particularization to specific community needs, and participation is recommended.


Assuntos
Asbestos , Neoplasias Pulmonares , Mesotelioma , Exposição Ocupacional , Asbestos/toxicidade , Feminino , Humanos , Itália , Mesotelioma/epidemiologia , Mesotelioma/etiologia , Montana , Pennsylvania , Saúde Pública , Turquia , Austrália Ocidental/epidemiologia
11.
BMC Health Serv Res ; 21(1): 149, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33588840

RESUMO

BACKGROUND: Existing comorbidity measures predict mortality among general patient populations. Due to the lack of outcome specific and patient-group specific measures, the existing indices are also applied to non-mortality outcomes in injury epidemiology. This study derived indices to capture the association between comorbidity, and burden and readmission outcomes for injury populations. METHODS: Injury-related hospital admissions data from July 2012 to June 2014 (161,334 patients) for the state of Victoria, Australia were analyzed. Various multivariable regression models were run and results used to derive both binary and weighted indices that quantify the association between comorbidities and length of stay (LOS), hospital costs and readmissions. The new and existing indices were validated internally among patient subgroups, and externally using data from the states of New South Wales and Western Australia. RESULTS: Twenty-four comorbidities were significantly associated with overnight stay, twenty-seven with LOS, twenty-eight with costs, ten with all-cause and eleven with non-planned 30-day readmissions. The number of and types of comorbidities, and their relative impact were different to the associations established with the existing Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Measure (ECM). The new indices performed equally well to the long-listed ECM and in certain instances outperformed the CCI. CONCLUSIONS: The more parsimonious, up to date, outcome and patient-specific indices presented in this study are better suited for use in present injury epidemiology. Their use can be trialed by hospital administrations in resource allocation models and patient classification models in clinical settings.


Assuntos
Comorbidade , Readmissão do Paciente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Hospitais , Humanos , Lactente , Recém-Nascido , Tempo de Internação , Masculino , Pessoa de Meia-Idade , New South Wales/epidemiologia , Vitória/epidemiologia , Austrália Ocidental/epidemiologia , Adulto Jovem
12.
Exp Parasitol ; 223: 108089, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33639135

RESUMO

The morphological, biological, and molecular characterisation of Cryptosporidium piscine genotype 7 from red-eye tetras (Moenkhausia sanctaefilomenae) are described, and the species name Cryptosporidium abrahamseni n. sp. is proposed. Histological analysis of intestinal tissue identified large numbers of Cryptosporidium organisms along the epithelial lining of the intestine. Sequence and phylogenetic analysis at 18S rRNA (18S) and actin loci conducted on intestinal scrapings revealed that C. abrahamseni n. sp. was genetically distinct from other Cryptosporidium species. At the 18S locus, it was most closely related to C. huwi (3.2% genetic distance) and exhibited genetic distances ranging from 5.9 to 6.5% (C. molnari) to 14.9% (C. scolpthalmi) from all other Cryptosporidium species. At the actin locus, the genetic distances were larger and C. abrahamseni n. sp. exhibited 10.3% genetic distance from C. huwi, and 17.6% (C. molnari) to 28% (C. canis) genetic distance from other Cryptosporidium spp. Phylogenetic analysis of concatenated 18S and actin sequences confirmed that C. abrahamseni n. sp. shares the closest genetic relationship with C. huwi (6.7% genetic distance), while the genetic distance between C. abrahamseni n. sp. and other Cryptosporidium spp. ranged from 12.1% (C. molnari) to 20.4% (C. canis). Based on genetic and histological data, C. abrahamseni n. sp. is validated as a separate species.


Assuntos
Characidae/parasitologia , Criptosporidiose/parasitologia , Cryptosporidium/classificação , Doenças dos Peixes/parasitologia , Enteropatias Parasitárias/veterinária , Actinas/genética , Animais , Evolução Biológica , Criptosporidiose/epidemiologia , Criptosporidiose/patologia , Cryptosporidium/genética , Cryptosporidium/ultraestrutura , Doenças dos Peixes/epidemiologia , Doenças dos Peixes/patologia , Genótipo , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Enteropatias Parasitárias/patologia , Intestinos/parasitologia , Intestinos/patologia , Filogenia , Prevalência , RNA Ribossômico 18S/genética , Austrália Ocidental/epidemiologia
13.
Maturitas ; 145: 6-11, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33541564

RESUMO

INTRODUCTION: Fractures are common and disabling health events, particularly later in life. The presence of clinically significant depressive symptoms has been associated with increased risk of fractures, and we designed the present study to clarify if this association is likely to be causal or due to the confounding effect of measures associated with both fractures and depression. METHOD: Cohort study of a community-derived sample of 4224 men aged 70 to 88 years at the start of the follow-up period of up to 17 years. Clinically significant symptoms of depression were defined as a recorded diagnosis of depressive episode in the Western Australian Data Linkage System (WADLS) or by a total score of 7 or greater on the 15-item Geriatric Depression Scale. Health contacts associated with fractures were retrieved from WADLS. Other measures included age, past history of fractures, education, smoking, frailty, poor vision, falls, medications, and the concentration of vitamin D, homocysteine, hsCRP and testosterone. Death was considered a competing risk for fractures. RESULTS: 911 (21.6%) participants had a bone fracture during follow-up. After adjustment for multiple potential confounders, past and current depression were associated with an increase in the risk of novel fractures; respective odds ratios were 1.41 (95%CI = 1.03, 1.93) and 1.64 (95%CI = 1.20, 2.25). Parsimonious competing risk regression showed that both past and current depression were associated with an increase in the risk of novel fractures: sub-hazard ratio = 1.29 (95%CI = 1.03, 1.63) and 1.27 (95%CI = 1.05, 1.55) respectively. Estimation of confounding due to unmeasured factors showed that a small additional effect could potentially dilute the association between depression and fractures. DISCUSSION: History of clinically significant symptoms of depression is associated with an increased risk of future fractures. This association may be due to multiple other associated risk factors, both measured and unmeasured, but nevertheless the presence of depression should alert clinicians to the need to develop a management plan that includes the management not only of depression but also of fracture risk.


Assuntos
Depressão/epidemiologia , Fraturas Ósseas/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Humanos , Masculino , Razão de Chances , Fatores de Risco , Austrália Ocidental/epidemiologia
14.
Artigo em Inglês | MEDLINE | ID: mdl-33535674

RESUMO

Drought is thought to impact upon the mental health of agricultural communities, but studies of this relationship have reported inconsistent results. A source of inconsistency could be the aggregation of data by a single spatiotemporal unit of analysis, which induces the modifiable areal and temporal unit problems. To investigate this, mental health-related emergency department (MHED) presentations among residents of the Wheat Belt region of Western Australia, between 2002 and 2017, were examined. Average daily rainfall was used as a measure of drought. Associations between MHED presentations and rainfall were estimated based on various spatial aggregations of underlying data, at multiple temporal windows. Wide variation amongst results was observed. Despite this, two key features were found: Associations between MHED presentations and rainfall were generally positive when rainfall was measured in summer months (rate ratios up to 1.05 per 0.5 mm of daily rainfall) and generally negative when rainfall was measured in winter months (rate ratios as low as 0.96 per 0.5 mm of daily rainfall). These results demonstrate that the association between drought and mental health is quantifiable; however, the effect size is small and varies depending on the spatial and temporal arrangement of the underlying data. To improve understanding of this association, more studies should be undertaken with longer time spans and examining specific mental health outcomes, using a wide variety of spatiotemporal units.


Assuntos
Secas , Saúde Mental , Agricultura , Estações do Ano , Austrália Ocidental/epidemiologia
15.
Addict Behav ; 117: 106871, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33609811

RESUMO

BACKGROUND: Mounting epidemiological evidence suggests an association between prenatal tobacco exposure and an increased risk of tobacco smoking in offspring. However, it is uncertain whether the association is due to the intrauterine or shared environmental exposures. METHODS: Study participants were from the Raine Study, a prospective birth cohort study based in Perth, Western Australia (N = 2730). Tobacco smoking in adolescents, at age 17 years, was measured using a self-reported questionnaire. Log-binomial regression was used to estimate the relative risks (RRs) of tobacco smoking in offspring exposed to maternal prenatal tobacco use during the first and third trimesters of pregnancy. We have also calculated the E-values to investigate the potential effect of unmeasured confounding. Paternal smoking during pregnancy was used as a negative control for comparison. RESULTS: A total of 1210 mothers-offspring pairs were included in the final analysis. After controlling for potential confounders, we found increased risks of tobacco smoking in offspring exposed to maternal prenatal tobacco use during the first trimester [RR 1.50 (95% CI: 1.13-1.97)] (E-value for point estimate = 2.37) and during both trimesters of pregnancy [RR 1.41 (95% CI: 1.03-1.89)] (E-value for point estimate = 2.17). However, we found insufficient statistical evidence for an association between paternal smoking during pregnancy and risk of tobacco smoking in offspring [RR 1.18 (95% CI: 0.84-1.67)]. CONCLUSION: Maternal prenatal tobacco exposure was associated with an increased risk of tobacco smoking in offspring at the age of 17 years. Tobacco smoking cessation at the early stages of gestation may reduce the risk of tobacco smoking in the next generation.


Assuntos
Efeitos Tardios da Exposição Pré-Natal , Adolescente , Estudos de Coortes , Feminino , Humanos , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Estudos Prospectivos , Fatores de Risco , Fumar/epidemiologia , Fumar Tabaco , Austrália Ocidental/epidemiologia
16.
Invest Ophthalmol Vis Sci ; 61(14): 26, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33355605

RESUMO

Purpose: To evaluate the contribution of genetic and early life environmental factors, as reflected by fetal anthropometric growth trajectories, toward the development of myopia during childhood and adolescence. Methods: This analysis included 498 singleton Caucasian participants from the Raine Study, a pregnancy cohort study based in Western Australia. Serial fetal biometric measurements of these participants were collected via ultrasound scans performed at 18, 24, 28, 34, and 38 weeks' gestation. At a 20-year follow-up, the participants underwent a comprehensive ophthalmic examination, including cycloplegic autorefraction and ocular biometry measurements. Using a group-based trajectory modeling approach, we identified groups of participants with similar growth trajectories based on measurements of fetal head circumference (HC), abdominal circumference, femur length (FL), and estimated fetal weight (EFW). Differences between trajectory groups with respect to prevalence of myopia, axial length (AL), and corneal radius of curvature measured at the 20-year follow-up were evaluated via logistic regression and analysis of variance. Results: Prevalence of myopia was highest among participants with consistently short or consistently long FLs (P = 0.04). There was also a trend toward increased prevalence with larger HC in late gestation, although not at a statistically significant level. Trajectory groups reflecting faster HC, FL, or EFW growth correlated with significantly flatter corneas (P = 0.03, P = 0.04, and P = 0.01, respectively) and a general, but not statistically significant, increase in AL. Conclusions: Environmental or genetic factors influencing intrauterine skeletal growth may concurrently affect ocular development, with effects persisting into adulthood.


Assuntos
Desenvolvimento Fetal , Miopia/etiologia , Feminino , Idade Gestacional , Humanos , Masculino , Miopia/epidemiologia , Estudos Prospectivos , Fatores de Risco , Ultrassonografia Pré-Natal , Austrália Ocidental/epidemiologia , Adulto Jovem
17.
Dis Aquat Organ ; 142: 197-201, 2020 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-33331287

RESUMO

Streptococcus iniae causes high mortality in cultured and wild fish stocks globally. Since the first report in captive Amazon river dolphins Inia geoffrensis in 1976, it has emerged in finfish across all continents except Antarctica. In March 2016, an estimated 17000 fish were observed dead and dying along a remote 70 km stretch of the Kimberley coastline north of Broome, Western Australia. Affected species included finfish (lionfish Pterois volitans, angelfish Pomacanthus sp., stripey snapper Lutjanus carponotatus, sand bass Psammoperca waigiensis, yellowtail grunter Amniataba caudavittata, damselfish Pomacentridae sp.), flatback sea turtles Natator depressus, and olive (Aipysurus laevis) and black-ringed (Hydrelaps darwiniensis) sea snakes. Moribund fish collected during the event exhibited exophthalmia and abnormal behaviour, such as spiralling on the surface or within the water column. Subsequent histopathological examination of 2 fish species revealed bacterial septicaemia with chains of Gram-positive cocci seen in multiple organs and within brain tissue. S. iniae was isolated and identified by bacterial culture, species-specific PCR, Matrix-Assisted Laser Desorption Ionisation Time-Of-Flight (MALDI-TOF) and biochemical testing. This is the first report of S. iniae associated with a major multi-species wild marine fish kill in Australia. Extreme weather events in the region including a marked decrease in water temperatures, followed by an extended period of above-average coastal water temperatures, were implicated as stressors potentially contributing to this outbreak.


Assuntos
Doenças dos Peixes , Infecções Estreptocócicas , Animais , Austrália , Doenças dos Peixes/epidemiologia , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/veterinária , Streptococcus iniae , Austrália Ocidental/epidemiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-33352982

RESUMO

We investigated patients presenting to emergency departments (EDs) with chest pain to identify factors that influence the use of invasive coronary angiography (ICA). Using linked ED, hospitalisations, death and cardiac biomarker data, we identified people aged 20 years and over who presented with chest pain to tertiary public hospital EDs in Western Australia from 1 January 2016 to 31 March 2017 (ED chest pain cohort). We report patient characteristics, ED discharge diagnosis, pathways to ICA, ICA within 90 days, troponin test results, and gender differences. Associations were examined with the Pearson Chi-squared test and multivariate logistic regression. There were 16,974 people in the ED chest pain cohort, with a mean age of 55.6 years and 50.7% males, accounting for 20,131 ED presentations. Acute coronary syndrome was the ED discharge diagnosis in 10.4% of presentations. ED pathways were: discharged home (57.5%); hospitalisation (41.7%); interhospital transfer (0.4%); and died in ED (0.03%)/inpatients (0.3%). There were 1546 (9.1%) ICAs performed within 90 days of the first ED chest pain visit, of which 59 visits (3.8%) had no troponin tests and 565 visits (36.6%) had normal troponin. ICAs were performed in more men than women (12.3% vs. 6.1%, p < 0.0001; adjusted OR 1.89, 95% CI 1.65, 2.18), and mostly within 7 days. Equal numbers of males and females present with chest pain to tertiary hospital EDs, but men are twice as likely to get ICA. Over one-third of ICAs occur in those with normal troponin levels, indicating that further investigation is required to determine risk profile, outcomes and cost effectiveness.


Assuntos
Dor no Peito/epidemiologia , Angiografia Coronária , Serviço Hospitalar de Emergência , Intervenção Coronária Percutânea , Adulto , Austrália , Dor no Peito/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/epidemiologia , Austrália Ocidental/epidemiologia , Adulto Jovem
19.
Australas Psychiatry ; 28(6): 627-631, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32961096

RESUMO

OBJECTIVE: Coronavirus (COVID-19) has led to high levels of psychological distress in the community. This study aimed to examine whether emergency departments (EDs) also recorded a rise in mental health presentations. METHOD: Changes in the number, and type, of mental health presentations to Western Australia EDs were examined between January and May 2020, and compared to 2019. RESULTS: Data showed an unexpected decrease in the number of mental health presentations, compared to 2019, which was temporally coincident with the rise in local COVID-19 cases. Presentations for anxiety and panic symptoms, and social and behavioural issues, increased by 11.1% and 6.5%, respectively, but suicidal and self-harm behaviours decreased by 26%. CONCLUSION: A rise in local COVID-19 cases was associated with a decrease in mental health presentations to EDs. This has important implications for the planning and provision of healthcare services in the current pandemic.


Assuntos
Infecções por Coronavirus , Serviço Hospitalar de Emergência/estatística & dados numéricos , Serviços de Emergência Psiquiátrica/estatística & dados numéricos , Transtornos Mentais , Pandemias , Pneumonia Viral , Angústia Psicológica , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Correlação de Dados , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Saúde Mental/tendências , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Austrália Ocidental/epidemiologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-32981492

RESUMO

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


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Infecções Assintomáticas , Austrália/epidemiologia , Betacoronavirus , Criança , Pré-Escolar , Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/transmissão , Feminino , Instituição de Longa Permanência para Idosos , Hospitalização , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , New South Wales/epidemiologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Pneumonia Viral/transmissão , Queensland/epidemiologia , Austrália do Sul/epidemiologia , Vitória/epidemiologia , Austrália Ocidental/epidemiologia , Adulto Jovem
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