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2.
BMJ Open ; 12(5): e057856, 2022 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-35508342

RESUMO

OBJECTIVE: This study sought whether higher risk patients with coronary heart disease (CHD) benefit more from intensive disease management. DESIGN: Longitudinal cohort study. SETTING: State-wide public hospitals (Queensland, Australia). PARTICIPANTS: This longitudinal study included 20 426 patients hospitalised in 2010 with CHD as the principal diagnosis. Patients were followed-up for 5 years. PRIMARY AND SECONDARY OUTCOMES AND MEASURES: The primary outcome was days alive and out of hospital (DAOH) within 5 years of hospital discharge. Secondary outcomes included all-cause readmission and all-cause mortality. A previously developed and validated risk score (PEGASUS-TIMI54) was used to estimate the risk of secondary events. Data on sociodemography, comorbidity, interventions and medications were also collected. RESULTS: High-risk patients (n=6573, risk score ≥6) had fewer DAOH (∆=-142 days (95% CI: -152 to -131)), and were more likely to readmit or die (all p<0.001) than their low-risk counterparts (n=13 367, risk score <6). Compared with patients who were never prescribed a medication, those who consumed maximal dose of betablockers (∆=39 days (95% CI: 11 to 67)), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (∆=74 days (95% CI: 49 to 99)) or statins (∆=109 days (95% CI: 90 to 128)) had significantly greater DAOH. Patients who received percutaneous coronary intervention (∆=99 days (95% CI: 81 to 116)) or coronary artery bypass grafting (∆=120 days (95% CI: 92 to 148)) also had significantly greater DAOH than those who did not. The effect sizes of these therapies were significantly greater in high-risk patients, compared with low-risk patients (interaction p<0.001). Analysis of secondary outcomes also found significant interaction between both medical and interventional therapies with readmission and death, implicating greater benefits for high-risk patients. CONCLUSIONS: CHD patients can be effectively risk-stratified, and use of this information for a risk-guided strategy to prioritise high-risk patients may maximise benefits from additional resources spent on intensive disease management.


Assuntos
Doença das Coronárias , Doença das Coronárias/prevenção & controle , Humanos , Armazenamento e Recuperação da Informação , Estudos Longitudinais , Queensland/epidemiologia , Prevenção Secundária
3.
Sci Rep ; 12(1): 5907, 2022 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-35396558

RESUMO

The compound extreme weather event that impacted northern Queensland in February 2019 featured record-breaking rainfall, persistent high wind gusts and relatively cold day-time temperatures. This caused livestock losses numbering around 500,000 in the northwest Queensland Gulf region. In this study, we examine the livestock chill conditions associated with this week-long compound weather event and its potential for prediction from eleven world-leading sub-seasonal to seasonal (S2S) forecast systems. The livestock chill index combines daily rainfall, wind and surface temperature data. Averaged over the event week, the potential heat loss of livestock was in the moderate to high category, with severe conditions on the day of peak rainfall (5 February). Using calibrated forecasts from the Bureau of Meteorology's S2S forecast system, ACCESS-S1, a 1-week lead prediction showed a 20-30% probability of extreme livestock chill conditions over the northwest Queensland Gulf region, however the highest probabilities were located to the west of where the greatest livestock impacts were observed. Of the remaining ten S2S systems, around half predicted a more than 20% chance of extreme conditions, more than twice the climatological probability. It appears that the prediction accuracy arose from the skilful forecasts of extreme rainfall, as opposed to cold day-time temperature and strong wind forecasts. Despite a clear association between the observed extreme weather conditions and an active Madden-Julian Oscillation (MJO) event stalling in the western Pacific, the majority of 1-week lead S2S forecasts showed little indication of a slow-down in the MJO. As the livestock chill index was developed for southern Australian sheep, it may not be the best metric to represent the effects of exposure on tropical cattle breeds. Hence, this study draws attention to the need for tailored diagnostics that better represent the cold effects of summer tropical cyclones and tropical depressions on northern Australian livestock.


Assuntos
Gado , Tempo (Meteorologia) , Animais , Austrália , Bovinos , Inundações , Queensland/epidemiologia , Ovinos
4.
Accid Anal Prev ; 171: 106663, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35439685

RESUMO

Right-turn movements (equivalent to left turn movements for countries that drive on the right) at intersections are among the most complex driving maneuvers and require a high level of attention for turning across (potentially) oncoming traffic by accepting a safe gap. Not surprisingly, right-turn-involved crashes are one of the most frequent collision types at intersections (e.g., 42% of all signalised intersection crashes in Queensland, Australia). Unfortunately, the causes and contributing factors to right-turn crashes are not well understood, particularly the effect of right-turn signal strategies on the crash risk. In the safety literature, signal strategies are coarsely considered in two generic categories-protected right-turns and permitted right-turns. In reality, right-turn signal strategies could be of various types (usually 5) based on the level of intersection complexity and potential traffic conflicts. The effects of these signal strategies, along with the geometric and traffic factors, have not been well studied. To fill this gap, this study investigates the effects of right-turn signal strategies, intersection geometry and traffic operations factors on right-turn crashes at signalised intersections. To achieve this aim, crash frequency models were estimated using crash data from 221 signalised intersections in Queensland from the years spanning 2012 to 2018. Hierarchical Poisson Regression Models (random intercept models) were employed to capture the hierarchical structure of influences on crashes, with upper-level capturing intersection characteristics and lower-level capturing approach characteristics. The hierarchical model structure, disaggregate exposure variables, and signal strategies examined in this study give rise to an entirely unique study in the literature.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Acidentes de Trânsito/prevenção & controle , Atenção , Austrália , Planejamento Ambiental , Humanos , Queensland
5.
Australas Psychiatry ; 30(2): 195-199, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35382610

RESUMO

OBJECTIVE: To evaluate the medical assessments of involuntary community patients in a regional mental health service, determine the compliance with requirements under Queensland's Mental Health Act 2016 (the Act) to regularly review orders and assess patients' mental capacity. METHOD: We audited 183 patient records on community treatment authorities (CTAs) to determine whether medical assessments undertaken under the Act included consideration of the person's capacity, and regular reviews by an authorised doctor as required1s205. RESULTS: The audit revealed that 51% of the CTA patients did not comply with legal requirements either to complete a capacity assessment and/or be medically assessed within three months of the last review. CONCLUSIONS: Over 50% of medical assessments did not comply with the legislative requirements to record capacity assessments and review involuntary treatment on at least a three-month basis. However, when the treatment criteria were met, it did not appear to be a basis for CTA revocation. Further research may help determine whether the Mental Health Review Tribunal (Tribunal) could play a greater role in overseeing compliance with the new legislative requirements or if other clinical oversight mechanisms would be appropriate to improve the assessment process.


Assuntos
Serviços de Saúde Mental , Saúde Mental , Direitos Humanos , Humanos , Queensland
6.
Artigo em Inglês | MEDLINE | ID: mdl-35457499

RESUMO

There is a high degree of expert consensus that anthropogenic climate change will be catastrophic if urgent and significant measures to reduce carbon emissions are not undertaken worldwide. Australia is a world-leading exporter of coal and gas, and does not have an effective emissions reduction strategy. Though many Australians support action on climate change, this has not affected voting patterns. In this qualitative study, we aimed to explore the attitudes of Australian voters in Brisbane, Queensland, Australia towards potential environmental policies. We approached people in public spaces, and invited them to participate in interviews. Six of the thirty-five interview participants who voted for the two main political parties or were undecided voters agreed with the transition to 100% renewables and/or no new coal mines in Australia. Many thought that renewables were not reliable enough and/or the economy was too dependent on coal to make the transition. There was strong support for political leadership in order to regulate mining and pollution, and for a transition plan for fossil-fuel-dependent communities. Participants were most concerned about tangible environmental issues, such as waste and pollution, and also described needing clear solutions in order to engage with the issues. Some described feeling 'shouted at' by protests and messaging about climate change and environmental issues. Our findings suggest that solution-based messaging may increase levels of engagement about climate change, and that waste and pollution can be entry-points for discussions about climate change. It is important to have conversations with people about this important issue.


Assuntos
Combustíveis Fósseis , Política Pública , Austrália , Mudança Climática , Carvão Mineral , Humanos , Queensland
7.
Arch Virol ; 167(5): 1317-1323, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35394246

RESUMO

Bermuda grass latent virus (BGLV; genus Panicovirus) is identified for the first time in Australia and in only the second country after the USA. A full-length genome sequence was obtained, which has 97% nucleotide sequence identity to that of the species exemplar isolate. Surveys for BGLV, utilising a newly designed universal panicovirus RT-PCR assay for diagnosis, demonstrated widespread infection by this virus in a broad variety of Bermuda grass cultivars (Cynodon dactylon and C. dactylon × C. transvaalensis) grown in both New South Wales and Queensland. The virus was also detected in Rhodes grass (Chloris gayana) and Kikuyu grass (Cenchrus clandestinus), which are both important pasture grasses in subtropical Australia, and the latter is also grown as turf. Furthermore, the Rhodes grass plant, which had strong mosaic symptoms, was also infected with sugarcane mosaic virus, warranting further investigations as to whether synergistic interactions occur between these two viruses.


Assuntos
Cynodon , Tombusviridae , Austrália , Queensland
8.
J Hist Dent ; 70(1): 47-70, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35468053

RESUMO

Accounts of dental history in Queensland are few and almost invariably authored by those who either held or hold power. The focus is 'who, what, when' rather than 'why and how'. House-related developments as a case study provide an opportunity to assess aspects of the Australian Dental Association Queensland Branch's (ADAQ) model of administration in the early 1970s. The authors use literature review and historical methods. The ADAQ's articles of association, codes of conduct and memoranda centralized Brisbane-based authority and elite leadership into its management. The ADAQ council's decision to build Christensen House in Brisbane, prompted by the posthumous benevolence of George Christensen, was informed, logical, measured and appeared timely. The advocates for the house were innovative, optimistic, resolute, and well-intentioned, with their design and selected location of the building being appropriate. However, the decision occurred at a time of latent discontent within the membership, many of whom did not support the project financially. Distance in Queensland dictates that provincial members either accept or tolerate Brisbane-based centralized authority within ADAQ administration. Nonetheless, when it comes to policy warranting membership subscription, the Christensen House experience demonstrates that the modus operandi of the ADAQ council should be, as far as possible, inclusive, and representative.


Assuntos
Processos Grupais , Liderança , Austrália , Humanos , Queensland
9.
Sci Rep ; 12(1): 6309, 2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35428853

RESUMO

We used an agent-based model Covasim to assess the risk of sustained community transmission of SARSCoV-2/COVID-19 in Queensland (Australia) in the presence of high-transmission variants of the virus. The model was calibrated using the demographics, policies, and interventions implemented in the state. Then, using the calibrated model, we simulated possible epidemic trajectories that could eventuate due to leakage of infected cases with high-transmission variants, during a period without recorded cases of locally acquired infections, known in Australian settings as "zero community transmission". We also examined how the threat of new variants reduces given a range of vaccination levels. Specifically, the model calibration covered the first-wave period from early March 2020 to May 2020. Predicted epidemic trajectories were simulated from early February 2021 to late March 2021. Our simulations showed that one infected agent with the ancestral (A.2.2) variant has a 14% chance of crossing a threshold of sustained community transmission (SCT) (i.e., > 5 infections per day, more than 3 days in a row), assuming no change in the prevailing preventative and counteracting policies. However, one agent carrying the alpha (B.1.1.7) variant has a 43% chance of crossing the same threshold; a threefold increase with respect to the ancestral strain; while, one agent carrying the delta (B.1.617.2) variant has a 60% chance of the same threshold, a fourfold increase with respect to the ancestral strain. The delta variant is 50% more likely to trigger SCT than the alpha variant. Doubling the average number of daily tests from ∼ 6,000 to 12,000 results in a decrease of this SCT probability from 43 to 33% for the alpha variant. However, if the delta variant is circulating we would need an average of 100,000 daily tests to achieve a similar decrease in SCT risk. Further, achieving a full-vaccination coverage of 70% of the adult population, with a vaccine with 70% effectiveness against infection, would decrease the probability of SCT from a single seed of alpha from 43 to 20%, on par with the ancestral strain in a naive population. In contrast, for the same vaccine coverage and same effectiveness, the probability of SCT from a single seed of delta would decrease from 62 to 48%, a risk slightly above the alpha variant in a naive population. Our results demonstrate that the introduction of even a small number of people infected with high-transmission variants dramatically increases the probability of sustained community transmission in Queensland. Until very high vaccine coverage is achieved, a swift implementation of policies and interventions, together with high quarantine adherence rates, will be required to minimise the probability of sustained community transmission.


Assuntos
COVID-19 , SARS-CoV-2 , Adulto , Austrália/epidemiologia , COVID-19/epidemiologia , Humanos , Queensland/epidemiologia , SARS-CoV-2/genética
10.
BMJ Open ; 12(4): e057011, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35365533

RESUMO

OBJECTIVE: Ear disease in rural and remote communities is occurring at high rates, with limited access to health services and health providers contributing to the problem. Community pharmacists are well-placed to provide expanded services to improve ear health in rural communities. We aimed to evaluate the feasibility, accessibility and acceptability of a pharmacist-led intervention for ear disease in consumers presenting to community pharmacy. DESIGN: Prospective preintervention and postintervention mixed-methods study. An ethnographic lens of rural culture was applied to the descriptive qualitative component of the study. SETTING: Two rural community pharmacies in Queensland, Australia. PARTICIPANTS: People aged 6 months or older, who present with an ear complaint to a participating community pharmacy. INTERVENTION: LISTEN UP (Locally Integrated Screening and Testing Ear aNd aUral Programme) is a community pharmacy-based intervention to improve the management of ear health. Trained pharmacists conducted ear examinations using otoscopy and tympanometry on consumers following a LISTEN UP protocol. They made recommendations including no treatment, pharmacy only products or general practitioner (GP) referral. Consumers were contacted 7 days later for follow-up. RESULTS: 55 rural consumers participated in the study. The most commonly reported complaints were 'blocked ear' and 'ear pain'. Pharmacists recommended over-the-counter products to two-thirds of the participants and referred one quarter to a GP. 90% (50/55) of the consumers were highly satisfied with the service and would recommend the service. All consumers described the service positively with particular reference to convenience, improved confidence and appreciation of the knowledge gained about their ear complaint. Pharmacists were motivated to upskill and manage workflow to incorporate the service and expected both consumers and GPs to be more accepting of future expanded services as a result of LISTEN UP. However, without funding to provide the service, during the study other remunerated pharmacy tasks took priority over providing LISTEN UP. CONCLUSION: Rural community pharmacists can provide an acceptable and accessible ear health service; however, it is not feasible without a clear funding structure to provide resources including additional pharmacists, equipment and training. TRIAL REGISTRATION NUMBER: ACTRN12620001297910.


Assuntos
Serviços Comunitários de Farmácia , Farmácias , Austrália , Estudos de Viabilidade , Humanos , Lactente , Farmacêuticos , Estudos Prospectivos , Queensland , População Rural
11.
PLoS Negl Trop Dis ; 16(4): e0010243, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35395009

RESUMO

Aedes aegypti is the primary vector of exotic arboviruses (dengue, chikungunya and Zika) in Australia. Once established across much of Australia, this mosquito species remains prevalent in central and northern Queensland. In 2011, Ae. aegypti was re-discovered in the town of Gin Gin, Queensland, by health authorities during routine larval surveillance. This town is situated on a major highway that provides a distribution pathway into the highly vulnerable and populous region of the state where the species was once common. Following the detection, larval habitat and adult control activities were conducted as a public health intervention to eliminate the Ae. aegypti population and reduce the risk of exotic disease transmission. Importantly, genetic analysis revealed a homogenous cluster and small effective population vulnerable to an elimination strategy. By 2015, adult surveillance revealed the population had expanded throughout the centre of the town. In response, a collaboration between research agencies and local stakeholders activated a second control program in 2016 that included extensive community engagement, enhanced entomologic surveillance and vector control activities including the targeting of key containers, such as unsealed rainwater tanks. Here we describe a model of the public health intervention which successfully reduced the Ae. aegypti population below detection thresholds, using source reduction, insecticides and novel, intensive genetic surveillance methods. This outcome has important implications for future elimination work in small towns in regions sub-optimal for Ae. aegypti presence and reinforces the longstanding benefits of a partnership model for public health-based interventions for invasive urban mosquito species.


Assuntos
Aedes , Dengue , Infecção por Zika virus , Zika virus , Animais , Austrália , Cidades , Dengue/epidemiologia , Larva/genética , Mosquitos Vetores , Saúde Pública , Queensland/epidemiologia
12.
Emerg Infect Dis ; 28(4): 701-706, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35319435

RESUMO

The epidemiology of bloodstream infections caused by Shewanella spp. is not well defined. Our objective was to define the incidence and determinants of Shewanella spp. bloodstream infections by using population-based surveillance in Queensland, Australia during 2000‒2019. The incidence was 1.0 cases/1 million persons annually and was highest during summer and in the tropical Torres and Cape region. Older persons and male patients were at highest risk. At least 1 concurrent condition was documented in 75% of case-patients, and 30-day all cause case-fatality rate was 15%. Aging populations in warm climates might expect an increasing burden of these infections.


Assuntos
Bacteriemia , Sepse , Shewanella , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Bacteriemia/epidemiologia , Humanos , Masculino , Queensland/epidemiologia
13.
Viruses ; 14(3)2022 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-35337056

RESUMO

Canegrubs (Coleoptera: Scarabaeidae) are major pests of sugarcane crops in Australia, but despite long-term and intensive research, no commercially viable biological control agents have been identified. We used the RNA-Seq approach to explore the viriomes of three different species of canegrubs from central Queensland, Australia to identify potential candidates for biological control. We identified six novel RNA viruses, characterized their genomes, and inferred their evolutionary relationships with other closely related viruses. These novel viruses showed similarity to other known members from picornaviruses, benyviruses, sobemoviruses, totiviruses, and reoviruses. The abundance of viral reads varied in these libraries; for example, Dermolepida albohirtum picorna-like virus (9696 nt) was built from 83,894 assembled reads while only 1350 reads mapped to Lepidiota negatoria beny-like virus (6371 nt). Future studies are essential to determine their natural incidence in different life stages of the host, biodiversity, geographical distributions, and potential as biological control agents for these important pests of sugarcane.


Assuntos
Besouros , Vírus de RNA , Saccharum , Animais , Austrália , Agentes de Controle Biológico , Queensland , Transcriptoma
14.
Breast Cancer Res Treat ; 193(1): 175-185, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35254604

RESUMO

PURPOSE: Our aim was to describe variations in the treatment of early-stage breast cancer and to examine factors associated with disease-specific survival (DSS). METHODS: The study used linked data for 24,190 women with a T1 (≤ 20 mm) breast cancer who underwent surgery from 2005 to 2019. Multivariate logistic regression was used to model predictors of receiving breast-conserving surgery (BCS) compared to mastectomy and a multinomial model was used to examine factors associated with type(s) of treatment received. RESULTS: Overall, 70.3% had BCS, with a reduced likelihood of BCS observed for younger women (p < 0.001), rural residence, (p < 0.001), socioeconomic disadvantage (p = 0.004), higher tumour grade (p < 0.001) and surgery in a public versus private hospital (p < 0.001). Compared to women who received BCS and radiation therapy (RT), those having mastectomy alone or mastectomy plus RT were more likely to be younger (p < 0.001), live in a rural area (p < 0.001), have higher-grade tumours (p < 0.001) and positive lymph nodes (p < 0.001). Overall 5-year survival was 95.3% and breast cancer-specific survival was 98.3%. Highest survival was observed for women having BCS and RT and lowest for those having mastectomy and RT (p < 0.001). CONCLUSION: Our results indicate some variation in the management of early-stage breast cancer. Lower rates of BCS were observed for rural and disadvantaged women and for those treated in a public or low-volume hospital. Whilst survival was high for this cohort, differences in tumour biology likely explain the differences in survival according to treatment type.


Assuntos
Neoplasias da Mama , Mastectomia , Austrália , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia/métodos , Mastectomia Segmentar , Estadiamento de Neoplasias , Queensland/epidemiologia , Radioterapia Adjuvante
15.
Aust N Z J Obstet Gynaecol ; 62(2): 219-225, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35257360

RESUMO

BACKGROUND: A significant barrier to the access of safe abortion is the lack of trained abortion providers. Recent studies show that with appropriate education, nurses and midwives can provide abortions as safely as medical practitioners. AIMS: To examine the attitudes and practices of registered midwives (RMs) and sexual health nurses (SHNs) in Queensland toward abortion. MATERIALS AND METHODS: A cross-sectional mixed-methods questionnaire was distributed to RMs and SHNs from the Queensland Nursing and Midwifery Union. Data were described and analysed both quantitatively and qualitatively. RESULTS: There was a 20% response rate (n = 624) to the survey from the overall study population. There were 53.5% who reported they would support the provision of abortion in any situation at all; 7.4% held views based on religion or conscience that would make them completely opposed to abortion. There were 92.9% who felt that education surrounding abortion should be part of the core curriculum for midwifery and/or nursing students in Australia. The qualitative responses demonstrated a variety of views and suggestions regarding the practice of abortion. CONCLUSIONS: There was a wide variation in views toward induced abortion from RMs and SHNs in Queensland. While a proportion of respondents opposed abortion in most circumstances, a significant group was in support of abortion in any situation and felt involvement in initiating and/or performing abortion would be within the scope of RMs and SHNs.


Assuntos
Aborto Induzido , Tocologia , Saúde Sexual , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Gravidez , Queensland
16.
BMC Public Health ; 22(1): 584, 2022 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-35331189

RESUMO

BACKGROUND: Global action to reduce obesity prevalence requires digital transformation of the public health sector to enable precision public health (PPH). Useable data for PPH of obesity is yet to be identified, collated and appraised and there is currently no accepted approach to creating this single source of truth. This scoping review aims to address this globally generic problem by using the State of Queensland (Australia) (population > 5 million) as a use case to determine (1) availability of primary data sources usable for PPH for obesity (2) quality of identified sources (3) general implications for public health policymakers. METHODS: The Preferred Reporting Items for Systematic Review and Meta-Analyses extension for scoping reviews (PRISMA-ScR) was followed. Unique search strategies were implemented for 'designed' (e.g. surveys) and 'organic' (e.g. electronic health records) data sources. Only primary sources of data (with stratification to Queensland) with evidence-based determinants of obesity were included. Primary data source type, availability, sample size, frequency of collection and coverage of determinants of obesity were extracted and curated into an evidence map. Data source quality was qualitatively assessed. RESULTS: We identified 38 primary sources of preventive data for obesity: 33 designed and 5 organic. Most designed sources were survey (n 20) or administrative (n 10) sources and publicly available but generally were not contemporaneous (> 2 years old) and had small sample sizes (10-100 k) relative to organic sources (> 1 M). Organic sources were identified as the electronic medical record (ieMR), wearables, environmental (Google Maps, Crime Map) and billing/claims. Data on social, biomedical and behavioural determinants of obesity typically co-occurred across sources. Environmental and commercial data was sparse and interpreted as low quality. One organic source (ieMR) was highly contemporaneous (routinely updated), had a large sample size (5 M) and represented all determinants of obesity but is not currently used for public health decision-making in Queensland. CONCLUSIONS: This review provides a (1) comprehensive data map for PPH for obesity in Queensland and (2) globally translatable framework to identify, collate and appraise primary data sources to advance PPH for obesity and other noncommunicable diseases. Significant challenges must be addressed to achieve PPH, including: using designed and organic data harmoniously, digital infrastructure for high-quality organic data, and the ethical and social implications of using consumer-centred health data to improve public health.


Assuntos
Armazenamento e Recuperação da Informação , Saúde Pública , Austrália , Pré-Escolar , Humanos , Obesidade/epidemiologia , Queensland/epidemiologia
17.
Front Public Health ; 10: 782373, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35252085

RESUMO

OBJECTIVE: High rates of dementia are evident in First Nations populations, and modifiable risk factors may be contributing to this increased risk. This study aimed to use a longitudinal dataset to gain insights into the long-term risk and protective factors for dementia and cognitive impairment not dementia (CIND) in a Torres Strait Islander and Aboriginal population in Far North Queensland, Australia. STUDY DESIGN AND SETTING: Probabilistic data linkage was used to combine baseline health check data obtained in 1998/2000 and 2006/2007 for 64 residents in remote communities with their results on a single dementia assessment 10-20 years later (2015-2018). The relationship between earlier measures and later CIND/dementia status was examined using generalized linear modeling with risk ratios (RRs). Due to the small sample size, bootstrapping was used to inform variable selection during multivariable modeling. RESULTS: One third of participants (n = 21, 32.8%) were diagnosed with dementia (n = 6) or CIND (n = 15) at follow-up. Secondary school or further education (RR = 0.38, 95% CI 0.19-0.76, p = 0.006) and adequate levels of self-reported physical activity (RR = 0.26, 95% CI 0.13-0.52, p < 0.001) were repeatedly selected in bootstrapping and showed some evidence of protection against later CIND/dementia in final multivariate models, although these had moderate collinearity. Vascular risk measures showed inconclusive or unexpected associations with later CIND/dementia risk. CONCLUSIONS: The preliminary findings from this small study highlighted two potential protective factors for dementia that may be present in this population. A tentative risk profile for later CIND/dementia risk is suggested, although the small sample size limits the applicability of these findings.


Assuntos
Disfunção Cognitiva , Demência , Serviços de Saúde do Indígena , Disfunção Cognitiva/epidemiologia , Demência/epidemiologia , Humanos , Armazenamento e Recuperação da Informação , Queensland/epidemiologia
18.
PLoS One ; 17(3): e0265410, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35312713

RESUMO

BACKGROUND: The epidemiology of central nervous system (CNS) infections in tropical Australia is incompletely defined. METHODS: A retrospective study of all individuals in Far North Queensland, tropical Australia, who were diagnosed with a CNS infection between January 1, 2000, and December 31, 2019. The microbiological aetiology of the infection was correlated with patients' demographic characteristics and their clinical course. RESULTS: There were 725 cases of CNS infection during the study period, meningitis (77.4%) was the most common, followed by brain abscess (11.6%), encephalitis (9.9%) and spinal infection (1.1%). Infants (24.3%, p<0.0001) and Aboriginal and Torres Strait Islander Australians (175/666 local residents, 26.3%, p<0.0001) were over-represented in the cohort. A pathogen was identified in 513 cases (70.8%); this was viral in 299 (41.2%), bacterial in 175 (24.1%) and fungal in 35 (4.8%). Cryptococcal meningitis (24 cases) was diagnosed as frequently as pneumococcal meningitis (24 cases). There were only 2 CNS infections with a S. pneumoniae serotype in the 13-valent pneumococcal vaccine after its addition to the National Immunisation schedule in 2011. Tropical pathogens-including Cryptococcus species (9/84, 11%), Mycobacterium tuberculosis (7/84, 8%) and Burkholderia pseudomallei (5/84, 6%)-were among the most common causes of brain abscess. However, arboviral CNS infections were rare, with only one locally acquired case-a dengue infection in 2009-diagnosed in the entire study period. Intensive Care Unit admission was necessary in 14.3%; the overall case fatality rate was 4.4%. CONCLUSION: Tropical pathogens cause CNS infections as commonly as traditional bacterial pathogens in this region of tropical Australia. However, despite being highlighted in the national consensus guidelines, arboviruses were identified very rarely. Prompt access to sophisticated diagnostic and supportive care in Australia's well-resourced public health system is likely to have contributed to the cohort's low case-fatality rate.


Assuntos
Abscesso Encefálico , Infecções do Sistema Nervoso Central , Austrália/epidemiologia , Abscesso Encefálico/epidemiologia , Infecções do Sistema Nervoso Central/epidemiologia , Humanos , Lactente , Queensland/epidemiologia , Estudos Retrospectivos
19.
J Clin Neurosci ; 99: 336-341, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35344871

RESUMO

Central nervous system tumours are the leading oncology cause of paediatric mortality. The aim of this research was to identify stages within the diagnostic process of a primary paediatric brain tumour that could be improved resulting in better outcomes. METHODS: The electronic medical records of Queensland Children's Hospital patients with central nervous system tumours between the 17/12/2014 till 11/12/2019 were retrospectively accessed. Time intervals of symptom onset to first medical review,location, time till medical imaging,subspecialty or neurosurgical review, timing of surgery, diagnosis and mortality status were recorded then analysed. RESULTS: A total of 168 patients were included. Mean age to 7.5, 65% male, with pilocytic astrocytoma representing 31%. 71.4% of the population were from a major city as determined by Remoteness Area classification, ABS, with 19% inner regional and 9.5% being outer regional and remote. The average time from first medical review to diagnostic imaging was significantly different when comparing remoteness classification (p = 0.044). There was also a statistically significant difference in the duration of time from medical imaging to specialist review comparing major city and outer regional/remote (p = 0.016) and inner regional versus outer regional/remote areas (p = 0.026). CONCLUSIONS: Delays in imaging in outer regional and remote Queensland are contributing to a delay in diagnosis and intervention in paediatric brain tumours. Service provision for neurosurgery in outer regional and remote Queensland is currently on par with inner regional and city areas. Suspicion of paediatric brain tumours is needed with clear referral pathways for general practitioners to access diagnostic imaging.


Assuntos
Neoplasias Encefálicas , Neoplasias do Sistema Nervoso Central , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Criança , Diagnóstico por Imagem , Feminino , Humanos , Masculino , Queensland/epidemiologia , Estudos Retrospectivos
20.
J Safety Res ; 80: 362-370, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35249616

RESUMO

INTRODUCTION: Maximizing the deterrent effects of Roadside Drug Testing (RDT) operations remains critical for improving road safety. While preliminary research has explored the impact of being tested at RDT sites, there is yet to be an investigation of different types of exposure (e.g., seeing an operation, being tested) and the subsequent relationship(s) with perceptions of certainty of apprehension and future intentions to offend. The overall objective of this research was to explore these relationships with a sample of drug takers. METHOD: A total of 803 Queensland motorists aged between 16 and 75 (M = 27.12, SD = 13.09) completed an online-based survey, and all reported consuming marijuana, MDMA, and/or methamphetamine at least once in the previous 12 months. A convenience sampling method was utilized (via Facebook). RESULTS: The drug driving proportion of the sample (58%) reported a total of 30,858 instances of drug driving, or 66 instances on average. Seeing RDT in the previous 12 months (26% of sample) was more common than being tested at RDT (7%). The results indicated that seeing RDT two or more times was related to increased certainty of apprehension (compared to those who had seen it only once or never), although the increase was relatively small. Correlational analyses suggest there were some positive (albeit weak relationships) between exposure to RDT (seen and tested) and past and future offending. However, only three significant predictors of future offending emerged: older age, lower perceptions of apprehension certainty, and greater use of marijuana. Practical Applications: The results illuminate the extent of the drug driving problem and the need for greater resourcing to increase the real threat of detection. While the effect of exposure to enforcement was small, it was positive, incremental and supportive of increased roadside police enforcement as well as further research to quantify such deterrent processes.


Assuntos
Condução de Veículo , Criança , Pré-Escolar , Humanos , Lactente , Intenção , Queensland , Detecção do Abuso de Substâncias , Inquéritos e Questionários
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