Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.259
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-32114974

RESUMO

The Australian Gonococcal Surveillance Programme (AGSP) has continuously monitored antimicrobial resistance in clinical isolates of Neisseria gonorrhoeae from all states and territories since 1981. In 2018, there were 9,006 clinical isolates of gonococci from public and private sector sources tested for in vitro antimicrobial susceptibility by standardised methods. This was the highest annual total of isolates tested since the inception of the AGSP. The current treatment recommendation for gonorrhoea, for the majority of Australia, remains dual therapy with ceftriaxone and azithromycin. Decreased susceptibility to ceftriaxone (minimum inhibitory concentration (MIC) value ≥0.06 mg/L) was found nationally in 1.73% of isolates. The highest proportions were reported from Tasmania and non-remote Western Australia (7.3% and 2.1% respectively). In 2018 two extensively drug-resistant isolates were reported from Queensland patients. These two isolates, with ceftriaxone MIC values of 0.50 mg/L, high-level resistance to azithromycin (MIC ≥ 256 mg/L), and resistance to penicillin and ciprofloxacin were identified and reported to the World Health Organization as isolates of international significance. Resistance to azithromycin (MIC value ≥1.0 mg/L) was found nationally in 6.2% of isolates, lower than the 9.3% reported in 2017, but more than double the proportion reported in 2015 (2.6%). The highest proportions were reported from the Australian Capital Territory (8.7%), Victoria (8.3%), and New South Wales (6.5%). High-level resistance to azithromycin (MIC value ≥256 mg/L) was reported in nine isolates nationally in 2018: four from New South Wales, three from Victoria, and two from Queensland. The proportion of isolates resistant to penicillin in non-remote Australia ranged from 8.8% in non-remote Northern Territory to 44.1% in South Australia. In remote Northern Territory penicillin resistance rates remain low (1.9%), and higher in remote Western Australia (6.5%). The proportion of isolates resistant to ciprofloxacin in non-remote Australia ranged from 10.3% in non-remote Northern Territory to 48.3% in South Australia. Ciprofloxacin resistance rates remain comparatively low in remote Northern Territory (1.9%) and remote Western Australia (4.6%).


Assuntos
Gonorreia/epidemiologia , Antibacterianos/uso terapêutico , Austrália/epidemiologia , Território da Capital Australiana , Ciprofloxacino/uso terapêutico , Gonorreia/tratamento farmacológico , Humanos , Testes de Sensibilidade Microbiana , Neisseria gonorrhoeae , New South Wales/epidemiologia , Northern Territory/epidemiologia , Resistência às Penicilinas , Penicilinas/uso terapêutico , Queensland/epidemiologia , Austrália do Sul/epidemiologia , Tasmânia/epidemiologia , Vitória/epidemiologia , Austrália Ocidental/epidemiologia
2.
Vet Parasitol ; 277: 109019, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31918044

RESUMO

Fasciola hepatica (liver fluke) is a widespread parasite infection of livestock in Victoria, South-eastern Australia, where high rainfall and a mild climate is suitable for the main intermediate host Austropeplea tomentosa. The aims of this study were to quantify the prevalence and intensity of F. hepatica in dairy cattle in the irrigated dairy regions of Victoria and determine if triclabendazole resistance was present in infected herds. Cattle in 83 herds from the following six irrigation regions were tested for F. hepatica: Macalister Irrigation District (MID), Upper Murray (UM), Murray Valley (MV), Central Goulburn (CG), Torrumbarry (TIA) and Loddon Valley (LV). Twenty cattle from each herd were tested using the F. hepatica faecal egg count (FEC) as well as the coproantigen ELISA (cELISA). The mean individual animal true prevalence of F. hepatica across all regions was 39 % (95 % credible interval [CrI] 27%-51%) by FEC and 39 % (95 % CrI 27%-50%) by cELISA with the highest true prevalence (75-80 %) found in the MID. Our results show that 46 % of the herds that took part in this study were likely to experience fluke-associated production losses, based on observations that herd productivity is impaired when the true within-herd prevalence is > 25 %. Using the FEC and cELISA reduction tests, triclabendazole resistance was assessed on 3 herds in total (2 from the 83 in the study; and 1 separate herd that did not take part in the prevalence study) and resistance was confirmed in all 3 herds. This study has confirmed that F. hepatica is endemic in several dairy regions in Victoria: triclabendazole resistance may be contributing to the high prevalence in some herds. From our analysis, we estimate that the state-wide economic loss associated with fasciolosis is in the order of AUD 129 million (range AUD 38-193 million) per year or about AUD 50,000 (range AUD 15,000-75,000) per herd per year.


Assuntos
Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/parasitologia , Resistência a Medicamentos , Fasciola hepatica/efeitos dos fármacos , Animais , Antiplatelmínticos/farmacologia , Bovinos , Indústria de Laticínios , Fasciolíase/tratamento farmacológico , Fasciolíase/prevenção & controle , Fasciolíase/veterinária , Prevalência , Triclabendazol/farmacologia , Vitória/epidemiologia
4.
Int J Biometeorol ; 64(4): 601-610, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31942644

RESUMO

Cases of anthrax in livestock are infrequently and irregularly reported in the state of Victoria, Australia; however, their impact on individual livestock, farming communities and the government agencies tasked with containing these outbreaks is high. This infrequency has been anecdotally associated with differences in annual and local weather patterns. In this study, we used historical anthrax cases and meteorological data from weather stations throughout Victoria to train a generalized linear mixed effects model to predict the daily odds of a case of anthrax occurring in each shire in the coming 30 days. Meteorological variables were transformed to deviations from the mean values for temperature or cumulative values for rainfall in the shire across all years. Shire was incorporated as a random effect to account for meteorological variation between shires. The model incorporated a post hoc weighting for the frequency of historic cases within each shire and the spatial contribution of each shire to the recently redefined Australian Anthrax Belt. Our model reveals that anthrax cases were associated with drier summer conditions (OR 0.96 (95% CI 0.95-0.97) and OR 0.98 (95% CI 0.97-0.99) for every mm increase in rainfall during September and December, respectively) and cooler than average spring (OR 0.20 (95% CI 0.11-0.52) for every °C increase in minimum daily temperature during November and warmer than average summer temperatures (OR 1.45 (95% CI 1.29-1.61) for every °C increase in maximum daily temperature during January. Cases were also preceded by a 40-day period of cooler, drier temperatures (OR 0.5 (95% CI 0.27-0.74) for every °C increase in maximum daily temperature and OR 0.96 (95% CI 0.95-0.97) for every mm increase in rainfall followed by a warmer than average minimum (or nightly) temperature 10 days immediately before the case (OR 1.46 (95% CI 1.35-1.58) for every °C increase in maximum daily temperature). These coefficients of this training model were then applied daily to meteorological data for each shire, and output of these models was presented as a choropleth and timeline plot in a Shiny web application. The application builds on previous spatial modelling and provides Victorian agencies with a tool to engage at-risk farmers and guide discussions towards anthrax control. This application can contribute to the wider rejuvenation of anthrax knowledge and control in Victoria and corroborates the anecdote that increased odds of disease can be linked to meteorological events.


Assuntos
Antraz , Meteorologia , Animais , Gado , Temperatura Ambiente , Vitória , Tempo (Meteorologia)
5.
Environ Pollut ; 259: 113865, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31891912

RESUMO

Compared to marine microplastics research, few studies have bio-monitored microplastics in inland waters. It is also important to understand the microplastics' uptake and their potential risks to freshwater species. The Australian glass shrimp Paratya australiensis (Family: Atyidae) is commonly found in fresh waterbodies in eastern Australia, and are sensitive to anthropogenic stressors but have a wide tolerance range to the natural environmental conditions. This study aimed to understand the microplastics' occurrence and types in water samples and the shrimp P. australiensis, and identify if the shrimp could be a suitable bioindicator for microplastic pollution. Surface water and P. australiensis across ten urban and rural freshwater sites in Victoria were sampled. In total, 30 water samples and 100 shrimp were analysed for microplastic content, and shrimp body weights and sizes were also recorded. Microplastics were picked, photographed and identified using FT-IR microscopy: in water samples, 57.9% of items including suspect items were selected to identify; all microplastics found in shrimp samples were identified. Microplastics were present in the surface waters of all sites, with an average abundance of 0.40 ± 0.27 items/L. A total of 36% of shrimp contained microplastics with an average of 0.52 ± 0.55 items/ind (24 ± 31 items/g). Fibre was the most common shape, and blue was the most frequent colour in both water and shrimp samples. The dominant plastic types were polyester in water samples, and rayon in shrimp samples. Even though results from this study show a relatively low concentration of microplastics in water samples in comparison with global studies, it is worth noticing that microplastics were regularly detected in fresh waterbodies in Victoria, Australia. Compared with water samples, shrimp contained a wider variety of plastic types, suggesting they may potentially behave as passive samplers of microplastics pollution in freshwater environments.


Assuntos
Monitoramento Ambiental , Água Doce , Poluentes Químicos da Água , Animais , Água Doce/química , Espectroscopia de Infravermelho com Transformada de Fourier , Vitória , Poluentes Químicos da Água/análise
6.
Environ Pollut ; 256: 113340, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31662257

RESUMO

BACKGROUND: Evidence of health effects following early life exposure to short-to-medium duration of high pollution levels is extremely limited. OBJECTIVES: We aimed to evaluate the associations between: 1. intrauterine exposure to fine particulate matter (PM2.5) from coal mine fire emissions and the frequencies of general practitioner attendances and dispensations of prescribed asthma inhalers, steroid skin creams, and antibiotics during the first year of life; 2. infant exposure and those outcomes during the year following the fire. METHODS: All participants were recruited from the Latrobe Valley of Victoria, Australia. Participants' 24-h average and hourly peak mine fire-specific PM2.5 exposures from 09/02/2014 to 31/03/2014 were estimated using chemical transport modelling. Outcome data were obtained from the Australian Medicare Benefits Schedule and Pharmaceutical Benefits Scheme from each child's birth to 31/12/2016. We used negative binomial and logistic regression models to independently assess risks of the outcomes associated with every 10 and 100 µg m-3 increase in average or peak PM2.5 exposure, respectively, while adjusting for potential confounders. RESULTS: We included 286 of 311 children whose parents consented to be linked, comprising 77 with no exposure, 88 with intrauterine exposure and 121 with exposure in infancy. 10- and 100- µg m-3 increases in average and peak PM2.5 exposure during infancy were associated with greater incidence of antibiotics being dispensed during the year following the fire: the adjusted incidence rate ratios were 1.24 (95% CI 1.02, 1.50, p = 0.036) and 1.14 (1.00, 1.31, p = 0.048) respectively. No other significant associations were observed. CONCLUSION: Exposure to coal mine fire emissions during infancy was associated with increased dispensing of antibiotics. This could reflect increased childhood infections or increased prescriptions of antibiotics in the year following the fire.


Assuntos
Poluição do Ar/análise , Asma/epidemiologia , Infecções Bacterianas/epidemiologia , Dermatite Atópica/epidemiologia , Uso de Medicamentos/estatística & dados numéricos , Exposição Ambiental/análise , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Poluentes Atmosféricos/análise , Asma/terapia , Infecções Bacterianas/terapia , Criança , Minas de Carvão , Dermatite Atópica/terapia , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Fogo , Humanos , Incidência , Lactente , Masculino , Material Particulado/análise , Gravidez , Efeitos Tardios da Exposição Pré-Natal/terapia , Fatores de Tempo , Vitória/epidemiologia
7.
Aust N Z J Public Health ; 44(1): 53-58, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31535416

RESUMO

OBJECTIVE: To determine the clinical characteristics, outcomes and longitudinal trends of sepsis occurring in cancer patients. METHOD: Retrospective study using statewide Victorian Cancer Registry data linked to various administrative datasets. RESULTS: Among 215,763 incident cancer patients, incidence of sepsis within one year of cancer diagnosis was estimated at 6.4%. The incidence of sepsis was higher in men, younger patients, patients diagnosed with haematological malignancies and those with de novo metastatic disease. Of the 13,316 patients with a first admission with sepsis, 55% had one or more organ failures, 29% required care within an intensive care unit and 13% required mechanical ventilation. Treatments associated with the highest sepsis incidence were stem cell/bone marrow transplant (33%), major surgery (4.4%), chemotherapy (1.1%) and radical radiotherapy (0.6%). The incidence of sepsis with organ failure increased between 2008 and 2015, while 90-day mortality decreased. CONCLUSIONS: Sepsis in patients with cancer has high mortality and occurs most frequently in the first year after cancer diagnosis. Implications for public health: The number of cancer patients diagnosed with sepsis is expected to increase, causing a substantial burden on patients and the healthcare system.


Assuntos
Mortalidade Hospitalar/tendências , Hospitalização/estatística & dados numéricos , Neoplasias/complicações , Sepse/epidemiologia , Feminino , Humanos , Incidência , Masculino , Neoplasias/epidemiologia , Estudos Retrospectivos , Web Semântica , Vitória/epidemiologia
8.
Aust N Z J Public Health ; 44(1): 59-64, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31535439

RESUMO

OBJECTIVE: To assess the impact of an enhanced viral hepatitis surveillance program on data completeness and on epidemiological assessment of affected populations. METHODS: Notified cases of non-acute hepatitis B and C were analysed to determine demographic characteristics and risk factors during the period prior to July 2015-June 2016, and during enhanced surveillance of the period July 2016-June 2017, during which time doctors were contacted for information about new diagnoses. RESULTS: During the enhanced period, completeness for country of birth and Indigenous status doubled for both hepatitis B and hepatitis C, from 18-37% to 48-65%. The incidence ratio of hepatitis C among Aboriginal and Torres Strait Islander people increased from eight-fold to 11.4-fold, and the proportion of hepatitis B cases reported as born in China and Vietnam relative to other countries increased. New data fields identified that 12% of hepatitis C diagnoses occurred in a correctional facility, and 2% of hepatitis B cases were healthcare workers. CONCLUSIONS: Improved data completeness highlighted the underlying epidemiology of chronic viral hepatitis, demonstrating the increased burden of infection among specific priority populations. Implications for public health: Enhanced surveillance provides greater insight into the epidemiology of chronic viral hepatitis, identifying groups at risk and opportunities for public health action.


Assuntos
Hepatite B Crônica/epidemiologia , Hepatite C Crônica/epidemiologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Vigilância da População/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Criança , Pré-Escolar , China/etnologia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Saúde Pública , Fatores de Risco , Vitória/epidemiologia , Vietnã/etnologia , Adulto Jovem
9.
Int J Cancer ; 146(6): 1541-1552, 2020 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-31187481

RESUMO

Adiposity increases estrogen receptor (ER)-positive postmenopausal breast cancer risk. While mechanisms underlying this relationship are uncertain, dysregulated sex-steroid hormone production and insulin signaling are likely pathways. Our aim was to quantify mediating effects of fasting insulin and free estradiol in the adiposity and ER-positive postmenopausal breast cancer association. We used data from a case-cohort study of sex hormones and insulin signaling nested within the Melbourne Collaborative Cohort Study. Eligible women, at baseline, were not diagnosed with cancer, were postmenopausal, did not use hormone therapy and had no history of diabetes or diabetes medication use. Women with ER-negative disease or breast cancer diagnosis within the first follow-up year were excluded. We analyzed the study as a cumulative sampling case-control study with 149 cases and 1,029 controls. Missing values for insulin and free estradiol were multiply imputed with chained equations. Interventional direct (IDE) and indirect (IIE) effects were estimated using regression-based multiple-mediator approach. For women with body mass index (BMI) >30 kg/m2 compared to women with BMI 18.5-25 kg/m2 , the risk ratio (RR) of breast cancer was 1.75 (95% confidence interval [CI] 1.05-2.91). The estimated IDE (RR) not through the mediators was 1.03 (95% CI 0.43-2.48). Percentage mediated effect through free estradiol was 72% (IIE-RR 1.56; 95% CI 1.11-2.19). There was no evidence for an indirect effect through insulin (IIE-RR 1.12; 95% CI 0.68-1.84; 28% mediated). Our results suggest that circulating free estradiol plays an important mediating role in the adiposity-breast cancer relationship but does not explain all of the association.


Assuntos
Adiposidade/fisiologia , Neoplasias da Mama/epidemiologia , Estradiol/sangue , Insulina/metabolismo , Pós-Menopausa/metabolismo , Adulto , Idoso , Índice de Massa Corporal , Neoplasias da Mama/sangue , Neoplasias da Mama/metabolismo , Estudos de Casos e Controles , Jejum/sangue , Jejum/fisiologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Pós-Menopausa/sangue , Receptores Estrogênicos/metabolismo , Medição de Risco , Vitória/epidemiologia , Circunferência da Cintura/fisiologia
10.
Int J Med Inform ; 134: 104042, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31855847

RESUMO

PURPOSE: To investigate whether the installation of electronic patient journey boards in an inpatient adult rehabilitation centre in Victoria, Australia, is associated with shorter lengths of stay for admitted adult rehabilitation patients. METHODS: A retrospective before-after analysis of 3 259 adult inpatient rehabilitation episodes from 2013 to 2018 was performed, analysing case-mix adjusted lengths of stay. RESULTS: A reduction in case-mix adjusted length of stay of 4.1 days per episode (95 % confidence interval: 2.0-6.4 days) was found. The corresponding reduction in hospital costs was estimated to be $3 738 per episode (95 % confidence interval $2 398-$4 983). CONCLUSIONS: Installation of electronic patient journey boards was associated with shorter lengths of stay in an inpatient adult rehabilitation centre. Additional research is needed to 1) provide further evidence of the causal effect of the boards on length of stay, and 2) investigate the mechanisms by which they reduce lengths of stay (e.g., increased currency of information, changes to procedures, remote viewing) in rehabilitation settings.


Assuntos
Apresentação de Dados/estatística & dados numéricos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Implementação de Plano de Saúde , Hospitalização/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Centros de Reabilitação/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Sistemas de Informação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Vitória
11.
Int J Radiat Oncol Biol Phys ; 106(1): 146-156, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31521718

RESUMO

PURPOSE: Human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) commonly affects people of working age, yet there is limited data regarding the return-to-work experience in this cohort. This study aimed to investigate the proportion of survivors currently working after completion of radiation therapy and to explore potential facilitators and barriers to working after treatment. METHODS: A cross-sectional, single-institutional study was undertaken at the Peter MacCallum Cancer Centre, a comprehensive cancer center in Melbourne, Victoria, Australia. Eligible participants were 18 to 65 years old at diagnosis, were employed at or within the 3 months before diagnosis, and had completed curative treatment for HPV-associated OPC ≥4 months before enrollment. Participants completed a paper-based survey to assess baseline demographics, employment status, and quality of life (QOL; Functional Assessment of Cancer Therapy Head and Neck). Open-ended questions explored factors affecting return to work. Associations between current employment status and various disease, treatment, and demographic variables and with QOL were examined. Free-text items were analyzed by summarizing content analysis. RESULTS: Of 93 participants approached, 68 responded (73.1%). Mean age was 54.1 years (range, 39-64 years), and 89.7% were male. Most participants (67.6%) had stage II disease and were treated with chemoradiation (85.3%). Mean time after treatment was 2.6 years (range, 0.3-9.1 years). Fifty-eight of 68 participants (85.3%) were working at enrollment; median time to return to work was 6.0 months (interquartile range, 4-10 months); 45 (77.6%) were in the same role and 35 (60.3%) worked the same number of hours. Ten participants were not working, 3 had retired, 5 reported persistent and significant treatment toxicity preventing employment. Survivors currently working reported higher physical, functional, and global QOL scores. Access to leave and support from treating doctors were facilitators for return to work, whereas fatigue was frequently reported as a barrier to returning to work. CONCLUSION: With time, the majority of participants with HPV-associated OPC will return to work after radiation therapy. Attention to symptom management and support from the workplace may enable more successful return to work.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Emprego/estatística & dados numéricos , Neoplasias Orofaríngeas/terapia , Infecções por Papillomavirus/complicações , Qualidade de Vida , Retorno ao Trabalho/estatística & dados numéricos , Adulto , Sobreviventes de Câncer/psicologia , Quimiorradioterapia/efeitos adversos , Quimiorradioterapia/estatística & dados numéricos , Estudos Transversais , Fadiga/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Orofaríngeas/patologia , Neoplasias Orofaríngeas/virologia , Papillomaviridae , Pesquisa Qualitativa , Aposentadoria/estatística & dados numéricos , Retorno ao Trabalho/psicologia , Licença Médica/estatística & dados numéricos , Apoio Social , Inquéritos e Questionários , Fatores de Tempo , Vitória , Tolerância ao Trabalho Programado , Local de Trabalho
12.
J Clin Nurs ; 29(1-2): 221-227, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31633855

RESUMO

BACKGROUND: In the case of life-threatening conditions such as respiratory or cardiac arrest, or the clinical deterioration of the patient, a Code Blue activation may be instigated. A Code Blue activation involves a team of advanced trained clinicians attending the emergency needs of the patient. AIMS AND OBJECTIVES: The aim of the study was to explore the number of cases of Code Blue activations, looking at the timing, clinical ward, diagnosis and activation criteria while noting cases where escalation from a Medical Emergency Team (MET) call occurs in one Regional Healthcare Service in Victoria, Australia, over a six-year period. METHODS: A quantitative retrospective descriptive study of Code Blue emergencies over a six-year period from June 2010 to June 2016 was conducted. Data collected from the RISKMAN program operating at a single site was imported into SPSS (V 22) for descriptive statistical analysis. A STROBE EQUATOR checklist was used for this study (see File S1). FINDINGS: The majority of Code Blue activations were male (59%, n = 127) and aged between 70 and 89 years of age (43%, n = 93). A Code Blue activation was more likely to occur at 08:00 hr, 14:00 hr or 22:00 hr, corresponding to the nurses' change in shift, with the majority of Code Blues (27.8%, n = 60) occurring in the emergency department. Cardiac arrest was the main activation criterion with 54.6% (n = 118) cases followed by respiratory arrest (14%, n = 32). Interestingly, 20% (n = 45) of the Code Blue activations were upgraded from a Medical Emergency Team (MET) call. CONCLUSION: This project has produced several interesting findings surrounding Code Blue activations at one regional healthcare service which are not present in existing literature and is worthwhile for further investigation. RELEVANCE TO CLINICAL PRACTICE: Understanding Code Blue activation criteria, common timings (month, time of day) and patient demographics ensures clinicians can remain vigilant in watching for the signs of patient deterioration and improve staff preparedness Code Blue events.


Assuntos
Reanimação Cardiopulmonar/estatística & dados numéricos , Emergências/epidemiologia , Equipe de Assistência ao Paciente/organização & administração , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Vitória , Adulto Jovem
13.
BMC Health Serv Res ; 19(1): 990, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31870375

RESUMO

BACKGROUND: Sexual violence is a global public health issue. It is a form of gender-based violence commonly experienced by women accessing mental health services. The biomedical model has been the dominant model of care in acute psychiatric units, however, there has been a global movement towards more gender-sensitive and trauma-informed models. To date, only a small amount of research has focused on evaluating these models of care and health professionals' experiences of providing this care. The aim of this study is to gain an in-depth understanding of healthcare professionals' perceptions of how Gender Sensitive Care (GSC) is enacted across acute psychiatric inpatient units for women who are survivors of sexual violence. METHODS: This study used case study methodology and the Normalisation Process Theory (NPT) conceptual framework. NPT is a practical framework that can be used to evaluate the implementation of complex models of care in health settings. It included semi-structured interviews with 40 health professionals, document and policy reviews, and observations from four psychiatric inpatient units within a large Australian public mental health organisation. Data were examined using thematic and content analysis. RESULTS: Themes were developed under the four NPT core constructs; 1) Understanding GSC in acute psychiatric units: "Without the corridors there's not a lot we can do", 2) Engagement and Commitment to GSC in acute psychiatric units: "There are a few of us who have that gender sensitive lens", 3) Organising, relating and involvement in GSC: "It's band aid stuff", 4) Monitoring and Evaluation of GSC in acute psychiatric units: "We are not perfect, we have to receive that feedback". DISCUSSION: Many health professionals held a simplistic understanding of GSC and avoided the responsibility of implementing it. Additionally, the competing demands of the biomedical model and a lack of appraisal has resulted in an inconsistent enactment of GSC. CONCLUSIONS: Health professionals in this study enacted GSC to varying levels. Our findings suggest the need to address each NPT construct comprehensively to adequately implement GSC.


Assuntos
Atitude do Pessoal de Saúde , Pessoal de Saúde/psicologia , Serviços de Saúde Mental/organização & administração , Unidade Hospitalar de Psiquiatria/organização & administração , Delitos Sexuais/psicologia , Sobreviventes/psicologia , Adulto , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Sobreviventes/estatística & dados numéricos , Vitória , Adulto Jovem
14.
J Law Med ; 26(4): 732-736, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31682352

RESUMO

The use of electroconvulsive therapy (ECT) is highly regulated across Australia. Its use on those under compulsory mental health treatment orders remains controversial and the United Nations Special Rapporteur on Torture and Other Cruel and Inhuman Treatment or Punishment has called for a ban on its nonconsensual use. Mental health tribunals must consider whether or not the person concerned has capacity to consent to ECT and there have been different understandings of just what capacity means in this regard. This column discusses the influence of human rights law and a recent decision by Justice Bell of the Supreme Court of Victoria setting a low threshold for a person's capacity to consent to or refuse ECT.


Assuntos
Eletroconvulsoterapia , Consentimento Livre e Esclarecido , Justiça Social , Humanos , Legislação Médica , Nações Unidas , Vitória
15.
Zootaxa ; 4565(1): zootaxa.4565.1.9, 2019 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-31716495

RESUMO

Pseudolaryngodus spectabilis gen. et sp. nov., from Little Desert National Park in Victoria, Australia, is described and illustrated. The monotypic new genus superficially resembles the udeocorine genus Laryngodus Herrich-Schaeffer in general facies, and is sympatric with one of the species of Laryngodus. Pseudolaryngodus has some characters that share its tribal placement within both Udeocorini and Myodochini of the family Rhyparochromidae. However, it lacks inner laterotergites on abdomen, making it a Myodochini rather than a Udeocorini. Details of the relationships between these two genera, along with their tribal placements, are discussed.


Assuntos
Hemípteros , Heterópteros , Distribuição Animal , Animais , Simpatria , Vitória
16.
Zootaxa ; 4560(3): zootaxa.4560.3.9, 2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-31716573

RESUMO

In his landmark revision of the Australian Dynastinae (Coleoptera: Scarabaeidae) Phil Carne (1957) described Novapus bifidus Carne, 1957 from males and females collected at Cape York and Thursday Island. The type series is in the Australian National Insect Collection, Canberra, Australia (ANIC); the Natural History Museum, London, United Kingdom; the South Australian Museum, Adelaide, Australia (SAM); and the Museum of Victoria, Melbourne, Australia. He noted "In the collections of the South Australian Museum there are specimens designated as types of bifidus Lea. No description of this species has been published, and it is now described under the same specific name". One of his paratypes is a female in SAM identified as "Lea's unpublished ♀ type" and two other paratypes are males in SAM. Cassis Weir (1992) noted that one of the SAM specimens has the registration number I4268, although they knew of only two paratypes (one male, one female) in that collection. The name has been attributed to Carne by most subsequent authors (Endrodi 1974, 1985; Carne Allsopp 1987; Cassis Weir 1992; Dechambre 2005; Atlas of Living Australia 2018.). Krajcik (2005, 2012) listed it in his scarab checklists but as "bifidus? Carne 1957".


Assuntos
Besouros , Animais , Feminino , Londres , Masculino , Reino Unido , Vitória
17.
Zootaxa ; 4647(1): zootaxa.4647.1.18, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31716986

RESUMO

Five new species of Topalia (Nosybeidae) are described from Australia: Topalia caliginosa sp. nov. from Victoria, T. corinnensis sp. nov. from Tasmania, T. dunlopi sp. nov. and T. katyae sp. nov. from Norfolk Island and T. royi sp. nov. from New South Wales. The genus was known previously from Australia from unidentified specimens only. I revise the generic definition, provide a key to species and clarify the family placement and taxonomic status of Topalia, Nosybea, Lamellocepheus and Charassobates. From a phylogenetic analysis and identification of synapomorphies, I consider Topalia, Nosybea and Lamellocepheus are valid, morphologically related and included in the Nosybeidae. The superfamily Charassobatoidea is valid, and contains Charassobatidae, Nosybeidae and Microtegeidae. These families have synapomorphies of a narrow, elongate subcapitulum, minute notogastral setae with at least one pair in the d series retained in the adults (dm in Nosybeidae, dp or dm in Microtegeidae, full complement in Charassobates). Immatures of Nosybeidae and Microtegeidae are undescribed, but in Charassobates are eupheredermous, plicate, and the tritonymph has the full complement of setae in the d series. Charassobates and Topalia have the synapomorphy of a ventral plate tectum, providing strong evidence for their relatedness. By way of contrast, the Cepheoidea, in which Nosybeidae and Microtegeidae have been placed by various authors, have a broad subcapitulum, well-developed setiform notogastral setae positioned marginally and lacking the d series, and no ventral plate tectum. The immatures are eupheredermous but non-plicate and the tritonymph lacks setae in the d series. Based on these differences, Nosybeidae, Microtegeidae and Charassobatidae cannot be included in the Cepheoidea.


Assuntos
Ácaros , Animais , Melanesia , New South Wales , Filogenia , Tasmânia , Vitória
18.
Zootaxa ; 4611(1): zootaxa.4611.1.1, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31717089

RESUMO

Samples of Pectinariidae in the Australian Museum and Museums of Victoria, Australia were examined. Thirteen species were identified, including three additional records of previously recorded species of Amphictene and two new species, A. cercusa n. sp. and A. undulata n. sp., two species of the genus Lagis which has not previously been recorded from Australia, including a new species, L. portus n. sp., and five additional records of previously recorded species of Pectinaria and one new species, P. ningalooensis n. sp. The study revealed additional characters which are useful to identify species of pectinariids, a pair of ear-shaped lobes which are adjacent to both sides of dorsal base of cephalic veil in species of Pectinaria and Amphictene, but in Lagis they are present between the buccal cavity and lateral margin of segment 1; and a pair of ventral lappets which have not previously been described on the lateral margin of segment I in all species of pectinariids from Australia. For species where numerous individuals were available for study, we investigated how some characters, change with increasing body size. A key to all recorded species from Australia is given, but does not imply any phylogenetic relationships.


Assuntos
Poliquetos , Distribuição Animal , Estruturas Animais , Animais , Tamanho Corporal , Tamanho do Órgão , Filogenia , Vitória
19.
Vet Microbiol ; 239: 108428, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31767084

RESUMO

A high morbidity, high mortality disease process caused flock deaths in an Indian ringneck parrot (Psittacula krameri) aviary flock in Victoria, Australia. Affected birds were either found dead with no prior signs of illness, or showed clinical evidence of respiratory tract disease, with snicking, sneezing and dyspnoea present in affected birds. Necropsy examinations performed on representative birds, followed by cytological and histopathological examination, demonstrated lesions consistent with a herpesvirus bronchointerstitial pneumonia. Transmission electron microscopy analysis of lung tissue demonstrated typical herpesvirus virions measuring approximately 220 nm in diameter. Next generation sequencing of genomic DNA from lung tissue revealed a highly divergent novel Psittacid alphaherpesvirus of the genus Iltovirus. Iltoviruses have been previously reported to cause respiratory disease in a variety of avian species, but molecular characterisation of the viruses implicated has been lacking. This study presents the genome sequence of a novel avian herpesvirus species designated Psittacid alphaherpesvirus-5 (PsHV-5), providing an insight into the evolutionary relationships of the alphaherpesviruses.


Assuntos
Genoma Viral/genética , Herpesviridae/genética , Herpesviridae/ultraestrutura , Psittacula/virologia , Animais , Herpesviridae/classificação , Microscopia Eletrônica de Transmissão , Filogenia , Especificidade da Espécie , Vitória
20.
BMC Public Health ; 19(1): 1420, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666042

RESUMO

BACKGROUND: Understanding levels of community readiness can result in prevention efforts that align with communities' ability and capacity for change and, therefore, be more effective and sustainable. Our study aimed to use baseline (pre-intervention) community readiness scores to assist with the development of obesity prevention strategies, and to assess changes in community readiness over time (pre/post- intervention), to provide evidence of intervention impact. METHOD: Our study was located in a rural and remote area of Victoria, Australia. Community readiness was part of a broader obesity prevention intervention designed to create healthier food and physical activity environments through the combination of systems thinking and collaborative community-led solutions. Interviews were conducted using the community readiness to change tool in 2016 (pre) and 2018 (post) with a community representative sample. Baseline data informed the development of community relevant strategies and the pre/post results formed part of the overall evaluation. RESULTS: The tool generated both quantitative and qualitative (quotes) data. A final readiness score was calculated that corresponded to one of the nine stages of readiness. Four of the five domains of the community readiness to change tool showed statistically significant improvements over time (p < 0.05): knowledge of effort, knowledge of issue, community climate, and leadership. The resources domain that did not improve pre/post intervention. CONCLUSION: Community readiness to change interviews, pre- and post- intervention, provided essential information related to the appropriate targeting and pitch of the prevention strategies, as well as providing an overall evaluation of the positive movement in the community's readiness to implement change.


Assuntos
Atitude , Pesquisa Participativa Baseada na Comunidade , Obesidade/prevenção & controle , Serviços Preventivos de Saúde , População Rural , Adulto , Dieta , Exercício , Humanos , Liderança , Vitória
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA