RESUMEN

INTRODUCTION: This paper explores the fate of South Australia's highly regarded Police Drug Diversion Initiative over the past 10 years. METHODS: The paper uses historical and legal analysis, including publicly available data as to rates of drug use, arrests and diversions, media reports, legislation and Hansard debates. RESULTS: In the mid-2010s, amidst growing anxiety about levels of amphetamine-type stimulants use in Adelaide, a coroner's report became the poster child for what was seen by the Liberal opposition as the excessive leniency and 'waste of resources' of the Police Drug Diversion Initiative. Despite being universally praised for its efficacy, the Liberal government, when elected, passed amendments to the legislation which 'capped' diversions at two. This ended the period in which diversions from criminal to social justice systems was mandatory for all persons charged with simple drug possession. But since then, the diversion rate in South Australia has plummeted in ways that cannot be explained merely because of these amendments. DISCUSSION AND CONCLUSIONS: The most highly regarded scheme for diversion of minor drug offenders to treatment is no longer effective. Indeed, the best scheme in the country may now be the worst. The essay draws attention to a catastrophe whose extent is not yet fully appreciated and suggests ways in which we can begin to explain why such a small change has had such dramatic and unforeseen consequences. Like some sort of perverse alchemy, Australia's gold standard for drug diversion has been turned into lead.

Asunto(s)

RESUMEN

BACKGROUND: Psychosocial factors and dentist-patient relationships (DPR) have been suggested to be associated with oral health outcomes. This study aimed to test a conceptual model which hypothesised relationships among psychosocial factors, DPR variables, and oral health-related quality of life (OHRQoL) in the 'distal-to-proximal' framework. METHODS: A total of 12,245 adults aged 18 years or over living in South Australia were randomly sampled for the study. Data were collected from self-complete questionnaires in 2015-2016. The outcome variable of Oral Health Impact Profile was used to measure OHRQoL. Psychosocial domain consisted of psychological well-being, social support, and health self-efficacy. DPR domain included trust in dentists, satisfaction with dental care, and dental fear. The hypothesised model was tested using the two-step approach in structural equation modelling. RESULTS: Data were analysed from 3767 respondents after the screening/preparing process (adjusted valid response rate 37.4%). In the first step of the analysis, confirmatory factor analyses produced acceptable measurement models for each of the six latent variables (GFI = 0.95, CFI = 0.98, RMSEA = 0.04). The final structural model indicated that better well-being, higher self-efficacy, and more satisfaction were associated with lower oral health impact (ß = - 0.12, - 0.07, - 0.14, respectively) whereas fear was positively associated (ß = 0.19). Among intermediates, support was positively associated with satisfaction within a small effect size (ß = 0.06) as compared to self-efficacy with trust (ß = 0.22). The invariance of the final model was also confirmed on participants' SES and dental service characteristics except the variable of 'last dental visit'. CONCLUSIONS: Psychosocial factors and DPR variables were associated with oral health impact in both direct and indirect paths. The framework of 'distal-to-proximal' actions is empirically supported from psychosocial factors via DPR variables to OHRQoL.

Asunto(s)

RESUMEN

BACKGROUND: Recent clinical trials have demonstrated that sodium-glucose cotransporter 2 inhibitors (SGLT2i), which were previously only indicated in treatment of type 2 diabetes mellitus (T2DM), can markedly reduce heart failure hospitalisation (HFH), with less striking potential reductions in acute coronary syndromes and cardiac arrhythmias. To evaluate the impact of SGLT2i on cardiovascular outcomes in real-world practice, we performed a retrospective cohort analysis on South Australian (SA) data. METHODS: A total of 842 individuals with T2DM receiving SGLT2i were identified from SA public hospitals between 2011 and 2019. Episodes of care were temporally matched with those of 3,128 individuals with T2DM not receiving SGLT2i (control). Baseline characteristics were adjusted using inverse probability treatment weighting. The incidence of cardiovascular events at 12 and 24 months was evaluated using coded (International Classification of Diseases, Tenth Revision, Australian Modification [ICD-10-AM]) data. RESULTS: The primary outcome of HFH was lower with SGLT2i use at 12 months (adjusted hazard ratio [HRadj] 0.44; 95% confidence interval [CI] 0.29-0.68; p<0.001) and 24 months. There were also lower hospitalisations due to acute myocardial infarction (HRadj 0.42; 95% CI 0.21-0.85; p=0.015) and atrial or ventricular arrhythmias (HRadj 0.29; 95% CI 0.14-0.59; p=0.001), with no difference observed in hospitalisation due to ischaemic cerebrovascular events. There was no difference in all-cause mortality at 12 months but interestingly a higher rate at 24 months (HRadj 2.08; 95% CI 1.59-2.72; p<0.001). Despite this, similar reductions in cardiovascular outcomes were observed at 24 months. CONCLUSION: Use of SGLT2i in patients with T2DM in SA was associated with reductions in cardiovascular events even before their recent Pharmaceutical Benefits Scheme (PBS) listing for heart failure. Furthermore, this analysis supports that SGLT2i play a role not only in HFH reduction but also in reducing coronary and tachyarrhythmic events. This real-world evidence supports the use of SGLT2i as broadly protective cardiovascular drugs.

Asunto(s)

RESUMEN

OBJECTIVE: Reducing tobacco licences is one potential lever to reduce tobacco-related harms. A 15-fold increase in annual tobacco retailer licence fees in 2007 led to a 24% decline in the number of licences in 2009. This study investigates the changes in tobacco licences over a subsequent decade in the absence of real fee increases. METHODS: The South Australian (SA) government tobacco licencing system databases for 2009 and 2020 were audited, measuring changes in the number and distribution of tobacco and vending machine licences by outlet type, disadvantage, and remoteness. RESULTS: The number of tobacco licences declined by 33.1% overall. Large reductions were observed in food service venues (65.2%) and hotel/motels (37.2%). In 2020, most licences were in service stations (25.1%), hotel/motels (22.9%), and supermarkets (22.2%). Despite proportional reductions across all disadvantage quintiles, the most disadvantaged areas continued to have the largest number of tobacco licensees. Vending machines declined by 63.6% and remained concentrated in hotels/motels (91.4%). CONCLUSIONS: Since a 15-fold licence fee increase in 2007 effectively reduced tobacco retailers from 2007-2009, the decline since has been incremental. IMPLICATIONS FOR PUBLIC HEALTH: Increasing tobacco licence fees is a straightforward and effective measure to reduce tobacco availability and should be re-prioritised.

RESUMEN

OBJECTIVE: This article aims to describe the rates of middle ear disease in Aboriginal children living in metropolitan Adelaide. METHODS: Data from the Under 8s Ear Health Program (population-based outreach screening) were analysed to identify rates of ear disease and the referral outcomes for children identified with ear conditions during screening. RESULTS: In total, 1598 children participated in at least one screening between May 2013 and May 2017. Males and females were equally represented; 73.2% had one or more abnormal findings on otoscopy at the first screening visit, 42% had abnormal tympanometry, and 20% registered a "fail" on otoacoustic emission testing. The referral pathway for children with abnormal findings included referrals to their GP, Audiology, and Ear Nose Throat (ENT) Departments. Also, 35% (562/1598) of the children screened required referral either to a GP or Audiology, and 28% of those referred (158/562) or 9.8% (158/1598) of the total number of children screened required further ENT management. CONCLUSIONS: High rates of ear disease and hearing problems in urban Aboriginal children were detected in this study. Existing social, environmental, and clinical interventions need to be evaluated. Closer monitoring including data linkage may assist to better understand the effectiveness, timeliness, and challenges of public health interventions and follow-up clinical services to a population-based screening program. IMPLICATIONS FOR PUBLIC HEALTH: Aboriginal-led population-based outreach programs such as the Under 8s Ear Health Program augmented by seamless integration with education, allied health and tertiary health services should be prioritised for expansion and continued funding.

Asunto(s)

RESUMEN

Nineteen new species of Karaops are described: K.durrantorumsp. nov. (♂), K.morganoconnellisp. nov. (♀♂), K.joehaenerisp. nov. (♀), K.dalmanyisp. nov. (♀♂), K.garyodwyerisp. nov. (♂), K.dejongisp. nov. (♀♂), K.malumbusp. nov. (♀♂), K.conilurussp. nov. (♂), K.yumbubaarnjisp. nov. (♀♂), K.markharveyisp. nov. (♀♂), K.nitmiluksp. nov. (♀), K.kennerleyorumsp. nov. (♂), K.jawaywaysp. nov. (♀), K.mparntwesp. nov. (♀), K.larapintasp. nov. (♀), K.kwartatumasp. nov. (♂), K.madhawundusp. nov. (♀), and K.mareebasp. nov. (♀). The male of K.umiida Crews, 2013 was found to be misidentified and is now K.conilurussp. nov.Karaopsyindjibarndisyn. nov. is a new synonym of K.nyiyaparli. Selenopsaustraliensis L. Koch, 1875 is considered a nomen dubium because the holotype is an immature male, and the species previously referred to as K.australiensis (L. Koch, 1875) is here described as K.strayamatesp. nov. (♀♂). The males of K.marrayagong Crews & Harvey, 2011 and K.banyjima Crews, 2013 are described for the first time. To manage the growing diversity of the genus, most of the species have been placed in species groups, which are diagnosed. They are the Central Desert group, the strayamate group, the raveni group, the dawara group, the francesae group, the Kimberley group, and the Pilbara-Gascoyne group. New keys are provided to accommodate the new species, and new distribution maps and new records are provided for all species. Diagnoses and descriptions are emended where required. Images of live spiders, many not previously seen alive, and natural history information are also provided.

RESUMEN

Objective: To determine the incidence of biopsy proven giant cell arteritis (GCA) in South Australia. Methods: Patients with biopsy-proven GCA were identified from pathology reports of temporal artery biopsies at state-based pathology laboratories, from 1 January 2014 to 31 December 2020. Incidence rates for biopsy-proven GCA were calculated using Australian Bureau of Statistics data for South Australian population sizes by age, sex, and calendar year. Seasonality was analyzed by cosinor analysis. Results: There were 181 cases of biopsy-proven GCA. The median age at diagnosis of GCA was 76 years (IQR 70, 81), 64% were female. The estimated population incidence for people over 50 was 5.4 (95% CI 4.7, 6.1) per 100,000-person years. The female: male incidence ratio was 1.6 (95% CI 1.2, 2.2). There was no ordinal trend in GCA incidence rates by calendar year (p = 0.29). The incidence was, on average, highest in winter, but not significantly (p = 0.35). A cosinor analysis indicated no seasonal effect (p = 0.52). Conclusion: The incidence of biopsy-proven GCA remains low in Australia. A higher incidence was noted compared to an earlier study. However, differences in ascertainment and methods of GCA diagnosis may have accounted for the change.

RESUMEN

Objective: The study aimed to examine the association between patient-reported oral health outcomes and the dental service sector and trust in dentists. The possible interaction effect of trust on this association was also explored. Methods: Randomly selected adults aged over 18 years living in South Australia were surveyed using self-administered questionnaires. The outcome variables were self-rated dental health and the evaluation outcome of the Oral Health Impact Profile. The dental service sector and the Dentist Trust Scale were included in bivariate and adjusted analyses with sociodemographic covariates. Results: Data from 4,027 respondents were analyzed. Unadjusted analysis showed that poor dental health and oral health impact were associated with sociodemographic characteristics, including lower income/education, public dental service, and lower trust in dentists (p < 0.01). Adjusted associations were similarly maintained (p < 0.05) but attenuated with the loss of statistical significance, mainly in the trust tertiles. Lower trust in dentists in the private sector had an interaction effect, with a higher prevalence ratio of oral health impact (prevalence ratio = 1.51; 95% confidence interval, 1.06-2.14; p < 0.05). Conclusion: Patient-reported oral health outcomes were associated with sociodemographic characteristics, the dental service sector, and trust in dentists. Implications for public health: The inequality of oral health outcomes between dental service sectors needs to be addressed both independently and in association with covariates including socioeconomic disadvantage.

Asunto(s)

RESUMEN

The Neoproterozoic carbonate record contains multiple carbon isotope anomalies, which are the subject of intense debate. The largest of these anomalies, the Shuram excursion (SE), occurred in the mid-Ediacaran (~574-567 Ma). Accurately reconstructing marine redox landscape is a clear path toward making sense of the mechanism that drives this δ13 C anomaly. Here, we report new uranium isotopic data from the shallow-marine carbonates of the Wonoka Formation, Flinders Ranges, South Australia, where the SE is well preserved. Our data indicate that the δ238 U trend during the SE is highly reproducible across globally disparate sections from different depositional settings. Previously, it was proposed that the positive shift of δ238 U values during the SE suggests an extensive, near-modern level of marine oxygenation. However, recent publications suggest that the fractionation of uranium isotopes in ferruginous and anoxic conditions is comparable, opening up the possibility of non-unique interpretations of the carbonate uranium isotopic record. Here, we build on this idea by investigating the SE in conjunction with additional geochemical proxies. Using a revised uranium isotope mass balance model and an inverse stochastic carbon cycle model, we reevaluate models for δ13 C and δ238 U trends during the SE. We suggest that global seawater δ238 U values during the SE could be explained by an expansion of ferruginous conditions and do not require a near-modern level of oxygenation during the mid-Ediacaran.

Asunto(s)

RESUMEN

BACKGROUND: Given the high incidence of melanoma in Australia alongside high mortality with later stage disease, we investigated the populations and locations most at risk, to optimise public health activities in areas where intervention is most needed. This study examines trends and identifies significant prognostic factors and potential disparities in incidence, mortality and survival between population groups in Victoria, Queensland and South Australia. METHODS: The analysis includes data from the population-based cancer registries of the three states over a twenty-year period (1997-2016). Age-standardized and age-specific incidence rates were calculated, and long-term trends analysed using Joinpoint Regression. Five-year relative survival estimates for the study population were calculated using the cohort method and multivariable flexible parametric survival models were applied for each jurisdiction to calculate adjusted excess mortality hazard ratios for the key characteristics. RESULTS: There were more males with melanoma than females in all the three states. Over 60% of the cases occurred in the 40-74 years age group. Most melanomas had a Breslow thickness less than or equal to 1.0 mm. For males, Victoria and Queensland had a statistically significant increasing trend whereas in South Australia there was a decreasing trend. For females, the incidence rate trend was stable in Victoria but significantly decreasing in South Australia. In Queensland there was an increasing and statistically significant trend from 2006 to 2016. Across all three states there was a reducing incidence rate in the youngest cohort, stabilizing incidence in the 40-59-year-old age group, and increasing in the oldest cohorts. Five-year relative survival decreased with increasing age and with Breslow thickness across all three jurisdictions. Males had between 43%- 46% excess mortality compared to females in all the three states. There was higher risk with increasing age and Breslow thickness, with the largest risk among the 75 + age group and those with a Breslow thickness of > 4 mm. CONCLUSION: It is the first time that data from these three registries has been analysed together in a uniform way, covering more than half of the Australian population. This study compares the epidemiology of melanoma across three states and provides a better understanding of trends and factors affecting outcome for Australians with melanoma. While there has been some improvement in aspects of incidence and mortality, this has not been evenly achieved across Australia.

Asunto(s)

RESUMEN

The potential link between certified organic farming and biodiversity and conservation remains unexplored in Australia, despite the country having the world's largest amount of certified organic farmland and unprecedented biodiversity loss. This study modelled the spatial effects of organic farming (intensity of local farming systems), environmental heterogeneity, and urbanisation on two widely studied environmental taxa - vascular plant and bird species richness (surrogate measures of biodiversity) - in South Australia, using a unique certified organic farming postcode level dataset from 2001 to 2016 (N = 5440). The spatial Durbin error model results confirmed the positive spatial congruence of organic farming with greater vascular plant species richness, whereas only weak to no significant evidence was found for bird species richness. Landscape features (habitat heterogeneity) and green vegetation (a proxy indicator of resource availability) - rather than organic farming - appeared to be most associated with bird species richness. Both plant and bird species richness were positively associated with habitat heterogeneity (land cover diversity and elevation range), plant productivity and proportion of conservation land and water bodies. Whereas, increased anthropogenic land use for cropping and horticultural farming, soil type diversity and proximity to the coast significantly reduced species richness of both taxa. The results suggest that a multi-scale spatially refined biodiversity conservation strategy, with spatial targeting that promotes low intensive farming systems and increases landscape heterogeneity to provide quality habitat (a whole of landscape approach by incorporating private agricultural landholders), could be beneficial for biodiversity conservation.

Asunto(s)

RESUMEN

Ericusa ngayawang sp. nov. is described from shells preserved in the Middle Miocene Cadell Formation in the western Murray Basin of South Australia. At the time the Murray Basin was part of the Southeastern Australian Marine Biogeographic Province. Ericusa ngayawang is a small heavily costate species of Ericusa with clear affinities to the Early Miocene E. atkinsoni of Victoria and Tasmania but can be distinguished from it by its smaller size, more slender proportions and its heavily costate body whorl. Ericusa atkinsoni and its relative, E. macroptera, inhabited the basins to the east of the Murray Basin during the Late Oligocene and Early Miocene but were extinct there before the end of the Burdigalian Stage of the Early Miocene. The persistence of E. ngayawang into the Langhian Stage of the Middle Miocene is another piece of evidence for partial biogeographic isolation of the western Murray Basin from the rest of the Southeastern Australian Province during the Miocene.

Asunto(s)

RESUMEN

BACKGROUND: In Australia, the relationships of cultural contexts with health challenges in older culturally and linguistically diverse (CALD) adults during the COVID-19 remain under-investigated. This study explored the older CALD adults' risk perceptions of COVID-19, and identified demographics and risk perceptions associated with their health precautions and emergency preparation in South Australia. METHODS: A cross-sectional online survey was conducted. 155 older adults aged 60 years and over from 28 CALD communities completed the surveys. We described demographics, risk perceptions, seven items of health precautions, and five items of emergency preparedness. Data were analyzed in Stata/MP version 13.0. RESULTS: Mean sum-score of fear was 7.3 [SD 1.9], signifying that the participants were afraid of being infected with COVID-19. Health precaution items presented a mean sum-score of 24.8, with a compliance in washing and disinfecting hands [M: 4.4], avoiding public places and events [M: 3.9] and transports [M: 3.8], but they did not present high-alignment with staying at home and avoiding meeting at risk population groups. Overall health precautions were positively influenced by ethnicity [Asian ß 3.40; 95% CI 1.21, 5.59; African ß 5.46; 95% CI 0.76, 10.16]; perceptions of long-term effects [ß 1.82; 95% CI 0.65, 2.99]; and fear [ß 0.55; 95% CI 0.08, 1.01]. Mean sum-score of emergency preparedness was 14.9, which indicated the participants' responses, on average, did not prevent them from buying large quantities and storing essential goods. CONCLUSION: A pandemic-related response plan is needed to ensure all older CALD adults receive and follow advice and care appropriately.

Asunto(s)

RESUMEN

OBJECTIVE: We explored the perspectives of professionals working in health and aged care services in South Australia about factors that influenced successful transitions from hospital to home or residential aged care home for older people. We examined successful and recommended strategies that could support safe transitions following hospital discharge and reduce avoidable hospital admissions in South Australia. METHODS: Nineteen professionals from acute, post-acute, primary, community and aged care settings in South Australia participated in semi-structured interviews. Qualitative content analysis was conducted. RESULTS: Participants reported that navigating service provision could be difficult, compounded by different funding arrangements for hospitals, community, primary care and aged care services. Some participants felt that there was an over-reliance on the hospital sector, leaving primary care and community-based services under-utilised to support hospital transitions. The importance of good communication between services and sectors was highlighted. Participants described different categories of services that supported safe transitions by supporting older people immediately post-discharge; services that provided support to stay at home in the weeks and months following discharge; and services that helped the person receive health care at locations other than hospitals or emergency departments when they were unwell. Participants noted that successful programs were not always maintained. CONCLUSIONS: Division of responsibility of aged and health-care services between state and national governance contributes to fragmentation of care in South Australia. Careful planning of transitions and coordination of services across sectors is required to ensure older people are supported in the months following discharge from hospital to reduce avoidable rehospitalisations.

Asunto(s)

RESUMEN

Microplastics, plastic particles <5 mm in size, are of global concern as human-caused pollutants in marine and fresh waters, and yet little is known of their distribution, behaviour and ecological impact in the intertidal environment of South Australia. This study confirms for the first time, the presence of microplastic in the South Australian intertidal ecosystem by quantifying the abundance of particles in intertidal water and in the keystone species, the blue mussel, Mytilus spp., an important fisheries species, at ten and six locations respectively, along the South Australian coastline. For a remote region known for its pristine environment, microplastic concentration in intertidal water was found to be low to moderate (mean = 8.21 particles l-1 ± 4.91) relative to global levels and microplastic abundance in mussels (mean = 3.58 ± 8.18 particles individual-1) was within the range also reported globally. Microplastic particles were ubiquitous across sites and bioavailable by size in water (mean = 906.36 µm) and in mussel (mean = 983.29 µm) raising concerns for the health of South Australia's unique coastal ecosystems and for the human food chain. Furthermore, a positive correlation was found between human coastal population size and microplastic concentration in intertidal water, irrespective of influences from industry - tourism, fishing and shipping ports. FTIR analysis determined plastic type to include polyamide (PA), polyethylene (PE), polypropylene (PP), acrylic resin, polyethyleneterephthalate (PET) and cellulose, suggesting synthetic and semi-synthetic particles from single-use, short-life cycle products, fabrics, ropes and cordage. Our findings shed light on the urgent need to establish the local sources of microplastic pollution in order to assist the community, industry and government to reduce the impact of microplastic on the fragile marine systems within South Australian intertidal waters and on the organisms associated with the human food chain.

Asunto(s)

RESUMEN

Background: Coping with COVID-19 is a challenge for culturally and linguistically diverse (CALD) older adults. In Australia, little attention has been given to understanding associations between cultural contexts, health promotion, and socio-emotional and mental health challenges of older CALD adults during the COVID-19 pandemic. Therefore, we have collected data from older CALD adults to examine their COVID-19 risk perceptions and its association with their health precautions, behavioural dimensions and emergency preparation. Methods: A cross-sectional survey was conducted in South Australia. The CALD population aged 60 years and above were approached through 11 South Australian multicultural NGOs. Results: We provide the details of 155 older CALD South Australians' demographics, risk perceptions, health precautions (problem-and-emotion-focused), behavioural dimensions and emergency preparation.  The explanatory variables included demographic characteristics (age, gender, education and ethnicity); and risk perception (cognitive [likelihood of being affected] and affective dimension [fear and general concerns], and psychometric paradigm [severity, controllability, and personal impact]. The outcome measure variables were health precautions (problem-focused and emotion-focused), behavioral adaptions and emergency preparation. Conclusions: This dataset may help the researchers who investigate multicultural health or aged care in the pandemic and or who may have interest to link with other datasets and secondary use of this primary dataset in order to develop culturally tailored pandemic-related response plan. The data set is available from Harvard Dataverse.

Asunto(s)

RESUMEN

Background: Risk perceptions and precaution-taking against COVID-19 are affected by individuals' health status, psychosocial vulnerabilities and cultural dimensions. This cross-sectional study investigates risk perceptions associated with COVID-19 and specifically the problem- and emotion-focused health precautions of older, culturally and linguistically diverse (CALD) South Australians. Methods: Cross-sectional research involving self-administration of an online survey. Participants were CALD adults living in South Australia, aged 60 years and above (n = 155). Multi-indicator surveys were analyzed using Stata/MP version 13.0 and multiple linear regression models fitted to examine associations between risk perceptions and problem- and emotion-focused health precautions. Results: Dread risk returned the highest mean score; COVID-19 was perceived as a catastrophe. Mean scores for fear showed that participants were worried about COVID-19 and scared of becoming infected. Participants followed health advice as they were worried [ß 0.15; 95% CI 0.07, 0.23] and realized the effect of COVID-19 on them [ß 0.15; 95% CI 0.02, 0.28], or worried and had trust in experts' knowledge and managing capacity [ß 0.17; 95% CI 0.06, 0.28]. Age was negatively associated with sum-score of problem-focused coping: compared to participants aged 60-69 years, 80+ years revealed a decrease in problem-focused health precautions. Variables like education (primary schooling [ß 2.80; 95% CI 0.05, 5.55] and bachelor degree [ß 3.16; 95% CI 0.07, 6.25] versus no formal education), self-confidence in reducing risk, and fear [ß 0.84; 95% CI 0.31, 1.36] significantly affected emotional-focused health precautions. Conclusion: This local study has global implications. It showed that COVID-19 has psychosocial and environmental implications for older CALD adults. When many CALD populations have existing vulnerabilities to intersecting disadvantage, cultural-tailoring of interventions and pandemic response plans may buffer the effects of compounding disaster. Larger studies are needed to compare risk perception and health response patterns across countries and cultural groupings.

RESUMEN

Marine sponges are an ideal source for isolating as yet undiscovered microorganisms with some sponges having about 50% of their biomass composed of microbial symbionts. This study used a variety of approaches to investigate the culturable diversity of the sponge-associated bacterial community from samples collected from the South Australian marine environment. Twelve sponge samples were selected from two sites and their bacterial population cultivated using seven different agar media at two temperatures and three oxygen levels over 3 months. These isolates were identified using microscopic, macroscopic, and 16S rRNA gene analysis. A total of 1234 bacterial colonies were isolated which consisted of four phyla: Actinobacteria, Firmicutes, Proteobacteria, and Bacteroidetes, containing 21 genera. The diversity of the bacterial population was demonstrated to be influenced by the type of isolation medium, length of the incubation period and temperature, sponge type, and oxygen level. The findings of this study showed that marine sponges of South Australia can yield considerable bacterial culturable diversity if a comprehensive isolation strategy is implemented. Two sponges, with the highest and the lowest diversity of culturable isolates, were examined using next-generation sequencing to better profile the bacterial population. A marked difference in terms of phyla and genera was observed using culture-based and culture-independent approaches. This observed variation displays the importance of utilizing both methods to reflect a more complete picture of the microbial population of marine sponges. KEY POINTS: Improved bacterial diversity due to long incubations, 2 temperatures, and 3 oxygen levels. Isolates identified by morphology, restriction digests, and 16S rRNA gene sequencing. At least 70% of culturable genera were not revealed by NGS methods.

Asunto(s)

RESUMEN

OBJECTIVE: To examine the screening-treatment-mortality pathway among women with invasive breast cancer in 2006-2014 using linked data. METHODS: BreastScreen histories of South Australian women diagnosed with breast cancer (n = 8453) were investigated. Treatments recorded within 12 months from diagnosis were obtained from linked registry and administrative data. Associations of screening history with treatment were investigated using logistic regression and with cancer mortality outcomes using competing risk analyses, adjusting for socio-demographic, cancer and comorbidity characteristics. RESULTS AND CONCLUSION: For screening ages of 50-69 years, 70% had participated in BreastScreen SA ≤ 5 years and 53% ≤ 2 years of diagnosis. Five-year disease-specific survival post-diagnosis was 90%. Compared with those not screened ≤5 years, women screened ≤2 years had higher odds, adjusted for socio-demographic, cancer and comorbidity characteristics, and diagnostic period, of breast-conserving surgery (aOR 2.5, 95% CI 1.9-3.2) and radiotherapy (aOR 1.2, 95% CI 1.1-1.3). These women had a lower unadjusted risk of post-diagnostic cancer mortality (SHR 0.33, 95% CI 0.27-0.41), partly mediated by stage (aSHR 0.65, 95% CI 0.51-0.81), and less breast surgery (aSHR 0.78, 95% CI 0.62-0.99). Screening ≤2 years and conserving surgery appeared to have a greater than additive association with lower post-diagnostic mortality (interaction term SHR 0.42, 95% CI 0.23-0.78). The screening-treatment-mortality pathway was investigated using linked data.

Asunto(s)

RESUMEN

Seagrasses are considered indicators of anthropogenic impact but surprisingly little is known about their temporal and spatial dynamics in impacted seascapes. In this study, we used three decades of Landsat imagery (1988-2018) off the coast of Adelaide, South Australia, to investigate how seagrass cover over 501 km2 responds to changes in land-based inputs, including breakpoints in system trajectory and associated timelags, and the identification of vulnerable meadows. Field data was used to help train benthic classification of summer imagery and define its accuracy. Temporal dynamics of seagrass cover were investigated in relation to annual and multi-year nitrogen and suspended solids loads. Spatial dynamics were inferred from maps of benthic cover persistence and trajectory for each decade. The region experienced a net regrowth of some 11,000 ha of seagrasses since the early 2000s, with the initial large-scale recruitment visible in the imagery 6 years after the closure of sludge outfalls. Seagrass expansion occurred primarily in deeper waters (>10 m) of the central coast and at the seaward edge of the distribution. Recovery continued until 2011 assisted by a window of opportunity created by a decade-long drought and further reductions in nitrogen loads from wastewater treatment plants and industry. Localized seagrass losses however continued to be observed as a result of either permanent or transient increases in suspended solids loads. Seagrass area in the central coast was well correlated (r2 = 0.88) with 5-year running averages of nitrogen and suspended solids loads. Meadows particularly vulnerable to changes in land-based discharges were located at the edges of the distribution, along erosional scarps and at depths >10 m south of the Torrens River. These areas were identified as useful indicators of seagrass status. Overall, seagrass persistence expanded from 48 to 69% of the mapped area, with the region now mostly covered by stable seagrasses.

Asunto(s)