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Social cognitive models are useful for improving our understanding of the relationship between people's health beliefs and disease risks and have been widely employed in human medicine. In veterinary science, there is little research about owners' perceptions of pet health and parasitic infections/infestations, despite the risk of transmission of zoonotic pathogens by ectoparasites. This study investigated the effects of demographic factors on pet owner's perception of ectoparasite infestation risk and behaviours related to animal health in southeast Queensland, Australia employing the Health Belief Model (HBM). A total of 241 dog owners were surveyed in 2018. The electronic survey was generated through SurveyMonkey and distributed utilising UQ SVS and Royal Society for the Prevention of Cruelty to Animals (RSPCA) email networks, informative posters and brochures placed in selected veterinary clinics, and in-person visits to dog parks. The relationship between dog owners' perception of flea and tick infestation risk was assessed using an adaptation of the Health Belief Model, social cognitive framework for health protection. Most survey respondents were between 26 and 45 years of age (40%), identified themselves as females (83%) and had a bachelor's degree (43%). Our results indicate that female owners had greater level of health concern related to ectoparasites compared to males. Similarly, owners aged 18 to 25, with a grade 10 to 12 level of attained education and living predominately in a rural setting showed greater level of health concern related to ectoparasite infestations. The results also indicated that cat owners had on average, higher levels of health concern than dog owners. Our study indicates that the perceptions of pet owners towards perception of flea and tick infestation risk varies demographically, and owner education is an important predictor of prevention behaviours towards tick and flea infestation of pets.

Asunto(s)

Enfermedades de los Perros , Infestaciones por Pulgas , Conocimientos, Actitudes y Práctica en Salud , Infestaciones por Garrapatas , Animales , Queensland/epidemiología , Perros , Femenino , Masculino , Humanos , Persona de Mediana Edad , Adulto , Enfermedades de los Perros/parasitología , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/psicología , Infestaciones por Garrapatas/veterinaria , Infestaciones por Garrapatas/epidemiología , Infestaciones por Garrapatas/psicología , Infestaciones por Pulgas/veterinaria , Infestaciones por Pulgas/parasitología , Infestaciones por Pulgas/epidemiología , Infestaciones por Pulgas/psicología , Encuestas y Cuestionarios , Adulto Joven , Propiedad/estadística & datos numéricos , Anciano , Adolescente , Mascotas/psicología , Mascotas/parasitología

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BACKGROUND: A dramatic decline in mental health of people worldwide in the early COVID-19 pandemic years has not recovered. In rural and remote Australia, access to appropriate and timely mental health services has been identified as a major barrier to people seeking help for mental ill-health. From 2020 to 2021 a care navigation model, Navicare, was co-designed with rural and remote communities in the Greater Whitsunday Region of Central Queensland in Australia. The Exploration, Preparation, Implementation and Sustainment (EPIS) framework was used to design and guide multiple aspects of a multisite study, The Bridging Study, to evaluate the implementation of Navicare in Australia. METHODS: A community-engaged hybrid effectiveness-implementation study design will focus on the tailored implementation of Navicare at three new sites as well as monitoring implementation at an existing site established since 2021. Study outcomes assessed will include sustained access as the co-primary outcome (measured using access to Navicare mental health referral services) and Proctor's Implementation Outcomes of feasibility, acceptability, appropriateness, adoption, fidelity, implementation cost, and sustainability. Data collection for the implementation evaluation will include service usage data, community consultations, interviews, and workshops; analysed using mixed methods and guided by EPIS and other implementation frameworks. Pre-post effectiveness and cost-consequence study components are embedded in the implementation and sustainment phases, with comparison to pre-implementation data and value assessed for each EPIS phase using hospital, service, and resource allocation data. A scaling up strategy will be co-developed using a national roundtable forum in the final year of the study. Qualitative exploration of other aspects of the study (e.g., mechanisms of action and stakeholder engagement) will be conducted. DISCUSSION: Our study will use tailoring to local sites and a community-engaged approach to drive implementation of a mental health care navigation service in rural and remote Australia, with expected benefits to mental healthcare access. This approach is consistent with policy recommendations nationally and internationally as building blocks for rural health including the World Health Organization Framework for Action on Strengthening Health Systems to Improve Health Outcomes. TRIAL REGISTRATION: Prospectively registered on April 2, 2024, on the Australian New Zealand Clinical Trials Registry, no. ACTRN12624000382572. https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=386665&isReview=true .

Asunto(s)

COVID-19 , Servicios de Salud Mental , Humanos , COVID-19/epidemiología , Servicios de Salud Mental/organización & administración , Navegación de Pacientes/organización & administración , Australia , Accesibilidad a los Servicios de Salud/organización & administración , Población Rural , Servicios de Salud Rural/organización & administración , SARS-CoV-2 , Trastornos Mentales/terapia , Ciencia de la Implementación , Queensland

RESUMEN

BACKGROUND AND OBJECTIVES: Surgical site infection (SSI) after dermatological surgery is associated with poor outcomes. Developing clinical prediction rules based on the predicted probability of infection might encourage guided prophylaxis and judicious prescribing. The purpose of this study was to develop a clinical prediction rule based on identified risk factors for SSI in a large general practice patient cohort. METHOD: We examined a large, pooled dataset from four randomised controlled trials performed in a regional centre of North Queensland, Australia. Multivariable logistic regression identified a prediction model. Bootstrapping was used for internal validation. A scoring system was based on predicted probabilities of infection. RESULTS: The final prediction rule included age >55 years and the anatomical site, histology and complexity of the excision. The area under the curve was 0.704. DISCUSSION: Our prediction rule encourages judicious use of prophylaxis in clinical practice.

Asunto(s)

Medicina General , Infección de la Herida Quirúrgica , Humanos , Infección de la Herida Quirúrgica/prevención & control , Medicina General/métodos , Medicina General/estadística & datos numéricos , Femenino , Persona de Mediana Edad , Queensland , Masculino , Factores de Riesgo , Anciano , Adulto , Procedimientos Quirúrgicos Menores/métodos , Procedimientos Quirúrgicos Menores/estadística & datos numéricos , Procedimientos Quirúrgicos Menores/efectos adversos , Modelos Logísticos , Reglas de Decisión Clínica

RESUMEN

Identifying mechanisms that drive population divergence under varying geographic and ecological scenarios can inform our understanding of evolution and speciation. In particular, analysis of genetic data from island populations with known colonisation timelines allows us to identify potential source populations of diverging island subspecies and current relationships among populations. Silvereyes (Zosterops lateralis) are a small passerine that have served as a valuable study system to investigate evolutionary patterns on both large and small geographic scales. We examined genetic relatedness and diversity of two silvereye subspecies, the mainland Z. l. cornwalli and island Z. l. chlorocephalus, and used 18 077 single nucleotide polymorphisms (SNPs), to compare locations across southeast Queensland, Australia. Although silvereyes are prolific island colonisers our findings revealed population divergence over relatively small spatial scales was strongly influenced by geographic isolation mediated by water barriers. Strong genetic connectivity was displayed between mainland sites, but minimal inter-island connectivity was shown despite comparable sampling distances. Genetic diversity analysis showed little difference in heterozygosity between island and mainland populations, but lower inbreeding scores among the island populations. Our study confirmed the range of the Z. l. chlorocephalus subspecies throughout the southern Great Barrier Reef. Our results show that water barriers and not geographic distance per se are important in driving incipient divergence in island populations. This helps to explain the relatively high number of phenotypically differentiated, but often geographically proximate, island silvereye subspecies compared to a lower number of phenotypically less well-defined Australian continental subspecies.

Asunto(s)

Variación Genética , Polimorfismo de Nucleótido Simple , Animales , Passeriformes/genética , Queensland , Genética de Población , Islas , Geografía , Australia

RESUMEN

Estuaries provide critical ecosystem services, and yet are increasingly under threat from urbanization. Non-invasive approaches to monitor biodiversity resident to or migrating through estuaries is critical to evaluate the holistic health of these ecosystems, often based entirely on water quality. In this study we compared tree of life metabarcoding (ToL-metabarcoding) biodiversity detections with measurements of physico-chemical variables (chlorophyll a, turbidity, total nitrogen, total phosphorous, dissolved oxygen) at eight sites of varying degrees of water quality in the Gold Coast Broadwater Estuary (Queensland, Australia). These sites were ranked according to an adapted Water Quality Index (WQI) score. Here, we detected 787 unique taxa, adding 137 new biodiversity records to the region, mostly micro-organisms such as bacteria, ciliates, diatoms, dinoflagellates, and cryptomonads. Sites with the lowest WQI were characterised by higher turbidity, lower dissolved oxygen, as well as higher total nitrogen and phosphorous, which correlated with an increased diversity of bacteria, ciliates, and green algae. Similarly, the composition of taxa was significantly different between sites with variable WQI values for most taxa but was less apparent for larger vertebrate groups. These findings suggest that rapid ToL-metabarcoding biodiversity detections, particularly for lower order taxonomic groups, can serve as valuable indicators of flora and fauna across the tree of life associated with dynamically shifting estuarine health along urbanized coastlines.

Asunto(s)

Biodiversidad , ADN Ambiental , Monitoreo del Ambiente , Estuarios , Urbanización , Calidad del Agua , ADN Ambiental/análisis , Queensland , Código de Barras del ADN Taxonómico , Fósforo/análisis , Ecosistema , Nitrógeno/análisis

RESUMEN

BACKGROUND: The care of wounds is an ongoing issue for Indigenous people worldwide, yet culturally safe Indigenous wound care training programs for rural and remote Australian Aboriginal Health Workers are largely unavailable. The higher prevalence of chronic disease, lower socioeconomic status and poorer access to services experienced by Aboriginal and Torres Strait Islanders compared to non-Indigenous people, leads to a greater incidence of chronic wounds in Aboriginal and Torres Strait Islander people. Identifying the barriers and enablers for delivering wound care will establish areas of need for facilitating the development of a specific wound care program for Aboriginal Health Workers and Aboriginal Health Practitioners. This paper reports the first phase of a larger project directly aligned to the Indigenous Australians' Health Program's objective of supporting the delivery and access to high quality, culturally appropriate health care and services to Aboriginal and Torres Strait Islander Australians. This study aimed to examine experiences of Aboriginal Health Workers, Aboriginal Health Practitioners, and nurses for managing chronic wounds within rural and remote Aboriginal Medical Services in Queensland, Australia. METHODS: Yarning facilitated by two Aboriginal researchers among Aboriginal Health Workers, Aboriginal Health Practitioners, and nurses currently employed within four Aboriginal Medical Services located in rural and remote areas of Queensland, Australia. RESULTS: Two themes were developed through rigorous data analysis of yarning information and responses: participants' experiences of managing wounds and barriers and enablers to effective wound care. CONCLUSIONS: This study contributes an insight into the experiences of Aboriginal Health Workers on the current barriers and enablers to timely treatment of chronic wounds. Results from this study indicate a significant barrier to obtaining timely and effective wound care in regional and remote settings is access to an appropriately skilled, culturally competent, and resourced health work force. A lack of education and professional development for Aboriginal Health Workers can compromise their ability to maximise patient outcomes and delay wound healing. Findings have informed the development of an evidence based, culturally competent open access chronic wound care education program for Aboriginal Health Workers.

Asunto(s)

Servicios de Salud del Indígena , Nativos de Hawái y Otras Islas del Pacífico , Servicios de Salud Rural , Heridas y Lesiones , Humanos , Queensland , Heridas y Lesiones/terapia , Heridas y Lesiones/etnología , Servicios de Salud del Indígena/organización & administración , Servicios de Salud Rural/organización & administración , Femenino , Masculino , Población Rural , Personal de Salud/educación , Mejoramiento de la Calidad , Adulto

RESUMEN

BACKGROUND: The global economic cost of cancer and the costs of ongoing care for survivors are increasing. Little is known about factors affecting hospitalisations and related costs for the growing number of cancer survivors. Our aim was to identify associated factors of cancer survivors admitted to hospital in the public system and their costs from a health services perspective. METHODS: A population-based, retrospective, data linkage study was conducted in Queensland (COS-Q), Australia, including individuals diagnosed with a first primary cancer who incurred healthcare costs between 2013 and 2016. Generalised linear models were fitted to explore associations between socio-demographic (age, sex, country of birth, marital status, occupation, geographic remoteness category and socio-economic index) and clinical (cancer type, year of/time since diagnosis, vital status and care type) factors with mean annual hospital costs and mean episode costs. RESULTS: Of the cohort (N = 230,380) 48.5% (n = 111,820) incurred hospitalisations in the public system (n = 682,483 admissions). Hospital costs were highest for individuals who died during the costing period (cost ratio 'CR': 1.79, p < 0.001) or living in very remote or remote location (CR: 1.71 and CR: 1.36, p < 0.001) or aged 0-24 years (CR: 1.63, p < 0.001). Episode costs were highest for individuals in rehabilitation or palliative care (CR: 2.94 and CR: 2.34, p < 0.001), or very remote location (CR: 2.10, p < 0.001). Higher contributors to overall hospital costs were 'diseases and disorders of the digestive system' (AU$661 m, 21% of admissions) and 'neoplastic disorders' (AU$554 m, 20% of admissions). CONCLUSIONS: We identified a range of factors associated with hospitalisation and higher hospital costs for cancer survivors, and our results clearly demonstrate very high public health costs of hospitalisation. There is a lack of obvious means to reduce these costs in the short or medium term which emphasises an increasing economic imperative to improving cancer prevention and investments in home- or community-based patient support services.

Asunto(s)

Supervivientes de Cáncer , Hospitalización , Neoplasias , Humanos , Supervivientes de Cáncer/estadística & datos numéricos , Masculino , Femenino , Hospitalización/economía , Hospitalización/estadística & datos numéricos , Persona de Mediana Edad , Queensland/epidemiología , Anciano , Adulto , Estudios Retrospectivos , Adolescente , Adulto Joven , Neoplasias/economía , Neoplasias/terapia , Neoplasias/mortalidad , Neoplasias/epidemiología , Costos de la Atención en Salud/estadística & datos numéricos , Lactante , Preescolar , Niño , Anciano de 80 o más Años , Almacenamiento y Recuperación de la Información/economía , Recién Nacido , Costos de Hospital/estadística & datos numéricos

Asunto(s)

Peso al Nacer , Femenino , Humanos , Recién Nacido , Embarazo , Queensland/epidemiología , Aborigenas Australianos e Isleños del Estrecho de Torres

RESUMEN

(1) Background: Mid-level managers in healthcare are central to improving safety and quality of care. Their ability in demonstrating leadership and management competency in their roles and supporting frontline managers and frontline staff has a direct effect on staff retention and turn-over. Yet, investment in their professional development and support for mid-level managers is often neither adequate nor effective, and high rates of staff turnover are evident. This study, set in northern Queensland, Australia, takes a strength-based approach to explore the role and strengths of mid-level managers and organisations' existing mechanisms in supporting managers. With broad involvement and contribution from managers at different management level and frontline staff, the project will identify strategies to address the challenges mid-level managers face while building on their capabilities. (2) Methods: Using co-design principles, a situation analysis approach will guide a mixed-methods, multiphase design. Qualitative data will be collected using transcripts of focus groups and quantitative data will be collected by surveys that include validated scales. (3) Results: Thematic analysis of the transcripts will be guided by the framework of Braun and Clarke. Quantitative data will employ descriptive and inferential analysis, including chi-squared, t-tests, and univariate analyses of variance. (4) Conclusions: This study will generate evidence to guide two partner organisations, and other similar organisations, to develop strategies to improve support for mid-level managers and build their capabilities to support and lead frontline managers and staff. Competent mid-level managers are critical to high-quality patient care and improve the outcomes of the population they serve.

Asunto(s)

Liderazgo , Queensland , Humanos , Fuerza Laboral en Salud/organización & administración , Empoderamiento , Personal de Salud , Grupos Focales

RESUMEN

PURPOSE: This study formed the development stage of a population-based survey aiming to: (i) understand the needs and experiences of people affected by cancer in Queensland, Australia and (ii) recruit a pool of participants for ongoing cancer survivorship research. The current study aimed to co-design and test a single qualitative survey question and study invitation materials to maximise acceptability of, and participation in, the survey and future research. METHODS: Fifty-two community members, including cancer survivors and caregivers, participated across 15 co-design workshops and 20 pretest interviews. During workshops, participants generated and refined ideas for an open-ended survey question and provided feedback on a study invitation letter. The use of a single, open-ended question aims to minimise participant burden while collecting rich information about needs and experiences. The research team then shortlisted the question ideas and revised study invitation materials based on workshop feedback. Next, using interviews, community members were asked to respond to a shortlisted question to test its interpretability and relevance and to review revised invitation materials. Content analysis of participant feedback was used to identify principles for designing study materials. RESULTS: Principles for designing qualitative survey questions were identified from participant feedback, including define the question timeframe and scope; provide reassurance that responses are valid and valued; and use simple wording. Principles for designing study invitation materials were also identified, including communicate empathy and sensitivity; facilitate reciprocal benefit; and include a 'human element'. The qualitative survey question and study invitation materials created using these principles were considered relevant and acceptable for use in a population-based survey. CONCLUSIONS: Through community consultation and co-design, this study identified principles for designing qualitative data collection and invitation materials for use in cancer survivorship research. These principles can be applied by other researchers to develop study materials that are sensitive to the needs and preferences of community members.

Asunto(s)

Neoplasias , Investigación Cualitativa , Humanos , Neoplasias/psicología , Encuestas y Cuestionarios , Femenino , Masculino , Supervivientes de Cáncer/psicología , Proyectos de Investigación , Queensland , Adulto , Persona de Mediana Edad , Anciano

RESUMEN

Macrocyclic lactone (ML) anthelmintics are currently the only class of drugs available for canine heartworm prevention. Recent reports of Dirofilaria immitis infection occurring in dogs reportedly receiving 'rigorous' prevention in Queensland, Australia, coupled with the confirmation of ML-resistant isolates in the USA, has led to speculation about the potential emergence of ML-resistance in Australia. In this study, we describe two cases (Dog 1 and 2) of asymptomatic canine heartworm disease in Townsville, Australia, that were reportedly receiving 'rigorous' heartworm prevention according to the owners' claims. We aimed to deploy currently available tools to assess the phenotypic and genotypic ML-resistance status of these two dogs. For phenotypic testing, we performed an in-vivo 7-day microfilariae suppression test using a dose of spot-on moxidectin (Advocate™ for Dogs, 100 g/L imidacloprid + 25 g/L moxidectin). This formulation is marketed as Advantage Multi® for Dogs in the USA, which claims a D. immitis microfilaricidal effect. For genetic testing, an Illumina amplicon metabarcoding approach was used to target single nucleotide polymorphisms (SNPs) previously associated with ML-resistance in D. immitis from the USA. Dog 1 and Dog 2 demonstrated <10 % and <40 % reductions in circulating microfilariae seven days after moxidectin treatment, respectively. These phenotypes were not corroborated by genetic SNP testing, as both dogs were classified as susceptible across all examined markers. To streamline testing of D. immitis SNPs, we developed a rhAmp™ SNP qPCR approach for rapidly genotyping suspect cases of ML-resistant infections at the two major loci (L15709_A and L30575). These findings illustrate a phenomenon shown in some heartworm cases outside the USA, whereby infected dogs are failing to see marked reductions in microfilaraemia after ML treatment but possess an ML-susceptible genotype.

Asunto(s)

Dirofilaria immitis , Dirofilariasis , Enfermedades de los Perros , Macrólidos , Neonicotinoides , Nitrocompuestos , Animales , Perros , Dirofilariasis/tratamiento farmacológico , Enfermedades de los Perros/tratamiento farmacológico , Enfermedades de los Perros/parasitología , Dirofilaria immitis/efectos de los fármacos , Dirofilaria immitis/genética , Macrólidos/uso terapéutico , Macrólidos/administración & dosificación , Neonicotinoides/uso terapéutico , Neonicotinoides/administración & dosificación , Nitrocompuestos/uso terapéutico , Masculino , Femenino , Filaricidas/uso terapéutico , Microfilarias/efectos de los fármacos , Resistencia a Medicamentos , Queensland

RESUMEN

BACKGROUND: Our prototype smoking cessation chatbot, Quin, provides evidence-based, personalized support delivered via a smartphone app to help people quit smoking. We developed Quin using a multiphase program of co-design research, part of which included focus group evaluation of Quin among stakeholders prior to clinical testing. OBJECTIVE: This study aimed to gather and compare feedback on the user experience of the Quin prototype from end users and smoking cessation professionals (SCPs) via a beta testing process to inform ongoing chatbot iterations and refinements. METHODS: Following active and passive recruitment, we conducted web-based focus groups with SCPs and end users from Queensland, Australia. Participants tested the app for 1-2 weeks prior to focus group discussion and could also log conversation feedback within the app. Focus groups of SCPs were completed first to review the breadth and accuracy of information, and feedback was prioritized and implemented as major updates using Agile processes prior to end user focus groups. We categorized logged in-app feedback using content analysis and thematically analyzed focus group transcripts. RESULTS: In total, 6 focus groups were completed between August 2022 and June 2023; 3 for SCPs (n=9 participants) and 3 for end users (n=7 participants). Four SCPs had previously smoked, and most end users currently smoked cigarettes (n=5), and 2 had quit smoking. The mean duration of focus groups was 58 (SD 10.9; range 46-74) minutes. We identified four major themes from focus group feedback: (1) conversation design, (2) functionality, (3) relationality and anthropomorphism, and (4) role as a smoking cessation support tool. In response to SCPs' feedback, we made two major updates to Quin between cohorts: (1) improvements to conversation flow and (2) addition of the "Moments of Crisis" conversation tree. Participant feedback also informed 17 recommendations for future smoking cessation chatbot developments. CONCLUSIONS: Feedback from end users and SCPs highlighted the importance of chatbot functionality, as this underpinned Quin's conversation design and relationality. The ready accessibility of accurate cessation information and impartial support that Quin provided was recognized as a key benefit for end users, the latter of which contributed to a feeling of accountability to the chatbot. Findings will inform the ongoing development of a mature prototype for clinical testing.

Asunto(s)

Grupos Focales , Cese del Hábito de Fumar , Humanos , Cese del Hábito de Fumar/métodos , Cese del Hábito de Fumar/psicología , Queensland , Masculino , Adulto , Femenino , Persona de Mediana Edad , Aplicaciones Móviles

RESUMEN

Canid alphaherpesvirus-1 (CaHV-1) may cause a highly fatal haemorrhagic disease in neonatal pups and is associated with reproductive, respiratory and ocular disease in older dogs. Although assumed to have a world-wide distribution, there have been few reports of CaHV-1 in Australia. The aim of this study was to investigate the seroprevalence of CaHV-1 in household dogs in a residential suburb in Townsville, as well as in dogs attending two dog shows in the region. Study participants were recruited through door-to-door non-probability sampling (Douglas dogs, n = 185) or invited to participate (Show dogs; n = 76). Dog owners completed a questionnaire that investigated possible risk factors for recent exposure to CaHV-1. A serum sample from each dog was assayed for anti-CaHV-1 antibodies using a commercially available ELISA. Associations between seropositive dogs and owner-reported risk factors were analysed using univariable analysis and multivariable logistic regression models. The seroprevalence of CaHV-1 was 11.4 % (95 % CI 6.8-15.9 %) and 17.1 % (95 % CI 5.5-28.8) for the Douglas and Show dogs, respectively, with a pooled seroprevalence of 13 % (95 % CI 8.3-17.7 %). Dogs that had suffered from conjunctivitis within the previous 3 months or were involved in breeding were more likely to be seropositive to CaHV-1. No other significant risk factors were identified. In conclusion, CaHV-1 is circulating in dogs in North Queensland and may be contributing to foetal and neonatal losses in this region.

Asunto(s)

Enfermedades de los Perros , Infecciones por Herpesviridae , Herpesvirus Cánido 1 , Animales , Perros , Estudios Seroepidemiológicos , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/virología , Factores de Riesgo , Queensland/epidemiología , Herpesvirus Cánido 1/aislamiento & purificación , Femenino , Masculino , Infecciones por Herpesviridae/veterinaria , Infecciones por Herpesviridae/epidemiología , Infecciones por Herpesviridae/virología , Ensayo de Inmunoadsorción Enzimática/veterinaria , Anticuerpos Antivirales/sangre , Modelos Logísticos

RESUMEN

INTRODUCTION: Despite disease modifying treatments (DMT), assisted ventilation is commonly required in children with Spinal Muscular Atrophy (SMA). Guidelines suggest screening with oximetry and transcutaneous carbon dioxide (TcCO2) for sleep disordered breathing (SDB). AIM: To determine the utility of pulse oximetry and TcCO2 as a screen for SDB and the need for Non-Invasive Ventilation (NIV) in children with SMA type 1-3. METHODS: A prospective cohort study was conducted in Queensland, Australia. Full diagnostic PSG was completed in DMT naïve children with SMA. Pulse oximetry and TcCO2 were extracted from PSG. Apnoea-hypopnoea indices (AHI) criteria were applied to PSG results to define the need for NIV. Abnormal was defined as: ≤3 months of age [mo] AHI≥10 events/hour; >3mo AHI ≥5 events/hour. Receiver operating characteristic curves were calculated for abnormal PSG and pulse oximetry/TcCO2 variables, and diagnostic statistics were calculated. RESULTS: Forty-seven untreated children with SMA were recruited (type 1 n = 13; 2 n = 21; 3 n = 13) ranging from 0.2 to 18.8 years old (median 4.9 years). Oxygen desaturation index ≥4 % (ODI4) ≥20events/hour had sensitivity 82.6 % (95 % CI 61.2-95.0) and specificity of 58.3 % (95 % CI 36.6-77.9). TcCO2 alone and combinations of oximetry/TcCO2 had low diagnostic ability. The same methodology was applied to 36 children who were treated (type 1 n = 7; type 2 n = 17; type n = 12) and oximetry±TcCO2 had low diagnostic ability. CONCLUSION: ODI4 ≥20events/hour can predict the need for NIV in untreated children with SMA. TcCO2 monitoring does not improve the PPV. If normal however, children may still require a diagnostic PSG. Neither oximetry nor TcCO2 monitoring were useful screening tests in the children treated with DMT.

Asunto(s)

Dióxido de Carbono , Oximetría , Atrofias Musculares Espinales de la Infancia , Humanos , Oximetría/métodos , Masculino , Femenino , Estudios Prospectivos , Preescolar , Niño , Lactante , Dióxido de Carbono/sangre , Adolescente , Atrofias Musculares Espinales de la Infancia/diagnóstico , Síndromes de la Apnea del Sueño/diagnóstico , Queensland , Ventilación no Invasiva/métodos , Polisomnografía/métodos , Monitoreo de Gas Sanguíneo Transcutáneo/métodos

RESUMEN

BACKGROUND: After receiving a diagnosis of a neuromuscular condition, patients have to make their way through a convoluted network of community and state resources as health care shifts from being family and child centered to adult focused. This study examined the barriers to successful transition from patient and clinician perspectives. METHODS: Adolescents with a primary diagnosis of a neuromuscular condition who were aged 16 years and over in Queensland, Australia, and who had started the transition process were eligible. Surveys were collected over six months and statistics used to characterize survey responses. RESULTS: There was a high degree of anxiety reported about the transition, with almost 50% of patients and families surveyed reporting concerns about moving across to the adult hospital system. The main barriers to effective transition identified by clinicians were limited time (84%), clinic space (58%), and a lack of an identified transition coordinator (79%). CONCLUSIONS: This study has provided a checklist to assist patients with neuromuscular disorders in transitioning from pediatric to adult care. A new model has been developed to enable a slow, personalized transition that is led by a multidisciplinary team.

Asunto(s)

Enfermedades Neuromusculares , Transición a la Atención de Adultos , Humanos , Enfermedades Neuromusculares/terapia , Adolescente , Transición a la Atención de Adultos/normas , Masculino , Femenino , Queensland , Australia , Adulto Joven , Ansiedad , Adulto

RESUMEN

Background This study aims to assess the effectiveness of a structured audio-visual educational session for people on asthma symptoms management during a general practitioner visit. Methods We conducted this single-centre intervention study in a general practice clinic in Queensland, Australia. There were 78 intervention and 78 control participants in this study. We followed 1:1 randomisation to allocate study intervention between two groups of participants with asthma. The intervention group received an audio-visual demonstration of asthma, its symptoms, triggers, and how to use inhalers correctly, along with the standard asthma management by a physician on enrolment. The control group received only the standard asthma management by a physician. We assessed the 'Asthma Control Test' score on enrolment and after 90days and compared the changes across the groups. Results Participants were, on average, 28years old (range: 6-60, 60% women). The intervention group showed a 1.9-unit increment, and the control group showed a -0.5-unit increment in 'Asthma Control Test' score from baseline to endline. The difference of differences between the intervention and control groups was 2.4 units (P =0.016) after adjusting for potential confounders. In age-stratified analysis, the children (6-17years) showed a significant difference (mean difference of 2.5 between intervention and control groups) in their asthma control score. Conclusions Structured educational sessions involving audio-visual media along with standard management for people with asthma during general practice visits would be effective for better asthma control. However, a further multi-centre study with a larger sample is needed to see its efficacy.

Asunto(s)

Asma , Medicina General , Educación del Paciente como Asunto , Humanos , Asma/terapia , Femenino , Masculino , Adulto , Adolescente , Queensland , Persona de Mediana Edad , Niño , Educación del Paciente como Asunto/métodos , Medicina General/métodos , Medicina General/educación , Adulto Joven , Recursos Audiovisuales , Australia

RESUMEN

Introduction: Noroviruses are one of the most common causes of gastroenteritis in all age groups, including children. However, little has been reported on the transmission of norovirus within childcare facilities and the subsequent impact at the household level. Methods: We conducted an outbreak investigation of norovirus gastroenteritis in Central Queensland, Australia during May 2021, in a childcare facility and the associated exposed households. Case definitions and outbreak management were employed as per the Communicable Disease Network Australia guidelines for norovirus and suspected viral gastroenteritis. Each case or carer and respective household member was interviewed to determine the date and time of symptom onset, health outcomes, and infector-infectee pairs. We estimated attack rates within the childcare facility and households, and basic reproductive number (R0) for norovirus using time-dependent methods. Results: A total of 41 people developed gastrointestinal symptoms as a result of this outbreak, with 25 cases (61%) acquiring the infection in the centre and 16 cases (39%) occurring at households. Serial intervals were estimated as a mean 2.4 days (standard deviation 1.7 days), with a majority of cases (73%) in children under two years of age within the centre. Three faecal specimens were obtained, all detecting norovirus genotype II. The time-dependent R0 was 1.5 (95% confidence interval [95% CI]: 1.0-2.2). Discussion: The attack rate within the childcare facility was highest amongst children aged less than 2 years, highlighting the risk of infection for this age group. We recommend the exclusion of asymptomatic household contacts from childcare facilities to reduce the length and severity of norovirus outbreaks. Further investigation into childcare facility risk factors and associated households are required to optimise public health interventions.

Asunto(s)

Infecciones por Caliciviridae , Brotes de Enfermedades , Composición Familiar , Gastroenteritis , Norovirus , Humanos , Gastroenteritis/epidemiología , Gastroenteritis/virología , Infecciones por Caliciviridae/epidemiología , Infecciones por Caliciviridae/virología , Queensland/epidemiología , Norovirus/genética , Preescolar , Femenino , Masculino , Lactante , Niño , Adulto , Guarderías Infantiles , Adolescente , Heces/virología , Persona de Mediana Edad

RESUMEN

Abstract: This study determined the hepatitis B e antigen (HBeAg) status of people living with chronic hepatitis B (CHB) in Far North Queensland (FNQ), Australia and their age of HBeAg loss. It was hoped that this would provide data to explain the stark difference in the incidence of hepatocellular carcinoma (HCC) between Aboriginal and Torres Strait Islander individuals living with CHB in FNQ, a finding that has been hypothesised to relate to differences in hepatitis B virus genotype. We identified every FNQ resident with CHB, determined their country of birth, their HBeAg status, the age they lost HBeAg and whether they identified as an Aboriginal, a Torres Strait Islander or a non-Indigenous individual. We then ascertained whether these demographic and virological variables were correlated. Of 1,474 individuals living with CHB in FNQ, 278 (19%) were Aboriginal, 507 (34%) were Torres Strait Islanders and 689 (47%) were non-Indigenous. Aboriginal individuals were less likely to be HBeAg positive (26/278, 9%) than Torres Strait Islander (91/507, 18%) and non-Indigenous (126/689, 18%) individuals, p < 0.0001. Aboriginal individuals lost HBeAg at an earlier age (median (interquartile range): 30 (23-39) years) than Torres Strait Islander (38 (29-49) years) and non-Indigenous (36 (29-47) years) individuals, p < 0.0001. Aboriginal individuals with CHB in FNQ are more likely to be HBeAg negative than Torres Strait Islander and non-Indigenous individuals and lose HBeAg at a younger age. This provides a biological basis for local clinicians' observation that Aboriginal individuals with CHB in FNQ are at a lower risk of HCC and data to support the principle of genotype-based care in the region.

Asunto(s)

Antígenos e de la Hepatitis B , Virus de la Hepatitis B , Hepatitis B Crónica , Nativos de Hawái y Otras Islas del Pacífico , Humanos , Antígenos e de la Hepatitis B/sangre , Femenino , Hepatitis B Crónica/epidemiología , Masculino , Adulto , Persona de Mediana Edad , Queensland/epidemiología , Virus de la Hepatitis B/genética , Carcinoma Hepatocelular/epidemiología , Australia/epidemiología , Adulto Joven , Genotipo , Neoplasias Hepáticas/epidemiología , Anciano , Aborigenas Australianos e Isleños del Estrecho de Torres

RESUMEN

This article reports on promising pilot research which indicates that intergenerational musical practices in diverse First Nations families and communities in Vanuatu and Australia can shape cultural determinants of health (CDoH). We contend that such strength- and culture-based approaches to health promotion may help to disrupt colonial and deficit constructions of First Nations People and our health and wellbeing. The pilot study used Indigenist yarning which prioritized First Nations ideas, concepts, and knowledges during informal and relational semi-structured interviews with 9 diverse First Nations musicians in Australia and Vanuatu. The pilot study underpins an ongoing international 3-year research project examining First Nations music as a determinant of health led by Griffith University, The University of the Sunshine Coast, The University of Queensland, and Edith Cowan University. Yarning interviews were analyzed using collaborative thematic analysis and Indigenous visual art responses. Major themes emerging from the data related to intergenerational music activity and transmission. Themes include Music as an intergenerational medium of cultures; Music as a bond between older and younger generations; Intergenerational musical activism and advocacy; and Musical lineages and strengths. Intergenerational musical practices in diverse First Nations families may provide protective cultural, social, economic, educative, and professional determinants of health. The study indicates that more research and new theory may unlock the potential of First Nations musical activities as protective and agentic cultural practices in our families and communities.

Asunto(s)

Relaciones Intergeneracionales , Música , Humanos , Música/psicología , Femenino , Masculino , Proyectos Piloto , Australia , Determinantes Sociales de la Salud , Adulto , Persona de Mediana Edad , Entrevistas como Asunto , Queensland

RESUMEN

In a parasitological survey of fishes from Moreton Bay (southeastern Queensland, Australia), 169 teleost fishes, representing 54 species from 28 families, were examined for larval cestodes. Of these 54 species, 36 were found to be infected by metacestodes. Metacestodes were characterised by morphological and molecular data (the D1-D3 region of the 28S rDNA gene); these data were analysed in parallel to inform larval type allocation. Metacestodes collected represented eight morphological types, seven previously reported (Types I, II, IV, V, VI, VII, and X) and one novel type (Type XVI). Phylogenetic analyses were conducted to genetically match larval types to adult cestodes. Six of the eight larval types found were matched to adult forms: Type I metacestodes matched species of Phoreiobothrium Linton, 1889 (Onchobothriidae); Type II metacestodes matched species of Acanthobothrium van Beneden, 1849 (Onchobothriidae); Type IV metacestodes matched species of Scyphophyllidium Woodland, 1927 and Alexandercestus Ruhnke & Workman, 2013 (Phyllobothriidae); Type VI metacestodes matched species of Anthobothrium van Beneden, 1850 (Tetraphyllidea incertae sedis); Type X metacestodes matched species of Ambitalveolus Caira & Jensen, 2022 (Tetraphyllidea incertae sedis); and Type XVI metacestodes matched species of Platybothrium Linton, 1890 (Onchobothriidae). Based on phylogenetic topology, Type V metacestodes are inferred to match Pedibothrium Linton, 1909 (Balanobothriidae) and Type VII metacestodes are inferred to match Spongiobothrium Linton, 1889 (Rhinebothriidae). These findings support and extend the unified morphological type system proposed previously, but suggest that morphological types will ultimately be informative to identify metacestodes to a group of related genera rather than any distinct genus.

Asunto(s)

Bahías , Cestodos , Peces , Filogenia , ARN Ribosómico 28S , Animales , Peces/parasitología , Cestodos/clasificación , Cestodos/genética , Cestodos/anatomía & histología , ARN Ribosómico 28S/genética , Queensland , Especificidad de la Especie , Larva/clasificación , Larva/anatomía & histología , ADN Ribosómico/genética