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To investigate: (1) the injury epidemiology in an Australian academy; (2) how athletes transition through the high-performance sport (HPS) pathway; and (3) why athletes leave this HPS program. This retrospective cohort study was conducted at an Australian HPS academy over a 4-year period. Medical attention injuries were prospectively recorded. Injury incidence rates (IIR) and burden were calculated per 365 athlete-days, according to sport, sex, and pathway level. Athlete pathway levels were mapped to the Foundations, Talent, Elite, and Mastery (FTEM) framework. Reasons for athletes transitioning out were reported. Four hundred and eighty-one injuries were reported across 124 athletes at an IIR of 2.09 injuries per 365 athlete-days (95% CI = 1.91-2.29). Most athletes (103, 83.1%) were injured at least once over the 4-year period. IIRs increased (IRR = 1.17, 95% CI = 1.06-1.29, p = 0.001) as athletes progressed through the pathway. The most common reason for athlete attrition was deselection due to performance (n = 18), with 55.6% of these athletes sustaining an injury in the season prior to deselection. Injury burden was highest at E2 (119.5 days absence per 365 athlete-days (95% CI = 62.18-229.67)) and lowest at T4 (30.47 days absence per 365 athlete-days (95% CI = 21.98-42.24)). Injury occurrence is common across HPS, with IIRs increasing as athletes progressed to higher talent levels. Deselection due to poor performance was the main attrition factor, with more than half the deselected athletes impacted by injury prior to deselection. This study highlights an increased risk of deselection, following injury, and indicates the need for further development of prevention strategies targeting pathway athletes.
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Atletas , Traumatismos em Atletas , Humanos , Estudos Retrospectivos , Traumatismos em Atletas/epidemiologia , Masculino , Feminino , Austrália/epidemiologia , Incidência , Adulto Jovem , Desempenho Atlético , Adulto , AdolescenteRESUMO
AIMS: This study aimed to investigate acamprosate and naltrexone dispensing patterns in Australia. METHODS: A 10% representative sample of medications subsidized by the Australian Pharmaceutical Benefits Scheme (PBS) was used to identify individuals who were dispensed naltrexone or acamprosate between January 2006 and December 2023. Data were used to examine concurrent dispensing, medication switching and treatment episode length, as well as changes in prevalence and incidence over time. RESULTS: During the study, we identified 22 745 individuals with a total of 117 548 dispensed prescriptions (45.3% naltrexone, 43.0% acamprosate, and 11.7% concurrent dispensing). Alcohol pharmacotherapy dispensing occurred in 1354 per 100 000 individuals. It is estimated that 2.9% of individuals with an alcohol use disorder in Australia are receiving a PBS-listed pharmacological treatment. For both pharmacotherapies, individuals were most likely to be male (60.0%) and 35-54 years of age (56.0%). Individuals were more likely to switch from acamprosate to naltrexone rather than the reverse. From 2006 and 2023, the number of prevalent individuals treated with an alcohol pharmacotherapy significantly increased, driven mainly the use of naltrexone, which more than doubled over the study period. Incident naltrexone-treated individuals were more likely to remain on treatment for the recommended minimum 3-month period compared to acamprosate treated individuals, although overall dispensing for at least 3 months was low (5.1%). CONCLUSIONS: In Australia between 2006 and 2023, rates of naltrexone dispensing have substantially increased, while acamprosate dispensing showed minimal changes. However, the use of alcohol pharmacotherapies remains low compared with the likely prevalence of alcohol use disorders.
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Acamprosato , Dissuasores de Álcool , Alcoolismo , Naltrexona , Humanos , Acamprosato/uso terapêutico , Austrália/epidemiologia , Masculino , Feminino , Naltrexona/uso terapêutico , Pessoa de Meia-Idade , Adulto , Dissuasores de Álcool/uso terapêutico , Alcoolismo/tratamento farmacológico , Alcoolismo/epidemiologia , Adulto Jovem , Idoso , AdolescenteRESUMO
BACKGROUND: While some evidence has potentially linked climate change to carcinogenic factors, the long-term effect of climate change on liver cancer risk largely remains unclear. OBJECTIVES: Our objective is to evaluate the long-term relationship between temperature increase and liver cancer incidence in Australia. METHODS: We mapped the spatial distribution of liver cancer incidence from 2001 to 2019 in Australia. A Bayesian spatial conditional autoregressive (CAR) model was used to estimate the relationships between the increase in temperature at different lags and liver cancer incidence in Australia, after controlling for chronic hepatitis B prevalence, chronic hepatitis C prevalence, and the Index of Relative Socio-economic Disadvantage. Spatial random effects obtained from the Bayesian CAR model were also mapped. RESULTS: The research showed that the distribution of liver cancer in Australia is spatially clustered, most areas in Northern Territory and Northern Queensland have higher incidence and relative risk. The increase in temperature at the lag of 30 years was found to correlate with the increase in liver cancer incidence in Australia, with a posterior mean of 30.57 [95% Bayesian credible interval (CrI): 0.17, 58.88] for the univariate model and 29.50 (95% CrI: 1.27, 58.95) after controlling for confounders, respectively. The results were not highly credible for other lags. DISCUSSION: Our Bayesian spatial analysis suggested a potential relationship between temperature increase and liver cancer. To our knowledge, this research marks the first attempt to assess the long-term effect of global warming on liver cancer. If the relationship is confirmed by other studies, these findings may inform the development of prevention and mitigation strategies based on climate change projections. https://doi.org/10.1289/EHP14574.
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Teorema de Bayes , Mudança Climática , Neoplasias Hepáticas , Humanos , Neoplasias Hepáticas/epidemiologia , Austrália/epidemiologia , Incidência , Análise Espacial , Temperatura , Temperatura AltaRESUMO
Australian Defence Force (ADF) personnel train and operate in malarious regions that include neighboring countries with high burden and species with latent hepatic parasites.1 We summarized longitudinal malaria case data, following a prior 10-year period review to 2007.2 Malaria case entries within the ADF Malaria and Infectious Diseases Institute (ADFMIDI)-managed Central Malaria Register (CMR) were examined. Data from cases confirmed between January 1, 2008 through December 31, 2022 were analyzed. Sixty ADF members were diagnosed with malaria, including 1 with a mixed Plasmodium falciparum and P. vivax infection. Of 61 malaria infections, 69% (42 of 61) were P. vivax. P. vivax infection resulted in delayed initial case presentation (more than 4 weeks after exposure) in at least 36% (15 of 42) of cases, and 5 personnel experienced further relapse. Most P. vivax infections were acquired in the U.S. Indo-Pacific Command (INDOPACOM) and P. falciparum in the U.S. Africa Command (AFRICOM) regions. The ADF experienced ongoing reduced malaria case incidence following high rates in the early 2000s. Maintenance of prophylactic vigilance, both for eradicating dormant hypnozoites and preventing P. vivax relapse, remains important, however.
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Malária Falciparum , Malária Vivax , Militares , Humanos , Militares/estatística & dados numéricos , Austrália/epidemiologia , Masculino , Feminino , Adulto , Malária Vivax/epidemiologia , Malária Falciparum/epidemiologia , Adulto Jovem , Incidência , Pessoa de Meia-Idade , Plasmodium vivax/isolamento & purificação , Malária/epidemiologia , Plasmodium falciparum/isolamento & purificação , Sistema de RegistrosRESUMO
Some military organizations in the U.S. Indo-Pacific Command (INDOPACOM) give returning soldiers presumptive treatment for filariasis. As there have been few clinical cases in recent decades, the historical basis for this chemotherapy was reviewed. During the Second World War, U.S. Marines stationed on Polynesian islands such as Tonga, Samoa, and Fiji experienced clinical lymphatic filariasis. Although thousands of both U.S. and Australian soldiers served in New Guinea, few, if any, cases of lymphatic filariasis were ascribed to Melanesia. While the French Army reported dozens of cases of filariasis among its service members during the 1950s Vietnam conflict, the U.S. military experienced only a few cases among the nearly 2 million service members who served in Vietnam in the 1960s. Australian soldiers deployed to Timor Leste in the 21st century showed rare seroconversions to filaria but no clinical disease. Following mass drug administration to eliminate lymphatic filaria in the INDOPACOM region, exposure in deployed soldiers rarely occurs and preventive chemotherapy should cease.
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Filariose Linfática , Militares , Humanos , Filariose Linfática/epidemiologia , Filariose Linfática/tratamento farmacológico , Militares/estatística & dados numéricos , Estados Unidos/epidemiologia , História do Século XX , Filaricidas/uso terapêutico , Austrália/epidemiologiaRESUMO
BACKGROUND: Historical data on smoking can enhance our comprehension of the effectiveness of past tobacco control policies and play a key role in developing targeted public health interventions. This study was undertaken to assess trends in smoking initiation and cessation in Australia for the period 1910-2005. METHODS: Rates of smoking initiation and cessation were calculated for participants in two population-based cohorts, the Busselton Health Study and the Tasmanian Longitudinal Health Study. The effects of time trends, gender and age group were evaluated. RESULTS: Of the 29,971 participants, 56.8% ever smoked. In males, over the period 1910-1999, the rate of smoking initiation in young adolescents remained high with a peak in the 1970s; in older adolescents it peaked in the 1940s and then declined; in young adults it showed a steady decline. In females, the rate of smoking initiation in young adolescents rose sharply in the 1960s and peaked in the 1970s, in older adolescents it increased throughout the period, and in young adults it declined after 1970. In the period 1930-2005, 27.3% of 9,605 people aged 36-50 years who smoked ceased smoking. Rates of cessation in this age group increased throughout but decreased in males after 1990 and plateaued around 2000 in females. CONCLUSION: Our findings show substantial variation in the efficacy of tobacco control policies across age groups, with a notable lack of success among the younger population.
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Abandono do Hábito de Fumar , Fumar , Humanos , Masculino , Feminino , Abandono do Hábito de Fumar/estatística & dados numéricos , Adolescente , Adulto , Pessoa de Meia-Idade , Austrália/epidemiologia , Fumar/epidemiologia , Fumar/tendências , Adulto Jovem , Estudos de Coortes , Estudos Longitudinais , IdosoRESUMO
Background Aging women living with HIV are significantly affected by menopause and comorbidities, yet international and Australian HIV guidance on the management of women is scarce. This study aimed to identify gaps in clinical management of menopause, age-related comorbidities, and psychosocial health of women living with HIV attending our metropolitan sexual health service. Methods A clinical audit of all cisgender women who attended Sydney Local Health District Department of Sexual Health Medicine for ongoing routine HIV care between 1 January 2021 and 1 January 2023 was undertaken. Results Twenty-seven patient files were examined. Half (13/27, 48.1%) of women were age 45years and older, of whom 6/13 (46.2%) were postmenopausal and 4/13 (30.8%) did not have menopause status recorded. In the prior 12months, most women had their blood pressure (19/27, 70.4%), total cholesterol (21/27, 77.8%), glycated haemoglobin (21/27, 77.8%), estimated glomerular filtration rate (27/27, 96.3%), and liver function tests (26/27, 96.3%) measured. Smoking and alcohol intake was documented for less than half of women (13/27, 48.1%; and 12/27, 44.4%; respectively). In women aged 45years and older, absolute cardiovascular disease risk was calculated in 2/13 (15.4%), and none had a Fracture Risk Assessment Tool score or cognitive screen performed in the prior 12months. One-fifth (5/27, 18.5%) had a documented history of depression or anxiety. Of those screened, half (4/8, 50.0%) disclosed past intimate partner violence. Conclusions Our service has now implemented a reference tool to guide routine monitoring of women living with HIV, with sections dedicated to reproductive health and psychological wellbeing. Australian HIV management guidelines would benefit from specific guidance for women.
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Infecções por HIV , Menopausa , Humanos , Feminino , Infecções por HIV/psicologia , Infecções por HIV/epidemiologia , Pessoa de Meia-Idade , Menopausa/psicologia , Adulto , Saúde Sexual , Austrália/epidemiologia , Comorbidade , IdosoRESUMO
Dietary patterns contribute to overall health and diseases of ageing but are understudied in older adults. As such, we first aimed to develop dietary indices to quantify Mediterranean Diet Score (MDS) utilisation and Ultra-processed Food (UPF) intake in a well-characterised cohort of relatively healthy community-dwelling older Australian adults. Second, we aimed to understand the relationship between these scores and the association of these scores with prevalent cardiometabolic disease and frailty. Our major findings are that in this population of older adults, (a) pre-frailty and frailty are associated with reduced MDS and increased UPF intake; (b) adherence to MDS eating patterns does not preclude relatively high intake of UPF (and vice versa); and (c) high utilisation of an MDS eating pattern does not prevent an increased risk of frailty with higher UPF intakes. As such, the Mediterranean Diet pattern should be encouraged in older adults to potentially reduce the risk of frailty, while the impact of UPF intake should be further explored given the convenience these foods provide to a population whose access to unprocessed food may be limited due to socioeconomic, health, and lifestyle factors.
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Dieta Mediterrânea , Fragilidade , Humanos , Dieta Mediterrânea/estatística & dados numéricos , Idoso , Masculino , Feminino , Fragilidade/epidemiologia , Fragilidade/prevenção & controle , Austrália/epidemiologia , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Fast Foods , Comportamento Alimentar , Idoso Fragilizado/estatística & dados numéricos , Alimento ProcessadoRESUMO
This study retrospectively analyzed the genetic characteristics of influenza A H3N2 (A/H3N2) viruses circulating in New South Wales (NSW), the Australian state with the highest number of influenza cases in 2022, and explored the phylodynamics of A/H3N2 transmission within Australia during this period. Sequencing was performed on 217 archived specimens, and A/H3N2 evolution and spread within Australia were analyzed using phylogenetic and phylodynamic methods. Hemagglutinin genes of all analyzed NSW viruses belonged to subclade 3C.2a1b.2a.2 and clustered together with the 2022 vaccine strain. Complete genome analysis of NSW viruses revealed highly frequent interclade reassortments between subclades 3C.2a1b.2a.2 and 3C.2a1b.1a. The estimated earliest introduction time of the dominant subgroup 3C.2a1b.2a.2a.1 in Australia was February 22, 2022 (95% highest posterior density: December 19, 2021-March 13, 2022), following the easing of Australian travel restrictions, suggesting a possible international source. Phylogeographic analysis revealed that Victoria drove the transmission of A/H3N2 viruses across the country during this season, while NSW did not have a dominant role in viral dissemination to other regions. This study highlights the importance of continuous surveillance and genomic characterization of influenza viruses in the postpandemic era, which can inform public health decision-making and enable early detection of novel strains with pandemic potential.
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COVID-19 , Vírus da Influenza A Subtipo H3N2 , Influenza Humana , Filogenia , Humanos , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza A Subtipo H3N2/classificação , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Influenza Humana/transmissão , Estudos Retrospectivos , COVID-19/epidemiologia , COVID-19/transmissão , COVID-19/virologia , COVID-19/prevenção & controle , Austrália/epidemiologia , New South Wales/epidemiologia , SARS-CoV-2/genética , SARS-CoV-2/classificação , Filogeografia , Estações do Ano , Genoma Viral/genética , Glicoproteínas de Hemaglutininação de Vírus da Influenza/genética , Vírus Reordenados/genética , Vírus Reordenados/classificaçãoRESUMO
BACKGROUND: An important element of reducing the sexual abuse and exploitation of children is to understand the behaviors of individuals who consume child sexual abuse material (CSAM), including the predictors of continued use. OBJECTIVE: To investigate predictors of 'ever viewing' CSAM and subsequent intentional use among individuals in the community. METHOD: This study used multivariate logistic regression analysis to identify significant predictors of ever viewing CSAM (n = 742) in an anonymous survey of 5512 Internet users in the community, and of subsequent intentional CSAM use among a subset of 459 CSAM viewers. RESULTS: The characteristics of respondents that were significantly associated with ever viewing CSAM were being male, older in age (25-34 and 55+ years cf. 18-24 years), residing in Australia, New Zealand, or Canada (cf. the United Kingdom), earlier exposure to adult pornography (<14 years), experiencing childhood physical abuse or neglect, viewing bestiality pornography featuring adults, viewing bondage/S&M (BDSM) pornography featuring adults, being likely (self-reported) to have sexual contact with a child, and visiting pedophilic chat forums online. In the subset sample, almost half (218, 47.5 %) viewed CSAM again intentionally after first exposure. Predictors of subsequent intentional viewing of CSAM after adjusting for age and country of residence were being male, ever experiencing loneliness, searching for CSAM intentionally at first exposure, being likely (self-reported) to have sexual contact with a child, and visiting pedophilic chat forums online. CONCLUSIONS: The findings have strong implications for prevention of first exposure to CSAM, and of continued CSAM use after exposure does occur.
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Abuso Sexual na Infância , Literatura Erótica , Internet , Humanos , Masculino , Feminino , Adulto , Abuso Sexual na Infância/estatística & dados numéricos , Abuso Sexual na Infância/psicologia , Pessoa de Meia-Idade , Literatura Erótica/psicologia , Criança , Adolescente , Adulto Jovem , Austrália/epidemiologia , Nova Zelândia , Canadá/epidemiologia , Inquéritos e Questionários , Modelos Logísticos , Idoso , Pedofilia/psicologiaRESUMO
BACKGROUND: Childhood Maltreatment (CM) is linked to adverse outcomes, including Borderline Personality Disorder (BPD) and increased propensity for offending behaviors. However, research on the specific role that BPD plays between the two is limited and highly relevant given the high prevalence of CM in Australia. OBJECTIVE: The present study aimed to investigate (1) the relationship between CM and subsequent offending behaviors, (2) whether BPD mediates the relation between CM and offending behaviors, and (3) which type of CM (physical, sexual, emotional abuse, neglect, exposure to domestic violence, multitype maltreatment) predicts BPD. PARTICIPANTS: The sample comprised 106 self-identified Australian female survivors of interpersonal violent crimes. METHODS: Participants completed an online survey consisting of the Adverse Childhood Events Questionnaire, the McLean Screening Instrument for BPD, and a self-created questionnaire to measure offending behaviors. Regression, mediation analysis, and logistic regression were conducted. RESULTS: CM significantly predicted offending behaviors (path c, B = 1.39, p <. 001) with BPD partially mediating the relationship (path c', B = 1.04, 95 % CI [0.31, 1.77], p = .006; path a, B = 0.47, 95 % CI [0.12, 0.83], p = .009, path b, B = 0.34, 95 % CI [0.07, 0.61], p = .014). Emotional abuse and multitype exposure were identified as predictors of BPD symptom development (OR = 9.42, 95 % CI OR [2.58, 34.40]; OR = 3.81, 95 % CI OR [1.41; 10.28], respectively). CONCLUSION: These findings indicate the necessity of early interventions addressing CM, with a particular focus on emotional abuse and exposure to more than one type of maltreatment, to reduce the risk of developing BPD symptomatology and mitigate future offending behaviors.
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Sobreviventes Adultos de Maus-Tratos Infantis , Transtorno da Personalidade Borderline , Humanos , Transtorno da Personalidade Borderline/psicologia , Transtorno da Personalidade Borderline/epidemiologia , Feminino , Adulto , Austrália/epidemiologia , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Adulto Jovem , Pessoa de Meia-Idade , Inquéritos e Questionários , Adolescente , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Criança , Criminosos/psicologia , Criminosos/estatística & dados numéricosRESUMO
Previous investigations on protein associations with diet quality and obesity still have inconclusive findings, possibly due to how protein intake was expressed. This study aimed to compare how different ways of expressing total protein intake may influence its relationships with diet quality and obesity. Usual protein intake was estimated from the 2011-12 Australian National Nutrition and Physical Activity Survey (n = 7637 adults, ≥19 years), expressed in grams (g/d), percent energy (%EI), and grams per actual kilogram body weight (g/kgBW/d). Diet quality was assessed using the 2013 Dietary Guidelines Index, and obesity measures included Body Mass Index (BMI) and waist circumference (WC). Sex-stratified multiple linear and logistic regressions were performed and adjusted for potential confounders. Total protein (g/d) was directly associated with diet quality (males, ß = 0.15 (95% CI 0.12, 0.19); females, ß = 0.25 (0.22, 0.29)), and this association was consistent across units. Protein intake (g/d) was directly associated with BMI (males, ß = 0.07% (0.04%, 0.11%); females, ß = 0.09% (0.04%, 0.15%)), and WC (males, ß = 0.04 (0.01, 0.06); females, ß = 0.05 (0.00, 0.09)). While in males, protein as %EI was associated with higher WC, no association was found in females. Adults with higher protein intake (g/d) had higher odds of overweight/obesity (males, OR = 1.01 (1.00, 1.01); females, OR = 1.01 (1.00, 1.01)), and central overweight/obesity (females, OR = 1.01 (1.00, 1.01)), but no significant association with females odds of overweight/obesity when protein was expressed in %EI. In conclusion, protein intake was positively associated with diet quality and obesity, yet these associations were stronger for women. The effect sizes also varied by measurement unit due to the different scales of those units.
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Índice de Massa Corporal , Dieta , Proteínas Alimentares , Obesidade , Circunferência da Cintura , Humanos , Masculino , Feminino , Obesidade/epidemiologia , Adulto , Austrália/epidemiologia , Pessoa de Meia-Idade , Inquéritos Nutricionais , Ingestão de Energia , Adulto Jovem , Estudos Transversais , Idoso , Política NutricionalRESUMO
This paper provides a summary of new and revised records of pentastomes published since 1985 and also presents a checklist of all pentastome records from Australian reptiles and amphibians. The need to identify pentastome species, through both morphological and molecular characterization, is highlighted to enable a determination of the true diversity of pentastome species and their distribution within amphibians and reptiles in Australia.
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Anfíbios , Doenças Parasitárias em Animais , Répteis , Animais , Anfíbios/parasitologia , Austrália/epidemiologia , Lista de Checagem/história , Lista de Checagem/estatística & dados numéricos , Répteis/parasitologia , Doenças Parasitárias em Animais/epidemiologia , Doenças Parasitárias em Animais/história , História do Século XX , História do Século XIXRESUMO
OBJECTIVES: Current American Academy of Pediatrics (AAP) and European Society of Hypertension (ESH) thresholds defining hypertension in children use blood pressure (BP) normalised to age, sex and height. However, scare data exists regarding the relative importance of these variables to accurately model the 95th quantile of BP. We hypothesised that height alone may fit the population data equally well compared to more complex definitions. We also compare the potential impact of various thresholds for defining hypertension in an Australian population. METHODS: Longitudinal data from the Raine Study were used, with 2248 participants contributing 7479 valid BP values across the 3/5/10/14/17-year study visits. BP was measured after 5 min rest, ≥3 times at each visit, using a Dinamap device. Quantile regression was used to predict the 95th percentile of BP, with nonlinear modelling of covariates through restricted cubic spline terms. RESULTS: At a single visit, 6-16% of young children exceeded the ESH threshold and 12-23% the AAP threshold. The transition to fixed thresholds (≥13âyears AAP, ≥16âyears ESH), increased the number of males (AAP only) and reduced the number of females considered hypertensive. A quantile regression model constructed with Raine Study data using height-only as the explanatory variable better predicted BP than the respective model using age-only (or a combination of the two). CONCLUSIONS: There may be large differences in the prevalence of hypertension according to AAP and ESH criteria, with a marked sex-discrepancy emerging from the point of fixed threshold application in adolescence. It may not be necessary to normalise BP by both age and height, the latter being a better predictor of childhood BP. Simpler methods may be preferable in clinical practice but require validation against clinical outcomes.
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Pressão Sanguínea , Hipertensão , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Criança , Masculino , Austrália/epidemiologia , Feminino , Adolescente , Estudos Longitudinais , Pré-Escolar , Estatura , Determinação da Pressão Arterial/métodosRESUMO
BACKGROUND: Aluminium industry workers are at risk of long-term health consequences. AIMS: To investigate mortality and cancer incidence in bauxite mine and alumina refinery workers. METHODS: A pre-existing cohort of workers was re-linked with the Australian National Death Index, and the Australian Cancer Database to provide additional death (7 years) and cancer (9 years) data. Standardized mortality ratios (SMRs) and standardized incidence rates (SIRs) were estimated by job category, duration of employment and time since first employment. RESULTS: Linkage was performed for 6935 (6207 male) workers. Compared with the general population, there was a reduced or similar risk of death for mine/refinery workers for all causes except mesothelioma which was increased amongst male production workers [SMR 2.42, 95% CI 1.11-4.60]. Mesothelioma incidence was also increased amongst males [SIR 2.50, 95% CI 1.60-3.71]. Male office workers had a greater incidence of prostate cancer [SIR 1.30, 95% CI 1.06-1.57] and thyroid cancer [SIR 3.47, 95% CI 1.66-6.38]. Melanoma incidence was increased in female office workers [SIR 2.27, 95% CI 1.36-3.54]. Lip cancer incidence was increased in male maintenance/production workers [SIR 2.04, 95% CI 1.02-3.65]. Overall cancer incidence was otherwise similar to the general Australian population. CONCLUSIONS: Overall risk of death and incidence of cancer for bauxite mine and alumina refinery workers was similar to the general population. Incidence and risk of death from mesothelioma were higher, likely due to historic asbestos exposure in this and other industries. The increased risk of melanoma, lip, prostate and thyroid cancers requires further investigation.
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Óxido de Alumínio , Mineração , Neoplasias , Doenças Profissionais , Exposição Ocupacional , Humanos , Masculino , Feminino , Exposição Ocupacional/efeitos adversos , Óxido de Alumínio/efeitos adversos , Doenças Profissionais/mortalidade , Doenças Profissionais/epidemiologia , Austrália/epidemiologia , Mineração/estatística & dados numéricos , Pessoa de Meia-Idade , Neoplasias/mortalidade , Neoplasias/epidemiologia , Adulto , Incidência , Fatores de Risco , Mesotelioma/mortalidade , Mesotelioma/epidemiologia , Idoso , Melanoma/mortalidade , Melanoma/epidemiologia , Metalurgia , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/epidemiologiaRESUMO
Objective: Ensuring the sustainability of the migrant workforce requires a comprehensive understanding of the psychological challenges faced by this sub-population due to concerns about the wellbeing and financial situation of family members in their home countries. Therefore, this study investigates the factors associated with psychological distress among sub-Saharan Africa (SSA) migrant workers across Australia and Canada during the COVID-19 pandemic. Method: Data were collected from 378 first-generation migrant workers with SSA ancestry residing in Australia and Canada using the Depression Anxiety and Stress Scale 21 (DASS-21). Multivariate logistic regression analysis was used to determine socio-demographic factors associated with depression, anxiety, and stress among SSA migrants' populations. Results: Across both countries, migrants with lower levels of education were more prone to reporting feelings of depression, anxiety, and stress during the pandemic. Female participants in Australia were more likely to report feeling of depression. Participants in Australia and Canada who were separated/divorced/widowed were less likely to report stress and depression, respectively. Participants in Australia who had lived in Australia between 11 and 20 years and those between 36 and 50 years old were more likely to report feelings of depression. Participants residing in Australia whose SSA ancestry was Southern Africa/Central Africa were more likely to report anxiety. Participants in Australia who worked as part-time permanent workers and those who worked as fixed-term workers/short-term/casual workers were less likely to report anxiety. Finally, participants in Canada who reported two or more people living with them had higher odds of reporting anxiety. Conclusions: The findings from this study highlight key factors associated with SSA migrant workers' psychological distress during the pandemic. The results can inform policies and provide insight to the development of mental health intervention strategies for migrant workers to minimize similar distress during pandemics.
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COVID-19 , Angústia Psicológica , Migrantes , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Feminino , Adulto , Masculino , Estudos Transversais , Pessoa de Meia-Idade , Austrália/epidemiologia , Canadá/epidemiologia , Migrantes/psicologia , Migrantes/estatística & dados numéricos , África Subsaariana/etnologia , África Subsaariana/epidemiologia , Adulto Jovem , Depressão/epidemiologia , Depressão/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Ansiedade/epidemiologia , Ansiedade/psicologia , Adolescente , SARS-CoV-2RESUMO
Group A Streptococcus (Strep A) skin infections (impetigo) can contribute to the development of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). This is of particular concern for Indigenous residents of remote communities, where rates of ARF and RHD are much higher than their urban and non-Indigenous counterparts. There are three main potential Strep A transmission pathways: skin to skin, surface to skin, and transmission through the air (via droplets or aerosols). Despite a lack of scientific certainty, the physical environment may be modified to prevent Strep A transmission through environmental health initiatives in the home, identifying a strong role for housing. This research sought to provide an outline of identified household-level environmental health initiatives to reduce or interrupt Strep A transmission along each of these pathways. The identified initiatives addressed the ability to wash bodies and clothes, to increase social distancing through improving the livability of yard spaces, and to increase ventilation in the home. To assist with future pilots and evaluation, an interactive costing tool was developed against each of these initiatives. If introduced and evaluated to be effective, the environmental health initiatives are likely to also interrupt other hygiene-related infections.
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Habitação , Cardiopatia Reumática , Infecções Estreptocócicas , Humanos , Austrália/epidemiologia , Cardiopatia Reumática/prevenção & controle , População Rural , Infecções Estreptocócicas/prevenção & controle , Streptococcus pyogenesRESUMO
N. gonorrhoeae, which causes the sexually transmissible infection gonorrhoea, remains a significant public health threat globally, with challenges posed by increasing transmission and antimicrobial resistance (AMR). The COVID-19 pandemic introduced exceptional circumstances into communicable disease control, impacting the transmission of gonorrhoea and other infectious diseases. Through phylogenomic and phylodynamic analysis of 5881 N. gonorrhoeae genomes from Australia, we investigated N. gonorrhoeae transmission over five years, including a time period during the COVID-19 pandemic. Using a novel cgMLST-based genetic threshold, we demonstrate persistence of large N. gonorrhoeae genomic clusters over several years, with some persistent clusters associated with heterosexual transmission. We observed a decline in both N. gonorrhoeae transmission and genomic diversity during the COVID-19 pandemic, suggestive of an evolutionary bottleneck. The longitudinal, occult transmission of N. gonorrhoeae over many years further highlights the urgent need for improved diagnostic, treatment, and prevention strategies for gonorrhoea.
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COVID-19 , Genoma Bacteriano , Genômica , Gonorreia , Neisseria gonorrhoeae , Filogenia , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/efeitos dos fármacos , Humanos , Gonorreia/transmissão , Gonorreia/epidemiologia , Gonorreia/microbiologia , Austrália/epidemiologia , Masculino , Feminino , COVID-19/transmissão , COVID-19/epidemiologia , Estudos Longitudinais , Adulto , SARS-CoV-2/genética , Adulto JovemRESUMO
INTRODUCTION: During 2020-2021 Australia maintained comparatively low rates of COVID-19 in the community and residential aged care facilities (RAC) due to stringent public health measures such as lockdowns. However, the public health measures implemented may have had unintended impacts on critical RAC resident health outcomes, such as falls, due to routine care disruptions and aged care resident isolation. We utilised a longitudinal data to assess the association between COVID-19 lockdowns and the rate of falls in RAC settings. METHODS: A longitudinal cohort study was conduct using routinely collected data from 25 RAC facilities from one non-profit aged care provider in Sydney, Australia. The study included 2,996 long term residents between March 2019 and March 2021. The outcome measures were all falls, injurious falls, and falls assessed as requiring hospitalisation. Generalised estimating equations (GEE) were applied to determine the association between COVID-19 lockdown periods and fall-related outcomes while adjusting for confounders and seasonality. RESULTS: During the study period 11,658 falls were recorded. Residents frequently experienced at least one fall during the study period (median: 1, interquartile range: 0-4). During Lockdown 1 (March-June 2020) the rate of all falls increased 32% (IRR 1.32, 95% CI 1.19-1.46, p < 0.01) and the rate of injurious falls increased by 28% (IRR 1.28, 95% CI 1.12-1.46, p < 0.01) compared to pre-pandemic rates. The rate of falls assessed as requiring hospitalisation remained unchanged during Lockdown 1 (IRR 1.07, 95% CI 0.86-1.32, p = 0.519). During Lockdown 2 (Dec 2020-Jan 2021) the rate of all falls, injurious falls, and falls assessed as requiring hospitalisation did not change significantly compared to pre-pandemic rates. CONCLUSION: These findings suggest that the consequences of stringent COVID-19 restrictions, as seen in Lockdown 1, produced changes in residents' care which contributed to more falls and associated harm. The subsequent lockdown, which were less restrictive and occurred after staff had gained experience, was associated with no significant increase in falls rate. The nature and extent of lockdowns implemented for infection control in RAC need to balance multiple potential adverse effects. Factors which facilitated resilience during this period require exploration in future research.
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Acidentes por Quedas , COVID-19 , Instituição de Longa Permanência para Idosos , SARS-CoV-2 , Humanos , Acidentes por Quedas/estatística & dados numéricos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Masculino , Feminino , Idoso , Estudos Longitudinais , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Austrália/epidemiologia , Idoso de 80 Anos ou mais , Hospitalização/estatística & dados numéricos , Quarentena , Pandemias , Casas de Saúde/estatística & dados numéricos , Controle de Doenças Transmissíveis/métodosRESUMO
BACKGROUND: Melanoma overdiagnosis occurs when melanomas, not destined to cause morbidity or death in a patient's lifetime, are identified and treated. OBJECTIVE: This study considers the causes and magnitude of melanoma overdiagnosis in Australia. We also speculate about a possible benefit of overdiagnosis in Australia; namely, a reduction in excess deaths in the geographical areas where melanoma is diagnosed most frequently. DISCUSSION: Overdiagnosis can arguably be mitigated by factors that reduce the number of lesions treated for each melanoma identified. Data from the Australian Cancer Atlas show that there is a reduction in excess deaths from melanoma in geographical areas where diagnostic rates are higher (Pearson correlation coefficient r=-0.5978, 95% CI: -0.6243 to -0.5699, P<0.0001); this being the strongest inverse correlation observed among the 20 cancer types in the Atlas. Is early diagnosis of actual life-threatening melanomas in these geographical regions impacting survival? Further research is planned.