ORCID Profile
0000-0003-1864-4552
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James Cook University
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Publisher: Wiley
Date: 24-11-2020
DOI: 10.1111/AJR.12679
Publisher: Springer Science and Business Media LLC
Date: 19-08-2015
Publisher: SAGE Publications
Date: 31-03-2015
Abstract: Mackay Whitsunday Safe Community (MWSC) was established in 2000 in response to high rates of injury observed in the region. MWSC assumed an ecological perspective, incorporating targeted safety promotion c aigns reinforced by supportive environments and policy. By involving the community in finding its own solutions, MWSC attempted to catalyze structural, social, and political changes that empowered the community and, ultimately, in iduals within the community, to modify their environment and their behavior to reduce the risk of injury. A community network consisting of 118 members and an external support network of 50 members was established. A social network analysis conducted in 2000 and 2004 indicated that the network doubled its cohesiveness, thereby strengthening its ability to collaborate for mutual benefit. However, while MWSC was rich in social resources, human and financial resources were largely controlled by external agencies. The bridging and linking relationships that connected MWSC to its external support network were the social mechanism MWSC used to access the resources it required to run programs. These boundary-spanning relationships accessed an estimated 6.5 full-time equivalents of human resources and US$750,000 in 2004 that it used to deliver a suite of injury control and safety promotion activities, associated with a 33% reduction in injury deaths over the period 2002 to 2010. MWSC can only be understood in its ecological context. The productivity of MWSC was vulnerable to the changing policy priorities of external sponsoring agents and critically dependent on the advocacy skills of its leaders.
Publisher: Wiley
Date: 2010
DOI: 10.1002/ERV.1052
Abstract: To describe patterns of weight change in patients admitted to a specialised eating disorder program with established protocols for inpatient refeeding. Weight records between January 2000 and December 2006 were categorised using Body Mass Index (BMI) at first admission (BMI ranges < 14.0, 14.1-17.49, 17.5-18.9 kg/m(2)). Total weight gained, number of days of inpatient treatment and rate of weekly weight gain were examined. In total there were 247 patients representing 414 admissions. The rate of weight gain was 0.77, 0.63 and 0.53 kg/week, respectively, for each BMI group. Twenty patients (8.1%) in the refeeding program did not gain weight. Weight gain in underweight patients is highly variable. A greater understanding of the processes that contribute to weight gain, and establishment of best practice in achieving weight gain in patients needs to be determined. This data provide detailed information about expectations for refeeding without artificial feeding.
Publisher: Springer Science and Business Media LLC
Date: 11-06-2018
Publisher: MDPI AG
Date: 06-01-2021
Abstract: Drowning is described as a public health challenge by the World Health Organization. This challenge faces the Philippines where drowning claims an average of 3276 lives annually (3.50/100,000 population). However, no research comprehensively documents prevention strategies implemented by government and non-government agencies at a national or local level in the Philippines. This study aimed to qualitatively explore the current situation and key challenges of preventing drowning in the Philippines through key informant interviews and make recommendations to guide prevention efforts. Interviews were conducted among government and non-government agencies involved in drowning prevention using purposive s ling. Qualitative data collected were thematically analyzed. Findings indicate government and non-government agencies implement drowning prevention programs or strategies based on the mandate of their institutions. Most commonly cited were activities related to education or information awareness, emergency and disaster preparedness, and swimming skills. It was revealed that each agency was relatively unaware of the drowning prevention programs of other agencies. A multisector approach is needed to develop coordinated and comprehensive programs and activities aimed at preventing drowning. In this way, duplication will be avoided and the minimal resources available will be used effectively to reduce the burden of drowning in the Philippines.
Publisher: MDPI AG
Date: 10-03-2023
Abstract: Heatwaves are a significant and growing threat to the health and well-being of the residents of Queensland, Australia. This threat is increasing due to climate change. Excess heat increases the demand for health services, including ambulance calls, and the purpose of this study was to explore this impact across Queensland. A state-wide retrospective analysis of heatwaves and emergency ‘Triple Zero’ (000) calls to Queensland Ambulance (QAS) from 2010–2019 was undertaken. Call data from the QAS and heatwave data from the Bureau of Meteorology were analysed using a case-crossover approach at the postcode level. Ambulance calls increased by 12.68% during heatwaves. The effect was greatest during low-severity heatwaves (22.16%), followed by severe (14.32%) and extreme heatwaves (1.16%). The impact varied by rurality, with those living in very remote areas and major cities most impacted, along with those of low and middle socioeconomic status during low and severe intensity heat events. Lag effects post-heatwave continued for at least 10 days. Heatwaves significantly increase ambulance call centre workload, so ambulance services must actively prepare resources and personnel to address increases in heatwave frequency, duration, and severity. Communities must be informed of the risks of heatwaves at all severities, particularly low severity, and the sustained risks in the days following a heat event.
Publisher: Elsevier BV
Date: 2017
Publisher: Oxford University Press (OUP)
Date: 2013
Publisher: Research Square Platform LLC
Date: 09-11-2021
DOI: 10.21203/RS.3.RS-1021472/V1
Abstract: Venomous snakebite is an important cause of preventable death. The World Health Organization (WHO) set a goal to halve snakebite mortality by 2030. We used verbal autopsy and vital registration data to model the proportion of venomous animal deaths due to snakes by location, age, year, and sex, and applied these proportions to venomous animal contact mortality estimates from the Global Burden of Disease 2019 study. In 2019, 63,400 people (95% uncertainty interval 38,900–78,600) died globally from snakebites, which was equal to an age-standardized mortality rate (ASMR) of 0.8 deaths (0.5–1.0) per 100,000 and represents a 36% (2–49) decrease in ASMR since 1990. India had the greatest number of deaths in 2019, equal to an ASMR of 4.0 per 100,000 (2.3-5.0). We forecast mortality will continue to decline, but not sufficiently to meet the WHO’s goals. Improved data collection should be prioritized to help target interventions, improve burden estimation, and monitor progress.
Publisher: Wiley
Date: 25-07-2022
Abstract: Wave forced impacts are known to result in cervical spine injuries (CSI) and approximately 20% of drownings in Australia occur at the beach. The most common mechanism of injury in studies examining the frequency of CSI in drowning patients is shallow water ing. The aim of the present study was to determine what proportion of CSIs occurring in bodies of water experienced a concomitant drowning injury in a location where wave forced impacts are likely to be an additional risk factor. Electronic medical records at the Sunshine Coast Hospital and Health Service EDs, Queensland Ambulance Service case records and Surf Life Saving Queensland data between 1 January 2015 and 21 April 2021 were manually linked. Outcomes recorded included victim demographics, scene information, hospital course and patient disposition. Ninety‐one of 574 (15.9%) CSIs occurred in a body of water with risk of drowning. However, only 4 (4.3%) had a simultaneous drowning injury, representing 0.8% (4/483) of drowning presentations. Ten (10.9%) patients reported loss of consciousness, including the four with drowning. The principal mechanism of CSI was a wave forced impact (71/91, 78%). Most injuries occurred at the beach (79/91, 86.8%). Delayed presentation was common (28/91, 31%). A history of axial loading was 100% sensitive when indicating imaging. The combination of CSI and drowning is uncommon. Cervical spine precautions are only required in drowning patients with signs or a history, or at high risk of, axial loading of the spine. This paper supports the move away from routine cervical spine precautions even in a high‐risk population.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2017
Publisher: Oxford University Press (OUP)
Date: 09-03-2011
Abstract: To describe the incidence of hypoglycaemia, and variables associated with hypoglycaemia, in eating disorder patients following a mixed meal stimulus. Postprandial blood glucose values of patients admitted to a specialist eating disorder hospital for treatment of an eating disorder between 2000 and 2006 were reviewed and compared to body mass index (BMI), electrolytes, and weight losing behaviours. Analysis of variance (ANOVA) and stepwise logistic regression were undertaken. 22% of patients had postprandial glucose values ≤3.5 mmol/l (63 mg/dl). Only low BMI significantly predicted postprandial hypoglycaemia. Clinicians should be aware that postprandial hypoglycaemia is a common finding in eating disorders patients receiving inpatient treatment. As hypoglycaemia is predicted by low BMI, weight restoration is a priority for treatment in patients experiencing hypoglycaemia. Future research should investigate the nutrient composition of refeeding regimens and whether altering the macronutrient composition attenuates the presence of hypoglycaemia. Investigation is warranted in a community s le of eating disorder patients to see if this finding is replicated in non-hospitalised patients.
Publisher: Wiley
Date: 20-11-2020
DOI: 10.1111/AJR.12674
Publisher: AMPCo
Date: 12-2011
DOI: 10.5694/MJA11.11319
Abstract: Teaching children how to behave around dogs can reduce the incidence.
Publisher: Elsevier BV
Date: 09-2022
Publisher: Elsevier BV
Date: 12-2023
Publisher: Public Library of Science (PLoS)
Date: 2016
Publisher: Wiley
Date: 08-2019
DOI: 10.1002/JPPR.1523
Publisher: Wiley
Date: 21-09-2020
DOI: 10.1002/HPJA.407
Abstract: Drowning is a global public health challenge with a need to ensure equity to drowning prevention information and interventions. In Australia, people born overseas are identified as being at greater risk of drowning. This paper presents findings from a community‐based qualitative evaluation of swimming and water safety (SWS) programs delivered to adults from migrant backgrounds in Sydney, Australia. A qualitative study was conducted in November‐December 2019 among 35 female participants of SWS programs targeted to adult migrants. While offered to all SWS program participants, no males took part in the study. Focus groups and interviews were recorded, transcribed and thematically analysed using a deductive approach. The domains of enquiry were guided by the health belief model and the theory of planned behaviour. Study participants were ≥25 years, first generation and most had lived in Australia for ≥10 years. Most were nonswimmers and were fearful of water prior to the program. Key themes were: direct SWS program outcomes, health and well‐being enablers and barriers to participation including: motivation, a program coordinator, fear and settlement priorities. Findings suggest that in order to increase SWS participation among migrant communities, the broader determinants of health need to be considered. Culturally appropriate strategies are required to enable both men and women equal opportunities to access SWS programs. SWS programs provide multiple benefits for adult migrants however, the impact on reducing inequities is limited, with broader multi‐strategic health promotion approaches and policies required for inclusion and sustainability.
Publisher: Informa UK Limited
Date: 11-07-2014
DOI: 10.1080/17457300.2014.912235
Abstract: This study describes a process to explore factors which contribute to child-drowning deaths and allows the development of appropriate strategies to prevent similar deaths in a selected site in the Northern Philippines. Data collection techniques used in obtaining baseline data include: review of drowning mortality records key informant interviews focus group discussions and community walk-throughs. Risk factors identified which could or did contribute to drowning events were: proximity to bodies of water inadequate child supervision lack of information/awareness of prevention strategies and lack of drowning prevention programme(s). Measures on how to prevent drowning deaths were explored and initial interventions were implemented through a committee convened by the community. These interventions include: community education sessions capability building measures redesigning of community wells development of playpens and use of barriers. Community engagement is a crucial element in the development and implementation of any health programme. This study demonstrates that by engaging and working with the community action occurs, however, there is a need to conduct further evaluation activities to determine if the actions by the community continued beyond the project and have resulted in a decrease in drowning. One of the strengths of the process described is that it is culturally appropriate and site-specific and allows the community to find the solutions itself. Exploration and delivery of further projects in larger areas is required to reduce drowning in the Philippines. An imperative is the evaluation which will provide valuable information on whether barriers are a sustainable and acceptable means of prevention to the community in the long term.
Publisher: MDPI AG
Date: 02-11-2021
Abstract: Injuries sustained while performing electrical work are a significant threat to the health and safety of workers and occur frequently. In some jurisdictions, non-fatal serious incidents have increased in recent years. Although significant work has been carried out on electrical safety from a human factor perspective, reviews of this literature are sparse. Thus, the purpose of this review is to collate and summarize human factors implicated in electrical safety events. Articles were collected from three databases (Scopus, Web of Science, and Google Scholar), using the search terms: safety, electri*, human factors, and arc flash. Titles and abstracts were screened, full-text reviews were conducted, and 18 articles were included in the final review. Quality checks were undertaken using the Mixed Methods Appraisal Tool and the Critical Appraisal Skills Program. Environmental, in idual, team, organizational, and macro factors were identified in the literature as factors which shape frontline electrical worker behavior, highlighting the complexity of injury prevention. The key contributions of this paper include: (1) a holistic and integrated summary of human factors implicated in electrical safety events, (2) the application of an established theoretical model to explain dynamic forces implicated in electrical safety incidents, and (3) several practical implications and recommendations to improve electrical safety. It is recommended that this framework is used to develop and test future interventions at the in idual, team, organizational, and regulator level to mitigate risk and create meaningful and sustainable change in the electrical safety space.
Publisher: Wiley
Date: 09-09-2005
DOI: 10.1111/J.1440-1584.2005.00721.X
Abstract: To examine drowning deaths of young children in Victorian dams to identify common contributing factors in order to develop strategies for future prevention. Case records of children aged zero to five years from the State Coroner's Office Victoria were reviewed for the 13-year period 1989-2001. Cases where the child drowned in a dam were extracted for analysis. During the 13-year period there were 27 deaths 11 occurred on farms, five on hobby farms and 11 on properties where it was not specified whether the property was a farm. Almost three quarters of the children were male and the majority were aged between one year and three years. Half of the incidents occurred on the weekend and nearly half occurred during the summer months. Five major factors were common among incidents: stage of the child's development absence of carer supervision child playing outside the house dam within 300 metres of where the child was playing and lack of effective barriers between the dam and the child. The coronial information examined identified patterns of behaviour by both carers and young children that contributed to these deaths. The results support the implementation of strategies such as the promotion of child safe play areas and targeted public awareness c aigns for rural and regional aquatic environments.
Publisher: MDPI AG
Date: 19-05-2020
Abstract: Learning to swim via a structured program is an important skill to develop aquatic competencies and prevent drowning. Fear of water can produce phobic behaviors counterproductive to the learning process. No research examines the influence of negative aquatic experiences on learning to swim. This study explored the influence of children’s negative prior aquatic experiences (NPAE) on learn-to-swim achievement via swim school data. Children’s enrolment records (5–12 years) in the Australian Capital Territory were analyzed via demographics, level achieved and NPAE. NPAE was recorded as yes/no, with free text thematically coded to 16 categories. Of 14,012 records analyzed (51% female 64% aged 6–8 years), 535 (4%) reported a NPAE at enrolment. Males, children with a medical condition and attending public schools were significantly more likely (p = 0.001) to report a NPAE. Children reporting a NPAE achieved a lower average skill level at each year of age. The largest proportion (19%) of NPAE reported related to swimming lessons. NPAE have a detrimental influence on aquatic skill achievement. We recommend increased adult supervision to reduce likelihood of an NPAE occurring, while also encouraging swim instructors to consider NPAE when teaching swimming and develop procedures to ensure a NPAE does not occur during instruction.
Publisher: Wiley
Date: 08-10-2010
DOI: 10.1002/ERV.1051
Abstract: To explore the reasons why eating disorder patients consume non-alcoholic fluids and to examine variables associated with poor and excessive drinking. A s le of 115 patients admitted for inpatient treatment to a specialist eating disorder facility completed a semi-standardised retrospective fluid intake history of type and amount of fluid and of reasons for drinking. ANOVA, chi-square and factor analysis were performed. The main reasons for consuming fluids were for fullness and appetite suppression for feelings of control including feeling empty to assist with purging and for physiological reasons such as drinking when thirsty, after exercising and to increase energy levels via caffeine ingestion. An eating disorder needs to be considered a disorder of fluid intake, as much as a disorder of food intake. Factors affecting the fluid intake of eating disorder patients are related to the presence of eating disorder behaviours.
Publisher: Public Library of Science (PLoS)
Date: 25-06-2015
Publisher: American Medical Association (AMA)
Date: 28-08-2018
Publisher: Wiley
Date: 05-09-2017
DOI: 10.1111/JPC.13688
Abstract: To establish the prevalence of unintentional fatal drowning in baths involving children <18 years in Australia and to identify causal factors to underpin prevention. We report a total population study of all childhood (0-17 years) unintentional drowning fatalities in baths (bathtubs, spa baths and showers) in Australia between 1 July 2002 and 30 June 2014. Demographic, forensic and aetiological data (including co-bathing, use of bath aids, supervision and enactment of cardiopulmonary resuscitation) were documented for each victim. Seventy-eight children were identified two thirds (66.7%) were under 2 years old, of which 43.6% were aged less than 1 year (1.0/100 000/annum) and 23.1% 1-2 years (0.27/100 000/annum). Nine older children (10-17 years) also drowned. Common causes included: infants and children unable to hold their head out of water while unsupervised and associated pre-existing medical conditions, including epilepsy. All children who drowned were left without adult supervision. No child drowned in a bath with water deeper than 40 cm (M = 19.4 cm). Custodian-reported 'time left unsupervised' ranged from 30 s to 60 min. Children with pre-existing medical conditions were, on average, older (9.9 years confidence interval: 7.9-11.9) and left unsupervised for longer (M = 15.4 min confidence interval: 3.8-27.1) than those without. On average, 6.5 children drown every year in baths in Australia. Children aged younger than 1 year are most affected, with both genders equally represented. Infants and toddlers left unsupervised, false confidence in the preventive role of bath aids, unrealistic expectations in the supervisory capabilities of co-bathing children and epilepsy remain threats to children in the bath.
Publisher: Wiley
Date: 24-07-2002
DOI: 10.1046/J.1440-1584.2002.00449.X
Abstract: This paper describes the types of, and circumstances surrounding, unintentional farm-related fatal injuries involving young and older adults in Australia. Information was obtained from an inspection of coronial files for the period 1989-1992. Around 14% of all farm-related fatalities in Australia during 1989-1992 were of young adults aged 15-24 years and approximately one-quarter were of older adults aged > or = 55 years. Young adults were commonly fatally injured in motor vehicle incidents and in incidents involving firearms. Tractors were the most common agent involved in fatal incidents involving older adults. Intervention measures to prevent fatalities of older adults in agriculture should focus on the safe use of tractors, while for young adults it appears prevention efforts should centre around safe use of firearms and operation of motor vehicles on the farm. Ways to overcome barriers to the use of injury prevention measures in rural Australia should be further explored.
Publisher: SAGE Publications
Date: 2019
DOI: 10.33151/AJP.16.711
Abstract: In 2006, the Queensland Ambulance Service (QAS) approved the use of magnesium sulphate for the management of patients with Irukandji syndrome (IS). The aim of this study was to compare pain scores and hypertensive (systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg) patients who received intravenous morphine as their treatment (morphine group) over those who received a combination of intravenous morphine and magnesium (magnesium group). A retrospective case review of all IS patients attended by the QAS between 2007 and 2014. A search of the QAS electronic data base found 112 patients had IS. Analyses in IBM SPSS v.22 was undertaken to determine the outcome in final pain scores and blood pressure between the two groups. Pain reduction was statistically different (F=29.18 p .01), between the morphine group and the magnesium group with mean numerical pain scores post-treatment of 4.91 (95% CI: 4.02–5.81) and 2.21 (95% CI: 1.66–2.76) respectively. There was a lower frequency of patients in the magnesium group who remained hypertensive on arrival at a medical facility, with a significant difference between mean arterial BP of 101 mmHg (95% CI: 96–105 p=.028) and diastolic BP of 84 mmHg (95% CI: 80–88 p=.029) post-treatment. Of the 54 cases in the magnesium group, 32 were normotensive post-treatment compared to only six from the morphine group (n=17). There has been considerable difference of opinion as to the utility of magnesium in IS and a marked difference in the results of case series versus a small randomised control trial. This study suggests that the combination of morphine and magnesium is more effective in treating patients with IS than morphine alone.
Publisher: American Society of Agricultural and Biological Engineers (ASABE)
Date: 2005
DOI: 10.13031/2013.18575
Abstract: Noise injury in agriculture is a significant yet often unrecognized problem. Many farmers, farm workers, and family members are exposed to noise levels above recommended levels and have greater hearing loss than their non-farming contemporaries. The aim of this study was to gather up-to-date information on farm noise levels and to enhance the quality of information available to assist farmers in reducing noise exposure and meeting Occupational Health and Safety (OHS) regulations regarding noise management. Farm visits were conducted on 48 agricultural establishments that produce a range of commodities. Noise levels were measured at the ears of operators and bystanders involved in typical activities on farms. The average and peak noise levels were measured for 56 types of machinery or sites of farming activity, totaling 298 separate items and activities. Common noise hazards identified included firearms, tractors without cabs, workshop tools, small motors (e.g., chainsaws, augers, pumps), manual handling of pigs, shearing sheds, older cabbed tractors, and heavy machinery such as harvesters, bulldozers, and cotton module presses. We found that use of firearms without hearing protection presents a pressing hearing health priority. However, farming activities involving machinery used for prolonged periods also present significant risks to farmers' hearing health. Noise management strategies on the farm are essential in order to prevent noise injury among farmers.
Publisher: Wiley
Date: 28-11-2019
DOI: 10.1002/HPJA.297
Abstract: Media reporting of drowning deaths can be used for multiple purposes, including advocacy, enhancing data on drowning and supporting policy development. Accurate, current and comprehensive data help ensure the development of effective prevention programs as well as being a tool for advocacy. Advocacy for drowning prevention through the media can create behaviour change aligned to the Health Belief Model (HBM). This study compares media reports of fatal unintentional drowning across the 2017/18 Australian summer (1-December-2017 to 28-February-2018) with drowning cases in the National Coronial Information System (NCIS). Media monitoring identified 84 cases, of which nine (11%), were deaths but not drowning. There were 104 NCIS deaths during this time of which 75 were reported in the media (72% capture). Media captured 100% of drowning incidents involving people 0-24 years and in ocean/harbour locations. Drowning incidents among older people (75+ years 36% capture), in bathtubs (0% capture), swimming pools (33% capture) and with an unknown activity (27% capture) were poorly reported. Where there are a lack of timely data on drowning, the use of media can help capture deaths, with limitations. Transmission of messages about drowning risk factors and prevention strategies, during summer, may lead to behaviour change at a time when drowning risk is highest. SO WHAT?: Working with the media to help enhance advocacy efforts, in particular the development and use of effective drowning prevention messages, is key to informing the public about risk factors in the HBM to achieve behaviour change.
Publisher: BMJ
Date: 28-09-2012
Publisher: Wiley
Date: 03-11-2020
DOI: 10.1111/APA.15618
Abstract: To explore temporal trends in fatal child drowning and benchmark progress across three high‐income countries to provide prevention and future investment recommendations. A total population analysis of unintentional fatal drownings among 0‐ to 19‐year‐olds in Australia, Canada and New Zealand from 2005 to 2014 was undertaken. Univariate and chi‐square analyses were conducted, age‐ and sex‐specific crude rates calculated and linear trends explored. A total of 1454 children drowned. Rates ranged from 0.92 (Canada) to 1.35 (New Zealand) per 100 000. Linear trends of crude drowning rates show both Australia ( y = −0.041) and Canada ( y = −0.048) reduced, with New Zealand ( y = 0.005) reporting a slight rise, driven by increased drowning among females aged 15‐19 years (+200.4%). Reductions of 48.8% in Australia, 51.1% in Canada and 30.4% in New Zealand were seen in drowning rates of 0‐ to 4‐year‐olds. First Nations children drowned in significantly higher proportions in New Zealand ( X 2 = 31.7 P .001). Continual investment in drowning prevention, particularly among 0‐ to 4‐year‐olds, is contributing to a reduction in drowning deaths however, greater attention is needed on adolescents (particularly females) and First Nation's children. Lessons can be learned from each country's approach however, further investment and evolution of prevention strategies will be needed to fully eradicate child drowning deaths.
Publisher: Korean Society for Preventive Medicine
Date: 31-01-2018
DOI: 10.3961/JPMPH.17.112
Publisher: Public Library of Science (PLoS)
Date: 10-11-2022
DOI: 10.1371/JOURNAL.PONE.0276396
Abstract: Indigenous peoples in high income countries are disproportionately affected by Type 2 Diabetes. Socioeconomic disadvantages and inadequate access to appropriate healthcare are important contributors. This systematic review investigates effective designs of primary care management of Type 2 Diabetes for Indigenous adults in Australia, Canada, New Zealand, and the United States. Primary outcome was change in mean glycated haemoglobin. Secondary outcomes were diabetes-related hospital admission rates, treatment compliance, and change in weight or Body Mass Index. Included studies were critically appraised using Joanna Briggs Institute appraisal checklists. A mixed-method systematic review was undertaken. Quantitative findings were compared by narrative synthesis, meta-aggregation of qualitative factors was performed. Seven studies were included. Three reported statistically significant reductions in means HbA1c following their intervention. Seven components of effective interventions were identified. These were: a need to reduce health system barriers to facilitate access to primary care (which the other six components work towards), an essential role for Indigenous community consultation in intervention planning and implementation, a need for primary care programs to account for and adapt to changes with time in barriers to primary care posed by the health system and community members, the key role of community-based health workers, Indigenous empowerment to facilitate community and self-management, benefit of short-intensive programs, and benefit of group-based programs. This study synthesises a decade of data from communities with a high burden of Type 2 Diabetes and limited research regarding health system approaches to improve diabetes-related outcomes. Policymakers should consider applying the seven identified components of effective primary care interventions when designing primary care approaches to mitigate the impact of Type 2 Diabetes in Indigenous populations. More robust and culturally appropriate studies of Type 2 Diabetes management in Indigenous groups are needed. Registered with PROSPERO (02/04/2021: CRD42021240098 ).
Publisher: Springer Science and Business Media LLC
Date: 19-02-2019
Publisher: Cambridge University Press (CUP)
Date: 11-11-2022
DOI: 10.1017/S1049023X22001480
Abstract: In Australia, aeromedical retrieval provides a vital link for rural communities with limited health services to definitive care in urban centers. Yet, there are few studies of aeromedical patient experiences and outcomes, or clear measures of the service quality provided to these patients. This study explores whether a previously developed quality framework could usefully be applied to existing air ambulance patient journeys (ie, the sequences of care that span multiple settings prehospital and hospital-based pre-flight, flight transport, after-flight hospital in-patient, and disposition). The study aimed to use linked data from aeromedical, emergency department (ED), and hospital sources, and from death registries, to document and analyze patient journeys. A previously developed air ambulance quality framework was used to place patient, prehospital, and in-hospital service outcomes in relevant quality domains identified from the Institutes of Medicine (IOM) and Dr. Donabedian models. To understand the aeromedical patients’ journeys, data from all relevant data sources were linked by unique patient identifiers and the outcomes of the resulting analyses were applied to the air ambulance quality framework. Overall, air ambulance referral pathways could be classified into three categories: Intraregional (those retrievals which stayed within the region), Out of Region, and Into Region. Patient journeys and service outcomes varied markedly between referral pathways. Prehospital and in-hospital service variables and patient outcomes showed that the framework could be used to explore air ambulance service quality. The air ambulance quality framework can usefully be applied to air ambulance patient experiences and outcomes using linked data analysis. The framework can help guide prehospital and in-hospital performance reporting. With variations between regional referral pathways, this knowledge will aid with planning within the local service. The study successfully linked data from aeromedical, ED, in-hospital, and death sources and explored the aeromedical patients’ journeys.
Publisher: Ordem dos Medicos
Date: 04-2022
DOI: 10.20344/AMP.17973
Abstract: N/a.
Publisher: SAGE Publications
Date: 03-05-2021
DOI: 10.1177/08982643211014770
Abstract: Objectives: To explore trends in unintentional fatal drowning among older adults (65 years and older). Methods: Total population retrospective analysis of unintentional fatal drowning among people aged 65 years and older in Australia, Canada and New Zealand (2005–2014) was conducted. Results: 1459 older adults died. Rates ranged from 1.69 (Canada) to 2.20 (New Zealand) per 100,000. Trends in crude drowning rates were variable from year to year. A downward trend was observed in New Zealand (y = −.507ln(x) + 2.9918), with upward trends in Australia (y = .1056ln(x) + 1.5948) and Canada (y = .1489ln(x) + 1.4571). Population projections suggest high annual drowning deaths by 2050 in Australia (range: 120–190 1.69–2.76/100,000) and Canada (range: 209–430 1.78–3.66/100,000). Significant locations and activities associated with older adult drowning differed by country and age band. Conclusions: Drowning among older adults is a hidden epidemic claiming increasing lives as the population ages. Targeted drowning prevention strategies are urgently needed in Australia, Canada, New Zealand and other similar countries.
Publisher: Springer Science and Business Media LLC
Date: 20-11-2018
Publisher: BMJ
Date: 07-09-2023
Publisher: Wiley
Date: 30-10-2019
DOI: 10.1111/JPC.14668
Abstract: Supervision is a strategy for preventing drowning among children. However, supervision lapses continue to be a contributory factor in child drowning. This study aims to identify, describe and analyse the causes of distraction leading to lapses in supervision in child drowning. A total population survey of all fatal unintentional drownings among children aged 0-4 years between 1 July 2002 and 30 June 2017 was undertaken using data from the Australian National Coronial Information System. Among closed coronial cases, causes of distraction leading to lapses in supervision were collected as free text from closed case documentation and subsequently thematically grouped into categories. Univariate and χ A total of 447 children drowned during the study period (62.0% male 66.9% aged 1-2 years 53.3% swimming pools 79.4% falls into water). Of the 426 (95.3%) closed cases, common supervision lapses were due to indoor household duties (27.6%), outdoor household duties (12.6%) and talking/socialising (11.9%). This study has identified common scenarios for distractions leading to supervision lapses including the link between indoor household duties and bathtub drowning deaths and talking/socialising for deaths in swimming pools and at rivers. Challenges include medical issues impacting sole carers. The 7% of cases where a supervision lapse occurred due to miscommunication are opportunities to further reinforce the need for a designated supervisor, particularly with two or more adults present. Study findings on distraction causes, and strategies to minimise them, should be incorporated into national public awareness c aigns aimed at parents and care givers of this at-risk group.
Publisher: BMJ
Date: 06-01-2020
DOI: 10.1136/INJURYPREV-2019-043432
Abstract: Some populations have been less susceptible to reductions in drowning than others. It has been hypothesised that this is due to prevention strategies failing to account for the influence of social determinants (such as ethnicity, socioeconomic status). Populations such as ethnic minorities have been over-represented in injury statistics, however this is not well explored in drowning. This study aims to identify high-risk populations for drowning, risk factors and prevention strategies. A literature review undertaken systematically using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach was conducted of peer-reviewed literature in English, published between 1990 and 2018 from high-income countries. Search terms included drowning, water safety, ethnic minority, migrant, and culturally erse. In total, 35 articles were included. High-risk populations identified were: ethnic minorities, First Nations/Aboriginal people, migrants and rural residents. Over half (51%) focused on children (0–18 years). Risk factors included social determinants, swimming ability and knowledge, attitudes and behaviour. Four intervention studies were found two focused on upskilling adults from high-risk populations to increase employment opportunities within the aquatic industry an evaluation of a 10-year rock fishing safety education project and a learn-to-swim programme for minority children. Proposed prevention strategies included education, practical skills, research, policy and engagement. Limited literature exists pertaining to drowning among adults from high-risk populations. There is a need to increase the sophistication of drowning prevention strategies addressing the disparities in drowning from a culturally appropriate perspective. Acknowledging the role of the social determinants of health in drowning prevention is essential in order to improve drowning outcomes for high-risk populations globally.
Publisher: BMJ
Date: 11-2015
Publisher: Cambridge University Press (CUP)
Date: 09-03-2016
DOI: 10.1017/DMP.2016.3
Abstract: The study aim was to undertake a qualitative research literature review to analyze available databases to define, describe, and categorize public health infrastructure (PHI) priorities for tropical cyclone, flood, storm, tornado, and tsunami-related disasters. Five electronic publication databases were searched to define, describe, or categorize PHI and discuss tropical cyclone, flood, storm, tornado, and tsunami-related disasters and their impact on PHI. The data were analyzed through aggregation of in idual articles to create an overall data description. The data were grouped into PHI themes, which were then prioritized on the basis of degree of interdependency. Sixty-seven relevant articles were identified. PHI was categorized into 13 themes with a total of 158 descriptors. The highest priority PHI identified was workforce. This was followed by water, sanitation, equipment, communication, physical structure, power, governance, prevention, supplies, service, transport, and surveillance. This review identified workforce as the most important of the 13 thematic areas related to PHI and disasters. If its functionality fails, workforce has the greatest impact on the performance of health services. If addressed post-disaster, the remaining forms of PHI will then be progressively addressed. These findings are a step toward providing an evidence base to inform PHI priorities in the disaster setting. ( Disaster Med Public Health Preparedness . 2016 :598–610)
Publisher: Springer Science and Business Media LLC
Date: 07-08-2023
DOI: 10.1186/S12889-023-16392-2
Abstract: Co-ordinated, evidence-based policy and programmatic efforts are needed to respond to complex drowning prevention problems. Comprehensive, current, and robust data are vital for agenda setting, burden and risk factor identification, intervention design and evaluation, as well as setting policy. We aim to record methods used in, and identify impacts of, the development of a national fatal drowning database (NFDD) in Australia, including lessons learned across research, policy, and practice. We employ a case study method using process mapping and document review to explore the evolution, drivers and impacts of the NFDD. We analyse methodological approaches including those relating to data definitions, drowning case collection, and management, as well as tracking the various outputs of the NFDD. We describe a development timeline that presents impact of drowning prevention policy, and research agendas on database development, and research investments more specifically. Our study identified that the collected variables grew 20-fold from 2002 to 2022, reaching 259 variables, and 5,692 unique cases of fatal drowning. The NFDD employs data triangulation methodology, combining keyword and targeted searches of coronial files, media report monitoring, and organisational data provision. Database development is influenced by the Australia Water Safety Strategy, policymaker and practitioner-initiated research agendas, and identification of knowledge gaps. We identified numerous outputs spanning publications, media, intervention development, and legislative submissions. A comprehensive and robust NFDD informed by policymaker and practitioner input can enhance surveillance, policy, and intervention development for drowning prevention. Employing mixed data collection and validation methods can supplement weaknesses in official data sources. There is a need for the NFDD to continue to evolve in its application while maintaining rigorous case identification and data quality assurance processes. Despite significant investment, the outputs and influence on drowning prevention practice in Australia has been extremely valuable and contributed to sizeable reductions in Australia’s fatal drowning rate.
Publisher: Informa UK Limited
Date: 13-07-2017
Publisher: Wiley
Date: 16-09-2018
DOI: 10.1002/HPJA.195
Abstract: Rivers are a leading location for fatal drowning worldwide, often geographically isolated from timely medical assistance. Cardiopulmonary resuscitation (CPR) benefits drowning victims and those who suffer cardiac arrests. This study explored CPR and first-aid training of river users in Australia. Adult river users (18+ years) were surveyed at four high-risk river drowning sites. Respondents were asked the last time they undertook CPR (responses converted into: "CPR ever undertaken"-yes/no and "CPR training current"-yes/no (training undertaken ≤12 months ago). Responses were explored by demographics and social determinants of health. Of those surveyed (N = 688), 98.4% responded regarding CPR. Seventy-five percent (74.9%) had undertaken CPR training previously. Females and 35- to 44-year-olds were more likely to have undertaken training (P < 0.05). Males and older people (65+ years) were less likely to hold a current qualification (P < 0.05). Major city residents reported a longer mean time (5.4 years) since last trained than remote and very remote locations (2.0 years). People in low socio-economic areas had a shorter time since qualification current (5.8 years) than those in areas deemed high (7.2 years). Current CPR qualifications are important, particularly among those visiting high-risk river drowning locations. System-level, upstream strategies that should be explored include compulsory CPR training in secondary schools and linking CPR updates to motor vehicle licence renewals. SO WHAT?: Cardiopulmonary resuscitation is a vital component of multifaceted river drowning prevention. Social determinants of health, such as socio-economic disadvantage and geographical isolation, were not barriers to participation or currency of qualification.
Publisher: Wiley
Date: 08-2018
DOI: 10.1002/HPJA.191
Publisher: Wiley
Date: 19-01-2020
DOI: 10.1111/AJR.12588
Abstract: To describe rates of hospitalisation and Coaching on Achieving Cardiovascular Health referral, for Queensland's adults with heart and related disease, and comparisons between Aboriginal and Torres Strait Islander and non-Indigenous peoples in northern Queensland. Descriptive retrospective epidemiological study of Queensland Health Patient Admission Data Collection for adults with heart and related disease, and Coaching on Achieving Cardiovascular Health referral data. Relative risk and age standardisation were calculated for Aboriginal and Torres Strait Islander and non-Indigenous peoples. Queensland's adults ≥20 years, hospitalised with heart and related disease (1 January 2012-31 December 2016). Queensland, Australia. Queensland Health Hospital and Health Services' hospitalisation and Coaching on Achieving Cardiovascular Health referral rates for heart and related disease. Queensland's Aboriginal and Torres Strait Islander peoples have a higher hospitalisation rate for heart and related disease, with higher rates for northern Queensland. Queensland's overall Coaching on Achieving Cardiovascular Health referral rates were low, but higher for Aboriginal and Torres Strait Islander peoples. Deficiencies in documentation of Aboriginal and Torres Strait Islander people's status affected results in some areas. Queensland's Aboriginal and Torres Strait Islander peoples were more likely to be admitted to hospital for heart and related disease and referred to Coaching on Achieving Cardiovascular Health than non-Indigenous peoples. However, hospitalisation and Coaching on Achieving Cardiovascular Health referral rates are unlikely to reflect the needs of Aboriginal and Torres Strait Islander peoples especially in rural and very remote areas given their higher mortality and morbidity rates and fewer services.
Publisher: Elsevier BV
Date: 07-2022
Publisher: Wiley
Date: 12-2003
DOI: 10.1111/J.1440-1584.2003.00537.X
Abstract: Data concerning farm-related injuries were collected from the Emergency Department at Tamworth Base Hospital over a 12-month period from 1 September 1997. The aim of the study was to collect information at a local level to establish baselines with a view to developing prevention strategies. All people who presented with a farm injury or illness to the emergency department participated in the study. During this period there were 384 injuries, of which nearly three-quarters were males (72.2%). Four injuries were fatal. The average rate of injury per 100 farms per annum in the service area of the Hospital was 30 per 100 farms (range 9-80 per 100 farms, per annum). Half (54.1%) of the people injured were employed at the time of the injury. Horses (21.1%) and motorcycles (15.8%) were the two most common injury agents. The information gained can be used to direct injury prevention at a local level and may be also used at the national level as a guide when grouped with other similar studies of different commodity groups.
Publisher: Cambridge University Press (CUP)
Date: 29-12-2014
DOI: 10.1017/S1049023X1400137X
Abstract: Traditionally, post disaster response activities have focused on immediate trauma and communicable diseases. In developed countries such as Australia, the post disaster risk for communicable disease is low. However, a “disease transition” is now recognized at the population level where noncommunicable diseases (NCDs) are increasingly documented as a post disaster issue. This potentially places an extra burden on health care resources and may have implications for disaster-management systems. With increasing likelihood of major disasters for all sectors of global society, there is a need to ensure that health systems, including public health infrastructure (PHI), can respond properly. There is limited peer-reviewed literature on the impact of disasters on NCDs. Research is required to better determine both the impact of NCDs post disaster and their impact on PHI and disaster-management systems. A literature review was used to collect and analyze data on the impact of the index case event, Australia's Severe Tropical Cyclone Yasi (STC Yasi), on PHI and the management of NCDs. The findings were compared with data from other world cyclone events. The databases searched were MEDLINE, CINAHL, Google Scholar, and Google. The date range for the STC Yasi search was January 26, 2011 through May 2, 2013. No time limits were applied to the search from other cyclone events. The variables compared were tropical cyclones and their impacts on PHI and NCDs. The outcome of interest was to identify if there were trends across similar world events and to determine if this could be extrapolated for future crises. This research showed a tropical cyclone (including a hurricane and typhoon) can impact PHI, for instance, equipment (oxygen, syringes, and medications), services (treatment and care), and clean water availability/access that would impact both the treatment and management of NCDs. The comparison between STC Yasi and worldwide tropical cyclones found the challenges faced were linked closely. These relate to communication, equipment and services, evacuation, medication, planning, and water supplies. This research demonstrated that a negative trend pattern existed between the impact of STC Yasi and other similar world cyclone events on PHI and the management of NCDs. This research provides an insight for disaster planners to address concerns of people with NCDs. While further research is needed, this study provides an understanding of areas for improvement, specifically enhancing protective PHI and the development of strategies for maintaining treatment and alternative care options, such as maintaining safe water for dialysis patients. Ryan BJ , Franklin RC , Burkle FM Jr , Watt K , Aitken P , Smith EC , Leggat P . Analyzing the impact of Severe Tropical Cyclone Yasi on public health infrastructure and the management of noncommunicable diseases . Prehosp Disaster Med . 2015 30 ( 1 ): 1 - 10 .
Publisher: Bowling Green State University Libraries
Date: 05-2014
Publisher: Elsevier BV
Date: 09-2018
Publisher: Springer Science and Business Media LLC
Date: 21-06-2019
Publisher: Elsevier BV
Date: 10-2017
Publisher: Wiley
Date: 25-04-2013
DOI: 10.1111/JPC.12213
Abstract: To explore clinical aspects of head injuries caused by ceiling fans in children. Cases were identified using a sensitive search strategy of the Townsville Emergency Department information system from 1 December 2005 to 30 April 2010, and a retrospective structured medical record review was undertaken. During the study period there were 136 presentations with relevant injuries, with a higher incidence in the warmer months. There were three common mechanisms those related to ingress and egress from bunk beds, children lifted by an adult, and children jumping from a piece of furniture. Aside from lacerations, the majority of children had unremarkable history and examination findings. There were 29 Computed Tomography (CT) scans of the head performed, four skull X-rays and no c-spine imaging. Forty-six children received sedation or anaesthesia as part of their management, 38 in the Emergency Department and eight in the operating theatre. Seven children sustained skull fractures and a total of 13 children were admitted to hospital for an average length of stay of 2.3 days. Ceiling fans are a small but important source of paediatric head injury in tropical Australia. Significant injuries are possible with 5% of patients having a positive finding on CT scan. Most fractures are palpable, CT is recommended if fracture cannot be confidently excluded clinically.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.AAP.2016.10.009
Abstract: Examine the prevalence of alcohol and its contributory role in unintentional fatal river drowning in Australia to inform strategies for prevention. Cases of unintentional fatal river drowning in Australia, 1-July-2002 to 30-June-2012, were extracted from the National Coronial Information System. Cases with positive alcohol readings found through autopsy or toxicology reports were retained for analysis. Discrete analysis was conducted on cases with a Blood Alcohol Content (BAC) of ≥0.05% (0.05grams of alcohol in every 100 millilitres of blood). Alcohol was known to be involved in 314 cases (40.8%), 279 recorded a positive BAC, 196 (70.3%) recorded a BAC of ≥0.05%. 40.3% of adult victims had a BAC of ≥0.20%. Known alcohol involvement was found to be more likely for victims who drowned as a result of jumping in (χ The number of people who drown with alcohol in their bloodstream is concerning and challenging for prevention. To assist with the prevention of alcohol related river drowning improved data quality, as well as a greater understanding of alcohol's contribution and consumption patterns at rivers (especially those <18 years of age) is required. Alcohol contributes to fatal unintentional drowning in Australian rivers. Although prevention is challenging, better data and exposure studies are the next step to enhance prevention efforts.
Publisher: Oxford University Press (OUP)
Date: 10-2023
Publisher: Wiley
Date: 17-11-2021
DOI: 10.1111/AJO.13457
Abstract: Severe maternal morbidity or maternal near miss (MNM) events can have significant consequences for in iduals, their families and society and the study of these events may inform practices to reduce future adverse pregnancy outcomes. To review the scope of MNM studies undertaken in Australia, New Zealand, South‐East Asia and the South Pacific region. A systematic search of four online databases (MEDLINE, EMBASE, SCOPUS and CINAHL) and the World Health Organization Library was conducted to identify all relevant studies published between 1 January 2011 and 31 December 2020. The studies were reviewed and included if they assessed MNM using a c omposite outcome or a predefined set of indicators. The literature search yielded 143 articles of which 49 are included in this review. There were substantial differences in the monitoring approach to MNM in the Australasian region. Overall rates of MNM in the region ranged from two to 100/1000 births and the most common aetiologies identified were direct obstetric causes such as postpartum haemorrhage, pre‐ecl sia and sepsis. Multidisciplinary review indicated a substantial number of MNM cases were preventable or amenable to improved management, mostly from a provider perspective. Assessment of MNM is an important part of the evaluation of maternity care provision. Reaching a consensus on indicators and how best to collect information will allow a more discerning assessment of MNM including longer‐term health outcomes, aspects of preventability and financial implications for health services.
Publisher: MDPI AG
Date: 14-01-2021
Abstract: Injuries, although almost entirely preventable, accounted for more than 4 [...]
Publisher: BMJ
Date: 07-2021
DOI: 10.1136/BMJOPEN-2021-050688
Abstract: Drowning is a global public health threat, disproportionately impacting low-income and middle-income countries. In the Philippines, it is estimated that more than 5200 people die from drowning per annum. This number is likely to be higher than currently estimated with the inclusion of disaster-related and transportation-related drowning. Drowning is preventable if appropriate preventive interventions are put in place which redress known risk factors. This study uses the PRECEDE–PROCEED model (PPM), an eight-step health promotion planning and evaluation model for building and improving intervention programmes. This mixed-methods study, which can be used in any location, will be implemented in Los Baňos, Laguna, Philippines, identified as an area of concern for drowning. Using the PPM, data on drowning will be collected from death records, community observation, key informant interviews, focus group discussions and community survey. A range of analytical methods will be used to explore drowning data including univariate and χ 2 analyses, analysis of variance, relative risk and calculating rates using population data. The quantitative data and themes drawn from qualitative data will be used to populate the first four phases of the PPM. Following the data collection, the remaining stages of the PPM will be designed and implemented in the barangay (village) with the highest drowning rate. This study has obtained ethical clearance from the University of the Philippines Manila Research Ethics Board (UPMREB 2017-425-01). Study findings will be disseminated through workshops and presentations to the local community as well as through peer-reviewed literature and conference presentations. The PPM has rarely been applied to drowning prevention and it is the aim that the study described in this protocol is expanded across other areas of the Philippines and to other countries with a high drowning burden to inform prevention efforts.
Publisher: Springer Science and Business Media LLC
Date: 02-04-2020
DOI: 10.1186/S13643-020-01316-7
Abstract: Dedicated air ambulance services provide a vital link for critically ill and injured patients to higher levels of care. The recent developments of pre-hospital and retrieval medicine create an opportunity for air ambulance providers and policy-makers to utilize a dashboard of quality performance measures to assess service performance. The objective of this scoping systematic review will be to identify and evaluate the range of air ambulance outcome measures reported in the literature and help to construct a quality dashboard based on a healthcare quality framework. We will search PubMed, MEDLINE, CINAHL, Scopus, and Cochrane Database of Systematic Reviews (from January 2001 onwards). Complementary searches will be conducted in selected relevant journals. We will include systematic reviews and observational studies (cohort, cross-sectional, interrupted time series) in critically ill or injured patients published in English and focusing on air ambulance delivery and quality measures. Two reviewers will independently screen all citations, full-text articles, and abstract data. The study methodological quality (or bias) will be appraised using appropriate tools. Analysis of the characteristics associated with outcome measure will be mapped and described according to the proposed healthcare quality framework. This review will contribute to the development of an air ambulance quality dashboard designed to combine multiple quality frameworks. Our findings will provide a basis for helping decision-making in health planning and policy. PROSPERO CRD42019144652
Publisher: Wiley
Date: 17-10-2016
Abstract: Signs of Irukandji syndrome (IS) suggest an underlying catecholamine storm with research demonstrating that Carukia barnesi venom causes a significant rise in adrenaline/noradrenaline serum levels. A systematic review was undertaken to ascertain the current evidence in treating IS with magnesium salts. A literature search was conducted using Scopus, Medline and ScienceDirect. Further articles were discarded via title description and/or abstract details. The remaining were read in full, and those identified as not having sufficient information regarding magnesium and patient outcomes were removed. Nine articles were identified. One article was a randomised controlled trial, which concluded that there appears to be no beneficial difference between those patients who received the magnesium sulphate (MgSO
Publisher: BMJ
Date: 07-2021
DOI: 10.1136/BMJOQ-2020-001091
Abstract: A national accreditation policy for the Australian primary healthcare (PHC) system was initiated in 2008. While certification standards are mandatory, little is known about their effects on the efficiency and sustainability of organisations, particularly in the Aboriginal Community Controlled Health Service (ACCHS) sector. The literature review aims to answer the following: to what extent does the implementation of the International Organisation for Standardization 9001:2008 quality management system (QMS) facilitate efficiency and sustainability in the ACCHS sector? Thematic analysis of peer-reviewed and grey literature was undertaken from Australia and New Zealand PHC sector with a focus on First Nations people. The databases searched included Medline, Scopus and three Informit sites (AHB-ATSIS, AEI-ATSIS and AGIS-ATSIS). The initial search strategy included quality improvement, continuous quality improvement, efficiency and sustainability. Sixteen included studies were assessed for quality using the McMaster criteria. The studies were ranked against the criteria of credibility, transferability, dependability and confirmability. Three central themes emerged: accreditation (n=4), quality improvement (n=9) and systems strengthening (n=3). The accreditation theme included effects on health service expenditure and clinical outcomes, consistency and validity of accreditation standards and linkages to clinical governance frameworks. The quality improvement theme included audit effectiveness and value for specific population health. The theme of systems strengthening included prerequisite systems and embedded clinical governance measures for innovative models of care. The ACCHS sector warrants reliable evidence to understand the value of QMSs and enhancement tools, particularly given ACCHS (client-centric) services and their specialist status. Limited evidence exists for the value of standards on health system sustainability and efficiency in Australia. Despite a mandatory second certification standard, no studies reported on sustainability and efficiency of a QMS in PHC.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.RESUSCITATION.2019.03.019
Abstract: To determine whether training history (including number of times and duration since last training), knowledge, self-efficacy or willingness are associated with cardiopulmonary resuscitation (CPR) psychomotor skills. Eight databases were systematically searched from January 2005 to February 2018 for articles that involved adult layperson participants and explored an association between training history, knowledge, self-efficacy or willingness and CPR psychomotor skills or survival outcomes after real CPR attempts. Thirty-four articles with a total of 35,421 participants were included. CPR training was found to improve psychomotor skills, compared to no training, and any previous training was associated with better skills, compared to no previous training, however only the use of a popular song promoted meaningful retention of a specifically targeted skill, compared to standard training methods. Skills deteriorated within 3 months, then plateaued from 3 to 6 months. Self-efficacy was weakly associated with skill level, however knowledge was not associated with skill level. No studies assessed the association between willingness and psychomotor skills. All laypeople should attend an instructor-led CPR training session with real-time or delayed feedback to improve CPR skills. Training sessions should utilise combinations of validated skill-specific training strategies, preferably including popular songs and feedback to help ensure skills retention. Refresher training, which focusses on skills and self-confidence rather than knowledge, should be undertaken every 3-6 months, although this timeframe needs further validation. All future studies assessing CPR psychomotor skills should adhere to a standardised reporting outcome list (proposed in this paper) to ensure consistency and comparability of results.
Publisher: BMJ
Date: 08-01-2020
DOI: 10.1136/INJURYPREV-2019-043296
Abstract: The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm—the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.
Publisher: BMJ
Date: 02-2023
DOI: 10.1136/BMJOPEN-2022-068380
Abstract: This retrospective observational study aims to create a comprehensive database of the circumstances of drowning (including care provided and outcomes of care) to report against the Utstein style for drowning (USFD) for patients presenting to the emergency department (ED). Four areas will be examined: a feasibility study of the USFD a comparison of classification and prognostication systems examination of indications and efficacy of different ventilation strategies and differences in the circumstances, severity, treatment and outcomes of drowning by sex and gender. This protocol outlines retrospective data collection for all patients presenting to EDs of the Sunshine Coast Hospital and Health Service in Queensland, Australia with the presenting problem or discharge diagnosis of drowning or immersion between 2015 and 2022. Patients computerised health records (emergency medical service record, pathology, radiology results, medical and nursing notes for ED, inpatient units and intensive care units) will be used to extract data for entry into an USFD database. Descriptive (eg, median, IQR) and inferential statistical analyses (eg, analysis of variance) will be used to answer the separate research questions. Development of an International Drowning Registry using the USFD dataset and the Research Electronic Data Capture (REDCap) web application is discussed. This study has been approved by Metro North Human Research and Ethics Committee (Project No: 49754) and James Cook University Human Research Ethics Committee (H8014). It has been endorsed by national drowning prevention organisations Royal Life Saving Society Australia (RLSSA) and Surf Life Saving Australia (SLSA). Study findings will provide data to better inform clinical management of drowning patients and provide an evidence base on sex and gender differences in drowning. Results will be disseminated through peer review publications, conference presentations and media releases. Results will also be disseminated through RLSSA and SLSA membership of the Australian and New Zealand Resuscitation Council and the Australian Water Safety Council.
Publisher: Springer Science and Business Media LLC
Date: 28-07-2022
DOI: 10.1186/S12913-022-08341-3
Abstract: Heatwaves have been linked to increased levels of health service demand in Australia. This systematic literature review aimed to explore health service demand during Australian heatwaves for hospital admissions, emergency department presentations, ambulance call-outs, and risk of mortality. A systematic review to explore peer-reviewed heatwave literature published from 2000 to 2020. Articles were reviewed from six databases (MEDLINE, Scopus, Web of Science, PsychINFO, ProQuest, Science Direct). Search terms included: heatwave, extreme heat, ambulance, emergency department, and hospital. Studies were included if they explored heat for a period of two or more consecutive days. Studies were excluded if they did not define a threshold for extreme heat or if they explored data only from workers compensation claims and major events. This review was prospectively registered with PROSPERO (# CRD42021227395 ). Forty-five papers were included in the final review following full-text screening. Following a quality assessment using the GRADE approach, data were extracted to a spreadsheet and compared. Significant increases in mortality, as well as hospital, emergency, and ambulance demand, were found across Australia during heatwave periods. Admissions for cardiovascular, renal, respiratory, mental and behavioural conditions exhibited increases during heatwaves. The most vulnerable groups during heatwaves were children ( 18 years) and the elderly (60+). Heatwaves in Australia will continue to increase in duration and frequency due to the effects of climate change. Health planning is essential at the community, state, and federal levels to mitigate the impacts of heatwaves on health and health service delivery especially for vulnerable populations. However, understanding the true impact of heatwaves on health service demand is complicated by differing definitions and methodology in the literature. The Excess Heat Factor (EHF) is the preferred approach to defining heatwaves given its consideration of local climate variability and acclimatisation. Future research should explore evidence-based and spatially relevant heatwave prevention programs. An enhanced understanding of heatwave health impacts including service demand will inform the development of such programs which are necessary to promote population and health system resilience.
Publisher: Frontiers Media SA
Date: 18-08-2023
Publisher: Wiley
Date: 06-07-2021
Publisher: Informa UK Limited
Date: 10-2020
Publisher: Penerbit Universiti Kebangsaan Malaysia (UKM Press)
Date: 30-04-2019
Publisher: SAGE Publications
Date: 2023
DOI: 10.1177/16094069231156345
Abstract: Unintentional injuries are a leading cause of preventable harm among adolescents. Adolescents also experience an increased risk of farm injury, and in Australia, injury-related farm fatalities among adolescents have remained largely unchanged over the past two decades. A third of all incidents involve farm visitors, indicating the need for population-level safety information. This project uses qualitative data to inform a co-design process with adolescents, and their teachers, to develop a game-based farm injury prevention online educational resource. This protocol describes the multi-phase co-design project. Focus group discussions regarding farm injury prevention will be held with students (Year 7 & 8 ∼12–14 years of age) and teachers at high schools with an agricultural focus across two Australian states. Inductive thematic analysis of discussion transcripts, and analysis of farm injury data, will inform the development of the modules and content of the game. User experience testing of the prototype will form the final phase of the project. This process is supported by a Stakeholder Advisory Group, which includes representatives of youth farming organisations, agricultural educators, and national child safety organisations. This group will assist in interpretation and dissemination of findings and promoting the resultant educational resource in schools. Ethical approval has been granted by the University of New South Wales Human Research Ethics Committee. Results will be disseminated through peer-reviewed publications, mass media releases, academic conferences, and the agricultural education sector in Australia via the stakeholder advisory group. This study will provide useful insights into co-designing injury prevention resources for adolescents using gamification and result in a co-designed farm injury prevention educational resource for schools and the general community via mobile and web-based applications.
Publisher: Elsevier BV
Date: 06-2023
Publisher: SAGE Publications
Date: 10-04-2018
Abstract: Retirement from work is a complex process, with work influencing this transition. Occupational therapists can facilitate a meaningful occupational transition to retirement for better health and wellbeing in later life. This article explores (1) how work attributes influence and relate to the work-to-retirement transition stages, (2) the relationship of findings to the Model of Human Occupation volitional processes and (3) the potential occupational therapy role. Semi-structured interviews were completed with retirees. In this qualitative study, themes were identified in relation to the work-to-retirement transition stages using thematic analysis with findings related to the Model of Human Occupation volitional processes. Eleven Australian participants (five females, six males) were recruited. Themes and sub-themes were identified within each stage of the work-to-retirement transition and collectively encapsulated all volitional processes. Themes were time to move on, taking action, ceasing work, feeling retired, letting go and work-related involvement. Work attributes related to personal factors, social factors, meaningful occupational engagement and the nexus of work and retirement influence all work-to-retirement transition stages. Volition assists in explaining the complexity of this transition. Occupational therapists can assist older workers to continue working or identify and implement meaningful occupations to replace work activities in retirement.
Publisher: Wiley
Date: 05-03-2018
DOI: 10.1002/HPJA.37
Abstract: Drowning is one of the leading causes of unintentional death in children worldwide. There is limited evidence about the effectiveness of programs targeting child drowning prevention at public swimming pools. We examined the effectiveness of a public education program (Keep Watch @ Public Pools) for improving child supervision levels by parents at public swimming pools. The program was evaluated via an observational study of parent supervision behaviour with children aged 0-14 years. Measures included domains of attention, proximity and preparedness. A rating scale from 0 = least effective to 4 = most effective was used, based upon the supervision domains. Seven public swimming pools in Melbourne, Victoria, Australia were randomised to either intervention or control pool. The intervention occurred over six weeks, and observations were taken over a one-week period both pre- and postintervention. Observations of a total of 10 186 children and 6930 parents/carers were recorded and analysed. A significant improvement in attention, proximity and preparedness was observed in parents of children aged 6-10 years at intervention pools. However, similar results were not observed in parents of children aged 0-5 years and 11-14 years. Supervision behaviour of parents can be modified, and the implications of these results for the community through to practice and policy are discussed. SO WHAT?: Targeted public education programs provide an effective way of improving parental supervision of children at public swimming pools. Such education programs should be widely implemented throughout public swimming pools, as one part of a comprehensive approach to drowning prevention.
Publisher: Informa UK Limited
Date: 06-09-2013
DOI: 10.1080/17457300.2012.717086
Abstract: This population-based retrospective case series study examined the frequency and distribution of protective stratagems (legislatively compliant safety barrier, adequate caregiver supervision, water familiarisation and early administration of cardiopulmonary resuscitation [CPR]) amongst drowning deaths of young children (0-4 years) in private swimming pools or spas in Victoria, Australia. In 65.0% (52/80) of deaths, none of the four protective stratagems were known to be present and there was only one case where all four were known to be present. This indicates that if the presence of all four stratagems is increased, this may reduce drowning in this age group and setting. While these results are positive, further examination of the presence and interaction of these stratagems for effectiveness is required. Further research is also warranted to explore the impact of enforcement of pool fencing legislation and potential associations between water familiarisation and drowning risk. In addition, a consensus on the definition of adequate supervision in needed.
Publisher: Informa UK Limited
Date: 25-05-2019
DOI: 10.1080/19338244.2018.1461600
Abstract: This article investigates the incidence, prevalence and factors associated with occupational tuberculosis (TB) in healthcare workers (HCWs) in sub-Saharan Africa (SSA). Studies were extracted from MEDLINE, PsycINFO, CINAHL, Cochrane Library, and SCOPUS databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement from inception to the 2
Publisher: Elsevier BV
Date: 08-2015
Publisher: Springer Science and Business Media LLC
Date: 03-02-2023
DOI: 10.1007/S00484-023-02430-6
Abstract: Heatwaves are a significant cause of adverse health outcomes and mortality in Australia, worsening with climate change. In Queensland, the northeastern-most state, little is known about the impact of heatwaves outside of the capital city of Brisbane. This study aims to explore the impact of heatwaves on mortality across various demographic and environmental conditions within Queensland from 2010 to 2019. The Excess Heat Factor was used to indicate heatwave periods at the Statistical Area 2 (SA2) level. Registered deaths data from the Australian Bureau of Statistics and heatwave data from the Bureau of Meteorology were matched using a case-crossover approach. Relative risk and 95% confidence intervals were calculated across years, regions, age, sex, rurality, socioeconomic status, and cause of death. Heatwaves were associated with a 5% increase in all-cause mortality compared to deaths on non-heatwave days, with variability across the state. The risk of death on a heatwave day versus a non-heatwave day varied by heatwave severity. In iduals living in urban centers, the elderly, and those living in regions of lower socioeconomic status were most impacted by heatwave mortality. The relative risk of dying from neoplasms, nervous system conditions, respiratory conditions, and mental and behavioral conditions increased during heatwaves. As heatwaves increase in Queensland due to climate change, understanding the impact of heatwaves on mortality across Queensland is important to tailor public health messages. There is considerable variability across communities, demographic groups, and medical conditions, and as such messages need to be tailored to risk.
Publisher: Wiley
Date: 14-11-2019
Abstract: Primary aeromedical retrievals are a direct scene response to patients with a critical injury or illness using a medically equipped aircraft. They are often high-acuity taskings. In Australia, information on primary retrieval taskings is housed by service providers, of which there are many across the country. This exploratory literature review aims to explore the contemporary peer-reviewed literature on primary aeromedical retrievals in Australia. The focus is on adult primary aeromedical retrievals undertaken in Australia and clinical tools used in this pre-hospital setting. Included articles were reviewed for research theme (clinical and equipment, systems and/or outcomes), data coverage and appraisal of the evidence. Of the 37 articles included, majority explored helicopter retrievals (n = 32), retrieval systems (n = 21), compared outcomes within a service (n = 10) and explored retrievals in the state of New South Wales (n = 19). Major topics of focus included retrieval of trauma patients and airway management. Overall, the publications had a lower strength of evidence because of the preponderance of cross-sectional and case-study methodology. This review provides some preliminary but piecemeal insight into primary retrievals in Australia through a localised systems lens. However, there are several areas for research action and service outcome improvements suggested, all of which would be facilitated through the creation of a national pre-hospital and retrieval registry. The creation of a registry would enable consideration of the frequency and context of retrievals, comparison across services, more sophisticated data interrogation. Most importantly, it can lead to service and pre-hospital and retrieval system strengthening.
Publisher: BMJ
Date: 31-12-2021
DOI: 10.1136/INJURYPREV-2021-044415
Abstract: Imprecise data systems hinder understanding of drowning burden, even in high-income countries like Portugal, that have a well-implemented death certificate system. Consequently, national studies on drowning mortality are scarce. We aimed to explore drowning mortality in Portugal using national data and to compare these to Global Burden of Disease (GBD) estimates. Data were obtained from the National Institute of Statistics (INE) for 1992–2019, using International Classification of Diseases (ICD)-9 and ICD-10 codes, by sex, age group and cause (unintentional water transport and intentional). GBD unintentional drowning data were obtained online. Age-standardised drowning rates were calculated and compared. INE data showed 6057 drowning deaths, 4327 classified as unintentional (75.2% male 36.7% 35–64 years 31.5% 65+years 15.2% 0–19 years). Following 2001, an increase in accidental drowning mortality and corresponding decrease in undetermined intent was observed, coincident with Portugal’s ICD-10 implementation. GBD modelled estimates followed a downward trend at an overall rate of decrease of −0.41/decade (95% CI (−0.45 to –0.37) R 2 adj =0.94 p .05). Conversely, INE data showed an increase in the rate of drowning deaths over the last decade (0.35/decade 95% CI (−0.18 to 0.89)). GBD estimates were significantly different from the INE dataset (alpha=0.05), either underestimating as much as 0.567*INE in 1996 or overestimating as much as 1.473*INE in 2011. While GBD mortality data estimates are valuable in the absence of routinely collected data, they smooth variations, concealing key advocacy opportunities. Investment in country-level drowning registries enables in-depth analysis of incident circumstances. Such data are essential to informing National Water Safety Plans.
Publisher: BMJ
Date: 06-06-2019
DOI: 10.1136/INJURYPREV-2018-042819
Abstract: Globally, rivers are a common drowning location. In Australia, rivers are the leading location for fatal drowning. Limited information exists on exposure and impact on river drowning risk. Australian unintentional fatal river drowning data (sourced from coronial records) and nationally representative survey data on river visitation were used to estimate river drowning risk based on exposure for adults (18 years and older). Differences in river drowning rates per 100 000 (population and exposed population) were examined by sex, age group, activity prior to drowning, alcohol presence and watercraft usage. Between 1 January 2014 and 31 December 2016, 151 people drowned in Australian rivers 86% male and 40% aged 18-34 years. Of survey respondents, 73% had visited a river within the last 12 months. After adjusting for exposure: males were 7.6 times more likely to drown at rivers female drowning rate increased by 50% (0.06-0.09 per 100 000) males aged 75+ years and females aged 55-74 years were at highest risk of river drowning and swimming and recreating pose a high risk to both males and females. After adjusting for exposure, males were more likely to drown with alcohol present (RR=8.5 95% CI 2.6 to 27.4) and in a watercraft-related incident (RR=25.5 95% CI 3.5 to 186.9). Calculating exposure for river drowning is challenging due to erse usage, time spent and number of visits. While males were more likely to drown, the differences between males and females narrow after adjusting for exposure. This is an important factor to consider when designing and implementing drowning prevention strategies to effectively target those at risk.
Publisher: Elsevier BV
Date: 2017
Publisher: Wiley
Date: 04-2018
DOI: 10.5694/MJA17.00728
Publisher: AMPCo
Date: 12-2012
DOI: 10.5694/MJA12.11557
Abstract: To evaluate the effect of the State of Origin rugby league series on the number of emergency department (ED) presentations in Queensland. Retrospective analysis of Emergency Department Information System data from 25 Queensland EDs for game 10s and matched control 10s during the annual State of Origin series from 2005 to 2012. The Queensland team won seven of the eight series in this period. Number of patients presenting to Queensland EDs on 24 game 10s and 80 control 10s. Proportionally, a binomial test indicated there were significantly fewer ED presentations on game 10s (49,702) than on control 10s (172,351) (P<0.001). On average, there were 2,154 presentations per 10 on control 10s and 2,071 on game 10s, representing a 4% reduction on game 10s. We found that the State of Origin series was associated with fewer ED presentations on game 10s. We believe these results have broader implications for workforce planning and resource allocation.
Publisher: Wiley
Date: 03-01-2018
DOI: 10.1002/HPJA.24
Abstract: Coronial data provide rich information on drowning causal factors. Coroners may make recommendations to prevent future drowning events. Rivers are the leading drowning location in Australia. This study examines coronial recommendations associated with unintentional fatal drowning in Australian rivers from an injury prevention perspective. All river drowning cases in Australia between 1 July 2002 and 30 June 2012 were extracted from the National Coronial Information System (NCIS). Recommendations were thematically analysed. Using a deductive process, each unique recommendation was coded to a category aligned to the Hierarchy of Control's 6 levels. An inductive process was used for those not categorised. Recommendations were also coded against a modified SMART principle. Of the 730 river drownings, 58 cases (7.9%) resulted in 71 unique recommendations. Victorian cases (X Coronial recommendations associated with river drowning in Australia are reasonably rare. Recommendations provide opportunities for organisations to enact change, however, they could be strengthened with a specified time period and higher order control strategies recommended. SO WHAT?: SMART coronial recommendations may be more successful in achieving the behavioural, social and societal change required to prevent future river drownings. The recommendations examined in this study can be used as a benchmark for what could be considered appropriate safety actions.
Publisher: Wiley
Date: 25-04-2013
DOI: 10.1111/JPC.12204
Abstract: To describe paediatric (0-15 years) motorcycle incidents in Queensland, inform safety policy and identify opportunities to improve data in this area. Population-based study of motorcycle-related child (0-15 years) trauma, resulting in fatality or hospital admission beyond 24 h to any Queensland public hospital (2007-2009). Data compiled by Statewide Trauma Network and Commission for Children and Young People and Child Guardian. Ten child fatalities were recorded (child death rate = 0.36/100,000 population 0-15 years). All were male and primary riders of their motorcycle. Nine fatalities were related to head injury of these, five wore inadequate head protection. The coroner identified rider factors as contributory (speed, age or substance abuse) in seven cases. Motorcycle-related incidents were the second most common mechanism recorded after bicycles, comprising 6.8% of 9141 paediatric trauma cases (619 motorcycle-related incidents 1225 injuries admission rate = 22.2/100,000 population 0-15 years). Compared with the all-trauma population, patients were older (median age = 13 vs. 10 years) and more frequently male (85% vs. 67%). Average admission was 4.4 days (head injuries = 7.0 days burns = 5.8 days). Most children incurred >1 injury (mean = 2.01 injuries) with fractures (45%) and open wounds (17%) most common. As a proportion of all diagnoses, most injuries were to lower limb (44%), upper limb (26%) or head and neck (16%). These data emphasise the need for children to use full protective equipment, especially helmets. Children are not currently protected by legislation mandating safety standards. Regulating rider age and safety standards (protective equipment, training and vehicle maintenance) may reduce the rate and severity of injury.
Publisher: Wiley
Date: 28-07-2017
DOI: 10.1111/AJD.12680
Abstract: Bacterial skin infections in Indigenous children in Australia frequently lead them to access primary health care. This systematic review aims to identify and analyse available studies describing the treatment and prevention of bacterial skin infections in Indigenous children. Electronic databases including Scopus, MEDLINE, CINAHL, ProQuest, Informit and Google Scholar were searched. Studies in English published between August 1994 and September 2016, with the subject of bacterial skin infections involving Indigenous children and conducted in Australia, New Zealand, the USA or Canada were selected. Initially 1474 articles were identified. After the application of inclusion and exclusion criteria, 10 articles remained. Strategies for the treatment and prevention of bacterial skin infections included the management of active infections and lesions, improving environmental and personal hygiene, the installation of swimming pools and screening and treatment. There is a need for more, rigorous, large-scale studies to develop evidence for appropriate, culturally acceptable methods to prevent and manage bacterial skin infections in Indigenous children in Australia. The problem is complex with multiple determinants. Until underlying socioeconomic conditions are addressed skin infections will continue to be a burden to communities.
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.AMJ.2019.09.003
Abstract: The purpose of this study was to investigate the epidemiology of air medical patients and referral patterns in Central Queensland Hospital and Health Service (CQHHS). Analysis of air medical transport from January 2010 to December 2014. Air medical tasks within the local health service boundary were included. All patients transported on rotor or fixed wing aircraft for medical purposes were included. Patterns of air medical tasks in and out of the region by referring and receiving location, aircraft type, flight priority, time of day, month, sex, age, illness, and referral indexes were analyzed. There were 11,456 air ambulance tasks in CQHHS region during the study period, an average of 2,291 retrievals per annum or 191 per month. Frequent referrals were to a tertiary facility, located 800 km across economic and political boundaries. Referral pattern indexes highlight a net patient flow of 1.2 to 1. Cardiology was the largest illness category (24%). Males represented 59% overall as well as patients 66 years and older (33%). Fixed wing aircraft carried out 87% of the tasks with a frequent response time of 6 to 24 hours. Air medical transports are an integral part of the health system in Central Queensland communities with vast geographic distances. Identifying regional referral pattern rates and ratios aid in the planning of resource allocation.
Publisher: MDPI AG
Date: 21-06-2020
Abstract: Aquatic competencies have been proposed as a prevention strategy for children aged 2–4 years who are over-represented in drowning statistics. For this recommendation to be made, exploration of the connection between aquatic competencies and drowning is required. This review critically analyzed studies exploring aquatic competencies and their effect on drowning and/or injury severity in children 2–4 years. English language peer-reviewed literature up to 31 July 2019 was searched and the PRISMA process utilized. Data were extracted from twelve studies that fulfilled the inclusion criteria. Findings from this study included that aquatic competencies were not found to increase risk of drowning and demonstrated children aged 2–4 years are capable of developing age-appropriate aquatic competencies. Age-appropriate aquatic competencies extracted were propulsion/locomotion, flotation/buoyancy, water familiarization, submersion and water exits. The acquisition of these competencies holds benefit for the prevention of drowning. No evidence was found relating to injury severity. There was limited exploration of the relationship between aquatic competencies attainment and age-related developmental readiness. The review highlights the need for consistent measures of exposure, clarity around skills acquisition, better age-specific data (2 years vs. 3 years vs. 4 years), studies with larger s le sizes, further exploration of the dose–response relationship and consistent skill level testing across age groups. Further investigation is required to establish the efficacy of aquatic competencies as a drowning prevention intervention, as well as exploring the relationship between aquatic competencies and age-related developmental readiness. In conclusion, early evidence suggests aquatic competencies can help to reduce drowning.
Publisher: Informa UK Limited
Date: 25-09-2019
Publisher: Elsevier BV
Date: 11-2006
Publisher: Wiley
Date: 02-08-2022
DOI: 10.1111/JAR.13025
Abstract: Staff members' views can have a significant impact on sexuality issues of people with intellectual disabilities. Research on the impact of sociocultural factors in this area in the Chinese context is sparse. Semi‐structured interviews were conducted with seven professionals (social worker, nurse, life skills trainer and manager) to explore their experiences of and attitudes towards the sexual needs of people with intellectual disabilities by applying interpretative phenomenological analysis. The study identified two major themes, each with two sub‐themes: 1. Professional handling of the sexual needs of people with intellectual disabilities (sex education and intervention) 2. Barriers (incompatible approaches and parental resistance). Participants also experienced feelings of resignation facing the barriers they encountered. Collectivism and cultural view about sex are potentially the influencing factors. This study highlights the need to adopt an evidence‐based sex education programme whose content and delivery should take account of cultural factors.
Publisher: Rural and Remote Health
Date: 09-11-2022
DOI: 10.22605/RRH7403
Publisher: BMJ
Date: 20-11-2021
DOI: 10.1136/HEARTJNL-2020-317333
Abstract: To describe annual incidence and temporal trends (2002–2014) in incidence of long-term outcomes of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics, by age, gender, geographical remoteness and socioeconomic status (SES). This is a retrospective cohort study. Cases were identified using the QAS OHCA Registry and were linked with entries in the Queensland Hospital Admitted Patient Data Collection and the Queensland Registrar General Death Registry. Population data were obtained from the Australian Bureau of Statistics to calculate incidence. Inclusion criteria were adult (18+ years) residents of Queensland who suffered OHCA of presumed cardiac aetiology and survived to hospital admission. Analyses were undertaken by three mutually exclusive outcomes: (1) survival to less than 30 days (Surv days) (2) survival from 30 to 364 days (Surv30–364 days) and (3) survival to 365 days or more (Surv365+ days). Incidence rates were calculated for each year by gender, age, remoteness and SES. Temporal trends were analysed. Over the 13 years there were 4393 cases for analyses. The incidence of total admitted events (9.72–10.13 p .01), Surv30–364 days (0.18–0.42 p .05) and Surv365+ days (1.94–4.02 p .001) increased significantly over time no trends were observed for Surv days. An increase in Surv365+ days over time was observed in all remoteness categories and most SES categories. Evidence suggests that implemented strategies to improve outcomes from OHCA have been successful and penetrated groups living in more remote locations and the lower socioeconomic groups. These populations still require focus. Ongoing reporting of long-term outcomes from OHCA should be undertaken using population-based incidence.
Publisher: BMJ
Date: 03-12-2015
Publisher: Springer Singapore
Date: 2021
Publisher: MDPI AG
Date: 02-2019
Abstract: Unintentional fatal drowning among older people is an issue as lifespans lengthen and older people embrace active retirement. While pre-existing medical conditions are a known risk factor for drowning among this age group, less is known about the role of alcohol and drugs. This 15-year (1 July 2002 to 30 June 2017) Australian study used coronial data to investigate the impact on older people (aged 65 years and older) of the obtundent effects of prescribed drugs which had been ingested by those with a positive blood alcohol concentration (BAC). Of the closed coronial cases with toxicological information (N = 471), one quarter (24.6% N = 116) had consumed alcohol prior to drowning (one in seven BAC ≥ 0.05%), of which a third also had obtundent drugs present (33.6% N = 39). Rivers/creeks/streams and swimming pools were the locations with the highest number of drowning deaths. Bathtubs (36.8%) and rivers/creeks/streams (17.9%) recorded the highest proportion of cases with victims having a BAC ≥ 0.05%. Bathtubs (13.2%), lakes (7.0%), and rivers/creeks/streams (6.8%) recorded the highest proportion of drowning cases with obtundent drug involvement. Obtundent drug involvement was significantly more likely for activities where the person who drowned was alone (i.e., unknown activity) (X2 = 6.8 p = 0.009). Common obtundent drugs included Diazepam, Tempazepam, and Codeine. Advocacy to prevent drowning in older people is a complex challenge, due to the myriad of locations where drowning occurs, the consumption of alcohol, and polypharmacy required for treating illness and maintaining good health.
Publisher: Elsevier BV
Date: 11-2023
Publisher: Elsevier BV
Date: 09-2017
Publisher: BMJ
Date: 20-02-2020
DOI: 10.1136/INJURYPREV-2019-043484
Abstract: Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study’s objective is to describe unintentional drowning using GBD estimates from 1990 to 2017. Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning. Globally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531 956 (uncertainty interval (UI): 484 107 to 572 854) to 295 210 (284 493 to 306 187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100 000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45 434 (40 850 to 50 539) YLLs per 100 000 across both sexes. There has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low- and middle-income countries.
Publisher: Wiley
Date: 21-12-2022
DOI: 10.1111/AJR.12956
Abstract: The primary aim is to explore rural clinicians' self‐reported knowledge, skills and attitudes in the decision‐making process for requesting aeromedical retrieval of patients with suspected appendicitis. A secondary aim is to understand the supports and barriers of rural clinicians experience in this clinical scenario. Clinician interviews conducted face‐to‐face in three rural hospitals in Central Queensland. Rural doctors and nurses. A five‐part qualitative content analysis. The majority of 44 participants identified the strong and effective teamwork. The decision to request aeromedical retrieval was a shared, joint process and identified a supportive collegial culture which supported the asking of questions and not expecting to have all the answers. Perceived barriers were lack of receiving clinicians understanding of transfer agreements, and data connectivity. Clinician pessimism was identified for perceived patient outcomes. Effective teamwork can nurture trust and collaboration across multiple health service roles. High job satisfaction may counter the physical isolation in some rural environments. Fragmentation of care is the unintended consequence of interhospital transfer and may impact rural clinicians' perception of patients' outcomes and hinder receiving clinicians' understanding of rural service limitations. Future work in the area of linked electronic medical records could remove a barrier for rural clinicians and improve their reflective practice by challenging their perception of definitive patient outcomes. Increased awareness by receiving clinicians of the limitation of rural services, may minimize communication barriers and thereby, improve timely patient care transfers.
Publisher: Elsevier BV
Date: 2015
Publisher: Wiley
Date: 08-2002
Publisher: Cambridge University Press (CUP)
Date: 14-11-2022
DOI: 10.1017/DMP.2022.204
Abstract: This research evaluated the resilience of 6 tertiary and rural health facilities within a single Australian Health Service, using the World Health Organization (WHO) Hospital Safety Index (HSI). This adaptation of the HSI was compared with existing national accreditation and facility design Standards to assess disaster preparedness and identify opportunities for improvement. This cross-sectional descriptive study surveyed 6 hospitals that provide 24/7 emergency department and acute inpatient services. HSI assessments, comprising 151 previously validated criteria, were conducted by Health Service engineers and facility managers before being externally reviewed by independent disaster management professionals. All facilities were found to be highly disaster resilient, with each recording high HSI scores. Variances in structure, architectural safety, continuity of critical services supply, and emergency plans were consistently identified. Power and water supply vulnerabilities are common to previously reported vulnerabilities in health facilities of developing countries. Clinical, engineering, and disaster management professionals assessed 6 Australian hospitals using the WHO HSI with each facility scoring highly, genuine vulnerabilities and practical opportunities for improvement were identified. This application of the WHO HSI, intended for use primarily in developing countries and disaster-affected regions, complimented and extended the existing Australian national health service accreditation and facility design Standards. These results support the expansion of existing assessment tools used to assess Australian health facility disaster preparedness and resilience.
Publisher: MDPI AG
Date: 24-12-2020
Abstract: Injuries are a leading cause of harm for children. This study explores the impact of determinants of health on children (0–19 years) injury-related mortality (namely remoteness and socio-economic disadvantage, calculated using the index of relative socio-economic advantage and disadvantage (IRSAD)). Cause of death data from the Australian Bureau of Statistics were sourced for children in Australia between 1 July 2007 to 30 June 2017. Fifteen injury categories (ICD-10-AM external cause codes) were used. Burden and trends by injury mechanism were explored. A total of 5153 children died with road traffic incidents (3.39 per 100,000 population), intentional self-harm (2.46) and drowning (0.72) being the leading mechanisms. Female fatality rates in very remote areas (8.73) were nine times higher than in major cities (Relative Risk [RR] = 8.73 95% Confidence Interval [95% CI]: 4.23–18.00). Fatality rates increased with remoteness very remote areas recording an injury-related fatality rated six times (RR = 5.84 95% CI: 3.76–9.12) that of major city residents. Accidental poisoning and intentional self-harm fatalities were more likely in high IRSAD areas, while road traffic fatalities were more likely in low and mid socio-economic areas (X2 = 69.1 p 0.001). People residing in regional and remote areas and from low socio-economic backgrounds already face significant health and lifestyle challenges associated with disadvantage. It is time to invest in injury prevention interventions for these populations, as well as upstream policy strategies to minimize any further preventable loss of life.
Publisher: Public Library of Science (PLoS)
Date: 14-02-2019
Publisher: MDPI AG
Date: 04-10-2019
Abstract: Rivers are a leading location for drowning, yet little is known about people’s usage of these waterways. This pilot study aimed to test the use of direct observations to calculate river usage. Direct observations were conducted at regular intervals within defined zones at four river drowning locations in Australia (including weekends and the Australia Day national public holiday). Data recorded were date and time of observation total people (including males, females, children, and adults) and number of people on, in, and beside the water. Univariate analysis with mean (SD) and range was conducted. Interrater reliability for observations was determined using the intraclass correlation coefficient (ICC) (one-way random-effects, average measures model), with a 95% confidence interval (CI). Across 149 time points, 309 observations resulted in 13,326 river interactions observed by multiple observers. There was an average of 39 people (M = 39.4, SD = 29.4, range = 0–137) per observation, 44 people (M = 44.2, SD = 32.7, range = 0–37) on an average weekend, and 97 people (M = 96.8, SD = 58.1, range = 20–190) on Australia Day. More females (M = 20.6, SD = 16.0, range = 0–83) than males (M = 18.3, SD = 14.5, range = 0–68) were observed. More people were observed in the water (M = 20.6, SD = 20.4, range = 0–84) than beside or on the water. Interrater reliability was excellent, consistently above 0.900 for all variables collected (apart from the variable of beside the river). Despite males accounting for 80% of river drowning fatalities, more females were observed than males. Increased visitation on the Australia Day public holiday may be linked to increased drowning risk. This study detailed a simple approach to data collection, exploring exposure within a defined zone at river locations. River usage is dynamic, with people’s movement in and out of the water changing their risk exposure. Observational-based data collection for drowning, particularly for rivers, is an important yet highly neglected area of research.
Publisher: Wiley
Date: 06-2013
DOI: 10.1111/AJR.12032
Abstract: To identify the barriers and facilitators for exercise in older adults (50 years or over) specific to those living in rural and remote areas in Australia and to identify how this relates to falls prevention exercise programs in these areas. Literature review. Search of the databases of Medline, Scopus and Social Sciences Citation Index. Rural and remote areas. Searching identified 56 articles relating to barriers or facilitators to exercise in older adults in general, of which 25 are discussed in the article. Five of these articles specifically related to rural and remote areas, of which all were from studies in the United States. No literature specifically relating to rural and remote Australia was identified. Therefore, articles included in the final review were from three different domains - world literature (excluding those specific to rural and remote areas of Australia), rural and remote literature (note not Australian), and Australian literature to enable a comparison between the different populations to occur. There are similarities and differences between the barriers and facilitators in various populations, and no one factor alone will enable exercise in older adults. Research needs to be conducted on the barriers and facilitators to exercise in older adults living in rural and remote areas in Australia. Falls prevention exercise programs need to be tailored to suit the unique needs of the rural and remote older population.
Publisher: Elsevier BV
Date: 06-2022
Publisher: BMJ
Date: 11-2017
DOI: 10.1136/BMJOPEN-2017-018562
Abstract: A challenge of conducting research in critically ill children is that the therapeutic window for the intervention may be too short to seek informed consent prior to enrolment. In specific circumstances, most international ethical guidelines allow for children to be enrolled in research with informed consent obtained later, termed deferred consent (DC) or retrospective consent. There is a paucity of data on the attitudes of parents to this method of enrolment in paediatric emergency research. To explore the attitudes of parents to the concept of DC and to expand the knowledge of the limitations to informed consent and DC in these situations. Children presenting with uncomplicated febrile seizures or bronchiolitis were identified from three separate hospital emergency department databases. Parents were invited to participate in a semistructured telephone interview exploring themes of limitations of prospective informed consent, acceptability of the DC process and the most appropriate time to seek DC. Transcripts underwent inductive thematic analysis with intercoder agreement, using Nvivo 11 software. A total of 39 interviews were conducted. Participants comprehended the limitations of informed consent under emergency circumstances and were generally supportive of DC. However, they frequently confused concepts of clinical care and research, and support for participation was commonly linked to their belief of personal benefit. Participants acknowledged the requirement for alternatives to prospective informed consent in emergency research, and were supportive of the concept of DC. Our results suggest that current research practice seems to align with community expectations.
Publisher: Springer Berlin Heidelberg
Date: 26-10-2013
Publisher: BMJ
Date: 08-05-2017
DOI: 10.1136/ARCHDISCHILD-2017-312684
Abstract: This study is an analysis of the contribution of pre-existing medical conditions to unintentional fatal child (0-14 years) drowning and a of critique prevention stratagems, with an exploration of issues of equity in recreation. This study is a total population, cross-sectional audit of all demographic, forensic and on-site situational details surrounding unintentional fatal drowning of children 0-14 years in Australia for the period of 1 July 2002 to 30 June 2012. Data were sourced from the National (Australia) Coronial Information System. Age-specific disease patterns in the general population were obtained from the Australian Institute of Health and Welfare. Four hundred and sixty-eight children drowned during the study period. Fifty-three (11.3%) had a pre-existing medical condition, of whom 19 suffered from epilepsy, 13 from autism and 5 with non-specific intellectual disabilities. Epilepsy is a risk factor in childhood drowning deaths, with a prevalence of 4.1% of drowning fatalities, compared with 0.7%-1.7% among the general 0-14 years population (relative risk: 2.4-5.8). Epilepsy was deemed to be contributory in 16 of 19 cases (84.2% of epilepsy cases) with a median age of 8 years. Asthma and intellectual disabilities were under-represented in the drowning cohort. Except for epilepsy, this research has indicated that the risks of drowning while undertaking aquatic activities are not increased in children with pre-existing medical conditions. Children with pre-existing medical conditions can enjoy aquatic activities when appropriately supervised.
Publisher: BMJ
Date: 04-01-2016
Publisher: Public Library of Science (PLoS)
Date: 28-07-2021
DOI: 10.1371/JOURNAL.PNTD.0008824
Abstract: Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.
Publisher: Informa UK Limited
Date: 30-03-2019
Publisher: American Society of Agricultural and Biological Engineers (ASABE)
Date: 19-01-2015
Abstract: In the U.S. and Australia, agriculture is consistently ranked as one of the most hazardous industries. The cost of injuries and deaths on Australian farms is significant, estimated to be between AU$0.5 billion and AU$1.2 billion per year. Death and injury in agriculture also place a significant financial and social burden on the family and friends of the injured, the community, and the health system. This article proposes that if farmers were to employ coaching in their businesses, they would benefit from advances in safety practices, resulting in associated improvements in overall farm productivity and a reduction in injury costs to the wider community. A coaching model is presented to demonstrate what an effective coaching process would need to include. An agenda for future research areas is also provided.
Publisher: BMJ
Date: 04-09-2015
DOI: 10.1136/INJURYPREV-2014-041216
Abstract: Drowning remains a leading cause of preventable death in children across the world. This systematic review identifies and critically analyses studies of interventions designed to reduce fatal and non-fatal drowning events among children and adolescents or reduce the injury severity incurred by such incidents. A systematic search was undertaken on literature published between 1980 and 2010 relating to interventions around fatal and non-fatal drowning prevention in children and adolescents 0-19 years of age. Search methods and protocols developed and used by the WHO Global Burden of Disease Injury Expert Group were applied. Seven studies fulfilled the inclusion criteria. Interventions were categorised into three themes of Education, Swimming Lessons and Water Safety, and Pool Fencing. All are possible effective strategies to prevent children from drowning, particularly young children aged 2-4 years, but very little evidence exists for interventions to reduce drowning in older children and adolescents. There were methodological limitations associated with all studies, so results need to be interpreted in the context of these. Relatively few studies employ rigorous methods and high levels of evidence to assess the impact of interventions designed to reduce drowning. Studies are also limited by lack of consistency in measured outcomes and drowning terminology. Further work is required to establish efficacy of interventions for older children and adolescents. There is a need for rigorous, well-designed studies that use consistent terminology to demonstrate effective prevention solutions.
Publisher: BMJ
Date: 10-2012
Publisher: Elsevier BV
Date: 08-2020
Publisher: Wiley
Date: 28-07-2019
Abstract: To describe temporal trends in incidence of pre-hospital outcomes from adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics between 2002 and 2014, by age, gender, geographical remoteness and socio-economic status. Cases included in this retrospective cohort study were identified from the QAS OHCA Registry. Included cases were linked with Queensland Hospital Admitted Patient Data Collection and Queensland Death Registry. Population data were obtained from the Australian Bureau of Statistics to calculate incidence rates for each year. Analyses were undertaken by four mutually exclusive pre-hospital outcomes: (i) no resuscitation (No-Resus) (ii) resuscitation, no pre-hospital return of spontaneous circulation (No-ROSC) (iii) resuscitation, pre-hospital return of spontaneous circulation not sustained to hospital (Unsustained-ROSC) and (iv) resuscitation, pre-hospital return of spontaneous circulation sustained to hospital (Sustained-ROSC). Trends over time were analysed for crude and specific rates for total OHCA events and for each outcome. Between 2002 and 2014, there were 30 560 OHCA cases. Crude incidence significantly increased over time for No-Resus and Sustained-ROSC, and significantly decreased for No-ROSC. These trends were reflected in major cities, inner and outer regional areas. There was a significant increase in Sustained-ROSC in remote areas, and no significant trends in very remote areas. Incidence of withholding resuscitation and ROSC sustained to hospital have independently increased over time. Factors of middle age, more rural location and lower socio-economic status should all be targeted in the development and implementation of future strategies.
Publisher: Wiley
Date: 28-07-2019
Abstract: To describe incidence in pre-hospital outcomes of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology, attended by Queensland Ambulance Service (QAS) paramedics between 2002 and 2014, by age, gender, geographical remoteness and socio-economic status. The QAS OHCA Registry was used to identify cases, which was then linked with Queensland Hospital Admitted Patient Data Collection and Queensland Death Registry. Population data were obtained for each calendar year by age and gender from the Australian Bureau of Statistics in order to calculate incidence rates. Four mutually exclusive pre-hospital outcomes were analysed: (i) no resuscitation (No-Resus) (ii) resuscitation, no pre-hospital return of spontaneous circulation (No-ROSC) (iii) resuscitation, pre-hospital return of spontaneous circulation not sustained to hospital (Unsustained-ROSC) and (iv) resuscitation, pre-hospital return of spontaneous circulation sustained to hospital (Sustained-ROSC). Over the 13 years, there were 30 560 OHCA cases for analyses. Incidence was significantly greater in males than females and incrementally increased with age, for each outcome. Incidence of total OHCA events generally increased as remoteness increased (major cities: 72.39 per 100 000 [95% CI 71.35-73.45] very remote: 87.01 per 100 000 [95% CI 78.03-95.98]). There was an inverse association between incidence of OHCA events and socio-economic status (SEIFA 1 and 2: 81.34 per 100 000 [95% CI 79.28-83.40] SEIFA 9 and 10: 61.57 per 100 000 [95% CI 59.67-63.46]). Rural-specific strategies should be continued. Prevention and management strategies for OHCA targeting lower socio-economic groups require focus.
Publisher: Elsevier BV
Date: 06-2021
Publisher: Elsevier BV
Date: 06-2023
DOI: 10.1016/J.AUEC.2022.10.006
Abstract: To identify predictors of longer-term outcomes from adult out-of-hospital cardiac arrest of presumed cardiac aetiology. In this retrospective cohort study, three large routinely collected databases were linked: 1)QAS Out-of-Hospital Cardiac (OHCA) Registry 2)Queensland Hospital Admitted Patient Data Collection and 3)Queensland Registrar General Death Registry. Participants were adult (18years+) residents of Queensland, who suffered an OHCA of presumed cardiac aetiology and had resuscitation attempted by QAS paramedics between 2002 and 2014. Four mutually exclusive outcomes were analysed: 1) No pre-hospital return of spontaneous circulation (ROSC) sustained to the Emergency Department (ED) or ROSC in ED 2) Survival< 30 days (Pre-hospital ROSC sustained to ED or ROSC in ED but death within 30 days 3) survival between 30 and 364 days and 4) survival to 365 + days. Multinomial logistic regression was used to calculate odds ratios and 95 % confidence intervals. Variables significantly predictive of survival to 365 + days after adjusting for all measured confounders are: an initial shockable rhythm bystander witnessed events with bystander CPR paramedic witnessed events intubation placement time of day (midday-2.59 pm) and attendance by Critical Care Paramedic (CCP). From a service provision perspective, attendance of a CCP at an OHCA may be an important factor to achieve preferred long-term outcomes. Enhanced experience, exposure and expertise, together with extended clinical practice, may explain this finding.
Publisher: Bowling Green State University Libraries
Date: 03-2019
Publisher: Elsevier BV
Date: 04-2020
Publisher: Frontiers Media SA
Date: 20-10-2022
Publisher: Springer Science and Business Media LLC
Date: 02-09-2013
Publisher: Elsevier BV
Date: 11-2019
Publisher: Cambridge University Press (CUP)
Date: 04-2019
DOI: 10.1017/S1049023X19000104
Abstract: First aid, particularly bystander cardiopulmonary resuscitation (CPR), is an important element in the chain of survival. However, little is known about what influences populations to undertake first aid/CPR training, update their training, and use of the training. The aim of this study was to explore the characteristics of people who have first aid/CPR training, those who have updated their training, and use of these skills. As part of the 2011 state-wide, computer-assisted telephone interviewing (CATI) survey of people over 18 years of age living in Queensland, Australia, stratified by gender and age group, three questions about first aid training, re-training, and skill uses were explored. Of the 1,277 respondents, 73.2% reported having undertaken some first aid/CPR training and 39.5% of those respondents had used their first aid/CPR skills. The majority of respondents (56.7%) had not updated their first aid/CPR skills in the past three years, and an additional 2.5% had never updated their skills. People who did not progress beyond year 10 in school and those in lower income groups were less likely to have undertaken first aid/CPR training. Males and people in lower income groups were less likely to have recently updated their first aid/CPR training. People with chronic health problems were in a unique demographic sub-group they were less likely to have undertaken first aid/CPR training but more likely to have administered first aid/CPR. Training initiatives that target people on the basis of education level, income group, and the existence of chronic health problems might be one strategy for improving bystander CPR rates when cardiac arrest occurs in the home. Franklin RC, Watt K, Aitken P, Brown LH, Leggat PA. Characteristics associated with first aid and cardiopulmonary resuscitation training and use in Queensland, Australia. Prehosp Disaster Med . 2019 (2):155–160
Publisher: MDPI AG
Date: 24-11-2017
Publisher: Cambridge University Press (CUP)
Date: 21-07-2021
DOI: 10.1017/S1049023X21000650
Abstract: The aim of this review was to explore hospital socio-natural disaster resilience by identifying: studies assessing structural and non-structural aspects of building resilience components required to maintain a safe and functional health facility and if the checklists used were comprehensive and easily performed. A review systemic approach using PRISMA was taken to search the literature. The search focused on articles that discuss hospital disaster resilience. This includes assessments and checklists for facility structural and non-structural components. This review identified 22 articles describing hospital assessments using checklists containing structural and non-structural elements of resilience. These studies identified assessments undertaken in ten countries, with eight occurring across Iran. A total of seven differing checklists were identified as containing aspects of structural or non-structural aspects of building resilience. The World Health Organization (WHO) has authored three checklists and four others were developed independently. The structural resilience domain includes building integrity, building materials, design standards, and previous event damages as important elements to determine resilience. Within the internal safety and resilience domains, 11 differing elements were identified as important to non-structural or internal infrastructure resilience. These included the safety of power, water, telecommunication, medical gas supply, and medical equipment resupply systems. Independent evaluation methods were reported in the majority of articles, with a small number highlighting the benefits of both self-evaluation and independent review processes. Implementation of training programs to evaluators was mentioned in three papers with the assessor’s knowledge and understanding of all checklist elements being highlighted as important to the validity of the evaluation. The review identified the assessment of hospital resilience as important for management to determine areas of vulnerability within the hospital’s infrastructure and to inform improvement strategies. Assessment criteria must be comprehensive, highlighting structural and non-structural aspects of facility infrastructure. These assessments are best done as a multi-disciplinary collective of experts, involving hospital employees in the journey. This collaborative approach provides a key educational tool for developing disaster capacity, engaging ownership of the process, and the resulting improvements. The on-going development of health facility and wider health system resilience must remain a key strategic focus of national governments and health authorities. The development of standardized procedures and guidelines must be embedded into daily practice.
Publisher: MDPI AG
Date: 14-01-2021
Abstract: Agriculture is one of Australia’s largest rural industries. Oversized and slow moving industry equipment and vehicles, hereafter referred to as large agricultural vehicles (LAVs), use public roads. Restrictions exist regarding their on-road operation, but whether this is a function of the risk that their on-road use represents is unknown. A convenience s le of community members was used to explore perspectives about LAVs’ presence on roads. An online survey was used to explore LAV interaction experiences, risk perceptions, and how best to promote safe interactions. Ethics approval was obtained. The participants’ (N = 239) exposure to LAVs on roads in the last 12 months was variable, but there were clear seasonal points when encounters could be expected. The participants indicated that LAVs have a right to drive on the road (94.8%), and most interactions were neutral, with four LAV crashes reported. Other vehicle types were perceived as representing a higher risk to rural road safety than LAVs. The use of the driver’s license test to increase knowledge about LAVs’ presence, how to respond, and the use of signs were suggested in order to improve safety. The participants commonly interacted with LAVs, and rarely experienced negative events such as crashes. Continued communication about LAV presence on rural roads is an important consideration in order to help ensure safe interactions.
Publisher: MDPI AG
Date: 15-09-2022
Abstract: Rural populations experience injury-related mortality and morbidity rates 1.5 times greater than metropolitan residents. Motivated by a call for stronger epidemiological evidence around rural injuries to inform prevention, a systematic review of peer-reviewed literature published between January 2010 and March 2021 was undertaken to explore the epidemiology of rural injury and associated risk factors in Australia. A subsequent aim was to explore definitions of rurality used in injury prevention studies. There were 151 papers included in the review, utilizing 23 unique definitions to describe rurality. People living in rural areas were more likely to be injured, for injuries to be more severe, and for injuries to have greater resulting morbidity than people in metropolitan areas. The increase in severity reflects the mechanism of rural injury, with rural injury events more likely to involve a higher energy exchange. Risk-taking behavior and alcohol consumption were significant risk factors for rural injury, along with rural cluster demographics such as age, sex, high socio-economic disadvantage, and health-related comorbidities. As injury in rural populations is multifactorial and nonhomogeneous, a wide variety of evidence-based strategies are needed. This requires funding, political leadership for policy formation and development, and implementation of evidence-based prevention interventions.
Publisher: Cambridge University Press (CUP)
Date: 12-2014
DOI: 10.1017/DMP.2014.118
Abstract: Tropical Cyclone Yasi in North Queensland activated the disaster management plans at The Townsville Hospital, including the establishment of an emergency child minding service to facilitate the return of staff to work. This report describes the establishment of this service and the results of brief electronic surveys that were distributed in the 2 weeks following the cyclone to gather feedback from staff who had placed their children in the care of the service (consumers), staff who had manned the service (staff), and allied health managers whose staff had manned the service (managers). Overall, approximately 94 episodes of care were provided by the child minding service. All consumers responded “‘yes’” in answer to the question of whether the emergency child minding service facilitated their return to work in the immediate post-disaster period. The survey also identified that a lack of effective advertising may have prevented further uptake of the child minding service. The provision of an emergency child minding service facilitated the return to work of health care staff immediately after Tropical Cyclone Yasi. More research is needed to understand the effect disaster type has on the uptake of a child minding service. ( Disaster Med Public Health Preparedness. 2014 :485-488)
Publisher: Informa UK Limited
Date: 03-07-2015
Publisher: Public Library of Science (PLoS)
Date: 12-08-2016
Publisher: Springer Science and Business Media LLC
Date: 27-05-2023
Publisher: MDPI AG
Date: 10-11-2015
Publisher: MDPI AG
Date: 25-09-2019
Abstract: Background and Objectives: Drowning is a leading cause of unintentional injury related mortality worldwide, and accounts for roughly 320,000 deaths yearly. Over 90% of these deaths occur in low- and middle-income countries with inadequate prevention measures. The highest rates of drowning are observed in Africa. The aim of this review is to describe the epidemiology of drowning and identify the risk factors and strategies for prevention of drowning in Africa. Materials and Methods: A review of multiple databases (MEDLINE, CINAHL, PsycINFO, Scopus and Emcare) was conducted from inception of the databases to the 1st of April 2019 to identify studies investigating drowning in Africa. The preferred reporting items for systematic review and meta-analysis (PRISMA) was utilised. Results: Forty-two articles from 15 countries were included. Twelve articles explored drowning, while in 30 articles, drowning was reported as part of a wider study. The data sources were coronial, central registry, hospital record, sea rescue and self-generated data. Measures used to describe drowning were proportions and rates. There was a huge variation in the proportion and incidence rate of drowning reported by the studies included in the review. The potential risk factors for drowning included young age, male gender, ethnicity, alcohol, access to bodies of water, age and carrying capacity of the boat, weather and summer season. No study evaluated prevention strategies, however, strategies proposed were education, increased supervision and community awareness. Conclusions: There is a need to address the high rate of drowning in Africa. Good epidemiological studies across all African countries are needed to describe the patterns of drowning and understand risk factors. Further research is needed to investigate the risk factors and to evaluate prevention strategies.
Publisher: MDPI AG
Date: 07-01-2021
Abstract: Drowning is a public health issue in the Philippines, with children at significantly increased risk. Determinants of health (DoH) such as education, socio-economic status, ethnicity, and urbanization are factors that impact drowning risk. As drowning is a multisectoral issue, a national drowning prevention plan can drive collaboration with relevant stakeholders. This study reports trends in unintentional child (0–14 years) drowning in the Philippines (incidence, rates, and trends over time for fatal and non-fatal (years lived with a disability (YLDs) and disability adjusted life years (DALYs) from 2008–2017 and conducts an analysis of the Philippines’ Multisector Action Plan (MSAP) on Drowning Prevention. From 2008–2017, 27,928 (95%UI [Uncertainty Interval]: 22,794–33,828) children aged 0–14 years died from drowning (52.7% aged 5–14 years old). Rates of drowning have declined among both age groups, with greater reductions seen among 0–4 year olds (y = −0.3368x + 13.035 R2 = 0.9588). The MSAP has 12 child drowning-specific activities and 20 activities were identified where DoH will need to be considered during development and implementation. The MSAP activities, and work done to prevent drowning more generally, must consider DoH such as education, urbanization, water and sanitation health, and safe water transportation. A national drowning surveillance system and investment in research in the Philippines are recommended.
Publisher: Informa UK Limited
Date: 06-2008
Publisher: Elsevier BV
Date: 10-2019
Abstract: To examine fatal drowning associated with aquatic rescues and prior self-reported experience of undertaking an aquatic rescue in Australia. Previous aquatic rescue experience was sourced through the 2013 Queensland Computer Assisted Telephone Instrument Survey and compared to data on rescue-related fatal unintentional drowning between 1 January 2006 and 31 December 2015. Twenty-three per cent (n=294/1291) of survey respondents had previously performed an aquatic rescue. Males (X Drownings are prevented by bystanders this is not without risk to the rescuer. Most people perform only one rescue in their life, often at a younger age, on an altruistic basis, of family members or young children. Community-wide rescue skills, taught at a young age, with consideration for coastal, inland and swimming pool environments, may prevent drowning. Implications for public health: There is a need to train people early in their life on how to undertake a safe rescue and provide resuscitation, including promoting regular updates, in particular if supervising children.
Publisher: Wiley
Date: 20-04-2023
DOI: 10.1111/AJR.12986
Abstract: Despite the importance of child road traffic death, a limited number of studies have investigated rural child road traffic death in high income countries. This review estimated the impact of rurality on child road traffic deaths and other potential risk factors in high‐income countries. We searched Ovid, MEDLINE, CINAHL, PsycINFO and Scopus databases and extracted studies focusing on the association between rurality and child road traffic death published between 2001 and 2021. Available data were extracted and analysed, to evaluate the impact of rurality on child road traffic death and explore other risk factors of child road traffic deaths. We identified 13 studies for child road traffic death between 2001 and 2021. Eight studies reported the impact of rurality on child road traffic death, and all of them alleged that the mortality rate and injury rate of children was significantly higher on rural road than on urban road. The impact of rurality varied between studies, from 1.6 times to 15 times higher incidence of road traffic death in rural areas. Vehicle type, speeding cars, driver loss of control, alcohol and drug use road environment were identified as risk factors of child road traffic death. Conversely, ethnicity, seat belts, nondeployed airbag, child restraint, strict driver licence system, camera law and accessibility of trauma centres were considered protective factors. Other factors, including age, gender and teen passengers, appeared ambiguous for child road traffic death. Rurality is one of the most important risk factors of child road traffic death. Therefore, we should consider the impact that rurality has on child road death and resolve the gap between rural and urban areas in order to prevent child road traffic death effectively. The findings of this literature review will assist policy‐makers to prevent child road traffic death by focusing on rural regions.
Publisher: Wiley
Date: 25-03-2022
DOI: 10.1111/AJR.12865
Abstract: To explore rural motor vehicle collision (MVC) fatalities by trends over time, mode of transport, age, state, sex, and Aboriginal and Torres Strait Islander status. A retrospective total population‐based time series was conducted using the Australian Bureau of Statistics (ABS) death registration data. All statistical local area (SLA) within Australia from 2006 to 2017. Australian residents whose deaths were registered with the ABS between 01 January 2006 and 31 December 2017 where the underlying cause of death was related to unintentional transport accidents. Fatality rates were determined using population data collected from the 2006, 2011 and 2016 census. Trends over time by rurality were analysed by financial year. Rates of transport deaths by vehicle type were determined by rurality. Risk ratios were calculated to compare demographic groups based on sex, Aboriginal and Torres Strait Islander status and age. A 3‐year scorecard was organised by state and rurality using 99.7% confidence intervals. Motor vehicle collision fatalities increase with increasing remoteness. Females, children from 0 to 14 years, pedestrians, and Aboriginal and Torres Strait Islander peoples are at a significantly higher risk of fatal MVCs than their respective metropolitan counterparts. The 3‐year scorecard indicates that road fatality rates in the NT, WA, and all rural and remote areas required immediate attention and targeted action. There is a need for investment in MVC fatality prevention in rural Australia from inner regional to remote areas in order to meet the road safety targets established by the National Road Safety Strategy.
Publisher: BMJ
Date: 30-03-2019
DOI: 10.1136/INJURYPREV-2019-043156
Abstract: Internationally, rivers are a leading drowning location, yet little evidence exists evaluating river drowning prevention strategies. This study aims to use expert opinion to identify strategies more likely to be effective. Using a modified Delphi process, a virtual panel of 30 experts from 12 countries considered, grouped and prioritised strategies for river drowning prevention. Proposed strategies were assessed against known evidence and suitability in high-income countries (HICs) as well as low-income and middle-income countries (LMICs) using expert opinion. The final phase consolidated a list of strategies whose effectiveness was assessed against 10 evidence-based river drowning scenarios. An initial list of 424 prevention strategies was refined to 22. After being assessed against the 10 scenarios, a final list of 13 strategies was derived. Strategies addressed alcohol consumption around rivers, flood mitigation, improving child supervision, learning to swim, increased lifejacket wear and achieving community-wide resuscitation skills. While all 13 strategies were assessed as being effective in both LMICs and HICs by at least 60% of the respondents, further work is required to define river drowning at a country level and therefore allow for effective solutions to be developed, particularly in LMICs. No strategy will be effective in isolation and must be implemented alongside policy and behaviour change, public awareness and education. Evaluation should be incorporated as part of any future implementation of strategies. This Delphi process identified 13 drowning prevention strategies for rivers. Further research is required to validate the efficacy of these findings through implementation and evaluation.
Publisher: MDPI AG
Date: 27-07-2019
Abstract: Disasters, such as flooding, are predicted to increase. Drowning is one of the leading causes of death during times of flood. This study examined the little explored topic of child drowning during floods, with the aim of identifying risk factors to inform prevention strategies. A retrospective, total population examination of cases of children and adolescents aged 0–19 years who died from unintentional flood-related drowning in Australia for the 16-year period 1 July 2002 to 30 June 2018 was undertaken. Univariate and chi-square analysis was conducted, with Fisher’s exact test used for cell counts . Across the study period, 44 flood-related drowning deaths occurred among children and adolescents (63.6% male 34.1% aged 10–14 years). Almost all (84.1%) occurred in rivers, creeks, or streams in flood, with the remaining incidents occurring in storm water drains (n = 7). Leading activities immediately prior to drowning were non-aquatic transport (40.9%), swimming in floodwaters (25.0%), and falls into floodwaters (15.9%). Flood-related fatal drowning among children and adolescents is rare (0.05 per 100,000 population), however flood-drowning risk increases as remoteness increases, with children and adolescents drowning in floodwaters in very remote areas at a rate 57 times that of major cities. All drownings are preventable, and this study has identified key causal factors that must be considered in advocacy and prevention efforts. These include: the importance of adult supervision, avoiding flooded waterways when driving or for recreational purposes, and the increased risks for those residing in geographically isolated and socially disadvantaged areas. Findings must be considered when developing interventions and advocacy for the purposes of the reduction of child and adolescent drowning during times of flood.
Publisher: Public Library of Science (PLoS)
Date: 20-05-2021
DOI: 10.1371/JOURNAL.PONE.0251938
Abstract: Suicide is an increasing global concern with multiple risk factors, yet location-based understanding is limited. In Australia, surf lifesavers (SLS) and lifeguards patrol the coast, performing rescues and assisting injured people, including people who suicide. This study is a descriptive epidemiological analysis of Australian coastal suicide deaths. The results will be used to inform training and support surf lifesaving personnel and suicide prevention organisations. This is a population-based cross-sectional study of suicide deaths at Australian coastal locations (between 1 January 2005 and 31 December 2019). Data were sourced from the National Coronial Information System and SLS Australia’s Incident Report Database. Analyses explored decedent, incident, and risk factors by sex and method. Across the study period, there were 666 coastal suicide deaths (71.0% male, 43.4% jumping from high places [X80]). Males were more likely to suicide by other means (hanging, self-poisoning, firearm discharge n = 145, 83.8%), compared to females who were more likely to suicide by drowning ([X71] n = 77, 37.7%). In one third (n = 225, 38.3%) toxicology was a contributing factor. The risk of coastal suicides was 10.3 times higher during the seven-days prior to their birthday (p .001). Evidence of mental ill health was reported in 61.4% (n = 409) of cases and evidence of suicidal behaviour was reported for 37.4% of decedents (n = 249), more prevalent in females. SLS responded in 10.7% (n = 71) of coastal suicides (most jumps from high places n = 36, 50.7%). Coastal suicides differ to national trends suggesting that location-based differences should be considered during development of preventative and protective measures, especially at a community level. Accessibility, availability, perceived lethality and symbolic qualities are proposed to influence suicide location decisions. These results will guide support and education strategies for surf lifesaving personnel, contributes to established, ongoing suicide surveillance efforts (including hot-spot identification) and add to the limited literature exploring place-based suicide.
Publisher: Wiley
Date: 24-01-2018
Abstract: The transition from work to retirement is a complex process and unique experience with a relationship existing between work and retirement with implications for health in later life. This review explored the relationship between pre-retirement job and participation in the work-to-retirement transition process in Australia by exploring: (i) factors influencing retirement in relation to pre-retirement job (ii) how jobs are classified (iii) the effect of pre-retirement job (based on categories) on this occupational transition and (iv) the potential role for occupational therapy in this occupational transition. An integrative literature review was completed. PRISMA guidelines were used. Study designs were analysed for methodological quality using the National Health and Medical Research Council levels of evidence. Thematic analysis determined retirement factors which were used to compare differences between jobs. This review included 15 papers. There were two Level III-2, one Level III-3 and 13 Level IV studies. Factors influencing retirement related to the stages of work, preparation, transition and retired. White collar and blue collar was the most common job classification system. Although white collar and blue collar worker definitions utilised were inconsistent, differences between the two groups were still determined in all stages. Differences in the work-to-retirement transition process, based on pre-retirement job, are evident. Understanding differences by job groupings may assist occupational therapists to understand in idualised needs during this occupational transition and subsequent tailoring of interventions (both in idual and group based) to enable engagement in meaningful occupation in the work-to-retirement occupational transition to effect active healthy ageing.
Publisher: Oxford University Press (OUP)
Date: 05-06-2013
Abstract: falls in older adults is a significant global public health challenge. Exercise interventions which incorporate the physiological components of balance and strength can reduce falls risk. However, the optimum qualities, such as type, duration and frequency of engagement in these exercise programmes, are yet to be established. the overall research project aimed to develop and test a tool for the assessment of physiological criteria in community exercise programmes and to determine which community exercise programmes may be modified to help reduce falls risk factors. This initial phase of the research and the aim of this paper are to describe the development of the Community Exercise Program Assessment Matrix (the Matrix). a review of the falls literature identified an existing classification system, which guided the development of the Matrix. An expert panel assisted in reviewing, testing and ongoing refinement of the Matrix. the Matrix contains a range of physiological and cognitive components as well as other items which capture non-physiological components. After testing some modifications were made to the Matrix to aid usage. this paper has outlined the development of the Matrix, which is intended to be used for the recording of physiological components (related to falls prevention) of an exercise programme in terms of type, duration and frequency. The next step is to use the Matrix in conjunction with pre- and post-physiological testing of participants to assess a range of exercise programmes and changes in participant physiological functioning.
Publisher: Elsevier BV
Date: 08-2019
Publisher: Springer Science and Business Media LLC
Date: 12-2018
Publisher: Informa UK Limited
Date: 02-11-2022
Publisher: Springer Science and Business Media LLC
Date: 22-07-2022
Publisher: Public Library of Science (PLoS)
Date: 2015
Publisher: BMJ
Date: 12-2017
DOI: 10.1136/BMJOPEN-2017-019407
Abstract: Fatal drowning estimates using a single underlying cause of death (UCoD) may under-represent the number of drowning deaths. This study explores how data vary by International Classification of Diseases (ICD)-10 coding combinations and the use of multiple underlying causes of death using a national register of drowning deaths. An analysis of ICD-10 external cause codes of unintentional drowning deaths for the period 2007–2011 as extracted from an Australian total population unintentional drowning database developed by Royal Life Saving Society—Australia (the Database). The study analysed results against three reporting methodologies: primary drowning codes (W65-74), drowning-related codes, plus cases where drowning was identified but not the UCoD. Australia, 2007–2011. Unintentional fatal drowning cases. The Database recorded 1428 drowning deaths. 866 (60.6%) had an UCoD of W65-74 (accidental drowning), 249 (17.2%) cases had an UCoD of either T75.1 (0.2%), V90 (5.5%), V92 (3.5%), X38 (2.4%) or Y21 (5.9%) and 53 (3.7%) lacked ICD coding. Children (aged 0–17 years) were closely aligned (73.9%) however, watercraft (29.2%) and non-aquatic transport (13.0%) were not. When the UCoD and all subsequent causes are used, 67.2% of cases include W65-74 codes. 91.6% of all cases had a drowning code (T75.1, V90, V92, W65-74, X38 and Y21) at any level. Defining drowning with the codes W65-74 and using only the UCoD captures 61% of all drowning deaths in Australia. This is unevenly distributed with adults, watercraft and non-aquatic transport-related drowning deaths under-represented. Using a wider inclusion of ICD codes, which are drowning-related and multiple causes of death minimises this under-representation. A narrow approach to counting drowning deaths will negatively impact the design of policy, advocacy and programme planning for prevention.
Publisher: Elsevier BV
Date: 11-2019
Publisher: S. Karger AG
Date: 2012
DOI: 10.1159/000338698
Abstract: The aquatic environment is a complex mix of waterways with varying uses and hazards. It is the intersection of the use of the water and the hazards which provides enjoyment to those who use them as well as risk to a person's health. Canoeing, kayaking and rafting have and continue to be popular recreation sports in aquatic environments. This chapter explores participation in, risks associated with and prevention strategies for keeping canoeists, kayakers and rafters safe and healthy. There is a dearth of good quality descriptive studies exploring these issues, particularly around the risks involved and the effectiveness of proposed prevention strategies. According to Outdoor Foundation, there are 23.9 million people in the USA who undertake paddling activities per annum, with canoeing (10.1 million) being the most popular activity followed by recreational kayaking (6.2 million). There were 141 deaths of canoeists (89) and kayakers (52) identified by the US Coast Guard in their recreational boating statistics data for 2009. The crude rate of death per 100,000 participants for canoeing ranges between 0.72 and 0.92 and for kayaking between 0.37 and 0.41 per annum. Although death is the most severe consequence of a misadventure while paddling, there are a range of other hazards faced such as hitting objects, waterborne diseases, hypothermia from unintended submersion, blisters, muscle strain, cuts and abrasions. There are a range of prevention strategies which have been proposed and provided in this chapter. However, there is very little evidence of their effectiveness. Further research is required in understanding the risk associated with paddling activities, the effectiveness of prevention strategies and how these strategies might be delivered.
Publisher: Wiley
Date: 17-03-2022
DOI: 10.1111/AJR.12861
Abstract: To address access to cardiac rehabilitation (CR) for people in R&R areas, this research aimed to investigate: (1) post discharge systems and support for people returning home from hospital following treatment for heart disease (HD). (2) propose changes to improve access to CR in R&R areas of NQ. Four focus communities in R&R areas of NQ. Focus communities' health staff (resident/visiting) (57), community leaders (10) and community residents (44), discharged from hospital in past 5 years following treatment for heart disease (purposeful s ling). A qualitative descriptive case study, with data collection via semi-structured interviews. Inductive/deductive thematic analysis was used to identify primary and secondary themes. Health service audit of selected communities. Health services in the focus communities included multipurpose health services, and primary health care centres staffed by resident and visiting staff that included nurses, Aboriginal and Torres Strait Islander Health Workers, medical officers, and allied health professionals. Post-discharge health care for people with HD was predominantly clinical. Barriers to CR included low referrals to community-based health professions by discharging hospitals poorly defined referral pathways lack of guidelines inadequate understanding of holistic, multidisciplinary CR by health staff, community participants and leaders limited centre-based CR services lack of awareness, or acceptance of telephone support services. To address barriers identified for CR in R&R areas, health care systems' revision, including development of referral pathways to local health professionals, CR guidelines and in-service education, is required to developing a model of care that focuses on self-management and education: Heart: Road to Health.
Publisher: Rural and Remote Health
Date: 07-11-2018
DOI: 10.22605/RRH4738
Publisher: BMJ
Date: 03-08-2017
DOI: 10.1136/INJURYPREV-2017-042351
Abstract: Drowning is a global public health issue and prevention poses an ongoing challenge for all countries. Many nations are experiencing ageing populations, and little is known about the epidemiology, risk factors and prevention of drowning deaths among older people. This paper reports on a systematic review of literature published on drowning among older people. A systematic literature review was undertaken using English-language, Portuguese-language and Spanish-language papers published between 1980 and 2015. The review explores gaps in the literature with a focus on the epidemiology, risk factors and strategies for the prevention of unintentional fatal drowning among people 50 years and over. Thirty-eight papers were deemed relevant to the study design, including 18 (47%) on epidemiology, 19 (50%) on risk factors and 9 (24%) on strategies for prevention. Risk factors identified included male gender, ethnicity, rurality and increasing age. Prevention strategies commonly proposed were education and wearing life jackets. Gaps identified in the published literature include a lack of consistency around age groupings used for epidemiological studies a lack of consensus on risk factors a lack of total population, country-level analysis and the need for older age-specific prevention strategies that have been implemented and their effectiveness evaluated. This review identified drowning deaths among older people as a global issue. Further work is required to reduce drowning in this cohort. High-quality epidemiological studies identifying risk factors using standardised age groupings to allow for international comparisons are required, as are implementation and evaluation of older age-specific prevention strategies.
Publisher: Wiley
Date: 17-05-2016
Abstract: Retirement from paid work is an occupational transition, which can have a profound impact on a person's life. This review explored occupational therapy's contribution to and involvement in the work-to-retirement transition process in Australia. An integrative literature review was undertaken using seven article repository databases. PRISMA guidelines informed searches. Articles were included if participants were Australian researchers' discussed retirement from an occupational perspective or the scope of practice of occupational therapists and publication was from 1994 to June 2015 in a peer-reviewed journal. Articles were critically appraised and thematic analysis explored: (i) occupational perspective, (ii) occupational therapy scope of practice, (iii) theory and (iv) retirement definitions. Eight articles met the review criteria. Three occupational perspective themes were identified: retirement intention influences, retirement preparation and retirement roles and activities. No articles on the current scope of practice of occupational therapy were found. Three articles discussed potential occupational therapy approaches. Three themes on what retirement is were identified: complete cessation, gradual transition and intermittent worker. Four theory themes were identified: occupational therapy, ageing, identity and work. Occupational therapy has the potential to be involved in improving health and well-being for people in the work-to-retirement transition process. It is suggested that future research explore not only people's experiences but also the approaches of occupational therapy in assisting people through this occupational transition. The use of theory to guide Australian occupational therapy practice on retirement should also be explored. The use of consistent retirement definitions will assist in understanding research.
Publisher: Public Library of Science (PLoS)
Date: 25-02-2015
Publisher: Cambridge University Press (CUP)
Date: 13-05-2019
DOI: 10.1017/S1049023X1900431X
Abstract: Natural disasters often damage or destroy the protective public health service infrastructure (PHI) required to maintain the health and well-being of people with noncommunicable diseases (NCDs). This interruption increases the risk of an acute exacerbation or complication, potentially leading to a worse long-term prognosis or even death. Disaster-related exacerbations of NCDs will continue, if not increase, due to an increasing prevalence and sustained rise in the frequency and intensity of disasters, along with rapid unsustainable urbanization in flood plains and storm-prone coastal zones. Despite this, the focus of disaster and health systems preparedness and response remains on communicable diseases, even when the actual risk of disease outbreaks post-disaster is low, particularly in developed countries. There is now an urgent need to expand preparedness and response beyond communicable diseases to include people with NCDs. The developing evidence-base describing the risk of disaster-related exacerbation of NCDs does not incorporate the perspectives, concerns, and challenges of people actually living with the conditions. To help address this gap, this research explored the key influences on patient ability to successfully manage their NCD after a natural disaster. A survey of people with NCDs in Queensland, Australia collected data on demographics, disease, disaster experience, and primary concern post-disaster. Descriptive statistics and chi-square tests with a Bonferroni-adjustment were used to analyze data. There were 118 responses to the survey. Key influences on the ability to self-manage post-disaster were access to medication, medical services, water, treatment and care, power, and food. Managing disease-specific symptoms associated with cardiovascular disease, diabetes, mental health, and respiratory diseases were primary concerns following a disaster. Stress and anxiety, loss of sleep, weakness or fatigue, and shortness of breath were common concerns for all patients with NCDs. Those dependent on care from others were most worried about shortness of breath and slow healing sores. Accessing medication and medical services were priorities for all patients post-disaster. The key influences on successful self-management post-disaster for people with NCDs must be reflected in disaster plans and strategies. Achieving this will reduce exacerbations or complications of disease and decrease demand for emergency health care post-disaster.
Publisher: Wiley
Date: 07-01-2022
Abstract: Retirement, being a major life event and a focus of healthy ageing in society, creates the opportunity for occupational therapists to support people transitioning from work to retirement. Little is known about the scope of practice of occupational therapy in the work‐to‐retirement transition. The aim of this study was to, in Australia, (1) explore the potential scope of practice and factors influencing the potential scope of practice of occupational therapy in the work‐to‐retirement transition and (2) map findings to occupational therapy theoretical frameworks to assist in articulating scope of practice. A qualitative study (thematic analysis as an independent approach within a qualitative descriptive methodology) was undertaken using semi‐structured interviews with Australian occupational therapists. Australian occupational therapists ( n = 14) were interviewed. Four themes were identified which related to the potential scope of occupational therapy practice in the work‐to‐retirement transition: finding meaningful occupation modifying lifestyles and homes for better living work engagement and application of occupational therapy skills . Six themes were identified which related to contextual factors influencing the potential scope of occupational therapy practice in the work‐to‐retirement transition: right time valuing our expertise promoting occupation(al therapy) finding the money life, work and retirement longevity and social responsibility . The work‐to‐retirement transition can be incorporated into other practice areas or can be a unique practice area allowing for a more targeted service. The frameworks of who, what, when, and where and enablement skills assist in articulating occupational therapy scope of practice in the work‐to‐retirement transition. A number of contextual factors can be barriers and/or facilitators to occupational therapy practice. More clearly articulating occupational therapy practice in the work‐to‐retirement transition will enable the profession to promote their scope of practice assisting in obtaining professional and public recognition and overcoming barriers such as funding to enable provision of services within this area.
Publisher: Elsevier BV
Date: 05-2023
Publisher: BMJ
Date: 09-2010
Publisher: Wiley
Date: 13-08-2019
DOI: 10.1002/HPJA.282
Abstract: There is a scarcity of research into portable pool drowning and its prevention. This total population study examines fatal drowning among children under five in portable pools in Australia. All child drowning deaths in portable pools for the period 1 July 2002 to 30 June 2018 were identified. A portable pool was defined as any structure used for swimming and wading which, when emptied, can be moved. Twenty-three children (aged 0-17 years) drowned in portable pools. The drowning rate for children less than 5 years of age was 0.09 per 100 000 population. The peak age of death was 12-23 months (RR = 2.99 CI: 1.09-8.23), with the majority (n = 20 deaths) aged 16-31 months. Ninety per cent followed a fall into water. None were supervised. Children commonly resided in areas classified as socially and economically disadvantaged (85% n = 17). Drowning rates in very remote areas were 15 times greater (RR = 15.41 CI: 0.03-7579.65) than city children. Eleven (55%) drowning deaths occurred in pools with a depth >300 mm, of which 10 (91%) were known to be unfenced. Social determinants impact child drowning in portables pools, which can occur quickly and in just 150 mm of water. Active supervision and a regulation-compliant barrier are effective prevention stratagems, factors which were absent from the deaths in this study. SO WHAT?: Portable pool drowning disproportionately impacts those aged 16-31 months who reside in very remote areas and areas classified as having high socio-economic disadvantage. Education for these groups on fencing and supervision of children must be provided.
Publisher: Springer Science and Business Media LLC
Date: 20-04-2014
Publisher: Wiley
Date: 08-2014
DOI: 10.1111/AJR.12114
Abstract: Falls in older adults represent a significant challenge in Australia however, the focus is often on urban-dwelling older adults. The aim of this review was to explore the literature on falls epidemiology and falls prevention interventions (FPI). A literature review was conducted searching Medline, Scopus, Social Sciences Citation Index, Google Scholar, Google and the Australian Institute of Health and Welfare publication catalogue. Rural and remote Australia. Rural and remote community dwelling Australians aged 50 years and older. Literature review. Falls epidemiology and effective falls prevention interventions. Twenty references were identified: 14 related to falls epidemiology and 7 to FPI. No significant differences were found between rural, remote and major cities residents in relation to falls hospitalisation, falls mortality or fall-related injuries sustained. There are a wide assortment of health professionals and non-health professionals who are involved in providing FPI in rural and remote Australia. However, there was limited information on the effectiveness of these interventions in influencing falls outcomes. Few studies explored falls and their prevention in rural and remote Australia. The limited literature on the topic suggests that a change in focus to one that utilises existing services and resources will be required to create sustainable outcomes. Four areas are proposed for concentrated effort to reduce the impact of fall-related injury in rural and remote Australia: integration and collaboration among health professionals, promotion of physical activity across the lifespan, community involvement and ownership of interventions, and evaluation and publication of findings.
Publisher: Public Library of Science (PLoS)
Date: 22-05-2020
Publisher: Springer Science and Business Media LLC
Date: 2019
Publisher: Springer Science and Business Media LLC
Date: 25-10-2022
DOI: 10.1038/S41467-022-33627-9
Abstract: Snakebite envenoming is an important cause of preventable death. The World Health Organization (WHO) set a goal to halve snakebite mortality by 2030. We used verbal autopsy and vital registration data to model the proportion of venomous animal deaths due to snakes by location, age, year, and sex, and applied these proportions to venomous animal contact mortality estimates from the Global Burden of Disease 2019 study. In 2019, 63,400 people (95% uncertainty interval 38,900–78,600) died globally from snakebites, which was equal to an age-standardized mortality rate (ASMR) of 0.8 deaths (0.5–1.0) per 100,000 and represents a 36% (2–49) decrease in ASMR since 1990. India had the greatest number of deaths in 2019, equal to an ASMR of 4.0 per 100,000 (2.3—5.0). We forecast mortality will continue to decline, but not sufficiently to meet WHO’s goals. Improved data collection should be prioritized to help target interventions, improve burden estimation, and monitor progress.
Publisher: Korean Society for Preventive Medicine
Date: 30-09-2017
DOI: 10.3961/JPMPH.17.040
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.JSR.2019.06.005
Abstract: Recreational boating is a popular pastime in many high income countries, and is a leading activity prior to drowning. This study reports on unintentional fatal drowning associated with boating-related incidents in Australia. A total population, retrospective, cross sectional design examined all boating-related unintentional drowning deaths between July 1, 2005 and June 30, 2015. Variables examined included age, sex, location of drowning incident, vessel type, activity, presence of alcohol/drugs, and lifejacket wear. Relative risk (with a 95% confidence interval) was calculated using fatal drowning rates per 100,000 population and rates per 100,000 registered vessels. Chi square analysis and non-parametric tests for significance were applied. Statistical significance was deemed p < .05. A total of 415 people drowned while boating during the study period, 91.8% male and 35.7% aged between 25 and 44 years. Men were 10 times more likely to drown when boating than females (RR = 10.64 CI:7.55-14.97). Over one-quarter (28.7%) of incidents involved alcohol, in 30.6% drugs were identified (31.3% were illegal) and 90.4% were not wearing a lifejacket. Children were more at risk of drowning on a houseboat than adults (RR = 7.13 CI:1.61-31.61). Females were more likely to drown than males when using a personal watercraft (RR = 10.53 CI:2.75-40.33). Boaters may be taking unnecessary risks by disregarding safety regulations, such as not wearing lifejackets and substance use (such as alcohol and illegal drugs). Boating in remote locations presents a high risk of drowning. While safety regulations are in place, enforcement and behavior change remain challenges. Practical application: Findings support recommendations for increased enforcement of alcohol-related regulations and introducing drug-testing for boaters. Consistency of boating safety regulations, especially around lifejacket wear, is recommended to influence behavior change. The effectiveness of current lifejacket regulations need to be critically evaluated in the context of increasing wear rates for adults and children.
Publisher: Elsevier BV
Date: 08-2019
Publisher: SAGE Publications
Date: 29-03-2019
Abstract: Gender is constructed from social and cultural meanings that dynamically shift and vary. Previous work has assumed that the constructions of masculinity in Australia are like those in other Western societies, and typically focus on qualities such as physical strength, courage and sometimes military engagement. This study explores whether these assumptions hold, by conducting telephone interviews among 617 Queensland men, aged 18 years and above, across all geographical parts of Queensland. This survey was administered in 2013, as part of the Queensland Social Survey series. The study explores the erse meanings associated with being a ‘real man’ given by the survey participants. Three main dimensions emerged from the thematic analysis: physicality personality and character social roles and relationships. The study confirmed that masculinities are dynamic and complex. Responses revealed a surprising emphasis on character and morality 44.5% (n = 684) as defining manhood, as against physical qualities 13.7% (n = 153).
Publisher: Springer Berlin Heidelberg
Date: 26-10-2013
Publisher: MDPI AG
Date: 02-01-2023
DOI: 10.3390/SU15010813
Abstract: Extreme weather events can cause significant human, economic and infrastructure losses. Within a changing climate, heatwaves, droughts, and floods are becoming more frequent and severe. Unfortunately, those who are most vulnerable are often disproportionately impacted. In this study, we examined the epidemiology of weather-related fatalities due to excessive heat (International Classification of Diseases [ICD]-10 codes X30) excessive cold (X31) storm and flood (X37 X38) and other causes (X32, X33, X39) in Australia between 2006–2019. There were 682 deaths due directly to weather-related events (41% excessive cold 37% excessive heat 15% storms and floods). The mean age of a weather-related victim in Australia was 60.8 years (SD = 24.1), with people aged 65+ years 12.8 times (95% confidence interval [CI]: 9.23–17.6) more likely to die due to a weather-related event. As the planet warms our study identifies declining excessive cold-related deaths, while other types of weather events remain steady or increase. In the context of climate change we must protect those most at risk children and adolescents due to storms and floods, those with co-morbidities (particularly circulatory system disorders) and the elderly. Special attention should be paid to preventing excessive heat-related death among Aboriginal and Torres Strait Islander Peoples and international visitors.
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.AUEC.2022.07.002
Abstract: Acute appendicitis is the most common cause of acute abdominal pain presentations to the ED and common air ambulance transfer. describe how linked data can be used to explore patients' journeys, referral pathways and request-to-activation responsiveness of patients' appendectomy outcomes (minor vs major complexity). Data sources were linked: aeromedical, hospital and death. Request-to-activation intervals showed strong right-tailed skewness. Quantile regression examined whether the longest request-to-activation intervals were associated with appendicitis complexity in patients who underwent an appendectomy. There were 684 patients in three referral pathways based on hospital capability levels. In total, 5.6 % patients were discharged from ED. 83.3 % of all rural origins entered via the ED. 3.8 % of appendicitis patients were triaged to tertiary hospitals. Appendectomy patients with major complexity outcomes were less likely to have longer request-to-activation wait times & had longer lengths of stay than patients with minor complexity outcomes. Linked data highlighted four aspects of a functioning referral system: appendectomy outcomes of major complexity were less likely to have longer request-to-activation intervals compared to minor (sicker patients were identified) few were discharged from EDs (validated transfer) few were triaged to tertiary hospitals (appropriate level for need), and no deaths relating to appendectomy.
Publisher: Elsevier BV
Date: 02-2023
Publisher: Elsevier BV
Date: 09-2020
Publisher: Springer Singapore
Date: 2021
Publisher: Springer Science and Business Media LLC
Date: 07-09-2022
DOI: 10.1186/S12916-022-02486-Y
Abstract: Onchocerciasis is a disease caused by infection with Onchocerca volvulus , which is transmitted to humans via the bite of several species of black fly, and is responsible for permanent blindness or vision loss, as well as severe skin disease. Predominantly endemic in parts of Africa and Yemen, preventive chemotherapy with mass drug administration of ivermectin is the primary intervention recommended for the elimination of its transmission. A dataset of 18,116 geo-referenced prevalence survey datapoints was used to model annual 2000–2018 infection prevalence in Africa and Yemen. Using Bayesian model-based geostatistics, we generated spatially continuous estimates of all-age 2000–2018 onchocerciasis infection prevalence at the 5 × 5-km resolution as well as aggregations to the national level, along with corresponding estimates of the uncertainty in these predictions. As of 2018, the prevalence of onchocerciasis infection continues to be concentrated across central and western Africa, with the highest mean estimates at the national level in Ghana (12.2%, 95% uncertainty interval [UI] 5.0–22.7). Mean estimates exceed 5% infection prevalence at the national level for Cameroon, Central African Republic, Democratic Republic of the Congo (DRC), Guinea-Bissau, Sierra Leone, and South Sudan. Our analysis suggests that onchocerciasis infection has declined over the last two decades throughout western and central Africa. Focal areas of Angola, Cameroon, the Democratic Republic of the Congo, Ethiopia, Ghana, Guinea, Mali, Nigeria, South Sudan, and Uganda continue to have mean microfiladermia prevalence estimates exceeding 25%. At and above this level, the continuation or initiation of mass drug administration with ivermectin is supported. If national programs aim to eliminate onchocerciasis infection, additional surveillance or supervision of areas of predicted high prevalence would be warranted to ensure sufficiently high coverage of program interventions.
Publisher: Wiley
Date: 10-10-2023
DOI: 10.1111/AJR.12932
Abstract: To focus on the needs, challenges and opportunities to improve access to cardiac rehabilitation (CR) (Heart: Road to health [HRH]) for Aboriginal and Torres Strait Islander peoples in rural and remote (R& R) areas of North Queensland. It is known that there is insufficient access to HRH for Aboriginal and Torres Strait Islander peoples in R& R areas of NQ, who have the highest rates of heart disease and socioeconomic disadvantage mainly due to poor social determinants of health. However, at least in part due to the impact of colonialism and predominantly western medicalised approach to health care, few gains have been made. This commentary draws on recent research and literature and reflects on cultural issues that impact on improving access to an HRH for Aboriginal and Torres Strait Islander peoples in R& R areas. The underutilisation of the skills of Aboriginal and Torres Strait Islander Health Workers (ATSIHW) and a lack of a defined process to ensure access to culturally responsive HRH are discussed. Finally, a way forward is proposed that includes the development of policies, pathways and guidelines to ensure that appropriate support is available in the client's home community. It is proposed that culturally responsive, accessible and effective HRH is achievable through the reorientation of current health systems that include a continuous client‐centred pathway from hospital to home. In this model, ATSIHW will take a lead or partnership role in which their clinical, cultural brokerage and health promotion skills are fully utilised.
Publisher: Frontiers Media SA
Date: 04-01-2023
Publisher: American Medical Association (AMA)
Date: 07-2015
Publisher: SAGE Publications
Date: 02-10-2019
DOI: 10.33151/AJP.16.752
Abstract: IntroductionHistorically, survival rates from out-of-hospital cardiac arrest (OHCA) have been low. In recent times, survival rates have increased substantially in some small population pockets, which sparked general interest in this field and the volume of research increased. Included was an increase in the number of strategies being investigated to improve outcomes. The aim of this review is to assemble these strategies and consolidate the findings of the pharmaceutical strategies.MethodsThis is a systematic search and review, rather than a systematic review. Four databases (MEDLINE, CINAHL, Informit, Scopus) were searched for papers published between 2007 and 2017 containing strategies that may be used by paramedics when resuscitating adult (18+ years) patients in cardiac arrest from presumed cardiac aetiology in the out-of-hospital environment. The search was undertaken in February 2017. Five separate search concepts were used on all databases. Each concept consisted of multiple search terms.ResultsThis review identified 28 separate studies for final review, which formulated six strategies. These were: use of a modified resuscitation protocol use of a mechanical chest compression device intra-thoracic pressure regulation vasopressin administration thrombolysis administration application of therapeutic hypothermia. This paper reports on the full results of the pharmaceutical strategies (vasopressin or thrombolysis administration). Part B will address the non-pharmaceutical strategies.ConclusionThere is no evidence to support the introduction of vasopressin or thrombolysis use during OHCA. Future studies should focus on study design and specific patient subsets.
Publisher: Wiley
Date: 21-12-2022
DOI: 10.1111/AJR.12818
Abstract: To assess implementation of in‐patient cardiac rehabilitation (Phase‐1‐cardiac rehabilitation), impact on people in rural and remote areas of Australia and potential methods for addressing identified weaknesses. Exploratory case study methodology using qualitative and quantitative methods. Qualitative data collection via semi‐structured interviews, using thematic analysis, augmented by quantitative data collection via a medical record audit. Four regional hospitals (2 Queensland Health and 2 private) providing tertiary health care. (a) Hospital in‐patients with heart disease ≥18 years. (b) Staff responsible for their care. Implementation of Phase‐1‐cardiac rehabilitation in tertiary hosptials in North Queensland and the impact on in‐patients discharge planning and post discharge care. Recommentations and implications for practice are proposed to address deficits. Phase‐1‐cardiac rehabilitation implementation rates, in‐patient understanding and multidisciplinary team involvement were low. The highest rates of Phase‐1‐cardiac rehabilitation were for in‐patients with a length of stay three days or more in cardiac units with cardiac educators. Rates were lower in cardiac units with no cardiac educators, and lowest for in‐patients in all areas of all hospitals with length of stay of two days or less days. Low Phase‐1‐cardiac rehabilitation implementation rates resulted in poor in‐patient understanding about their disease, treatment and post‐discharge care. Further, medical discharge summaries rarely mentioned cardiac rehabilitation/secondary prevention or risk factor management resulting in a lack of information for health care providers on cardiac rehabilitation and holistic health care. Implementation of Phase‐1‐cardiac rehabilitation in regional hospitals in this study fell short of recommended best practice, resulting in patients' poor preparation for discharge, and insufficient information on holistic care for health care providers in rural and remote areas. These factors potentially impact on holistic care for people returning home following treatment for heart disease.
Publisher: Elsevier BV
Date: 03-2018
Publisher: SAGE Publications
Date: 2019
DOI: 10.33151/AJP.16.753
Abstract: Out-of-hospital cardiac arrest (OHCA) historically has low survival rates. Higher rates of survival have recently developed in some small geographical areas, which pre-empted an increase in the volume of research in this field. The aim of this paper is to consolidate the findings of the strategies that do not focus on drugs. This is a systematic search and review, rather than a systematic review. A search of four databases (MEDLINE, CINAHL, Informit, Scopus) was undertaken in February 2017. Papers published between 2007 and 2017 containing strategies that may be used by paramedics when resuscitating adult patients in OHCA from presumed cardiac aetiology were identified. Twenty-eight studies were included in the review, comprising six separate strategies. This manuscript reports on the four non-pharmaceutical strategies (use of a modified resuscitation protocol use of a mechanical chest compression device intra-thoracic pressure regulation and application of therapeutic hypothermia). Use of a modified resuscitation protocol to improve the quality of cardiopulmonary resuscitation, was the only strategy showing evidence to warrant a recommendation for immediate implementation. Future studies should focus on strategy specific patient subsets.
Publisher: Wiley
Date: 09-05-2019
DOI: 10.1002/HPJA.254
Abstract: Cycling participation rates in Australia and Queensland remain low. Rural residents typically do not have distinct cycling infrastructure available for use. Investigating current cycling participation and barriers to cycling engagement will inform future work to promote cycling engagement. Data were collected through the inclusion of cycling-related questions in the 2012 Queensland Social Survey. The majority of the s le had not cycled in the previous 12 months (66% n = 831). Significantly more rural residents reported not cycling due to environmental concerns (P < 0.05) and preferring other modes of transport or exercise (P < 0.01). Rural cyclists (31.4% n = 113) had higher levels of cycling engagement in the previous week (41.6% to 32.6% urban χ One-third of all adults cycled in the previous 12 months irrespective of location however reasons for not cycling varied by urban/rural location. Results indicate that environmental factors appear to be inhibiting cycling participation in rural areas. Advocating for government commitment for infrastructure development to support safe cycling across Queensland including outside of metropolitan areas is required. SO WHAT?: This research explores self-reported cycling engagement amongst a s le of urban and rural dwelling Queenslanders. Differences in cycling exposure and reasons for lack of engagement offer insights into what may encourage greater cycling participation.
Publisher: Wiley
Date: 02-05-2018
Abstract: To give voice to the general public's views of prospective and retrospective (deferred) consent in the emergency research setting. A cross-sectional, stratified population-based, telephone survey was conducted in April to July 2016. A questionnaire consisting of standardised health and demographic details, and seven specifically designed, and pilot-tested questions, five closed and two open text, based on literature review and previous surveys in the field was used. Quantitative and qualitative techniques were used in the data analysis. This was a centrally coordinated national telephone survey in Australia, the 2016 National Social Survey, coordinated by Central Queensland University. Data for 1217 adult (18+ years) participants were included in the analysis, with a response rate of 26%. The s le demographics were broadly representative of the Australian population. The majority of respondents were supportive of research in emergency circumstances without prospective informed consent. However, the type of research and level of risk influence its acceptability. Common themes in qualitative analysis included the critical or life-threatening nature of the illness being researched, and the potential harms and benefits of participation. This research provided the first opportunity for the community to contribute to discourse about prospective and retrospective (deferred) consent in the emergency research setting in Australia. Further work is needed to determine community expectations of how this process can be optimised and implemented, and to identify potential situations where this may not be acceptable.
Publisher: Elsevier BV
Date: 06-2020
Publisher: American Society of Agricultural and Biological Engineers (ASABE)
Date: 2006
DOI: 10.13031/2013.20388
Abstract: Hearing injury due to exposure to excessive noise during common farming activities is a significant problem for farmers. The aim of this study was to investigate factors that affect the level of risk to hearing caused by common farming activities. Noise levels on farms were measured across a range of activities and producer groups, and situational factors that effect noise levels were also investigated. Older tractors were found to be 6 dB louder than newer tractors. Cabs reduced noise to the operator by 16 dB, which was halved to 8 dB if a door was open. Radios added between 3 and 5 dB to the noise in the cab. These variables significantly affect the noise level at the ear of operators and others in the workplace, and affect the subsequent exposure limits that are considered safe. Situational factors need to be considered in assessing the level of risk to farmers' hearing and in choosing noise management strategies on the farm. This information has been incorporated into material about hearing and discussions with farmers who participated in field day hearing screening programs in Australia.
Publisher: Elsevier BV
Date: 06-2020
Publisher: Wiley
Date: 08-02-2023
DOI: 10.1111/BLD.12448
Abstract: This qualitative study explored the attitudes and experiences of Hong Kong Chinese parents/carers relating to the sexual needs of their child with intellectual disabilities. Semi‐structured interviews were conducted in Hong Kong with seven parents/carers applying Interpretative Phenomenological Analysis to explore their experiences of and attitudes towards the sexual needs of their adult child with intellectual disabilities. Data revealed three salient variations in participants' attitudes towards the child's sexual needs: concern, reluctance and prohibition. Participants' anxiety about discussing sexuality was evident. Most participants further displayed a layer of feeling that combined ‘love’ and ‘grief’. Based on Goffman's dramaturgical perspective, participants exhibited front stage and back stage behaviours that are believed to be strongly influenced by stigmatisation and collectivist culture. Various levels of intervention to reduce stigma are identified and discussed. This study also highlighted the role of caring professionals in generating awareness of the cultural impact on the family and the need to carefully address the subtle feelings experienced by family members with intellectual disabilities.
Publisher: MDPI AG
Date: 21-07-2022
Abstract: Medical conditions can increase drowning risk. No prior study has systematically reviewed the published evidence globally regarding medical conditions and drowning risk for adults. MEDLINE (Ovid), PubMed, EMBASE, Scopus, PsycINFO (ProQuest) and SPORTDiscus databases were searched for original research published between 1 January 2005 and 31 October 2021 that reported adult (≥15 years) fatal or non-fatal drowning of all intents and pre-existing medical conditions. Conditions were grouped into the relevant International Classifications of Diseases (ICD) codes. Eighty-three studies were included (85.5% high-income countries 38.6% East Asia and Pacific region 75.9% evidence level III-3). Diseases of the nervous system (n = 32 studies 38.6%), mental and behavioural conditions (n = 31 37.3%) and diseases of the circulatory system (n = 25 30.1%) were the most common categories of conditions. Epilepsy was found to increase the relative risk of drowning by 3.8 to 82 times, with suggested preventive approaches regarding supervised bathing or showering. Drowning is a common suicide method for those with schizophrenia, psychotic disorders and dementia. Review findings indicate people with pre-existing medical conditions drown, yet relatively few studies have documented the risk. There is a need for further population-level research to more accurately quantify drowning risk for pre-existing medical conditions in adults, as well as implementing and evaluating population-level attributable risk and prevention strategies.
Publisher: Wiley
Date: 26-10-2010
DOI: 10.1111/J.1440-1754.2010.01889.X
Abstract: Introduction: Non‐intentional child drowning remains a leading cause of child mortality. A related and secondary syndrome is composed of those who drown in impulsive, altruistic attempts to go to the aid of a drowning child. Such ‘rescuers’ who attempt to save a drowning child may themselves drown, a tragic event we term the AVIR syndrome or aquatic victim‐instead‐of‐rescuer. Methods: This study is composed of a five‐year (1 July 2002 to 30 June 2007) total population Australian survey, using the National Coroners Information System to identify cases and an analysis of every immersion rescuer–victim dyad where the primary ‘victim’ was a child and where the ‘rescuer’ drowned. Results: In Australia (2002–2007), 17 rescuers drowned in 15 incidents in which the primary victim was a drowning child. In 93% of the incidents, the primary ‘child–victim’ survived, 82% of the victims were unfamiliar with the aquatic location (i.e. were a visitor) and 76% of the victims were a male parent, partner of first‐degree relative. Alcohol was not generally involved. Conclusion: We define the AVIR syndrome as one that typically involves the following: a male, parent, partner or relative an unfamiliar water hazard a ‘rescuer’ who is a tourist alcohol is not usually involved and the primary victim usually survives. We posit that an increased awareness of such risks, the promotion of rudimentary rescue skills (e.g. being able to throw a lifeline) and increased advocacy for parents to learn the simple and basic life‐saving skills of non‐contact rescue will help reduce these drowning tragedies.
Publisher: Oxford University Press (OUP)
Date: 02-2016
DOI: 10.1093/JTM/TAV031
Abstract: . Drowning deaths of travelers are commonly reported in the media, creating a perception that they are at a higher risk of drowning than residents. This may be true, due in part to unfamiliarity with the risks posed by the hazard, however there is limited information about drowning deaths of travelers in Australia. This study aims to identify the incidence of drowning among international travelers in Australia and examine the risk factors to inform prevention strategies. . Data on unintentional fatal drowning in Australian waterways of victims with a residential postcode from outside Australia were extracted from the Royal Life Saving Society-Australia National Fatal Drowning Database. . Between 1 July 2002 and 30 June 2012 drowning deaths among people known to be international travelers accounted for 4.3% (N = 123) of the 2870 drowning deaths reported in Australian waterways. Key locations for drowning deaths included beaches (39.0%), ocean/harbour (22.0%) and swimming pools (12.2%). Leading activities prior to drowning included swimming (52.0%), ing (17.9%) and watercraft incidents (13.0%). . International travelers pose a unique challenge from a drowning prevention perspective. The ability to exchange information on water safety is complicated due to potential language barriers, possible differences in swimming ability, different attitudes to safety in the traveler's home country and culture, a lack of opportunities to discuss safety, a relaxed attitude to safety which may result in an increase in risk taking behaviour and alcohol consumption. . Prevention is vital both to reduce loss of life in the aquatic environment and promote Australia as a safe and enjoyable holiday destination for international travelers.
Publisher: Informa UK Limited
Date: 03-04-2021
Publisher: Bowling Green State University Libraries
Date: 04-2020
Abstract: The rescuer who drowns can result from the attempted rescue of a human or an animal. We report here a total population analysis of all drowning fatalities for the 14-year period 1–July-2002 to 30-June-2016 which involved an attempted rescue of an animal. Cases were drawn from the Royal Life Saving National Fatal Drowning Database, which in turn, derived its data primarily from the National Coronial Information System (NCIS). Eight people drowned, all adults (ranging in age from 19-74 years), in the attempted rescue of an animal. Seven of the animals were domestic pet dogs, and in two cases farm animals. Six of the eight fatalities occurred in inland waterways. The AVIR-A syndrome, the ‘Aquatic Victim Instead of Rescuer– Animal’ (AVIR-A) drowning syndrome, is a subset of the AVIR drowning syndrome. Environmental design and regulation are unlikely to prevent this type of fatality. Public awareness, with emphasis on non-contact rescue training should be the approach taken.
Publisher: Elsevier BV
Date: 11-2023
Publisher: Elsevier BV
Date: 06-2023
Publisher: Springer Science and Business Media LLC
Date: 05-04-2022
Publisher: Bowling Green State University Libraries
Date: 04-2020
Abstract: Most deaths by drowning (91%) have occurred in low- and middle-income countries (LMICs), particularly in Southeast Asia (35%) and Africa (20%), in proportion to total drowning deaths worldwide. Poor data collection in LMICs hinders the planning, implementation, and evaluation of prevention strategies. The objective of this study was to review the rates and risk factors of unintentional drowning in LMICs and to identify drowning prevention strategies within a socio-ecological health promotion framework. A systematic search, guided by PRISMA, was conducted on Ovid MEDLINE, CINAHL, Informit health, PsycINFO (ProQuest), Scopus, SafetyLit, Google Scholar, and BioMed Central databases for all relevant studies published between 2012 and 2017. McMaster appraisal guideline was used for critical review. The disparity of available drowning data was observed across selected countries. The highest rates were identified in low-middle income South-east Asian countries. The socio-economic background of the family, overcrowding, and living close to water bodies were important predictors for paediatric drowning in LMICs, while the presence of mother as caregiver was identified as a protective factor. The over-reliance on active injury prevention strategies was identified. Further research focusing on developing relevant upstream drowning prevention and water safety promotion is needed to ensure the sustainability of drowning prevention in LMICs.
Publisher: BMJ
Date: 09-2010
Publisher: James Cook University
Date: 2015
No related grants have been discovered for Richard Franklin.