Journal: Public health research & practice
Mosquito-borne disease is an annual problem in Australia, with endemic pathogens such as Ross River virus infecting thousands of people each year. The recent emergence of Zika virus in South America and the Pacific, together with ongoing outbreaks of dengue viruses in Southeast Asia, generated great community interest in the most effective strategies to avoid mosquito bites. Large-scale mosquito control programs are not common in Australia and are limited in New South Wales (NSW). The use of topical insect repellents is a key recommendation by health authorities to prevent mosquito-borne disease. All products sold in Australia purporting to repel mosquitoes must be registered with the Australian Pesticides and Veterinary Medicines Authority. Despite around 100 commercial products registered as repelling mosquitoes, there are relatively few active ingredients used across these formulations. The most common are diethyltoluamide (DEET), picaridin, p-menthane-3,8-diol (PMD) and a range of plant-derived products (e.g. melaleuca, eucalyptus, citronella oils). Research has shown that each of these active ingredients varies in the duration of protection provided against biting mosquitoes. Recommendations by health authorities are informed by this research, but inconsistencies between recommendations and available repellent formulations and their concentration of active ingredients can cause confusion in the community. There are conflicts between the data resulting from scholarly research, marketing promotion by manufacturers and recommendations provided by overseas health authorities. A review was undertaken of NSW Health’s current recommendations on choosing and using insect repellents, taking into consideration recent research and currently registered topical repellents.
Inhalation of asbestos fibres is the predominant cause of malignant mesothelioma. Domestic exposure to asbestos is a major community concern in the Australian Capital Territory (ACT) because of loose-fill asbestos home insulation. Little is known about how trends in mesothelioma rates in the ACT compare with those elsewhere. The objective of this study was to describe trends in mesothelioma rates in the ACT and compare them with those for the rest of Australia.
Mosquito-borne diseases caused by endemic pathogens such as Ross River, Barmah Forest and Murray Valley encephalitis viruses are an annual concern in New South Wales (NSW), Australia. More than a dozen mosquito species have been implicated in the transmission of these pathogens, with each mosquito occupying a specialised ecological niche that influences their habitat associations, host feeding preferences and the environmental drivers of their abundance. The NSW Arbovirus Surveillance and Mosquito Monitoring Program provides an early warning system for potential outbreaks of mosquito-borne disease by tracking annual activity of these mosquitoes and their associated pathogens. Although the program will effectively track changes in local mosquito populations that may increase with a changing climate, urbanisation and wetland rehabilitation, it will be less effective with current surveillance methodologies at detecting or monitoring changes in exotic mosquito threats, where different surveillance strategies need to be used. Exotic container-inhabiting mosquitoes such as Aedes aegypti and Ae. albopictus pose a threat to NSW because they are nuisance-biting pests and vectors of pathogens such as dengue, chikungunya and Zika viruses. International movement of humans and their belongings have spread these mosquitoes to many regions of the world. In recent years, these two mosquitoes have been detected by the Australian Government Department of Agriculture and Water Resources at local airports and seaports. To target the detection of these exotic mosquitoes, new trapping technologies and networks of surveillance locations are required. Additionally, incursions of these mosquitoes into urban areas of the state will require strategic responses to minimise substantial public health and economic burdens to local communities.
Objectives and importance: Paramedics have high rates of occupational injury and fatality. The objective of this study is to describe their specific risks of violence-related injury.
The impact of drug and alcohol misuse has been the subject of widespread media discussion in the past year, particularly in the context of restricted alcohol trading hours in an effort to reduce alcohol-fuelled violence. A recent study evaluating NSW Health’s drug and alcohol consultation liaison (CL) services1 demonstrates how pervasive drug and alcohol problems are, and the impact they have on the health system. This paper highlights how expanding CL services to fill current unmet need could deliver a range of benefits to patients and hospitals.
To ensure that the contribution of patients and consumers in health research is better understood, respected and fully utilised. Type of program or service: Consumer representative networks that form part of a broader quality improvement program in local health services.
Mental health leaders, policy makers and successive national and state governments have tried countless incremental reforms. Yet, for decades in Australia, independent inquiries and reports have concluded that our mental health ‘system of care’ is a misnomer. It is fragmented, ineffective, inefficient and unfair. For far too long, people, families and communities have paid a heavy price for this. Reform in itself will not be the solution that we can hang all our hopes on. Disruptive innovations are now sneaking into the mental health sector and beginning to be taken up en masse. Sitting alongside this is a budding revolution - an unrest stirring in our communities that has not been seen before in the history of mental health. People are raising their expectations and communities are demanding better. With external (revolution, disruption) and internal (reform) forces colliding at a similar time, a perfect storm is being created for what could be the long-awaited and much-needed change we have longed to see. But it will not be without pain because, given a choice, most will opt for stability over change. But ignoring what is coming may not be wise.
Overdiagnosis occurs in a population when conditions are diagnosed correctly but the diagnosis produces an unfavourable balance between benefits and harms. In cancer screening, overdiagnosed cancers are those that did not need to be found because they would not have produced symptoms or led to premature death. These overdiagnosed cancers can be distinguished from false positives, which occur when an initial screening test suggests that a person is at high risk but follow-up testing shows them to be at normal risk. The cancers most likely to be overdiagnosed through screening are those of the prostate, thyroid, breast and lung. Overdiagnosis in cancer screening arises largely from the paradoxical problem that screening is most likely to find the slow-growing or dormant cancers that are least likely to harm us, and less likely to find the aggressive, fast-growing cancers that cause cancer mortality. This central paradox has become clearer over recent decades. The more overdiagnosis is produced by a screening program, the less likely the program is to serve its ultimate goal of reducing illness and premature death from cancer. Thus, it is vital that health professionals and researchers continue an open, scientific inquiry into the extent and consequences of overdiagnosis, and devise appropriate responses to it.
To explore the challenges that arise through the multidisciplinary nature of evidence informed policy making (EIPM). Type of program or service: Education and practice for EIPM.
Pokémon Go has been subject to much attention - from both the players that download the augmented reality game and the news media. Amid the exaggerated media reports, Pokémon Go may have unintended health benefits. Players have reported walking more, spending more time with family, experiencing improvements in their mental health and feeling more connected to their communities. It is hard to imagine public health researchers developing a similar game that is fun, taps into pop culture, reaches a wide target audience, makes use of physical and virtual environments, creates a sense of both competition and community, and has spin-off health benefits. Companies that endanger public health immediately recognised the value of the Pokémon Go app, and exploited it to advertise and promote consumption of unhealthy foods. Public health stakeholders need to develop mobile-based interventions within a framework that embraces pleasure, rewards, participation and community. Public health agencies need to be just as nimble and responsive as companies that are harmful to health, or forever be creating games that nobody plays.