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Objective: 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. Design: A retrospective total population‐based time series was conducted using the Australian Bureau of Statistics (ABS) death registration data. Setting: All statistical local area (SLA) within Australia from 2006 to 2017. Participants: 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. Main outcome measures: 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. Results: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

Background Infectious disease epidemiology is continuously shifting. While travel has been disrupted by the COVID-19 pandemic and travel-related epidemiological research experienced a pause, further shifts in vaccine-preventable diseases (VPDs) relevant for travellers have occurred. Methods We conducted a literature search on the epidemiology of travel-related VPD and synthesized data for each disease with a focus on symptomatic cases and on the impact of the respective infection among travellers, considering the hospitalization rate, disease sequela and case fatality rate. We present new data and revised best estimates on the burden of VPD relevant for decisions on priorities in travel vaccines. Results COVID-19 has emerged to be a top travel-related risk and influenza remains high in the ranking with an estimated incidence at 1% per month of travel. Dengue is another commonly encountered infection among international travellers with estimated monthly incidence of 0.5–0.8% among non-immune exposed travellers; the hospitalized proportion was 10 and 22%, respectively, according to two recent publications. With recent yellow fever outbreaks particularly in Brazil, its estimated monthly incidence has risen to >0.1%. Meanwhile, improvements in hygiene and sanitation have led to some decrease in foodborne illnesses; however, hepatitis A monthly incidence remains substantial in most developing regions (0.001–0.01%) and typhoid remains particularly high in South Asia (>0.01%). Mpox, a newly emerged disease that demonstrated worldwide spread through mass gathering and travel, cannot be quantified regarding its travel-related risk. Conclusion The data summarized may provide a tool for travel health professionals to prioritize preventive strategies for their clients against VPD. Updated assessments on incidence and impact are ever more important since new vaccines with travel indications (e.g. dengue) have been licensed or are undergoing regulatory review. [ABSTRACT FROM AUTHOR]

Objectives: 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 diving. 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. Methods: 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. Results: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

Background. Malaria continues to represent a significant risk for some travelers and malaria chemoprophylaxis has remained an important countermeasure. Trends in antimalarial use may be influenced by a number of factors, including the availability of antimalarials, increasing resistance, the issuing of updated guidelines for malaria chemoprophylaxis, and continuing education. The aim of this study was to investigate the trends in prescription of antimalarial drugs, particularly those recommended for chemoprophylaxis in Australia, from 2005 to 2009. Methods. In 2011, data were extracted from the online Australian Statistics on Medicines reports published by the Pharmaceutical Benefits Advisory Committee, Drug Utilization Committee, on antimalarials used in Australia for the period 2005 to 2009. Results. Among the drugs solely used as antimalarial drugs from 2005 to 2009, atovaquone plus proguanil and melfloquine were the most commonly prescribed antimalarials. Mefloquine prescriptions increased by 38% from 2005 to 2008 before decreasing by 17% from 2008 to 2009. The number of prescriptions for atovaquone plus proguanil has trebled during the period. Prescriptions for proguanil have dropped over 90% from 2005 to 2009. The diaminopyrimidines, pyrimethamine-containing antimalarials, have mostly been removed from the prescription drug list. Prescriptions for chioroquine have reduced by 66% from 2005 to 2008 and chioroquine was only available on special access from 2009. Artemether plus lumefantrine combination has been used in relatively small quantities and only on special authority from 2007 to 2009. Quinine prescriptions have fallen by 60%. Although a considerable quantity of doxycycline was prescribed, it was unknown how much was intended for malaria chemoprophylaxis. Conclusions. The prescription of antimalarials in Australia was consistent with the national guidelines with the most commonly prescribed antimalarials being atovaquone plus proguanil, mefloquine, and most likely doxycycline. Other antimalarials previously used for chemoprophylaxis have continued to be removed from the prescriber list between 2005 and 2009. The prescriptions of quinine maybe becoming displaced by newer antimalarial drugs for treatment, but this needs further investigation. [ABSTRACT FROM AUTHOR]

Background: It is likely that calls for disaster medical assistance teams (DMATs) continue in response to international disasters. As part of a national survey, the present study was designed to evaluate the Australian DMAT experience and the need for logistic support. Methods: Data were collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster. Results: The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the South East Asian Tsunami affected areas. The DMAT members had significant clinical and international experience. There was unanimous support for dedicated logistic support with 80% (47/59) strongly agreeing. Only one respondent (2%) disagreed with teams being self sufficient for a minimum of 72 hours. Most felt that transport around the site was not a problem (59%; 35/59), however, 34% (20/59) felt that transport to the site itself was problematic. Only 37% (22/59) felt that pre-deployment information was accurate. Communication with local health providers and other agencies was felt to be adequate by 53% (31/59) and 47% (28/59) respectively, while only 28% (17/59) felt that documentation methods were easy to use and reliable. Less than half (47%; 28/59) felt that equipment could be moved easily between areas by team members and 37% (22/59) that packaging enabled materials to be found easily. The maximum safe container weight was felt to be between 20 and 40 kg by 58% (34/59). Conclusions: This study emphasises the importance of dedicated logistic support for DMAT and the need for teams to be self sufficient for a minimum period of 72 hours. There is a need for accurate pre deployment information to guide resource prioritisation with clearly labelled pre packaging to assist access on site. Container weights should be restricted to between 20 and 40 kg, which would assist transport around the site, while transport to the site was seen as problematic. There was also support for training of all team members in use of basic equipment such as communications equipment, tents and shelters and water purification systems. [ABSTRACT FROM AUTHOR]

Background: Calls for disaster medical assistance teams (DMATs) are likely to continue in response to international disasters. As part of a national survey, this study was designed to evaluate Australian DMAT experience in relation to the human resources issues associated with deployment. Methods: Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 South East Asian Tsunami disaster. Results: The response rate for this survey was 50% (59/118). Most personnel had deployed to the Asian Tsunami affected areas with DMAT members having significant clinical and international experience. While all except one respondent stated they received a full orientation prior to deployment, only 34% of respondents (20/59) felt their role was clearly defined pre deployment. Approximately 56% (33/59) felt their actual role matched their intended role and that their clinical background was well suited to their tasks. Most respondents were prepared to be available for deployment for 1 month (34%, 20/59). The most common period of notice needed to deploy was 6–12 hours for 29% (17/59) followed by 12–24 hours for 24% (14/59). The preferred period of overseas deployment was 14–21 days (46%, 27/59) followed by 1 month (25%, 15/59) and the optimum shift period was felt to be 12 hours by 66% (39/59). The majority felt that there was both adequate pay (71%, 42/59) and adequate indemnity (66%, 39/59). Almost half (49%, 29/59) stated it was better to work with people from the same hospital and, while most felt their deployment could be easily covered by staff from their workplace (56%, 33/59) and caused an inconvenience to their colleagues (51%, 30/59), it was less likely to interrupt service delivery in their workplace (10%, 6/59) or cause an inconvenience to patients (9%, 5/59). Deployment was felt to benefit the affected community by nearly all (95%, 56/59) while less (42%, 25/59) felt that there was a benefit for their own local community. Nearly all felt their role was recognised on return (93%, 55/59) and an identical number (93%, 55/59) enjoyed the experience. All stated they would volunteer again, with 88% strongly agreeing with this statement. Conclusions: This study of Australian DMAT members provides significant insights into a number of human resources issues and should help guide future deployments. The preferred 'on call' arrangements, notice to deploy, period of overseas deployment and shift length are all identified. This extended period of operations needs to be supported by planning and provision of rest cycles, food, temporary accommodation and rest areas for staff. The study also suggests that more emphasis should be placed on team selection and clarification of roles.While the majority felt that there was both adequate pay and adequate indemnity, further work clarifying this, based on national conditions of service should be, and are, being explored currently by the state based teams in Australia. Importantly, the deployment was viewed positively by team members who all stated they would volunteer again, which allows the development of an experienced cohort of team members. [ABSTRACT FROM AUTHOR]

The authors reflect on various factors that must be considered to reduce the risk of influenza among travelers. They state that influenza risk reduction requires complementary efforts which involve simple public health and educational messages, increase coverage of influenza vaccination among travelers and risk evaluation. Moreover, they mention that the Committee to Advise on Tropical Medicine and Travel (CATMAT) in Canada has proposed influenza vaccination for every healthy traveler.

Vector-borne diseases stand out as major concerns for military deployments. Of particular concern are malaria, arboviral diseases and, more recently, leishmaniasis. Vaccine preventable diseases also remain important globally. Other common problems, for example diarrhoeal disease and non-infectious hazards, such as trauma, also need to be addressed. Disclaimer: The author does not necessarily represent the views of the Australian Defence Force, The Australasian College of Tropical Medicine or of any other organisation mentioned in this paper. [ABSTRACT FROM AUTHOR]

Objective: Short-term isolation might occur during pandemic disease or natural disasters. We sought to measure preparedness for short-term isolation in an Australian state during pandemic (H1N1) 2009. Methods: Data were collected as part of the Queensland Social Survey (QSS) 2009. Two questions related to preparedness for 3 days of isolation were incorporated into QSS 2009. Associations between demographic variables and preparedness were analysed using χ2, with P < 0.05 considered statistically significant. Results: Most respondents (93.6%; confidence interval [CI] 92.2-94.9%) would have enough food to last 3 days, but only 53.6% (CI 50.9-56.4%) would have sufficient food and potable water if isolated for 3 days with an interruption in utility services. Subpopulations that were less likely to have sufficient food and potable water reserves for 3 days' isolation without utility services included single people, households with children under 18 years of age, people living in South-East Queensland or urban areas, those with higher levels of education and people employed in health or community service occupations. Conclusions: The majority of Queensland's population consider themselves to have sufficient food supplies to cope with isolation for a period of 3 days. Far fewer would have sufficient reserves if they were isolated for a similar period with an interruption in utility services. The lower level of preparedness among health and community service workers has implications for maintaining the continuity of health services. [ABSTRACT FROM AUTHOR]

Background. Global disease outbreaks, such as the recent Pandemic (H1N1) 2009 (the so-called Swine flu), may have an impact on travel, including raising the concerns of travelers. The objective of this study was to examine the level of concern of Australians regarding travel during Pandemic (H1N1) 2009 and how this impacted on their travel. Methods. Data were collected by interviews as part of the Queensland Social Survey (QSS) 2009. Specific questions were incorporated regarding travel and Pandemic (H1N1) 2009. Multivariate logistic regression was used to analyze associations between demographic variables and concern and likelihood of cancelling travel. Results. There were 1,292 respondents (41.5% response rate). The sample was nearly equally divided between males and females (50.2% vs 49.8%). Younger people (18–34 y) were under-represented in the sample; older people (>55y) were over-represented in the sample. About half (53.2%) of respondents indicated some level of concern about Pandemic (H1N1) 2009 when traveling and just over one-third (35.5%) indicated they would likely cancel their air travel if they had a cough and fever that lasted more than one day. When cross-tabulating these responses, people who expressed concern regarding Pandemic (H1N1) 2009 when they traveled were more likely than those without concern to cancel their air travel if they had a cough and fever lasting more than one day (44.7% vs 27.7%, χ2 = 33.53, p < 0.001). People with higher levels of education [adjusted odds ratio (AOR): 0.651], people with higher incomes (AOR: 0.528) and people living outside of metropolitan Southeast Queensland (AOR: 0.589) were less likely to be concerned about Pandemic (H1N1) 2009 when traveling, and younger people (AOR: 0.469) were less likely than others to cancel travel if they had a cough and fever. Conclusions. Pandemic (H1N1) 2009 was of some concern to more than half of Queensland travelers. None-the-less, the majority of Queenslanders would not have postponed their own travel, even if they exhibited symptoms consistent with Pandemic (H1N1) 2009. [ABSTRACT FROM AUTHOR]

The authors reflect on Australian Health Management Plan for Pandemic Influenza (AHMPPI), a pandemic plan released by Australian government in 2008. They discuss the pandemic of swine flu and argue on its implication to the public health of the country. They reveal that the plan include the mobilization of neuraminidase inhibitors; however, travelers are not prioritize to receive it. They imply on the inappropriateness of the plan in responding to the pandemic case of swine flu in Australia.

The authors reflect on the medical care for the Australian Defence Force (ADF) provided by the Defence Health Service (DHS) and contracted health providers in Australia. They state that core Defence business and deployments will be the basis for ADF and civilian health education and training. The authors note that generalist military officers have led health operations.

Background. The health and safety of international visitors remain an important issue for Australia and other tourist destinations. The death of visitors remains an important indicator of safety. The aim of this study was to provide updated figures on deaths of overseas travelers in Australia. Methods. Data were sourced from the Australian Bureau of Statistics concerning deaths of overseas visitors for the years 2001 to 2003. Results. There were 1,068 overseas visitor deaths (701 males, 66%) during the study period 2001 to 2003. Death by natural causes increased with age, while deaths associated with accidents were more frequent among younger age groups. The majority of deaths were from natural causes (782, 73%), particularly ischemic heart diseases (26%). There were a total of 247 accidental deaths (23% of all deaths) with the main causes being transportation accidents (14% of all deaths) and accidental drowning/submersion (5% of all deaths). The countries contributing the most deaths were the UK (247, 23%), New Zealand (108, 10%) Melanesia/Micronesia (95, 9%), and the United States (57, 5%). Conclusions. Australia remains a relatively safe destination for international travelers, at least in terms of fatalities, which appear to be declining. Most deaths of overseas tourists in Australia are due to natural causes with cardiovascular disease being the predominant cause of death in this group. Accidents remain the most common preventable cause of death of travelers, with road and water safety being the major issues. It is important that tourism and travel medicine groups continue to advocate for improved health and safety of international travelers visiting Australia. [ABSTRACT FROM AUTHOR]

Background. Prescribing patterns of antimalarial drugs have previously been observed to vary considerably in Australia. The aim of this study was to investigate the trends in prescription of antimalarial drugs recommended for chemoprophylaxis in Australia from 2002 to 2005. Methods. In 2007, data were extracted from the online Australian Statistics on Medicines reports published by the Pharmaceutical Benefits Advisory Committee, Drug Utilization Sub-Committee on antimalarials used in Australia for the period 2002 to 2005. Results. Doxycycline probably remains the malaria chemoprophylaxis of choice prescribed for Australians visiting multiple drug–resistant malarious areas. Over the past 15 years, there has been a marked drop in the prescription of less useful antifolate drugs, such as pyrimethamine-containing antimalarial drugs. There has also been a reduction in the number of prescriptions of chloroquine and proguanil, although the downward trend in prescriptions of mefloquine appears to have arrested and has trended upward. The number of prescriptions of atovaquone and proguanil has been increasing dramatically, particularly since inclusion of this combination antimalarial in the prevailing Australian guidelines. Artemether plus lumefantrine combination is now available, but it is used in relatively small quantities. Conclusions. The prescription of the antimalarial drugs, proguanil, chloroquine, and the pyrimethamine-containing compounds, has generally reduced in number. Prescription of mefloquine trended upward during 2002 to 2005, following a period of reducing prescriptions. The atovaquone plus proguanil combination has steadily increased in use and is presumably displacing older antimalarials. The use of quinine has halved, which might be related in part to the uptake of newer antimalarial drugs for treatment. Trends in antimalarial use may be influenced by a number of factors, including the availability of antimalarials, increasing resistance, the issuing of updated guidelines for malaria chemoprophylaxis, and continuing education. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the extent to which musculoskeletal disorders [MSD] affect military populations, as well as intrinsic and extrinsic factors associated with MSD and the relative contribution of training, sports, and manual handling. A search of published literature was conducted using PubMed-listed articles published up to February 2006. Findings: Although physical conditioning represents an important facet of military preparedness. up to half of all recruits may suffer an injury during their basic military training. Musculoskeletal disorders are a common occurrence for soldiers and represent an important source of morbidity for the military as a whole. Intrinsic risk factors linked to military training injuries include a diverse range of inherent variables such as the level of prior physical conditioning, psychological make up, age, height, weight, and gender. Extrinsic risk factors for military MSD include training surface, exercise when fatigued, progressive training in place of cyclical training, and the type of footwear usually worn. Other military-specific variables may also include drill methods. the arrangement of platoons, training technique, and the actual training distance. Conclusions: Overall, this review suggests that MSD arc a common occurrence for military personnel and represent an important source of morbidity for the military as a whole. In meeting this problem, there is clearly an urgent need to target effective preventive measures, especially those involving military-specific training and sports activities, [ABSTRACT FROM AUTHOR]

The article presents information about a study aimed to estimate of rates of tobacco smoking by occupation in Australia. The data for the study was obtained from the National Health Surveys conducted by Australian Bureau of Statistics in 2004 and 2005. The purpose of these surveys was to gain a clearer understanding of the health status of all Australians. The data were stratified into nine major job categories currently used in the Australian Standard Classification of Occupations. An estimate for the total number of workers in each category was calculated.

Cyanoacrylate (CA) and its homologues have a variety of medical and commercial applications as biological adhesives and sealants. Homologues of CA are being widely promoted in surgery as a tissue adhesive to replace traditional suturing techniques. Potential benefits of using CA adhesives include better cosmetic results, more rapid wound closure, and perhaps most significantly, the potential for significant reductions in percutaneous injuries from suture needles, which would in turn also reduce the risk of transmission of infectious diseases. Nevertheless, certain concerns have been raised regarding the potential toxicity of CA within patients, as well as among health professionals who are occupationally exposed when using CA compounds. Reported toxicity of CA in the workplace may result in dermatological, allergic and respiratory conditions. To help reduce the occupational burden, therefore, medical staff using CA adhesives should avoid direct contact with the compound and use appropriate personal protective measures at all times. Maintaining higher levels of humidity, optimizing room ventilation and using special air conditioning filters in surgical suites and operating theatres may also be useful in minimizing the exposure to volatile CA adhesives. [ABSTRACT FROM AUTHOR]

Background. Little is known about the level of concern and sources of information of hostelers concerning personal safety and terrorism. This study was designed to investigate these in the Australian context. Methods. In 2006, self-administered questionnaires were distributed to hostelers attending a travelers’ information evening in Brisbane. Results. Forty questionnaires (60.8%) were returned. Over two thirds of attendees were women (71.4%). About two thirds of the hostelers attending the travelers’ information evening reported being aged 29 years or younger (64.2%). Anticipated main destinations were Europe (68.3%), Asia (14.3%), and North America (11.9%). Nearly two thirds (63.4%) intended to travel in more than 8 weeks time or were not sure. Of those departing within 8 weeks, only 40% had sought travel health advice from their general practitioner and/or travel clinic. Nonmedical sources of information on travel health included travel books and guides (40.5%), Internet (35.7%), and travel agents (19.0%). On a five-point rating scale (1 being not concerned to 5 being extremely concerned), median ratings of hostelers’ concern for personal safety (4.0) was significantly higher than for terrorism (2.5), with the range being 1 to 5 in each case ( p < 0.001). Nearly three quarters (73.8%) of hostelers would seek personal safety advice from multiple sources, and sources of information included the Internet (69.0%, 29), travel books and guides (59.5%), physicians (57.1%), and travel agents (45.2%). Only three (7.1%) nominated the physician as their only source of personal safety advice. Conclusions. Hostelers attending a travelers’ information night in Australia expressed more concern for their personal safety when traveling than for terrorism. Since this group of travelers uses multiple sources of information with the Internet most commonly used, Web sites that provide accurate and relevant information in an acceptable format could play an important role in supporting this group. It is important that policies being promoted by travel health advocacy groups in Australia continue to advocate that travelers seek travel health advice from a qualified source early, preferably around 6 to 8 weeks before travel, and that personal safety be discussed as part of the travel health consultation. [ABSTRACT FROM AUTHOR]

Background: Tobacco smoking by physicians represents a contentious issue in public health, and regardless of what country it originates from, the need for accurate, historical data is paramount. As such, this article provides an international comparison of all modern literature describing the tobacco smoking habits of contemporary physicians. Methods: A keyword search of appropriate MeSH terms was initially undertaken to identify relevant material, after which the reference lists of manuscripts were also examined to locate further publications. Results: A total of 81 English-language studies published in the past 30 years met the inclusion criteria. Two distinct trends were evident. Firstly, most developed countries have shown a steady decline in physicians' smoking rates during recent years. On the other hand, physicians in some developed countries and newly-developing regions still appear to be smoking at high rates. The lowest smoking prevalence rates were consistently documented in the United States, Australia and the United Kingdom. Comparison with other health professionals suggests that fewer physicians smoke when compared to nurses, and sometimes less often than dentists. Conclusion: Overall, this review suggests that while physicians' smoking habits appear to vary from region to region, they are not uniformly low when viewed from an international perspective. It is important that smoking in the medical profession declines in future years, so that physicians can remain at the forefront of anti-smoking programs and lead the way as public health exemplars in the 21st century. [ABSTRACT FROM AUTHOR]

Dermatitis is a common problem both in the workplace and in the general community. Airline personnel represent a novel occupational group as they are also exposed to a wide range of potential chemical irritants and other aggravating factors, such as low relative humidity and airborne pollutants. Common skin irritants include dielectric fluids from electrodischarge machining, ‘prepreg’ materials and sealants in aircraft manufacture, kerosene and various jet-fuel components. Commercial jet fuel is a complex mixture of aliphatic and aromatic compounds, and there is potential for dermal exposure among refueling and maintenance crew. Low relative humidity appears to exacerbate dermatitis amongst aircrew, especially on longer flight durations. Pilots may also be exposed to additional skin irritants outside of the cabin environment, such as ethylene glycol, hydraulic fluid or jet fuel, all of which may be encountered during routine inspections of aircraft before and after flight. Given these factors, preventive measures must carefully consider the undoubted potential for contact with irritants and allergens, which may lead to dermatitis in airline personnel. [ABSTRACT FROM AUTHOR]

Background: Previous research in a number of countries has suggested considerable variability in prescribing patterns of antimalarial drugs. The aim of this study was to investigate the trends in prescription of antimalarial drugs recommended for chemoprophylaxis in Australia from 1998 to 2002.Methods: In 2005 data was extracted from the online Australian Statistics on Medicines reports published by the Pharmaceutical Benefits Advisory Committee, Drug Utilization Sub-committee, on antimalarials used in Australia from 1998 to 2002.Results: Doxycycline probably remains the malaria chemoprophylaxis of choice prescribed for Australians visiting multiple drug-resistant malarious areas. Over the past 10 years, there has been marked drop in the prescription of less useful antifolate drugs such as pyrimethamine combination antimalarial drugs, especially pyrimethamine plus dapsone, which was withdrawn by 1999. There has also been a reduction in the number of prescriptions for chloroquine, mefloquine, and proguanil. The number of prescriptions for atovaquone and proguanil remain small, although they have increased steadily since its introduction in 2000, in the absence of a recommendation in the prevailing Australian guidelines.Conclusions: The prescription of antimalarials such as proguanil, chloroquine, mefloquine, and the pyrimethamine-containing compounds reduced considerably between 1998 and 2002. This was probably largely influenced by the availability of antimalarials, increasing resistance, the issuing of updated guidelines for malaria chemoprophylaxis, and continuing education. Newer drugs such as atovaquone plus proguanil may displace older antimalarials, particularly in the prevention of Plasmodium falciparum infection. [ABSTRACT FROM AUTHOR]

Background: Previous research in a number of countries has suggested considerable variability in prescribing patterns of antimalarial drugs. The aim of this study was to investigate the trends in prescription of antimalarial drugs recommended for chemoprophylaxis in Australia from 1998 to 2002. Methods: In 2005 data was extracted from the online Australian Statistics on Medicines reports published by the Pharmaceutical Benefits Advisory Committee, Drug Utilization Sub-committee, on antimalarials used in Australia from 1998 to 2002. Results: Doxycycline probably remains the malaria chemoprophylaxis of choice prescribed for Australians visiting multiple drug-resistant malarious areas. Over the past 10 years, there has been marked drop in the prescription of less useful antifolate drugs such as pyrimethamine combination antimalarial drugs, especially pyrimethamine plus dapsone, which was withdrawn by 1999. There has also been a reduction in the number of prescriptions for chloroquine, mefloquine, and proguanil. The number of prescriptions for atovaquone and proguanil remain small, although they have increased steadily since its introduction in 2000, in the absence of a recommendation in the prevailing Australian guidelines. Conclusions: The prescription of antimalarials such as proguanil, chloroquine, mefloquine, and the pyrimethamine-containing compounds reduced considerably between 1998 and 2002. This was probably largely influenced by the availability of antimalarials, increasing resistance, the issuing of updated guidelines for malaria chemoprophylaxis, and continuing education. Newer drugs such as atovaquone plus proguanil may displace older antimalarials, particularly in the prevention of Plasmodium falciparum infection. [ABSTRACT FROM AUTHOR]

Whole-body vibration (WBV) is an important risk factor for occupational illness and injury. Technological advances have created more powerful and faster machines that in turn produce more vibration, meaning more workers are potentially affected by WBV. Fortunately, WBV research has also evolved in recent years thanks to an increased understanding of biomechanics and the increasing sophistication of WBV measurement devices. Although many preventive methodologies have been proposed, by far the most useful strategy focuses on the reduction of WBV exposure to the lowest possible level and limiting the overall duration of WBV exposure wherever possible. The article discusses the various effects of WBV, measurement methods and what can be done to mitigate this hazard. INSETS: Acute & Chronic Health Effects of WBV;Controlling WBV.

Lymphatic filariasis (LF) is the second most common parasitic disease worldwide, after malaria. It should always be considered in the differential diagnosis for military personnel returning from disease-endemic areas. Numerous outbreaks of LF have been reported in military deployments from World War II. In contrast to the presentation of LF in indigenous populations, which often involves such uncommon complications as elephantiasis and hydrocele. the clinical presentation of LF in military personnel can vary widely and is often vague and nondescript. Common symptoms are pain and swelling of the genitalia. closely followed by lymphangitis of the arms and legs. All three species produce similar disease. [ABSTRACT FROM AUTHOR]

To investigate the prevalence of musculoskeletal disorders (MSD) among rural Australian nursing students and compare the results with other international studies.A self-reporting questionnaire adapted from previous research, was administered to 260 students from all three grades of a major nursing school in regional north Queensland, Australia.A high proportion of students reported an MSD at some body site (80.0%), with low back pain being the most common condition (59.2%). This was followed by MSD of the neck (34.6%), knee (25.0%), shoulder (23.8%), feet (16.5%), wrist (12.7%) and legs (11.9%). MSD of the shoulder was slightly more common among males when compared to females (39.3%vs22.0%,P  = 0.0424). Previous paid employment as a nurse or nursing assistant was found to increase the risk of upper arm MSD by a factor of 10.8 (odds ratio 10.8, 95% confidence interval 1.9–205.8,P  = 0.0276).Overall, this investigation suggests that MSD is more frequent among rural Australian nursing students, when compared to their counterparts around the world. Their high rate of MSD is also comparable to that reported by hospital nurses in other countries.Although musculoskeletal disorders (MSD) are known to affect nursing students at reasonably high rates, few studies have been undertaken in rural Australia. Therefore, it was considered necessary to investigate MSD among a complete cross-section of rural Australian nursing students, using a questionnaire adapted from previous research. Findings were then compared with similar international studies.A high proportion of students reported an MSD at some body site, with low back pain being the most common condition. Overall, this investigation suggests that MSD is more frequent among rural Australian nursing students, when compared to their counterparts around the world. Their high rate of MSD is also comparable to that reported by hospital nurses in other countries. [ABSTRACT FROM AUTHOR]

This article offers information about the disease lymphatic filariasis. Lymphatic filariasis (LF) is, after malaria, the second most common mosquito-borne disease globally. LF is caused by three species of nematode parasites, which can be spread by a wide range of mosquito species. There have been several recent case reports of LF occurring in travelers. LF has a widespread geographic distribution, mainly affecting the tropical regions of the world, particularly the Indian subcontinent, tropical Africa, South and Central America, Southeast Asia and the Pacific Island countries. Routine screening tests, such as a full blood count, may reveal eosinophilia, and, although this may be a useful marker for various helminthic infections, including LF, in the returned traveler, it is nonspecific. Unlike community control programs, where a single annual dose of diethylcarbamazine (DEC) plus albendazole/ivermectin is used for all population members, the treatment of individual patients relies on multiple doses of DEC alone. DEC is the only antifilarial drug that is both microfilaricidal and macrofilaricidal. Recently, there has been some suggestion that doxycycline at a dose of 100 mg daily may be useful in preventing LF. This drug regimen is thought to be sufficient to eradicate endosymbiont Wolbachia, which appears to be present in the LF nematodes. Interestingly, doxycycline is one of the preferred malarial chemoprophylaxis regimens for many travelers to malarial areas, which often are also LF endemic. However, further research is needed.

Presents a study that investigated the illnesses and injuries suffered by travelers that joined the Blake Expedition in 2001 to the Amazon regions of Brazil and Venezuela. Methods; Results; Discussion.

Provides information on resources utilized by general practitioners for advising travelers from Australia. Factors that should characterize resources used in the provision of travel health advice; Usefulness of computerized databases for providing information on travel medicine; Variation in the use of travel medicine information.

Presents a study that investigated the preparedness of general practitioners in Australia for the Sydney 2000 Olympic and Paralympic Games. Demographic and practice characteristics; Expectation of additional travelers; Willingness of physicians to participate in travelers' health care during the games.

Presents a study that investigated the trends in prescription of antimalarial drugs recommended for chemoprophylaxis in South Africa from 1994 to 2000. Escalation of malaria in 1996; Monotonic decrease in the use of chloroquine; Ratio of chloroquine to proguanil consumption.

Investigates the uptake of first aid training and travel insurance by hostelers in north and central Queensland, who were attending a Youth Hostels Association travelers' information evening. Distribution by gender of how many hostelers reportedly knew about first aid; Aspects about healthy travel.

Examines several of the major health and safety issues to be considered for advising a traveler to New Zealand. Amenities of the country; Adventure opportunities available in the country; Overview of travel health and safety Internet resources and contacts.

Examines the importation of dengue into north Queensland, Australia by soldiers returning from East Timor, Indonesia. Background on dengue transmission; Assessment of the measures taken by the Australian Defence Force to prevent local transmission of the disease; Details on the number of potentially viremic cases of dengue detected after the soldiers' redeployment; Ways of preventing the spread of the disease from soldiers.

Provides information on a study that investigated trends in the use of anti-malarial drugs prescribed in New Zealand from 1993 to 1998. Methodologies used; Results and discussion; Conclusion.

Presents a study that investigated travel insurance claims made by travelers from Australia. Examination of demographic factors, type of travel insurance coverage, nature and duration of travel; Method used in the study; Statistics on insurance claims; Cause of problems reported in claims; Results and discussion.

Background: Little is known about the health advice provided to hostelers and the role and influence of hosteling organizations' travelers' information evenings in giving travel health advice. This study was designed to investigate these in relation to the Australian context. Methods: In 1997, hostelers attending travelers' information evenings in two regional centers and one metropolitan location in Queensland were asked to complete self-administered questionnaires. Results: Of 158 questionnaires, 110 (69.6%) were returned. Missing data have been excluded from the analysis. About two-thirds of the hostelers attending the travelers' information evening reported being age 35 years or younger (43/65, 66.2%). Almost two-thirds of attendees were female (42/65, 64.6%). The hostelers responding to this study were fairly evenly divided between regional centers (54/110, 49.1%) and the metropolitan center (56/110, 50.9%). Hostelers indicated that they were traveling to Europe and the United Kingdom (53/62, 85.5%), Canada (17/62, 27.4%), Asia (15/62, 24.2%), United States (10/52, 19.2%), and other destinations (7/51, 13.7%), mostly Africa. Hostelers were significantly more likely to have obtained travel health advice (χ² = 5.02, df = 1, p < .05) if they were traveling within 6 weeks. Hostelers indicated that they obtained advice from general practitioners (41/67, 61.2%), travel agents (29/67, 43.3%), books (22/67, 32.8%), travel clinics (10/67, 14.9%), and other sources (6/67, 9.0%). Most hostelers indicated that they learnt something new about healthy travel from the travelers' information evening (76/100, 76.0%). Of those hostelers who had not sought travel health advice or who had not planned to seek travel health advice prior to the travelers' information evening, almost all indicated that they now would seek travel health advice (32/33, 97.0%). Conclusions: This cross-sectional study found that most hostelers attending an international hosteling... [ABSTRACT FROM AUTHOR]

Addresses questions about the health risks of traveling in wildlife reserves in South Africa. Animals that are considered dangerous; Safety of reserves; Precautions for walking trail participants.

Presents personal safety advice for travelers abroad. Causes of travelers' deaths; Child safety; Protection from unwanted characters.

This paper explores learning experiences from both a general and a medical education perspective. A broad range of learning experiences, both planned and incidental, are identified. The former is dealt with in greater detail as it would seem to have more immediate practical relevance. Ultimately, all learning experiences should in some way be linked to the stated learning objectives. Planned learning experiences cover such traditional teaching-learning methods as lectures, tutorials, projects and assignments. The application and explosion of new technologies is also discussed. Modern computer, video and Internet technology is playing an increasing role in medical education, particularly in bringing rural and remote participants into closer contact with their city counterparts. The advantages and disadvantages of each approach are examined. A successful approach to teaching and learning in medical education is likely to involve the application of a number of different types of learning experiences. [ABSTRACT FROM AUTHOR]

Objective: Surf zone injuries include cervical spine injuries (CSI). Risk factors for CSI have not been extensively investigated. The objective was to examine risk factors associated with diagnosed CSI that occurred in a beach setting.Methods: This retrospective case series used manually linked data from Sunshine Coast Hospital and Health Service Emergency Departments, Queensland Ambulance Service, Surf Life Saving Queensland (SLSQ), and Bureau of Meteorology data from 01/01/2015-21/04/2021. Variables included victim demographics, mechanism of injury, scene information, and patient course.Results: Seventy-nine of the 574 (13.8%) confirmed CSI occurred at the beach. Local residents and visitors were injured equally. Females represented a minority (12.7%) of those diagnosed with CSI but were a higher proportion of suspected spinal incidents reported to SLSQ (45%). Surfers were more likely to be injured through shallow water diving than swimmers (27.6% vs 2.2%). Females were more likely to be injured by shallow water diving than males (30.0% vs 8.7%). Visitors were more likely to be injured swimming and local residents surfing (68.2% vs 77.8% respectively). CSI occurred most commonly (40.0%) with a below average ocean wave height (0.75-1.25 m) and were most likely (45.3%) to occur in the second half of the outgoing tide. One beach had a statistically significant greater incidence of spinal incidents (OR 3.9, 95% CI: 2.1-7.2) and of CSI (OR 10.7, 95% CI: 1.5-79.5).Conclusions: Risk factors for CSI at the beach include male sex, smaller wave height and an outgoing tide. Shallow water diving among surfers and females should be addressed urgently. [ABSTRACT FROM AUTHOR]

Objectives: Cardiac rehabilitation (CR) provides evidence-based secondary prevention for people with heart disease (HD) (clients). Despite HD being the leading cause of mortality and morbidity, CR is under-utilised in Australia. This research investigated healthcare systems required to improve access to CR in rural and remote areas of North Queensland (NQ). Methods: A qualitatively dominant case study series to review management systems for CR in rural and remote areas of NQ was undertaken. Data collection was via semi-structured interviews in four tertiary hospitals and four rural or remote communities. An audit of discharge planning and CR referral, plus a review of community-based health services, was completed. An iterative and co-design process including consultation with healthcare staff and community members culminated in a systems-based model for improving access to CR in rural and remote areas. Results: Poorly organised CR systems, poor client/staff understanding of discharge planning and low referral rates for secondary prevention, resulted in the majority of clients not accessing secondary prevention, despite resources being available. Revised health systems and management processes were recommended for the proposed Heart: Road to health model, and given common chronic diseases risk factors it was recommended to be broadened into Chronic disease: Road to health. Conclusion: A Chronic disease: Road to health model could provide effective and efficient secondary prevention for people with chronic diseases in rural and remote areas. It is proposed that this approach could reduce gaps and duplication in current healthcare services and provide flexible, client-centred, holistic, culturally responsive services, and improve client outcomes. What is known about the topic? Cardiac rehabilitation is known to improve health outcomes and reduce hospitalisations, but referrals and attendance are low (30%). What does this paper add? A revised systems-based model for improved access to secondary prevention for people with heart and related chronic diseases in rural and remote areas of North Queensland is proposed: Chronic disease: Road to health. What are the implications for practitioners? A functional system from hospitalisation to local healthcare services has been designed to improve access to secondary prevention. Staff require support and education to improve skills, better manage care and improve job satisfaction. [ABSTRACT FROM AUTHOR]

Sexuality is a valuable part of people's lives, including people with intellectual disabilities (ID). Parents and social services personnel are significant parties for promoting the autonomy of people with ID regarding sexuality, although evidence reveals their actions tend to be in the opposite direction. Sexual attitudes do not emerge solely as personal or individual but evolve from interactions with others in a particular sociocultural environment. To explore the sexuality of people with ID, this study set out to understand the dynamic of people with ID, parents and social services personnel within the cultural context of Hong Kong. In total, 19 participants including people with mild ID, parents and social services personnel were recruited. Individual interviews were conducted, and the data were analyzed applying Interpretative Phenomenological Analysis and dramaturgy. Findings revealed the participants' experiences, obstacles, and underlying feelings regarding the sexuality of people with ID, and the phenomenon, "not taking action" formed by all the groups. Chinese Confucian culture was revealed as the factor influencing the dynamic on the issues of sexuality. With respect to cultural expectations, government and social services agency leadership should take the lead to adopt an evidence-based sex education protocol. [ABSTRACT FROM AUTHOR]

Questions have often been raised by journal readers, authors and editors regarding the intrinsic value of 'Special Issues'. We examine the bibliometric performance and relative impact of a special issue published in the Japanese journal, Industrial Health, in 2007. Citations tracked by the Web of Science" database between 2007 and 2011 were analysed by type, frequency and impact. Overall, our results suggest that the special issue had a considerable influence on the bibliometric profile of the journal in which it appeared. The study revealed that special issues can attract more immediate citations and more overall citations than regular issues as well as having a positive effect on its impact factor in the years immediately following publication. Further bibliometric analyses are now warranted to evaluate the long-term performance of special issues and to investigate their overall impact on the scientific community. [ABSTRACT FROM AUTHOR]

Background: Although hand dermatitis (HD) represents a frequent occupational issue for many health professionals, little is known about the prevalence and distribution of HD among veterinarians, particularly in Australia. Aim: We utilized a previously validated questionnaire survey to examine a cross-section of veterinarians from Queensland, Australia, to determine the prevalence of HD and its associated factors. Method: We conducted a questionnaire-based survey of HD, which was mailed to 1094 veterinarians registered with the Veterinary Surgeons Board of Queensland during 2006 (64.0% response rate). Results: The overall prevalence rate of HD during this study was 15.9%. HD prevalence was significantly higher in those with current allergic disease ( P < 0.001), among female veterinarians ( P < 0.001), and those reporting latex allergy in the past 12 months ( P < 0.001). Conclusions: Overall, this study suggests that HD may be more prevalent among veterinarians in Queensland than among their counterparts studied elsewhere. Veterinary practices may need to consider making non-latex gloves available or avoiding latex products wherever possible, particularly for their female staff. The importance of HD to the veterinary profession is predicted to increase as females begin to make up a greater proportion of registered veterinarians as result of a demographic shift. [ABSTRACT FROM AUTHOR]

Although hand dermatitis (HD) is a frequent occurrence for many health professionals, little is known about the prevalence of HD among medical students, particularly in Australia. A questionnaire-based survey of HD was administered to 261 students at a medical school in tropical northern Australia during 2004 (98.9% response rate). The prevalence of HD varied by year of study, ranging from 9.7% to 20.4% ( P=0.322), with an overall prevalence of 17.4%. HD prevalence was significantly higher in those with current allergic disease ( P=0.012). Some students (13.8%) reported a reaction immediately after exposure to latex products, a finding which was associated with higher prevalence of HD ( P=0.001). HD may be more prevalent among students of a tropical Australian medical school than among their counterparts studied elsewhere. The identification of allergy as a significant correlate again stresses the importance of allergic disease and its relationship with skin conditions. [ABSTRACT FROM AUTHOR]

The article presents a study aimed at investigating the trends in use of antimalarial drugs prescribed in Australia from 1992 to 1998. The data was extracted from the Australian Statistics in Medicine reports published by the Pharmaceutical Benefits Advisory Committee, Drug Utilization Committee, on antimalarials used in Australia for the said period. The said study has shown a marked fall in pyrimethamine-combination antimalarial drugs over the period with a rise in mefloquine and proguanil.

Presents a study that investigated the use of antimalarial drugs for travelers in Australia. Increase in the prescriptions for quinine; Number and percentage change of prescriptions of antimalarials; Use of chloroquine and hydroxychloroquine.

Presents several letters to the editor related to health and diseases. Trends in antimalarial drugs prescribed in New Zealand from 1993 to 1998; Interaction between mefloquine and coumarin anticoagulants; Case study of gnathostomiasis without eosinophilia in a 37-year-old Caucasian woman.

Talks about content in medical education which should be based on health problems and sequenced to capitalize on prior knowledge. Development of scope and sequence; Organizing content; Inclusion of content; Balance of breadth and depth; Sequence of content.