Australian Capital Territory Region Research Articles

Exploring Food Charity Managers Perceived Barriers to Food Security for Vulnerable Women in the Australian Capital Territory Region: A Qualitative Study

ABSTRACT This qualitative study explores the barriers to food security for vulnerable women from the perspective of charity managers within the Australian Capital Territory (ACT) Region. Interviews were conducted with six charity managers. Analysis of charity’s perspectives identified nine themes across two overarching areas: barriers to charity providing food security services (charity accessibility, inter-charity support and charity reliance on donations) and barriers to women attaining food security (income, accommodation type, transport, women’s attitudes and beliefs, stigma/trust and food literacy). Understanding the barriers to women’s food security is essential in addressing the underlying social and economic issues creating food insecurity.

Serious cycling-related fractures in on and off-road accidents: A retrospective analysis in the Australian Capital Territory region

Cycling is an increasingly popular activity which is widely supported by health advocates. In the last year, more than a third of Australians used a bike [1]. While road cycling remains popular, participation in off-road recreational cycling, including mountain biking, bicycle moto cross (BMX) riding, and outdoor leisure cycling, is increasing and this is associated with an increase in the number and cost of cycling injuries [2–5]. The aim of this study was to describe and compare contemporary patterns of cycling fracture requiring hospitalisation as a function of cycling mode in the Australian Capital Territory region.This retrospective analysis of cycling-related-fracture hospitalisations in the ACT region described data recorded between July 2012 and December 2019. Logistic regression models were used to calculate probabilities of sustaining a fracture at different sites for each of the cycling modes (on-road, mountain, BMX, leisure, unspecified). These likelihoods were then compared against the on-road fracture profile.Cycling-related-fracture hospitalisations increased by 32% in the seven years analysed. Of all fracture admissions, 442 (33%) were on-road, 658 (49%) off-road, and 242 (18%) unknown. The majority were male (79%), median age 37 (IQR 16, 52). Median length of stay was two days. The number of fractures per admission ranged from one to thirteen with a median of one. Wrist, clavicle, ribs, and skull were the four most frequent fracture sites for all cycling modes. Fracture profiles of on- and off-road accidents were similar, with the exception of wrist fractures which were more likely in off-road (OR 1.96, p < 0.01) and unspecified cycling accidents (OR 5.07, p < 0.01). Skull fractures comprised 19% of all BMX-related fractures. More than half of all fracture-related admissions required surgery.With increasing support for sustainable and healthy transport and recreation activities, the fracture profiles of different cycling modes must first be assessed in order to inform strategies to reduce and manage this injury burden.

Assessing the diet quality of individuals with rheumatic conditions: a cross-sectional study.

Arthritis is a significant cause of chronic pain and disability, affecting around 3.5 million Australians. However, little is known regarding the overall diet quality of those living with arthritis. This study aimed to assess the dietary quality of Australians living in the Australian Capital Territory region with arthritis. This cross-sectional study analysed dietary intake data of individuals living with arthritis using a validated food frequency questionnaire. Dietary quality was assessed using the Healthy Eating Index-2015 (HEI-2015) to examine associations between diet composition, age, income and arthritis impact using the short form of the Arthritis Impact Measurement Scales 2 (AIMS2-SF). Participants, predominantly female (82.6%), were grouped by age: 18-50years (n = 32), 50-64years (n = 31), and 65 + years (n = 23). Significant correlations were observed between age and HEI-2015 (rs = 0.337, p = 0.002) and income and AIMS2-SF (rs = -0.353, p < 0.001). The mean HEI-2015 score for the 18-49years group was fair (72.1 ± 12.3), lower than both the 50-64years group score of good (81.5 ± 9.72) (p = 0.004), and the 65 + years group score of good (81.8 ± 12.1) (p = 0.007). Dietary fibre, seafood and plant protein, fatty acids, and refined grains were identified as dietary components of concern for the 18-49years group, and total fruit and added sugar were components of concern for people in the worst tertile for the AIMS2-SF. People aged between 18 and 49years are consuming a lower quality diet compared to people aged 50years and over. Further research is needed to understand why this association is occurring in this high socioeconomic region of Australia (a high-income country).

Food security, access and quality among charitable food programs serving the homeless in the Australian capital territory region

Food security, access and quality among charitable food programs serving the homeless in the Australian capital territory region

Sex differences in psychosocial impairment associated with eating disorder features in adolescents: A school‐based study

To examine sex differences in psychosocial impairment associated with eating disorder features (EDF) in adolescents. Questionnaires that assessed EDF (extreme dietary restriction, objective binge eating, subjective binge eating, purging, excessive exercise, and weight/shape overvaluation) and psychosocial impairment (general psychological distress and quality of life) were completed by a school-based sample of adolescent males (n = 531) and females (n = 1135) in the Australian Capital Territory region of Australia. Each of the EDF assessed was associated with significant impairment in both male and female participants and this was the case for measures of both general psychological distress and quality of life, the only exception being that subjective binge eating was associated with elevated levels of distress in girls but not boys. The occurrence of subjective binge eating was associated with greater impairment in quality of life in girls than in boys. Otherwise, the effects of EDF on psychosocial functioning did not differ by sex. The prevalence of most EDF was higher in girls than in boys, although EDF were not uncommon in boys. There appear to be few differences between male and female adolescents in terms of psychosocial impairment associated with EDF. The findings support the need for preventive interventions that seek to reduce the adverse impact of EDF in both boys and girls. The logistic and policy challenges inherent in such efforts warrant greater consideration. Further research is needed to elucidate the help-seeking behavior of young men with EDF who experience psychosocial impairment.

Comparing the Health Burden of Eating-Disordered Behavior and Overweight in Women

We compared the health burden of eating-disordered behavior with that of overweight in a community-based sample of women aged 18-42 years residing in the Australian Capital Territory region of Australia. Participants (n = 4643) completed self-report measures of eating disorder psychopathology, health-related quality of life and health service utilization. Body mass index (BMI) was derived from self-reported height and weight. Overweight was associated with marked impairment in physical health functioning and comparatively little impairment in psychosocial functioning, whereas eating-disordered behavior was associated with marked impairment in psychosocial functioning and comparatively little impairment in physical health functioning. Further, (1) impairment in psychosocial functioning associated with eating-disordered behavior was greater than impairment in physical health functioning associated with overweight, and (2) impairment in physical health functioning associated with eating-disordered behavior was greater than impairment in psychosocial functioning associated with overweight. Overweight and eating-disordered behavior were associated with similarly elevated rates of primary care consultations during the past 6 months and of lifetime treatment from a health professional for an eating or weight problem. In young adult women, the health burden of eating-disordered behavior may be more substantial than previously recognized. Better information concerning the spectrum of disordered eating that exists at the population level needs to be made available. Eating-disordered behavior warrants greater attention when considering the public health burden of obesity and in developing programs to reduce this burden.

SO04 MANAGEMENT OF SUSPICIOUS MELANOCYTIC LESIONS IN GENERAL PRACTICE

Purpose: General practitioners (GPs) are involved in the management of most melanocytic skin lesions in Australia. A high quality biopsy is crucial in initial management, as it is recognised that poor techniques can mislead, prolong, or miss a diagnosis of melanoma. There has been little published data on the biopsy decisions and techniques of general practitioners. Our study sought to redress this gap by describing how general practitioners make decisions on biopsy and to compare their techniques with current NH and MRC best practice guidelines.Methodology: All GPs working in the Australian Capital Territory region were presented with a survey of three clinical scenarios of increasing complexity in which a referral, or biopsy decision was specified.Results: 392 surveys were mailed; 299 surveys were returned (76.3%) of which 285 (72.7%) were included for data analysis. Average monthly biopsy number was 4.2 lesions per GP. Referral rates ranged from 30% to 87% – plastic and general surgery were the most common referral pathways. Ten GPs did half of all biopsies and their techniques demonstrated a range of consistency with guidelines. Overall, a significantly high range of non‐guideline biopsy techniques was demonstrated including shave, punch biopsy and full excision with flap. Most biopsies (57%) were according to NH and MRC guidelines.Conclusion: Concern exists for the high prevalence of non‐guideline biopsy techniques used in general practice in which melanocytic diagnoses could be missed. Recommendations include a review of guideline knowledge and education, and targeted quality improvement of biopsy techniques.

Probable consequences of high female mortality for speckled warblers living in habitat remnants

The effects of habitat fragmentation on the Australian avifauna have been widespread with species richness and abundance declining with reduced remnant size and habitat quality and increased habitat isolation. The speckled warbler, Chthonicola sagittata is one species from the highly fragmented temperate woodlands of eastern Australia that has declined across its range and populations that remain appear to be patchily distributed in habitat remnants. Specific causes of decline are unknown but several aspects of its biology make the species particularly vulnerable to decline in fragmented landscapes. Here, we analyse survey data (presence/absence) of speckled warblers in a large sample of habitat remnants from three regions to identify patterns of occupancy. We explore the effects of patch size on extinction risk using population viability analyses (PVA) and detailed demographic data from a behavioural study of individuals in the Australian Capital Territory, south-eastern Australia. Patch size was a strong predictor of the persistence of speckled warblers in habitat remnants. High density populations had higher probabilities of persisting, and inclusion of an Allee effect during drought decreased the probability of persistence. In the absence of an Allee effect, only high density populations in patches greater than 300 ha and low density populations in patches greater than700 ha had more than an 80% probability of persisting over 100 years. The accelerating decrease in population persistence below approximately 200–400 ha suggests that small populations were particularly vulnerable to stochastic demographic and environmental events. Adult female mortality was the single most important factor in driving population extinction. Our PVA model predictions matched the survey data for the Australian Capital Territory region remarkably well, but failed to predict occupancy rates in remnants in other regions. Differences in occupancy patterns between regions may, however, have resulted from inbreeding depression. This study demonstrates both the strengths and limitations of PVA analysis. PVA can predict occupancy patterns with reasonable accuracy, given good demographic data, but data for one region cannot be used universally for all regions. We highlight the need for studies of demography in different regions to interpret regional patterns of occupancy and to identify mechanisms of decline in remnant habitat.

Disability associated with community cases of commonly occurring eatinq disorders

Objective: To examine disability associated with community cases of the more commonly occurring eating disorders and with particular eating disorder behaviours.Method: Self‐report questionnaires, which included measures of eating disorder symptoms and impairment in everyday functioning, were completed by 495 female residents of the Australian Capital Territory region aged between 18 and 45 years. A structured interview for the assessment of eating disorders was completed by a subgroup (n=208) of participants. Discriminant function analysis was used to identify cases of eating disorders in the total sample (n=495) based on the characteristics of individuals interviewed. Impairment in functioning, as measured by the Medical Outcomes Study Short Form, was compared among eating disorder cases and non‐cases, among subgroups of participants engaging in particular eating disorder behaviours, and among community cases of anxiety and affective disorders identified from the Australian National Survey of Mental Health and Well‐Being.Results: Community cases of eating disorders (n=31; 6.3%) were associated with substantial impairment in functioning, comparable with that of community cases of anxiety and affective disorders. Among eating disorder behaviours, the use of extreme weight‐control behaviours, in particular self‐induced vomiting, was associated with the highest levels of impairment, although the occurrence of regular episodes of overeating was also associated with considerable impairment.Conclusions: The burden on the community of the more commonly occurring eating disorders may be substantial. Improving women's recognition of the adverse effects of eating disordered‐behaviour on functioning, as well as their knowledge of effective treatments, will be important in reducing this burden.

Invasive Haemophilus influenzae infection in the Australian Capital Territory region.

To investigate the pattern of invasive Haemophilus influenzae disease in the Australian Capital Territory (ACT) region with a view to assessing the possible benefits of vaccination in this community. The microbiology department of Royal Canberra Hospital processes all specimens from the three public hospitals in the ACT. Together these hospitals provide all paediatric medical and approximately 80% of adult inpatient beds available in the ACT. We identified all laboratory isolates of H. influenzae obtained from normally sterile sites from 1984 to 1990, and reviewed the clinical records of these patients. Also included in this analysis were all cases of acute epiglottitis identified in hospital discharge summaries, intensive care and coroners' records. Epidemiological, clinical and microbiological data were gathered and assessed. We identified 138 cases of infection. Forty per cent (36 of 66 cases of meningitis, 5 of 44 cases of epiglottitis, 10 of 12 cases of cellulitis) occurred in children aged less than 18 months. Meningitis (48%), epiglottitis (32%), cellulitis (9%) and primary bacteraemia (4%) were the most common syndromes seen. The annual incidence of invasive H. influenzae disease in Canberra was 63.2 per 100,000 children aged under five years. Approximately 1 in 225 children under five years of age and resident in Canberra developed invasive H. influenzae disease. Ninety-eight per cent of isolates serotyped were type b. A vaccination program effective in preventing H. influenzae type b infection, completed in infants before 6 months of age, could prevent upwards of 80% of invasive H. influenzae disease in our population. Such a program should be cost effective although precise assessment is hampered by the lack of accurate data on the acceptance rate, costs and efficacy of the current childhood vaccination schedule in our region.