Cairns Region Research Articles

The role of community pharmacists as oral health advisors in the management of oral effects of asthma medications: an exploratory survey.

To investigate community pharmacists' attitudes, confidence, practice, knowledge, and barriers towards the management of oral side effects of asthma medications. A paper-based questionnaire was developed from previous research, trialled, and validated. Convenience sampling through web search was used to identify pharmacy practices across Cairns, Queensland, Australia. Practices were contacted by email and phone before hand-delivering and collecting questionnaires. Thirty eight community pharmacist responses were descriptively analysed. Community pharmacists surveyed within the Cairns region feel that it is within their role to help manage the side effects of asthma medications. Many feel this is best conveyed during inhaler dispensing and instruction. Current advice is more prompted rather than preventative. Pharmacists routinely advise patients of mouth-rinsing following inhaler use, however the link to preventing side effects is not clearly communicated. Pharmacists are confident in recognizing and managing common side effects such as oral thrush and dry mouth, but fewer are aware of dental decay and gingivitis. Many identify a lack of guidelines as the largest barrier to providing preventive oral health advice. Cairns community pharmacists already self-perceive their role in the management of oral side effects of asthma medications. Advice given to patients is practical but does not clearly convey the causative associations between asthma medications and their potential oral side effects. Patient education is prompted more by enquiry rather than a preventative approach. The development of standardized practice protocols and integration within undergraduate degrees or continuing education may benefit the community-pharmacist delivered care.

Interprofessional Collaboration to Develop and Deliver Domestic Violence Curriculum to Dental Students

ABSTRACT Domestic violence (DV) is a serious social problem that impacts significantly on communities globally. While dentists are uniquely positioned to identify patients who experience DV, there is limited content specifically addressing the issue in their undergraduate training. James Cook University (JCU) dental students revealed this gap, and, in response, an interprofessional collaboration between JCU Social Work, JCU Dentistry and the Cairns Regional Domestic Violence Service was established to codesign and deliver the Dentists and Domestic Violence—Recognise, Respond and Refer program, evaluated through Participatory Action Research (PAR) cycles. The program is informed by critical and feminist social work theory with a gendered analysis of DV. The authors present the program’s evolution and examine the four elements identified as central to its success: interprofessional collaboration, critical and feminist theory and gendered analysis, scaffolded content, and skills-based activities. This article will provide a guide for others starting work in this space. IMPLICATIONS Designing and implementing an interprofessional domestic violence curriculum informed by critical theory and tailored for dental students’ can help meet their learning needs. Collaboratively educating dental students to recognise and respond to domestic violence cases will enable appropriate clinical interactions with patients who are victim-survivors of domestic violence and improve the quality of referrals and interactions with community support services. Undertaking evaluation research that guides effective domestic violence training for students across disciplines contributes to addressing domestic violence.

Undetected serovars: leptospirosis cases in the Cairns region during the 2021 wet season.

Leptospirosis infection can lead to serious renal and cardiopulmonary complications and can be fatal. Following heavy rainfall and localised flooding in early 2021, Tropical Public Health Services in Cairns were alerted to an increase in leptospirosis cases in the region, with notifications almost three times higher than usual by mid-February. An epidemiological investigation was undertaken. Leptospirosis notification data were obtained from the Queensland Notifiable Conditions System. Confirmed and probable cases residing in the Cairns region, with an onset date between 1 January and 31 May 2021, were included in the investigation. Case demographics, pathology results, symptoms, hospital stay information and presumed exposure sources were obtained from Queensland Health records; local rainfall data was obtained from the Australian Bureau of Meteorology. Case characteristics and rainfall were compared to the prior ten-year period and the distribution of cases by week of onset, address, exposure source and infecting serovar analysed. A total of 43 leptospirosis cases were notified between January and May 2021, the highest number recorded for the region since 2011. Presumed exposure sources were available for 40 cases (93.0%), with 33 cases (82.5%) exposed occupationally, including 25 cases working on banana farms. Infecting Leptospira serovars were identified for five cases (11.6%), with four infected with serovar Australis and one with serovar Zanoni. Limited information about the specific exposure sites for each case and a low serovar detection rate hampered the ability to confirm the presence or absence of a leptospirosis outbreak. While heavy rainfall is likely to have contributed to the spike in cases, no factors were identified as clearly associated with the increase. A number of pathways are proposed to improve the collection of exposure site data and the identification of infecting serovars, in order to strengthen local leptospirosis surveillance and the ability to detect outbreaks in the Cairns region.

Whose Heritage

Whose Heritage

Impact of European settlement and land use changes on Great Barrier Reef river catchments reconstructed from long-term coral Ba/Ca records

The increase in sediment and nutrient loads entering the coastal waters of the Great Barrier Reef (GBR) and the associated degradation of water quality represents a major threat to coral reefs. Although the strengthening of preventative management strategies remains a priority, there is a general lack of terrestrial runoff baseline information with respect to the spatial and temporal severity of disturbances associated with ongoing European-style land use practices. Here we use new and existing high-resolution coral Ba/Ca and luminescence records from the central Cairns region to the southern GBR shelf to reconstruct sediment fluxes discharged into the GBR from before European settlement in the 1860s to the present-day. Since the commencement of European settlement in the 1860s we document a tripling of flood-plume suspended sediment loads delivered by the Burdekin River to the GBR lagoon relative to ‘natural’ pre-European baseline levels. We show that this is indicative of a much more extreme degradation of the river catchments than hitherto appreciated with intensified discharge events particularly from the central and southern catchments carrying higher sediment loads. More-over from the 1930s onwards the Burdekin River, the largest source of both sediment and freshwater to the GBR, has also exhibited a progressive northwards expansion of its flood plume. This, together with increased variability of freshwater inputs indicated by coral luminescence records, now shows that the inner GBR not only continues to be impacted by increasing sediment/nutrient loads but is also subject to higher intensity river discharge events due to the loss of ground cover causing increased overland runoff and erosion.

Genetic stability of Aedes aegypti populations following invasion by wMel Wolbachia

BackgroundWolbachia wMel is the most commonly used strain in rear and release strategies for Aedes aegypti mosquitoes that aim to inhibit the transmission of arboviruses such as dengue, Zika, Chikungunya and yellow fever. However, the long-term establishment of wMel in natural Ae. aegypti populations raises concerns that interactions between Wolbachia wMel and Ae. aegypti may lead to changes in the host genome, which could affect useful attributes of Wolbachia that allow it to invade and suppress disease transmission.ResultsWe applied an evolve-and-resequence approach to study genome-wide genetic changes in Ae. aegypti from the Cairns region, Australia, where Wolbachia wMel was first introduced more than 10 years ago. Mosquito samples were collected at three different time points in Gordonvale, Australia, covering the phase before (2010) and after (2013 and 2018) Wolbachia releases. An additional three locations where Wolbachia replacement happened at different times across the last decade were also sampled in 2018. We found that the genomes of mosquito populations mostly remained stable after Wolbachia release, with population differences tending to reflect the geographic location of the populations rather than Wolbachia infection status. However, outlier analysis suggests that Wolbachia may have had an influence on some genes related to immune response, development, recognition and behavior.ConclusionsAe. aegypti populations remained geographically distinct after Wolbachia wMel releases in North Australia despite their Wolbachia infection status. At some specific genomic loci, we found signs of selection associated with Wolbachia, suggesting potential evolutionary impacts can happen in the future and further monitoring is warranted.

Impact of an integrated community-based model of care for older people with complex conditions on hospital emergency presentations and admissions: a step-wedged cluster randomized trial

BackgroundHealth systems must reorient towards preventative and co-ordinated care to reduce hospital demand and achieve positive and fiscally responsible outcomes for older persons with complex needs. Integrated care models can improve outcomes by aligning primary practice with the specialist health and social services required to manage complex needs. This paper describes the impact of a community-facing program that integrates care at the primary-secondary interface on the rate of Emergency Department (ED) presentation and hospital admissions among older people with complex needs.MethodsThe Older Persons Enablement and Rehabilitation for Complex Health Conditions (OPEN ARCH) study is a multicentre randomised controlled trial with a stepped wedge cluster design. General practitioners (GPs; n = 14) in primary practice within the Cairns region are considered ‘clusters’ each comprising a mixed number of participants. 80 community-dwelling persons over 70 years of age if non-Indigenous and over 50 years of age if Indigenous were included at baseline with no new participants added during the study. Clusters were randomly assigned to one of three steps that represent the time at which they would commence the OPEN ARCH intervention, and the subsequent intervention duration (3, 6, or 9 months). Each participant was its own control. GPs and participants were not blinded. The primary outcomes were ED presentations and hospital admissions. Data were collected from Queensland Health Casemix data and analysed with multilevel mixed-effects Poisson regression modelling to estimate the effectiveness of the OPEN ARCH intervention. Data were analysed at the cluster and participant levels.ResultsFive clusters were randomised to steps 1 and 2, and 4 clusters randomised to step 3. All clusters (n = 14) completed the trial accounting for 80 participants. An effect size of 9% in service use (95% CI) was expected. The OPEN ARCH intervention was found to not make a statistically significant difference to ED presentations or admissions. However, a stabilising of ED presentations and a trend toward lower hospitalisation rates over time was observed.ConclusionsWhile this study detected no statistically significant change in ED presentations or hospital admissions, a plateauing of ED presentation and admission rates is a clinically significant finding for older persons with complex needs. Multi-sectoral integrated programs of care require an adequate preparation period and sufficient duration of intervention for effectiveness to be measured.Trial registrationThe OPEN ARCH study received ethical approval from the Far North Queensland Human Research Ethics Committee, HREC/17/QCH/104–1174 and is registered on the Australian and New Zealand Trials Registry, ACTRN12617000198325p.

'Candidatus Phytoplasma dypsidis', a novel taxon associated with a lethal wilt disease of palms in Australia

A phytoplasma was initially detected in Dypsis poivriana by nested and real-time PCR from the botanical gardens in Cairns, Queensland, Australia in 2017. Further surveys in the Cairns region identified phytoplasma infections in eight additional dying ornamental palm species (Euterpe precatoria, Cocos nucifera, Verschaffeltia splendida, Brassiophoenix drymophloeodes, Burretiokentia hapala, Cyrtostachys renda, Reinhardtia gracilis, Carpoxylon macrospermum), a Phoenix species, a Euterpe species and two native palms (Archontophoenix alexandrae). Analysis of 16S rRNA gene sequences showed that this phytoplasma is distinct as it shared less than 97.5 % similarity with all other 'Candidatus Phytoplasma' species. At 96.3 % similarity, the most closely related formally described member of the provisional 'Ca. Phytoplasma' genus was 'Ca. Phytoplasma noviguineense', a novel taxon from the island of New Guinea found in monocotyledonous plants. It was slightly more closely related (96.6-96.8 %) to four palm-infecting strains from the Americas, which belong to strain group 16SrIV and which have not been assigned to a formal 'Candidatus Phytoplasma' species taxon. Phylogenetic analysis of the 16S rRNA gene and ribosomal protein genes of the phytoplasma isolate from a dying coconut palm revealed that the phytoplasma represented a distinct lineage within the phytoplasma clade. As the nucleotide identity with other phytoplasmas is less than 97.5 % and the phylogenetic analyses show that it is distinct, a novel taxon 'Candidatus Phytoplasma dypsidis' is proposed for the phytoplasma found in Australia. Strain RID7692 (GenBank accession no. MT536195) is the reference strain. The impact and preliminary aspects of the epidemiology of the disease outbreak associated with this novel taxon are described.

Beyond multimorbidity: primary care and the older person with complex needs.

The aim of this study was to present the health and social characteristics of community-dwelling older people within the Cairns region who were identified by their GP as having complex care needs. This paper reports the subanalysis of baseline data from the Older Persons Enablement and Rehabilitation (OPEN ARCH) stepped wedge randomised controlled trial of an integrated model of care for community-dwelling older people. Data were analysed at the level of the participant and the level of the participant cluster (group of participants from the one GP). Median quality of life, as assessed by the EQ-5D, was higher for females than males (80 vs 70 respectively; P=0.05) and for people living alone than living with family (80 vs 60 respectively; P=0.0940). There was greater functional independence among non-Indigenous than Indigenous participants (median Functional Independence Measure scores of 122 vs 115 respectively; P=0.0937) and the incidence rate (95% confidence intervals) of presentation to the emergency department was sevenfold higher for Indigenous than non-Indigenous participants (11.47 (5.93-20.03) vs 1.65 (0.79-3.04) per 1000 person days respectively). Finally, 61.3% of participants required support to remain living in the community and 44% accessed allied health, with podiatry the most common intervention. The findings indicate that previous hospital utilisation is not a consistent indicator of complexity. Multimorbidity, cultural context and the living and caring situation are considered as matters of complexity, yet variation exists at the participant level.

Novel reusable canopy trap for sampling arboreal populations of electric ant, Wasmannia auropunctata (Hymenoptera: Formicidae)

AbstractHere we describe and test a novel canopy trap design for catching the little fire ant, Wasmannia auropunctata, known as the electric ant in Australia, as part of the National Electric Ant Eradication Program (the program) in North Queensland. As W. auropunctata is known to nest and forage both on the ground and in tree canopies, an effective arboreal trap to monitor their presence is a critical management tool. Our trap design addresses known issues with arboreal sampling such as sample retention, weather and debris proofing, robustness and canopy access. The trap is cost effective and friendlier to the environment compared with single‐use traps, due to its reusability and recyclable or biodegradable components. Field testing carried out in the Cairns region demonstrated that the canopy trap successfully collected ants with minimal non‐ant bycatch. In a known W. auropunctata‐infested area, the canopy trap recorded an 88% sensitivity rate and continues to be used as a surveillance tool within the program. Additional research is required to further evaluate the sensitivity of the canopy trap for monitoring W. auropunctata populations. We believe that the trap has potentially wider applications for arboreal arthropod sampling and can be modified to suit.

Wolbachia Genome Stability and mtDNA Variants in Aedes aegypti Field Populations Eight Years after Release.

SummaryA dengue suppression strategy based on release of Aedes aegypti mosquitoes infected with the bacterium Wolbachia pipientis is being trialed in many countries. Wolbachia inhibits replication and transmission of dengue viruses. Questions remain regarding the long-term stability of virus-suppressive effects. We sequenced the Wolbachia genome and analyzed Ae. aegypti mitochondrial DNA markers isolated from mosquitoes sampled 2–8 years after releases in the greater Cairns region, Australia. Few changes were detected when Wolbachia genomes of field mosquitoes were compared with Wolbachia genomes of mosquitoes obtained soon after initial releases. Mitochondrial variants associated with the initial Wolbachia release stock are now the only variants found in release sites, highlighting maternal leakage as a possible explanation for rare Wolbachia-negative mosquitoes and not migration from non-release areas. There is no evidence of changes in the Wolbachia genome that indicate selection against its viral-suppressive effects or other phenotypes attributable to infection with the bacterium.

Scleroderma in Cairns: an epidemiological study.

Systemic sclerosis (SSc) refers to an autoimmune fibrosing disorder with high disease burden and mortality. The prevalence of 23/100 000 in South Australia (SA) is among the highest documented, but anecdotally it is higher still in Cairns. To ascertain the prevalence of SSc in Cairns and surrounding regions, and to compare the demographic and clinical characteristics of patients with SSc in Cairns with those in SA. Patients with SSc in Cairns were ascertained through hospital records and by referrals from specialist physicians in the region. These patients were interviewed and completed a structured questionnaire. Their physical findings and autoantibodies were recorded. These patients were compared with the SA patients enrolled in the Australian Scleroderma Cohort Study. A total of 81 patients was identified in Cairns, giving an estimated cross-sectional prevalence of 33.7/100 000. Among 65 patients interviewed in Cairns, 23 were born in Cairns, 16 had migrated to Cairns to ameliorate their Raynaud phenomenon and 26 for other reasons. The clinical features in both cohorts were similar, although Cairns had a lower prevalence of digital ulcers (30.8% vs 46.6%; odds ratio (OR) = 0.5035, 95% confidence interval (CI): 0.2839-0.8929, P = 0.0271) and higher prevalence of calcinosis (29.2% vs 17.0%; OR = 2.005, 95% CI: 1.055-3.382). The higher prevalence of SSc in Cairns is partly, but not completely, due to migration. Differences in clinical features are not entirely explained by the warmer climate. There is a need for greater rheumatologic services in the Cairns region.

Innovation Through Collaboration

With little data available on the quality of stormwater discharging from urban catchments to the Great Barrier Reef (GBR), the driver for the Smart Catchments: Saltwater Creek project was “If we don’t monitor, we can’t manage”. To do this, near real-time high-frequency discharge and water quality data are needed. A second driver was to make available, for the first time in a GBR catchment, near real-time water quality data for Council’s management actions but also for the community from an education perspective to engage them in water quality issues. Working collaboratively with industry, community, educators and scientists, the project, led by Cairns Regional Council, fulfils a commitment to the Reef 2050 Long-Term Sustainability Plan. This paper presents a more holistic and effective approach to monitor and manage water quality runoff from urban catchments.

Performance of recycled waste glass sand as partial replacement of sand in concrete

The aim of this research is to utilize recycled waste glass effectively as a partial replacement for the sand in concrete. A series of tests were conducted to determine the properties of the constituents, fresh concrete, and hardened concrete including its durability characteristics to investigate the suitability of using recycled waste glass sand (RGS) in concrete. Concrete was produced by replacing natural river sand with 20%, 40% and 60% of recycled glass sand. In this study, mixed-colour soda lime glass, collected by Cairns Regional Council, Australia was used. The test results showed a significant improvement in the strength of concrete. RGS concrete also showed improved resistance to chloride ion penetration. Besides, RGS addition significantly reduced expansion caused by alkali-silica reaction. The experimental results ascertain that the addition of RGS can be a good substitute for natural sand, and therefore, can be effectively used in industrial applications.

Computational Fluid Dynamic Modelling and Optimisation of Wastewater Treatment Plant Bioreactor Mixer

This study aims to determine the optimal configuration (position and operation duration) for wall mounted mechanical mixers based on the comparison of three-dimensional computational fluid dynamics (CFD) modelling results and physical data collected from the treatment plant. A three dimensional model of anoxic zone in 1, 2 and 3 of Northern Wastewater Treatment Plant (NWWTP) located at Cairns Regional Council, Cairns, Queensland, Australia was developed and validated. The model was used to simulate the flow pattern of the WWTP and the simulation results are in good agreement with the physical data varying between 0% to 15% in key locations. The anoxic zones were subject to velocities less than the desired 0.3 m per second however results for mixed liquor suspended solids (MLSS) concentration indicate that good mixing is being achieved. Results for suspended solids concentrations suggest that the anoxic zones are towards the upper limits recommended by literature for specific power dissipation. The duration for operation of mechanical mixers was investigated and identified that the duration could be reduced from 900 s down to 150 s. Alternative mixer positioning was also investigated and identified positioning which would increase the average flow velocity with decreased duration (150 s). The study identified that Council may achieve savings of $28,500 per year through optimisation of the mechanical mixers and would be expected to extend the operational life of the mixers.

Factors correlating to the propensity of general practitioners to substitute borderline vitamin B12 deficiency

Objective: This study aims to identify factors which correlate to the propensity of general practitioners (GPs) to prescribe supplementation for borderline vitamin B12 deficiency.Design: Cross-sectional surveys were distributed in person.Setting: Conferences held in Cairns, Palm Cove Beach, Mt Isa; educational meetings in Atherton; and meetings with individual general practices within the Cairns and Hinterland region. All located in Queensland, Australia.Subjects: 128 practicing GP specialists and registrars (practitioners in training).Main outcome measures: Responses to the Likert scale statements with its five options scaling from ‘strongly disagree’ to ‘strongly agree’ were recoded to have binary outcomes for analysis.Results: A survey response rate of 89% was achieved. Participants who felt patient demands influence the management of borderline vitamin B12 deficiency were more likely to prescribe supplementation (OR 2.4, p = 0.037). Participants who perceived an overuse of vitamin B12 were less likely to prescribe B12 (OR 0.39, p = 0.019). Participants who often saw patients with vitamin B12 deficiency were less likely to request for the complementary biomarkers plasma methylmalonic acid or total homocysteine (OR 0.41, p = 0.045).Conclusions: The identified disparity to prescribe vitamin B12 for borderline deficiency may be described as an attempt in the GP collective to seek a balance between being the patient’s or the society’s doctor. We propose that relevant authorities try to reduce this disparity by describing a management strategy for borderline vitamin B12 deficiency.Key pointsGeneral practitioners hold different thresholds for commencing supplementation in cases of borderline vitamin B12 deficiency.Participants from Australia were asked to fill out a cross-sectional survey to explore factors which correlate with the propensity to prescribe in clinical practice.Our study identified that patient demands and a practitioner’s perception of whether there is an overuse of vitamin B12 in the community influenced the propensity to treat for deficiency.The results give insight into reasons for initiating supplementation, and will help inform general practitioners on their current management.

Jazz Culture in the North: A Comparative Study of Regional Jazz Communities in Cairns and Mackay, North Queensland

Jazz Culture in the North: A Comparative Study of Regional Jazz Communities in Cairns and Mackay, North Queensland

Developing a Startup and Innovation Ecosystem in Regional Australia

IntroductionThe Cairns region of Australia (Box 1) faces challenges that are similar to other regional areas in Australia and around the world: declines in traditional industries, a boom-and-bust economic cycle, and a scarcity of "good jobs". With young talent facing a choice between moving to the big cities or staying behind but remaining unemployed, it is no wonder that an

Financial literacy:the case of migrant African-Australian women entrepreneurs in the cairns region

Purpose: To explore the financial literacy of eleven migrant African-Australian women entrepreneurs in the Cairns region. Methods: A qualitative case study approach was used to investigate financial literacy of eleven women via semi-structured interviews; survey questionnaire; and researcher's reflective journal. Findings: revealed that: (1) all the participating women had a high level of financial literacy; (2) the higher the level of education and English language proficiency of the women, the higher the level of financial literacy. Research limitations/Implications: The data was gathered from migrant women in one geographical region, so the results are limited in applicability and cannot be inferred to be similar to different regions and cultures. Similar research could be undertaken and cover a wider region, in order to gather more substantial data from a larger number of women and obtain more representative findings. Originality/value: This study provides empirical data of financial literacy among participating women, contributes to a new body of knowledge and provides a foundation for further research in this area. The study serves to inform aspiring migrant African-Australian women entrepreneurs themselves and may inform policymakers.

Nitrogen fixation of Acacia mangium Willd. from two seed sources grown at different levels of phosphorus in an Ultisol, South Sumatra, Indonesia

Phosphorus (P) is required to facilitate the fixation of atmospheric nitrogen (N) by leguminous species such as Acacia mangium. We studied the N fixation of A. mangium trees grown from two seed sources. These consisted of bulk seedlots collected from seed orchards in Sumatra, one based on natural provenances from the Cairns region, Queensland, Australia, and the other on the Muting natural provenance, Papua, Indonesia. The seedlots were grown under contrasting P supply (application rates of 0 and 100 kg ha−1) on acidic clay soils in a field experiment at Lematang, South Sumatra. The 15N natural abundance method was used, with Eucalyptus pellita as a non-N-fixing reference species. Foliage samples were collected at age 12 and 18 months. Application of P increased stem volume, foliage N concentrations and the amount of N fixed in both seed sources at 12 and 18 months of age. For the Cairns-origin seed source, the percentage of N derived from atmospheric N was low (c. 14%) without P addition, but increased by more than four-fold with P addition. In contrast, N fixed by the Muting-origin seed source (c. 45–60%) was not significantly affected by P addition. The Cairns-origin seed source partly compensated for lower N fixation by taking up a larger amount of soil N. Thus there were significant differences between seed sources in their N-fixing capacity and the effect of P nutrition on this process. The higher productivity of Muting under low P application appeared to be associated with better P utilisation and greater N fixation, but it was still responsive to P application.