General Population Of Australia Research Articles

Perceptions and recall of treatment for prostate cancer: A survey of two populations.

BackgroundThe complexity of prostate cancer care can impact on patient understanding and participation in shared decision-making. This study used a survey-based approach to investigate patients’ recall of their prostate cancer treatment, and more broadly, to understand the perceptions of patients and the general population of prostate cancer treatment.MethodThe survey was completed by 236 patients with prostate cancer (PCa cohort) and 240 participants from the general population of Australia (GenPop cohort). Free-text comments from both cohorts were analysed using content analysis. The PCa cohort reported which treatments and image-guidance related procedures they had received. These patient-reports were compared to medical records and analysed using proportion agreement, kappa statistics and regression analysis.Results135 (57%) PCa and 99 (41%) GenPop respondents provided at least one comment. Five major themes were identified by both cohorts: sharing experiences of treatment; preferences insights and reflections; mindsets; general commentary on the survey; and factors missing from the survey. There was overall good treatment recall amongst the PCa cohort, with proportions of correct recall ranging from 97.3% for chemotherapy to 66.8% for hormone therapy. There was a tendency for younger patients (<70 years old) to recall their hormone treatment more correctly.ConclusionParticipant comments suggest the complexity of prostate cancer diagnosis and treatment, and the varying perceptions and experiences of participants with prostate cancer. Patients’ recall overall was good for both treatment and image-guidance related procedures/approaches, however the poorer recall of hormone therapy requires further investigation.

An overview of current mental health in the general population of Australia during the COVID-19 pandemic: Results from the COLLATE project

The novel coronavirus disease (COVID-19) poses mental health challenges globally; however, to date, there is limited community level data. This study reports on the COLLATE project (COvid-19 and you: mentaL heaLth in AusTralia now survEy), an ongoing study aimed at understanding the impact of the COVID-19 pandemic on Australian mental health and well-being. We addressed prevailing primary concerns related to the COVID-19 pandemic, current levels of negative emotions and risk factors predicting negative emotions. On April 1st to 4th 2020, 5158 adults from the general public completed an online survey. Participants ranked their top ten current primary concerns about COVID-19, and completed standardized measures of negative emotions. The top three primary concerns were related to health and well-being of family and loved ones. Levels of negative emotion were high. Modelling of predictors of negative emotions established several risk factors related to demographic variables, personal vulnerabilities, financial stresses, and social distancing perceptions; particularly being young, female, or having a mental illness diagnosis. The data provides important characterization of the current Australian mental health. It appears that specific groups may need special attention to ensure their mental health is protected. These results may provide direction for international researchers characterizing similar issues.

The relationship between shift-work, sleep, and mental health among paramedics in Australia

ObjectivesThis study aimed to investigate the prevalence of sleep and mental health issues, the role of chronotype, and the relationship between these variables in Australian paramedics. DesignA cross-sectional study. SettingsCross-sectional survey. MeasurementsParamedics were invited to complete an online survey to assess stress, posttraumatic stress disorder (PTSD), depression, anxiety, daytime sleepiness, insomnia, sleep quality, shift-work disorder, bruxism, obstructive sleep apnea, narcolepsy, chronotype, fatigue, and well-being. ParticipantsA total of 136 paramedics responded to the survey (age, 39.1 ± 12.1 years; 45.8% men and 54.2% women; 85.4% rotating shift-workers, 7% rural shift-workers, and 7.6% fixed rosters). ResultsParamedics reported significantly higher levels of depression symptoms, anxiety symptoms, fatigue, PTSD symptoms, insomnia symptoms, narcolepsy, and significantly poorer sleep quality and general well-being than norms from the general population of Australia and Western countries (all p < .05). From regression analyses, insomnia explained the greatest amount of variance in depression and anxiety scores, followed by fatigue and PTSD (adjusted R-squared for depression and anxiety models = .58 and = .44, respectively, p < .001). The majority of participants were intermediate chronotype (57%), followed by morning (32%) and evening type (11%). Evening chronotypes showed significantly higher depression scores (p < .001), anxiety (p < .05), PTSD symptoms (p < .05), poorer sleep quality (p < .05), and general well-being (p < .001) compared with morning types. ConclusionAddressing sleep issues and matching chronotype to shift preference in paramedics may help to reduce depression, anxiety, and improve well-being.

Modelling the decline and future of hepatitis A transmission in Australia

Hepatitis A incidence has declined in most countries through a combination of prevention measures, augmented through the use of a highly effective vaccine. In Australia, the proportion of the population susceptible to hepatitis A infection has declined over time due to high rates of opportunistic vaccination as well as the sustained inflow of seropositive immigrants from high-endemicity countries. These factors have contributed to a rapid decline in incidence. An age-structured hepatitis A transmission model incorporating demographic changes was fitted to seroprevalence and disease notification data and used to project incidence trends and transmission potential for hepatitis A in the general population. Robustness of findings was assessed through worst-case scenarios regarding vaccine uptake, migration and the duration of immunity. The decline in age-specific seroprevalence until the introduction of hepatitis A vaccine in 1994 was well explained through a declining basic reproduction number (R0 ) that remained >1. Accounting for existing immunity, we estimated that the effective reproduction number (Reff ) <1 in the general population of Australia since the early 1990s, declining more rapidly after the introduction of the hepatitis A vaccine. Future projections under a variety of scenarios support Reff remaining <1 with continued low incidence in the general population. In conclusion, our results suggest that sustained endemic transmission in the general Australian population is no longer possible although risks of sporadic outbreaks remain. This suggests potential for local elimination of hepatitis A infection in Australia, provided that elimination criteria can be defined and satisfied in risk groups. The methodology used here to investigate elimination potential can easily be replicated in settings such as in the USA where sequential seroprevalence studies are supported by routine notification data.

The D-Health Trial: A randomized trial of vitamin D for prevention of mortality and cancer

BackgroundVitamin D, specifically serum 25(OH)D has been associated with mortality, cancer and multiple other health endpoints in observational studies, but there is a paucity of clinical trial evidence sufficient to determine the safety and effectiveness of population-wide supplementation. We have therefore launched the D-Health Trial, a randomized trial of vitamin D supplementation for prevention of mortality and cancer. Here we report the methods and describe the trial cohort. MethodsThe D-Health Trial is a randomized placebo-controlled trial, with planned intervention for 5years and a further 5years of passive follow-up through linkage with health and death registers. Participants aged 65–84years were recruited from the general population of Australia. The intervention is monthly oral doses of 60,000IU of cholecalciferol or matching placebo. The primary outcome is all-cause mortality. Secondary outcomes are total cancer incidence and colorectal cancer incidence. ResultsWe recruited 21,315 participants to the trial between February 2014 and May 2015. The participants in the two arms of the trial were well-balanced at baseline. Comparison with Australian population statistics shows that the trial participants were less likely to report being in fair or poor health, to be current smokers or to have diabetes than the Australian population. However, the proportion overweight or with health conditions such as arthritis and angina was similar. ConclusionsObservational data cannot be considered sufficient to support interventions delivered at a population level. Large-scale randomized trials such as the D-Health Trial are needed to inform public health policy and practice.

Horis, neffs and aunties: Social media, language and identity for young Ma-ori in Australia

Abstract With more than 140,000 ‘Mozzies’ (Ma-ori Aussies) living in Australia, people of Ma-ori ancestry constitute Australia’s largest Polynesian ethnic group. One in six of all Ma-ori leave New Zealand (Aotearoa) indefinitely to live and work in Australia. Ma-ori who make this journey encounter difficulties in maintaining cultural traditions, missing extended family (whanau), feelings of difference with both the general population of Australia and Ma-ori back at home, and a variation of expectations of returning home. Many of these issues are expressed in the New Zealand television series The GC (2012) – a Jersey-shore type docu-drama covering the lives of several young Ma-ori based on the Gold Coast in Queensland, Australia. A closer analysis of the members of The GC highlights the diversity of life experiences and cultural understanding amongst them, with agreement not even reached on their self-definition as Mozzies. Similarly, the social media language of young Ma-ori in Australia, when deconstructed, provides a veritable melting-pot of ‘flavours’ and influences. I argue that young Ma-ori Australians provide an important view into the Mozzie experience as they are a large part of the Mozzie population in Australia. Furthermore, they are more likely to experience and question elements of belonging and identity in relation to their Ma-oritanga/culture in the context of an Australian upbringing. Based on a survey of twelve Mozzie participants, I found that Ma-ori language use in social media among them incorporated a mix of English, Ma-ori te reo/Ma-ori language), text-speak and slang, which reflected a similar hybridization of language to that adopted by the young Ma-ori Australian actors on The GC. The aim of this article is to examine this social media language and explore the cultural, generational, technological and social factors influencing its organic growth amongst users. I suggest that this social media language is revealing of the range of experiences of young Ma-ori in Australia – expressing their attempts to maintain close links with Ma-ori culture (Ma-oritanga) and whanau from home, while also establishing a hybridized identity in Australia.

Nature and outcomes of the increased incidence of colorectal malignancy after liver transplantation in Australasia

To examine whether incidence of colorectal malignancy is increased in Australasian liver transplant recipients compared with the general population of Australia, and to assess the characteristics and outcomes of colorectal malignancy in this patient group. Data on patients who underwent orthotopic liver transplantation (OLTx) and had a diagnosis of de-novo colorectal malignancy after transplantation during the period 1985-2011 were obtained from the Australia and New Zealand Liver Transplant Registry, and these data were compared with colorectal malignancy data from the Australian Institute of Health and Welfare. Time from OLTx to diagnosis of colorectal malignancy, stage of colorectal malignancy at diagnosis, patient survival, and standardised incidence ratio (SIR) for colorectal malignancy. Forty-eight of 3735 recipients (1.3%) were diagnosed with colorectal malignancy at a median of 7.3 years after OLTx. More advanced colorectal malignancy (regional or metastatic disease) was evident at diagnosis in 20 of the 48 patients; these patients tended to be younger than patients with less advanced malignancy (P = 0.01) and diagnosed sooner after OLTx (P = 0.005). Despite treatment predominantly with surgery, 19 of the 48 patients died from the malignancy. The overall SIR for colorectal malignancy liver transplant recipients compared with the general population of Australia was 2.80 (95% CI, 2.06-3.71). The incidence of colorectal malignancy is increased in liver transplant recipients in comparison with the general population. Of concern is the tendency for advanced malignancy to be diagnosed in younger patients. These data highlight the importance of considering whether specific guidelines for colorectal malignancy screening in the Australasian adult liver transplant population are needed.

Recruitment and Results of a Pilot Trial of Vitamin D Supplementation in the General Population of Australia

The benefits of high serum levels of 25-hydroxyvitamin D [25(OH)D] are unclear. Trials are needed to establish an appropriate evidence base. We plan to conduct a large-scale trial of vitamin D supplementation for the reduction of cancer incidence and overall mortality and report here the methods and results of a pilot trial established to inform its design. Pilot D-Health was a randomized trial carried out in a general community setting with 12 months intervention and follow-up. Participants were 60- to 84-yr-old residents of one of the four eastern Australian states who did not have any vitamin D-related disorders and who were not taking more than 400 IU supplementary vitamin D per day. A total of 644 participants were randomized, and 615 completed the study (two persons withdrew because of nonserious adverse events). The interventions were monthly doses of placebo or 30,000 or 60,000 IU vitamin D(3). The main outcomes were the recruitment rate and changes in serum 25(OH)D. Ten percent of those approached were recruited. At baseline, the mean 25(OH)D was 42 nmol/liter in all three study arms. The mean change in 25(OH)D in the placebo group was 0.12 nmol/liter, compared with changes of 22 and 36 nmol/liter in the 30,000- and 60,000-IU groups, respectively. The D-Health pilot has shown that a large trial is feasible in Australia and that a dose of 2000 IU/d will be needed to ensure that a large proportion of the population reaches the target serum 25(OH)D level.

Southern Geographies and the Domestication of Science in the Photography of J.W. Lindt

John William Lindt's (I845-1926) photography of his house and garden retreat, The Hermitage, in the Yarra Ranges near Melbourne, attests to contemporary debates on what one contemporary termed the domestication of science : the call for the common man and increasingly, the interested woman to participate first-hand in the scientific study of the natural world, especially the disciplines of botany and geography. Recalling the earlier doctrines of German naturalist Alexander von Humboldt (l769-1859), who linked the botanical geography of southern continents with the development of egalitarian values in art and science and the advancement of modern civilization, Australian protagonists of such ideals coupled field research by the average citizen with the intellectual progress of the colony. We argue that Limit 's Hermitage, which was designed on Humboldtian principles, also became an important site for scientific activities that were intellectually indebted to Humboldtian ideals. In order to show how Lindt's photographic images of The Hermitage and surrounds specifically address contemporary discourses on the access to science by non-professionals, including women, we will focus on Lindt's practical involvement in the Royal Geographical Society of Australasia , including his participation in scientific expeditions to New Guinea and Fiji, and his use of The Hermitage as a base for geographical carnivals and field trips . These images were widely disseminated by Llndt in diverse forms such as stereographs, tourist postcards and in scientific presentations. By these means, Lindt was able to impart to a global audience Humboldtian insights about the botanical abundance of me south and its potential to awaken a comprehension of science and art in the general population of Australia.

Knowledge of the ocular effects of diabetes among the general population of Australia and the members of Diabetes Australia

Background: Early diagnosis and treatment of diabetes mellitus is importam for limiting its adverse effects. We sought to determine the level of awareness of diabetes and its ocular complications within the community and among the members of Diabetes Australia. Methods: Two groups were surveyed: 1. 1,000 people randomly selected from the Queensland electoral role (people without diabetes) and 2. A random sample of 500 members of Diabetes Australia (Queensland) (people with diabetes). The surveys consisted primarily of questions relating to the person's current knowledge of diabetes, including ocular and health complications, and their knowledge of available eye care services. Resulte: The rate of return was greater for the members of Diabetes Australia (58.6 per cent) than for the public (33.5 per cent). The majority of respondents without diabetes tended to consult an optometrist for their eye care (76 per cent), while the group with diabetes consulted ophthalmologists more (63.6 per cent). People with diabetes tended to have more frequent eye examinations, 86.7 per cent had been for an eye examination within the preceding 18 months (compared with 36.6 per cent of the public). The levei of awareness of the ocular effects of diabetes was high: 96 per cent of people with and 78.5 per cent of people without diabetes knew that diabetes could be sight‐threatening. Conclusion: The membership of Diabetes Australia had a greater understanding of the possible ocular effects of diabetes and the need for regular eye examinations than the general community. Potential sample bias and the fact that respondents could infer a link between eye problems and diabetes from the survey questions should be taken into account in interpreting the data presented here.