Australian and New Zealand Journal of Public Health最新文献_第3页

Increasing awareness of sexually transmitted infections (STI) testing and addressing stigma may improve STI testing in Aboriginal and Torres Strait Islander youth: Evidence from the Next Generation Youth Wellbeing Study 提高原住民和托雷斯海峡岛民青少年对性传播感染（STI）检测的认识并消除耻辱感，可以改善性传播感染检测：下一代青年福祉研究》（Next Generation Youth Wellbeing Study）提供的证据。

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-11-16 DOI: 10.1016/j.anzjph.2024.100203

Tabassum Rahman , Fabian Yuh Shiong Kong , Robyn Williams , Katiska Davis , Justine Whitby , Francine Eades , Simon Graham , Grace Joshy , Sandra Eades

Objective

To quantify the prevalence of sexually transmitted infections (STI) testing in relation to sociodemographic, behavioural, and health related factors, and patterns in sexual health service (SHS) use and non-use among Aboriginal and Torres Strait Islander (hereafter Aboriginal) youth.

Methods

The analyses included N=198 sexually active 16-24-year-olds from Central Australia, Western Australia, and New South Wales participating in the Next Generation Youth Wellbeing Study. Modified Poisson regression estimated age-sex-adjusted prevalence ratios (PRs) for ever testing for STIs.

Results

Approximately 55% of the participants ever tested for STIs. Over 44% of the participants ever accessed SHS; perceived irrelevance (50%) and embarrassment (15%) were the main reasons for not accessing SHS. STI testing was higher among: 21–24-year-olds (68.75% vs 37.04% among 16–17-year-olds, PR: 1.82; confidence interval 1.23–2.67); those with high/very-high psychological distress (63.39% vs 44.55% among low/moderate group, 1.50;1.16–1.94); and those who lived in ≥3 houses in the past five years (65.43% vs 48.11% among those who lived in 1–2 houses, 1.33;1.04–1.70).

Conclusions

STI testing should be offered to sexually active Aboriginal youth at every opportunity.

Implications for public health

Sexual health messages should further promote the benefit of regular STI testing and where to access free SHS among Aboriginal youth.

目的量化原住民和托雷斯海峡岛民（以下简称 "原住民"）青少年性传播感染（STI）检测率与社会人口、行为和健康相关因素的关系，以及使用和不使用性健康服务（SHS）的模式：分析对象包括澳大利亚中部、西澳大利亚州和新南威尔士州参加 "下一代青年福祉研究 "的 16-24 岁性生活活跃的 198 名青少年。修正的泊松回归估算了曾经接受性传播感染检测的年龄-性别调整流行率（PRs）：结果：约 55% 的参与者曾接受过性传播感染检测。超过 44% 的受试者曾经接受过卫生和保健服务；认为无关紧要（50%）和尴尬（15%）是不接受卫生和保健服务的主要原因。以下人群的性传播感染检测率较高：21-24 岁人群（68.75% 对 16-17 岁人群中的 37.04%，PR：1.82；置信区间 1.23-2.67）；有高度/极高度心理困扰人群（63.39% 对低度/中度人群中的 44.55%，1.50;1.16-1.94）；以及过去五年中居住过≥3 套住房的人群（65.43% 对居住过 1-2 套住房人群中的 48.11%，1.33;1.04-1.70）：结论：应利用一切机会为性行为活跃的原住民青年提供性传播感染检测：性健康信息应进一步向原住民青年宣传定期进行性传播感染检测的益处，以及在哪里可以获得免费的社会医疗服务。

{"title":"Increasing awareness of sexually transmitted infections (STI) testing and addressing stigma may improve STI testing in Aboriginal and Torres Strait Islander youth: Evidence from the Next Generation Youth Wellbeing Study","authors":"Tabassum Rahman , Fabian Yuh Shiong Kong , Robyn Williams , Katiska Davis , Justine Whitby , Francine Eades , Simon Graham , Grace Joshy , Sandra Eades","doi":"10.1016/j.anzjph.2024.100203","DOIUrl":"10.1016/j.anzjph.2024.100203","url":null,"abstract":"<div><h3>Objective</h3><div>To quantify the prevalence of sexually transmitted infections (STI) testing in relation to sociodemographic, behavioural, and health related factors, and patterns in sexual health service (SHS) use and non-use among Aboriginal and Torres Strait Islander (hereafter Aboriginal) youth.</div></div><div><h3>Methods</h3><div>The analyses included N=198 sexually active 16-24-year-olds from Central Australia, Western Australia, and New South Wales participating in the Next Generation Youth Wellbeing Study. Modified Poisson regression estimated age-sex-adjusted prevalence ratios (PRs) for ever testing for STIs.</div></div><div><h3>Results</h3><div>Approximately 55% of the participants ever tested for STIs. Over 44% of the participants ever accessed SHS; perceived irrelevance (50%) and embarrassment (15%) were the main reasons for not accessing SHS. STI testing was higher among: 21–24-year-olds (68.75% vs 37.04% among 16–17-year-olds, PR: 1.82; confidence interval 1.23–2.67); those with high/very-high psychological distress (63.39% vs 44.55% among low/moderate group, 1.50;1.16–1.94); and those who lived in ≥3 houses in the past five years (65.43% vs 48.11% among those who lived in 1–2 houses, 1.33;1.04–1.70).</div></div><div><h3>Conclusions</h3><div>STI testing should be offered to sexually active Aboriginal youth at every opportunity.</div></div><div><h3>Implications for public health</h3><div>Sexual health messages should further promote the benefit of regular STI testing and where to access free SHS among Aboriginal youth.</div></div>","PeriodicalId":8620,"journal":{"name":"Australian and New Zealand Journal of Public Health","volume":"48 6","pages":"Article 100203"},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A cross-sectional study of the experiences of distressed callers when accessing financial assistance from a telephone-based cancer information and support service 一项横断面研究，内容是受困来电者从电话癌症信息和支持服务获取经济援助时的经历。

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-11-16 DOI: 10.1016/j.anzjph.2024.100199

Elizabeth A. Fradgley , Paula Bridge , Katherine Lane , Danielle Spence , Della Yates , Melissa A. Carlson , Jo Taylor , Christine L. Paul

Objective

The objective of this study was to explore the experiences of distressed people calling helplines regarding offer and uptake of financial services after cancer diagnosis.

Methods

Cancer patients and caregivers reported whether they had discussed then used financial services and perceptions surrounding service uptake. Associations between being offered services and demographic, clinical and financial characteristics were explored.

Results

Of the 508 patients and caregivers in this sample, 107 (21%) people who recalled discussing financial support used the service. Of those, 34 (32%) participants actioned a financial support referral, of which 32 (94%) reported that the support was helpful. Of the 401 (79%) who did not recall discussing financial support, 26 (6%) would have liked to do so. The following characteristics were significantly associated with a greater likelihood of discussing financial support: younger age, being married, metastatic disease, higher out-of-pocket costs, not having private health insurance, being on leave and being absent for more days from work.

Conclusions

Although users of financial supports find them helpful, there is need for more structured approaches to referral to achieve equitable access.

Implications for public health

A pro-active, structured approach to assessing financial toxicity and offering support is warranted in community-based organisations that offer cancer information and support.

研究目的本研究旨在探讨癌症患者在被诊断为癌症后致电求助热线时对金融服务的提供和使用情况的体验：方法：癌症患者和护理人员报告他们是否讨论过并使用过金融服务，以及对服务使用情况的看法。结果：在 508 名癌症患者和护理人员中，有 1.5%的人在接受金融服务时，会对金融服务进行讨论：在抽样调查的 508 名患者和护理人员中，107 人（21%）回忆起曾讨论过财务支持问题，并使用了服务。其中 34 人（32%）转介了财务支持服务，32 人（94%）表示该支持服务很有帮助。在 401 人（79%）中，有 26 人（6%）不记得曾讨论过财务支持问题，但他们希望能讨论过。以下特征与讨论财务支持的可能性明显相关：年龄较小、已婚、转移性疾病、自付费用较高、没有私人医疗保险、正在休假以及缺勤天数较多：结论：尽管经济援助的使用者认为这些援助很有帮助，但仍需要更有条理的转介方法，以实现公平获取：提供癌症信息和支持的社区组织应采取积极主动的结构化方法来评估财务毒性并提供支持。

{"title":"A cross-sectional study of the experiences of distressed callers when accessing financial assistance from a telephone-based cancer information and support service","authors":"Elizabeth A. Fradgley , Paula Bridge , Katherine Lane , Danielle Spence , Della Yates , Melissa A. Carlson , Jo Taylor , Christine L. Paul","doi":"10.1016/j.anzjph.2024.100199","DOIUrl":"10.1016/j.anzjph.2024.100199","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to explore the experiences of distressed people calling helplines regarding offer and uptake of financial services after cancer diagnosis.</div></div><div><h3>Methods</h3><div>Cancer patients and caregivers reported whether they had discussed then used financial services and perceptions surrounding service uptake. Associations between being offered services and demographic, clinical and financial characteristics were explored.</div></div><div><h3>Results</h3><div>Of the 508 patients and caregivers in this sample, 107 (21%) people who recalled discussing financial support used the service. Of those, 34 (32%) participants actioned a financial support referral, of which 32 (94%) reported that the support was helpful. Of the 401 (79%) who did not recall discussing financial support, 26 (6%) would have liked to do so. The following characteristics were significantly associated with a greater likelihood of discussing financial support: younger age, being married, metastatic disease, higher out-of-pocket costs, not having private health insurance, being on leave and being absent for more days from work.</div></div><div><h3>Conclusions</h3><div>Although users of financial supports find them helpful, there is need for more structured approaches to referral to achieve equitable access.</div></div><div><h3>Implications for public health</h3><div>A pro-active, structured approach to assessing financial toxicity and offering support is warranted in community-based organisations that offer cancer information and support.</div></div>","PeriodicalId":8620,"journal":{"name":"Australian and New Zealand Journal of Public Health","volume":"48 6","pages":"Article 100199"},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Psychedelic medicine and cultural responsiveness: A call for Aboriginal and Torres Strait Islander engagement in Australian clinical trials and practice 迷幻药与文化响应：呼吁土著居民和托雷斯海峡岛民参与澳大利亚临床试验和实践。

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-11-07 DOI: 10.1016/j.anzjph.2024.100200

Bianca Sebben , Jem Stone , Jerome Sarris , Daniel Perkins , Kirt Mallie , Scarlet Barnett , Simon G.D. Ruffell , Vanessa L. Beesley

引用次数: 0

An evaluation of the population uptake and contact tracer utilisation of the Covid-19 Bluetooth Exposure Notification Framework in New Zealand 对新西兰 Covid-19 蓝牙暴露通知框架的人口吸收和接触追踪器使用情况的评估。

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-11-05 DOI: 10.1016/j.anzjph.2024.100197

Tim Chambers , Andrew Anglemyer , Andrew Chen , June Atkinson , Phoebe Elers , Michael G. Baker

Objective

Our primary research objective was to assess the population uptake and contact tracer utilisation of the Bluetooth function of the New Zealand Covid Tracer App (NZCTA) throughout the pandemic.

Methods

We adopted a retrospective cohort study design using all diagnosed COVID-19 community cases from December 12, 2020 to February 16, 2022.

Results

At its height, more than 60 % of the eligible population had the Bluetooth function of NZCTA activated. However, only an estimated 2.2 % of the population was able to fully participate. Cases managed by the national case investigation service were 17 times (aRR 17.54, 95%CI: 13.02-23.90) and 9 times (aRR 9.27, 95%CI: 6.91, 12.76) more likely to generate a Bluetooth token than cases managed by local public health units during the Delta and Omicron periods, respectively.

Conclusions

The Bluetooth functionality of the NZCTA likely had a low impact on the pandemic response in NZ despite its exceptionally high levels of public uptake. The primary reason for the lack of impact was the low utilisation by contact tracers.

Implications for public health

The results highlight the need for greater consultation and collaboration with the public health sector during the development and implementation of digital contact tracing tools.

目标：我们的主要研究目标是评估整个大流行期间人群对新西兰 Covid 追踪应用程序蓝牙功能的接受程度和接触者追踪器的使用情况：我们的主要研究目标是评估新西兰Covid示踪应用程序（NZCTA）蓝牙功能在整个大流行期间的人群吸收率和接触者示踪使用率：我们采用了回顾性队列研究设计，使用了2020年12月12日至2022年2月16日期间所有确诊的COVID-19社区病例：在疫情最严重的时候，超过60%的合格人群激活了NZCTA的蓝牙功能。然而，估计只有 2.2% 的人口能够完全参与。在德尔塔期和欧米克隆期，由国家病例调查服务机构管理的病例生成蓝牙令牌的可能性分别是由地方公共卫生单位管理的病例的17倍（aRR 17.54，95%CI：13.02-23.90）和9倍（aRR 9.27，95%CI：6.91-12.76）：尽管公众对 NZCTA 蓝牙功能的使用率极高，但该功能对新西兰大流行应对措施的影响可能较小。缺乏影响的主要原因是接触追踪器的使用率较低：研究结果突出表明，在开发和实施数字化接触者追踪工具的过程中，需要加强与公共卫生部门的协商与合作。

{"title":"An evaluation of the population uptake and contact tracer utilisation of the Covid-19 Bluetooth Exposure Notification Framework in New Zealand","authors":"Tim Chambers , Andrew Anglemyer , Andrew Chen , June Atkinson , Phoebe Elers , Michael G. Baker","doi":"10.1016/j.anzjph.2024.100197","DOIUrl":"10.1016/j.anzjph.2024.100197","url":null,"abstract":"<div><h3>Objective</h3><div>Our primary research objective was to assess the population uptake and contact tracer utilisation of the Bluetooth function of the New Zealand Covid Tracer App (NZCTA) throughout the pandemic.</div></div><div><h3>Methods</h3><div>We adopted a retrospective cohort study design using all diagnosed COVID-19 community cases from December 12, 2020 to February 16, 2022.</div></div><div><h3>Results</h3><div>At its height, more than 60 % of the eligible population had the Bluetooth function of NZCTA activated. However, only an estimated 2.2 % of the population was able to fully participate. Cases managed by the national case investigation service were 17 times (aRR 17.54, 95%CI: 13.02-23.90) and 9 times (aRR 9.27, 95%CI: 6.91, 12.76) more likely to generate a Bluetooth token than cases managed by local public health units during the Delta and Omicron periods, respectively.</div></div><div><h3>Conclusions</h3><div>The Bluetooth functionality of the NZCTA likely had a low impact on the pandemic response in NZ despite its exceptionally high levels of public uptake. The primary reason for the lack of impact was the low utilisation by contact tracers.</div></div><div><h3>Implications for public health</h3><div>The results highlight the need for greater consultation and collaboration with the public health sector during the development and implementation of digital contact tracing tools.</div></div>","PeriodicalId":8620,"journal":{"name":"Australian and New Zealand Journal of Public Health","volume":"48 6","pages":"Article 100197"},"PeriodicalIF":2.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Infection, ageing and patient rights: Time for single-occupancy hospital rooms 感染、老龄化和病人权利：单人病房的时代来临了。

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-10-30 DOI: 10.1016/j.anzjph.2024.100198

Cindy Towns , Matthew Kelly , Angela Ballantyne

引用次数: 0

How should we fund integrated primary care for children in Australia? A resource allocation study 我们应该如何资助澳大利亚儿童综合初级保健？资源分配研究。

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-10-25 DOI: 10.1016/j.anzjph.2024.100196

Cate Bailey , Suzy Honisett , Jacinta Dermentzis , Janelle Devereux , Jo-Anne Manski-Nankervis , Kim Dalziel , Harriet Hiscock

Objectives

Integrated primary care provides health and social care services to intervene early and support children and families. Funding of integrated care is a barrier to care provision, but evidence is limited for which funding models are most appropriate. Our study aimed to provide expert judgement on what funding model, or mix of models, are most likely effective for integrating primary care for families with children aged 0-12 years in Australia.

Methods

We conducted a resource allocation survey to value funding models for integrated care. Participants were purposively sampled experts in primary health, social care and mental health care. Six funding types were included in the study. Outcome measures included ranking of funding model preferences and qualitative analysis from open-ended questions.

Results

Block-funding, alternative-payment-methods and incentive-payments were preferred models for integrated care individually and within a blended model. Fee-for-service, capitation and pay-for-performance were the least preferred models. There was agreement Fee-for-service may hinder integrating care.

Conclusions

A blended model, including alternative-payment-methods, incentive-payments and block-funding, were preferred models to best integrate care for child outcomes.

Implications for Public Health

Determining how best to fund integrated primary care for children is a priority for decision-making in Australia, as fee-for-service is no longer considered appropriate.

目标：综合初级保健提供健康和社会保健服务，以便及早干预并支持儿童和家庭。综合医疗的资金是提供医疗服务的一个障碍，但关于哪种资助模式最合适的证据却很有限。我们的研究旨在提供专家判断，哪种资助模式或模式组合最有可能有效地整合澳大利亚 0-12 岁儿童家庭的初级保健：我们进行了一项资源分配调查，以评估整合护理的资助模式。参与者是有目的地抽取的初级医疗、社会医疗和心理医疗专家。研究包括六种资助类型。结果测量包括筹资模式偏好排名和开放式问题的定性分析：结果：整笔供资、替代支付方法和奖励支付是单独和混合模式中首选的综合医疗模式。收费服务、按人头付费和按绩效付费是最不受欢迎的模式。大家一致认为，收费服务可能会阻碍整合护理：结论：混合模式，包括替代性支付方法、激励性支付和整笔供资，是最有利于整合医疗服务以促进儿童健康的首选模式：对公共卫生的影响：在澳大利亚，由于收费服务不再被认为是合适的，因此确定如何为儿童综合初级保健提供最佳资金是决策的当务之急。

{"title":"How should we fund integrated primary care for children in Australia? A resource allocation study","authors":"Cate Bailey , Suzy Honisett , Jacinta Dermentzis , Janelle Devereux , Jo-Anne Manski-Nankervis , Kim Dalziel , Harriet Hiscock","doi":"10.1016/j.anzjph.2024.100196","DOIUrl":"10.1016/j.anzjph.2024.100196","url":null,"abstract":"<div><h3>Objectives</h3><div>Integrated primary care provides health and social care services to intervene early and support children and families. Funding of integrated care is a barrier to care provision, but evidence is limited for which funding models are most appropriate. Our study aimed to provide expert judgement on what funding model, or mix of models, are most likely effective for integrating primary care for families with children aged 0-12 years in Australia.</div></div><div><h3>Methods</h3><div>We conducted a resource allocation survey to value funding models for integrated care. Participants were purposively sampled experts in primary health, social care and mental health care. Six funding types were included in the study. Outcome measures included ranking of funding model preferences and qualitative analysis from open-ended questions.</div></div><div><h3>Results</h3><div>Block-funding, alternative-payment-methods and incentive-payments were preferred models for integrated care individually and within a blended model. Fee-for-service, capitation and pay-for-performance were the least preferred models. There was agreement Fee-for-service may hinder integrating care.</div></div><div><h3>Conclusions</h3><div>A blended model, including alternative-payment-methods, incentive-payments and block-funding, were preferred models to best integrate care for child outcomes.</div></div><div><h3>Implications for Public Health</h3><div>Determining how best to fund integrated primary care for children is a priority for decision-making in Australia, as fee-for-service is no longer considered appropriate.</div></div>","PeriodicalId":8620,"journal":{"name":"Australian and New Zealand Journal of Public Health","volume":"48 6","pages":"Article 100196"},"PeriodicalIF":2.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The association between vaping and subsequent initiation of cigarette smoking in young Australians from age 12 to 17 years: a retrospective cohort analysis using cross-sectional recall data from 5114 adolescents 澳大利亚 12 至 17 岁青少年吸食电子烟与随后开始吸烟之间的关系：利用 5114 名青少年的横断面回忆数据进行的回顾性队列分析。

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-10-01 DOI: 10.1016/j.anzjph.2024.100173

Sam Egger , Michael David , Christina Watts , Anita Dessaix , Alecia Brooks , Emily Jenkinson , Paul Grogan , Marianne Weber , Qingwei Luo , Becky Freeman

Objective

The objective of this study was to estimate the association between vaping and subsequent initiation of smoking among Australian adolescents and explore the impact of design and analytical methods in previous studies.

Methods

We conducted a retrospective cohort analysis of cross-sectional data from 5114 Australian adolescents aged 14–17 recalling information on smoking and vaping initiation from age 12 to 17. The outcome was smoking initiation, analysed with negative-binomial regression to estimate incidence rate ratios (IRRs) for vape status (ever-vaped vs never-vaped) as a time-varying exposure. We also re-analysed using the methods of previous studies not accounting for the time-varying nature of e-cigarette exposure.

Results

Participants (n=5114) were retrospectively followed for 20478 person-years. After adjusting for socio-demographic variables and proxy measures of common liabilities for vaping and smoking, the rate of smoking initiation for those who ever-vaped was nearly 5 times that of those who never-vaped (IRR=4.9; 95% confidence interval: [3.9, 6.0], p<0.001), with IRRs considerably higher at younger ages. Not accounting for the time-varying nature of e-cigarette exposure in re-analysis attenuated the estimated IRR by 44%.

Conclusions

Controlled analyses indicate that vaping markedly increases the risk of subsequent smoking initiation among Australian adolescents from age 12 to 17, with those aged 12, 13, and 14 bearing an alarmingly disproportionate burden of the elevated risk. Additionally, the relative risk of future smoking due to vaping may have been underestimated in other studies due to methodological differences.

Implications for public health

Our findings highlight the need for public health interventions and strict e-cigarette access laws.

本研究的目的是估算澳大利亚青少年吸食电子烟与随后开始吸烟之间的关系，并探讨以往研究中的设计和分析方法的影响。方法我们对5114名14-17岁澳大利亚青少年的横断面数据进行了回顾性队列分析，他们回忆了12-17岁期间吸烟和开始吸食电子烟的信息。分析结果为开始吸烟，采用负二叉回归法估算作为时变暴露的吸食状况（吸食过与从未吸食过）的发病率比（IRR）。我们还使用以往研究中未考虑电子烟暴露时变性质的方法进行了重新分析。结果对参与者（n=5114）进行了 20478 人年的回顾性随访。在对社会人口学变量以及吸食电子烟和吸烟的共同责任的替代措施进行调整后，曾经吸食电子烟者的吸烟率是从未吸食者的近5倍（IRR=4.9；95%置信区间：[3.9，6.0]，p<0.001），年龄越小，IRR越高。结论对照分析表明，吸食电子烟明显增加了12至17岁澳大利亚青少年随后开始吸烟的风险，其中12、13和14岁的青少年承担的风险升高的负担过重，令人震惊。此外，由于方法上的差异，其他研究可能低估了吸食电子烟导致未来吸烟的相对风险。

{"title":"The association between vaping and subsequent initiation of cigarette smoking in young Australians from age 12 to 17 years: a retrospective cohort analysis using cross-sectional recall data from 5114 adolescents","authors":"Sam Egger , Michael David , Christina Watts , Anita Dessaix , Alecia Brooks , Emily Jenkinson , Paul Grogan , Marianne Weber , Qingwei Luo , Becky Freeman","doi":"10.1016/j.anzjph.2024.100173","DOIUrl":"10.1016/j.anzjph.2024.100173","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to estimate the association between vaping and subsequent initiation of smoking among Australian adolescents and explore the impact of design and analytical methods in previous studies.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort analysis of cross-sectional data from 5114 Australian adolescents aged 14–17 recalling information on smoking and vaping initiation from age 12 to 17. The outcome was smoking initiation, analysed with negative-binomial regression to estimate incidence rate ratios (IRRs) for vape status (ever-vaped vs never-vaped) as a time-varying exposure. We also re-analysed using the methods of previous studies not accounting for the time-varying nature of e-cigarette exposure.</div></div><div><h3>Results</h3><div>Participants (n=5114) were retrospectively followed for 20478 person-years. After adjusting for socio-demographic variables and proxy measures of common liabilities for vaping and smoking, the rate of smoking initiation for those who ever-vaped was nearly 5 times that of those who never-vaped (IRR=4.9; 95% confidence interval: [3.9, 6.0], <em>p</em><0.001), with IRRs considerably higher at younger ages. Not accounting for the time-varying nature of e-cigarette exposure in re-analysis attenuated the estimated IRR by 44%.</div></div><div><h3>Conclusions</h3><div>Controlled analyses indicate that vaping markedly increases the risk of subsequent smoking initiation among Australian adolescents from age 12 to 17, with those aged 12, 13, and 14 bearing an alarmingly disproportionate burden of the elevated risk. Additionally, the relative risk of future smoking due to vaping may have been underestimated in other studies due to methodological differences.</div></div><div><h3>Implications for public health</h3><div>Our findings highlight the need for public health interventions and strict e-cigarette access laws.</div></div>","PeriodicalId":8620,"journal":{"name":"Australian and New Zealand Journal of Public Health","volume":"48 5","pages":"Article 100173"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Affirming schools, population-level data, and holistic public health are key to addressing mental ill-health and substance use disparities among gender and sexuality diverse young people in Australia and Aotearoa New Zealand 要解决澳大利亚和新西兰奥特亚罗瓦地区不同性别和性取向青少年的精神疾病和药物使用差异问题，关键在于肯定学校、人口层面的数据以及全面的公共卫生。

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-10-01 DOI: 10.1016/j.anzjph.2024.100183

Sasha Bailey , Yael Perry , Kyle Tan , Jack Byrne , Taine H. Polkinghorne , Nicola C. Newton , Jaimie Veale , John Fenaughty , The Matilda Centre Gender and Sexuality Diverse Youth Advisory Committee , Raaya Tiko , Maree Teesson , Emma L. Barrett

引用次数: 0

Mental and neurodevelopmental health needs of Aboriginal children with experience of out-of-home care: a Western Australian data-linkage study 有家庭外照料经历的原住民儿童的心理和神经发育健康需求：西澳大利亚州数据链接研究。

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-10-01 DOI: 10.1016/j.anzjph.2024.100181

Benjamin Harrap , Alison Gibberd , Melissa O’Donnell , Jocelyn Jones , Richard Chenhall , Bridgette McNamara , Koen Simons , Sandra Eades

Objective

To identify additional mental and neurodevelopmental health needs of Aboriginal children born in Western Australia, who are placed in out-of-home care (OOHC), relative to Aboriginal children born in Western Australia who were not placed.

Methods

Data-linkage of hospitalisations, health registries and child protective services data for all Aboriginal children born in WA between 2000 and 2013 was used. Children placed in out-of-home care between 2000 and 2019 were matched to children never placed and prevalence and cumulative incidence estimates of mental and neurodevelopmental health conditions were compared.

Results

Children placed in out-of-home care had a three times greater prevalence of mental and neurodevelopmental health conditions generally. The prevalence of foetal alcohol spectrum disorder was ten times higher, and post-traumatic stress disorder was seven times higher for those placed in out-of-home care. Cumulative incidence plots highlighted for different conditions the ages at which the rate of diagnosis diverges between the two groups.

Conclusions

Children placed in out-of-home care had greater mental and neurodevelopmental health needs generally when compared to children never placed in out-of-home care .

Implications for Public Health

Child protective services must ensure culturally safe, comprehensive, wrap-around services for Aboriginal children and their families are provided. Approaches should build on the strength of children, families and culture and avoid stigmatising children and their parents.

目标：确定在西澳大利亚州出生并接受家庭外照料（OOHC）的原住民儿童与在西澳大利亚州出生但未接受家庭外照料的原住民儿童相比在精神和神经发育健康方面的额外需求：方法：对 2000 年至 2013 年期间西澳大利亚州出生的所有土著儿童的住院、健康登记和儿童保护服务数据进行数据链接。将2000年至2019年期间被置于家庭外照料的儿童与从未被置于家庭外照料的儿童进行配对，并对精神和神经发育健康状况的流行率和累积发病率估计值进行比较：结果：被置于家庭外照料的儿童的精神和神经发育健康状况的患病率普遍高出三倍。胎儿酒精谱系障碍的发病率是被置于家庭外照料的儿童的十倍，创伤后应激障碍的发病率是被置于家庭外照料的儿童的七倍。累积发病率图突出显示了两组儿童在不同疾病诊断率上的年龄差异：结论：与从未被安置在家庭外的儿童相比，被安置在家庭外的儿童普遍有更大的精神和神经发育健康需求：儿童保护服务机构必须确保为原住民儿童及其家庭提供文化上安全、全面的全方位服务。所采取的方法应以儿童、家庭和文化的力量为基础，避免对儿童及其父母进行侮辱。

{"title":"Mental and neurodevelopmental health needs of Aboriginal children with experience of out-of-home care: a Western Australian data-linkage study","authors":"Benjamin Harrap , Alison Gibberd , Melissa O’Donnell , Jocelyn Jones , Richard Chenhall , Bridgette McNamara , Koen Simons , Sandra Eades","doi":"10.1016/j.anzjph.2024.100181","DOIUrl":"10.1016/j.anzjph.2024.100181","url":null,"abstract":"<div><h3>Objective</h3><div>To identify additional mental and neurodevelopmental health needs of Aboriginal children born in Western Australia, who are placed in out-of-home care (OOHC), relative to Aboriginal children born in Western Australia who were not placed.</div></div><div><h3>Methods</h3><div>Data-linkage of hospitalisations, health registries and child protective services data for all Aboriginal children born in WA between 2000 and 2013 was used. Children placed in out-of-home care between 2000 and 2019 were matched to children never placed and prevalence and cumulative incidence estimates of mental and neurodevelopmental health conditions were compared.</div></div><div><h3>Results</h3><div>Children placed in out-of-home care had a three times greater prevalence of mental and neurodevelopmental health conditions generally. The prevalence of foetal alcohol spectrum disorder was ten times higher, and post-traumatic stress disorder was seven times higher for those placed in out-of-home care. Cumulative incidence plots highlighted for different conditions the ages at which the rate of diagnosis diverges between the two groups.</div></div><div><h3>Conclusions</h3><div>Children placed in out-of-home care had greater mental and neurodevelopmental health needs generally when compared to children never placed in out-of-home care .</div></div><div><h3>Implications for Public Health</h3><div>Child protective services must ensure culturally safe, comprehensive, wrap-around services for Aboriginal children and their families are provided. Approaches should build on the strength of children, families and culture and avoid stigmatising children and their parents.</div></div>","PeriodicalId":8620,"journal":{"name":"Australian and New Zealand Journal of Public Health","volume":"48 5","pages":"Article 100181"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How do we fund Public Health in Australia? How should we? 我们如何资助澳大利亚的公共卫生事业？我们应该如何做？

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-10-01 DOI: 10.1016/j.anzjph.2024.100187

Alan Shiell , Kate Garvey , Shane Kavanagh , Victoria Loblay , Penelope Hawe

Objective

To map how public health is funded in Australia. To assess whether changes to funding methods might improve system performance.

Methods

Review of publicly accessible documents and discussions with public health key informants.

Results

Australia spent $140 per person on public health in 2019-20, (1.8% of total health spending). But there is considerable state and territory variation. This money flows through multiple channels and payment mechanisms. Responsibility for what is funded is largely delegated to authorities close to the problems. This makes it easier to choose the best mechanism for funding an activity. Much information is hidden from view, however. This makes it impossible to assess whether the potential for population benefit is fully realised.

Conclusions

Australia avoids some of the difficulties experienced elsewhere because funding is largely devolved to states in block grants; they shape their own investments. The US, by contrast, prefers categorical funds for specific purposes. Three suggestions for making the funding system here more visible, useful and accountable are canvassed, including ‘satellite accounts’.

Implications for Public Health

Funding needs to be more transparent before it is possible to assess whether public health system performance could be improved through changes to the way public health is funded.

目标：绘制澳大利亚公共卫生资金来源图。评估改变资助方式是否能改善系统绩效：方法：查阅可公开获取的文件，并与公共卫生主要信息提供者进行讨论：2019-20 年，澳大利亚在公共卫生方面的人均支出为 140 澳元（占卫生总支出的 1.8%）。但各州和地区之间存在很大差异。这些资金通过多种渠道和支付机制流动。资金的使用主要由与问题密切相关的部门负责。这样就更容易选择资助某项活动的最佳机制。然而，许多信息是不为人知的。结论：澳大利亚避免了其他国家遇到的一些困难：结论：澳大利亚避免了其他国家遇到的一些困难，因为资金主要以整笔拨款的形式下放到各州；各州自行决定自己的投资。相比之下，美国更倾向于为特定用途提供分类资金。本文提出了三项建议，包括 "卫星账户"，以使澳大利亚的资助体系更加可见、有用和负责：对公共卫生的影响：在评估是否可以通过改变公共卫生的供资方式来提高公共卫生系统的绩效之前，需要提高供资的透明度。

{"title":"How do we fund Public Health in Australia? How should we?","authors":"Alan Shiell , Kate Garvey , Shane Kavanagh , Victoria Loblay , Penelope Hawe","doi":"10.1016/j.anzjph.2024.100187","DOIUrl":"10.1016/j.anzjph.2024.100187","url":null,"abstract":"<div><h3>Objective</h3><div>To map how public health is funded in Australia. To assess whether changes to funding methods might improve system performance.</div></div><div><h3>Methods</h3><div>Review of publicly accessible documents and discussions with public health key informants.</div></div><div><h3>Results</h3><div>Australia spent $140 per person on public health in 2019-20, (1.8% of total health spending). But there is considerable state and territory variation. This money flows through multiple channels and payment mechanisms. Responsibility for what is funded is largely delegated to authorities close to the problems. This makes it easier to choose the best mechanism for funding an activity. Much information is hidden from view, however. This makes it impossible to assess whether the potential for population benefit is fully realised.</div></div><div><h3>Conclusions</h3><div>Australia avoids some of the difficulties experienced elsewhere because funding is largely devolved to states in block grants; they shape their own investments. The US, by contrast, prefers categorical funds for specific purposes. Three suggestions for making the funding system here more visible, useful and accountable are canvassed, including ‘satellite accounts’.</div></div><div><h3>Implications for Public Health</h3><div>Funding needs to be more transparent before it is possible to assess whether public health system performance could be improved through changes to the way public health is funded.</div></div>","PeriodicalId":8620,"journal":{"name":"Australian and New Zealand Journal of Public Health","volume":"48 5","pages":"Article 100187"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0