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Act fast, stop COVID: The successful implementation of the first decentralised Victorian COVID-19 contact tracing and monitoring unit 快速行动,制止 COVID:维多利亚州首个分散式 COVID-19 接触者追踪和监测单位的成功实施
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-10 DOI: 10.1016/j.anzjph.2024.100186
Bridgette J. McNamara , Jessica McDonald , Kelvin Heard , N. Deborah Friedman , Frances Diver , Eugene Athan , Amanda J. Wade , Fiona Brennan , Melissa Warburton , Caroline Bartolo , Callum Maggs , Nicole Miller , Megan Smith , John Stenos , Daniel P. O’Brien

Objectives

To describe the operational model, epidemiology and outcomes of COVID-19 cases managed by the first decentralised Victorian Public Health Unit (PHU) in the Barwon South-West (BSW) region in 2020.

Methods

The Barwon Health team used a clinician-led, locally-based interprofessional model of care, combining clinical care and monitoring, contact tracing and public health measures.

Results

From 7th March to 5th October 2020, 575 confirmed COVID-19 cases (82 in Wave 1; 493 in Wave 2) were identified in residents of the BSW region. Overall, 4.7% were admitted to local hospitals (0.7% to intensive care units) and 1.7% died. COVID-19 incidence in the region was 129 cases/100,000. Wave 2 in the region featured community transmission in high-risk settings and among culturally and linguistically diverse and mobile populations. Within 3 months of the initial local case in Wave 2, SARS-COV-2 was eliminated from the community.

Conclusions

A local interprofessional model of care was key to the containment of community transmission and complex outbreaks with the elimination of COVID-19 in the community.

Implications for Public Health

Key successes and learnings from the BSW PHU contributed to the improvement of statewide systems and responses and provided an impetus for the implementation of a decentralised public health model for Victoria.

目标描述 2020 年巴原西南(BSW)地区首个分散式维多利亚州公共卫生单位(PHU)管理的 COVID-19 病例的运作模式、流行病学和结果。方法巴原卫生团队采用临床医生主导的本地跨专业护理模式,将临床护理和监测、接触者追踪和公共卫生措施结合起来。总体而言,4.7%的患者入住当地医院(0.7%入住重症监护室),1.7%的患者死亡。该地区 COVID-19 的发病率为 129 例/100,000 人。该地区第二波的特点是在高风险环境、文化和语言多样性以及流动人口中的社区传播。结论 本地跨专业护理模式是遏制社区传播和复杂疫情的关键,并在社区消除了 COVID-19。对公共卫生的启示 BSW 公共卫生单位的主要成功经验和教训有助于改善全州的系统和应对措施,并为维多利亚州实施分散的公共卫生模式提供了动力。
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引用次数: 0
Establishing the Vaccine Safety Health Link: A large, linked data resource for the investigation of vaccine safety concerns 建立疫苗安全与健康的联系:用于调查疫苗安全问题的大型链接数据资源
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-10 DOI: 10.1016/j.anzjph.2024.100188
Hannah J. Morgan , Hazel J. Clothier , Philip Witowski , James H. Boyd , Gonzalo Sepulveda Kattan , Gerardo Luis Dimaguila , Aishwarya N. Shetty , Jim P. Buttery

Objective

Post-licensure vaccine safety surveillance of adverse events following immunisation is critical to ensure public safety and confidence in vaccines. This paper aims to describe the governance structure and data linkage methodology behind the establishment of the largest linked vaccine safety surveillance data resource in Australia – The Vaccine Safety Health Link (VSHL).

Methods

The Vaccine Safety Health Link contains linked records from the Australian Immunisation Register with records from hospital, perinatal, mortality, and notifiable disease datasets in near real-time. Linkage is done by the Centre for Victorian Data Linkage who receive the datasets in an identifiable format which then undergo standardisation, enrichment, linkage, quality assurance and de-identification, prior to being supplied for analysis.

Results

The VSHL data resource allows sensitive and rapid analysis of a broad spectrum of suspected adverse events to ensure the safety of all vaccines administered. It is also used to refute spurious concerns where no associations are found, upholding trust, and maintaining vaccine confidence.

Conclusions

The Vaccine Safety Health Link's surveillance design complements existing vaccine safety surveillance methods. Challenges encountered and lessons learnt using Vaccine Safety Health Link would benefit linkage projects globally.

Implications for public health

In its first two years, The Vaccine Safety Health Link has been used for 14 vaccine safety investigations. Studies into these conditions would not have otherwise been possible. The Vaccine Safety Health Link also partners with the Global Vaccine Data Network™ for approved collaborative studies with a combined population of over 300 million people.

目的 对免疫接种后的不良事件进行许可后疫苗安全监测对于确保公众对疫苗的安全和信心至关重要。本文旨在介绍澳大利亚最大的链接疫苗安全监控数据资源--疫苗安全健康链接(VSHL)--建立背后的管理结构和数据链接方法。方法疫苗安全健康链接包含来自澳大利亚免疫登记册的链接记录,以及来自医院、围产期、死亡率和应通报疾病数据集的近乎实时的记录。链接由维多利亚州数据链接中心(Centre for Victorian Data Linkage)完成,该中心以可识别的格式接收数据集,然后对数据集进行标准化、丰富化、链接、质量保证和去标识化处理,最后提供给分析机构。结论疫苗安全健康链接的监测设计是对现有疫苗安全监测方法的补充。在使用疫苗安全健康链接过程中遇到的挑战和吸取的经验教训将使全球的链接项目受益。如果没有疫苗安全健康链接,就不可能对这些情况进行研究。疫苗安全健康链接 "还与 "全球疫苗数据网络"(Global Vaccine Data Network™)合作,开展已获批准的合作研究,研究对象总人数超过 3 亿。
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引用次数: 0
Estimating levels of mental health service need by small geographic area: A case study for Aboriginal and Torres Strait Islander adults living in South East Queensland 按小型地理区域估算心理健康服务需求水平:针对居住在昆士兰东南部的土著居民和托雷斯海峡岛民成年人的案例研究。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-05 DOI: 10.1016/j.anzjph.2024.100185
Imogen S. Page , Claudia Pagliaro , Alize J. Ferrari , Harvey Whiteford , Sandra Diminic

Objective

The objective of this study was to determine regional variation in need for mental health care for Aboriginal and Torres Strait Islander adults (18+ years).

Methods

Three Australian Indigenous health surveys were analysed, and prevalence rates of high/very high psychological distress (as per the Kessler-5 tool) by the Index of Relative Socio-economic Disadvantage were computed and combined via meta-analysis. These estimates were applied to census population data to estimate regional needs and summed to geographic planning regions. Final estimates were assessed for face validity by comparing with other existing estimates of mental health need.

Results

The Index of Relative Socioeconomic Disadvantage had a dose–response relationship with high/very high psychological distress, whereby the more disadvantaged an area, the greater the levels of reported distress. This methodology resulted in varying levels of need within South East Queensland.

Conclusions

The approach was found to have good face validity and provides a data-driven method to determine relative levels of need.

Implications for Public Health

To ensure equity of mental health service provision, planners should account for variation in levels of need within a catchment. This method may be used throughout Australia to determine regional variation in need for care where other data are lacking to ensure evidence-based investment planning decisions at the local level.

研究目的本研究旨在确定土著居民和托雷斯海峡岛民成年人(18 岁以上)在心理保健需求方面的地区差异:方法:对三项澳大利亚原住民健康调查进行了分析,并按相对社会经济劣势指数(Index of Relative Socio-economic Disadvantage)计算出了高/极高心理压力流行率(根据凯斯勒-5工具),然后通过荟萃分析进行了合并。将这些估算值应用于人口普查数据,以估算地区需求,并汇总到地理规划区域。通过与其他现有的心理健康需求估计值进行比较,对最终估计值的表面有效性进行了评估:结果:相对社会经济劣势指数与高/极高心理压力之间存在剂量-反应关系,即一个地区越是劣势,报告的心理压力水平就越高。这种方法导致昆士兰东南部地区的需求水平各不相同:结论:该方法具有良好的表面效度,为确定相对需求水平提供了一种数据驱动方法:对公共卫生的启示:为确保心理健康服务的公平性,规划者应考虑到服务范围内需求水平的差异。这种方法可在澳大利亚全国范围内使用,以确定缺乏其他数据的地区在医疗需求方面的差异,从而确保在地方层面做出以证据为基础的投资规划决策。
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引用次数: 0
Identifying Service, Research and Policy priorities for preventing the impacts of family adversity on children’s mental health: An Australian national resource allocation study with professional and lived experience experts 确定预防家庭逆境对儿童心理健康影响的服务、研究和政策优先事项:与专业和生活经验专家共同开展的澳大利亚全国资源分配研究
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-31 DOI: 10.1016/j.anzjph.2024.100184
Harriet Hiscock , Ashraful Kabir , Suzy Honisett , Tamara Morris , Leanne Constable , Suzie Forell , Sue Woolfenden , Sharon Goldfeld , Anthony Jorm

Objectives

The objective of this study was to develop Service, Research and Policy priorities to prevent the impact of family adversity on child mental health and determine comparative priorities of diverse stakeholders to those with lived experience of adversity.

Methods

Value-weighting approach conducted in a staged process: (i) professionals and experts with lived experience from health, education, justice and social care sectors attended a national symposium to identify priorities for family adversity and mental health and (ii) a subsequent resource allocation survey gathered views from participants and external experts on symposium priorities.

Results

Consensus was reached on priorities. Service priorities included establishing intersectoral hubs for children and families and early childhood nurse home-visiting programs. Research priorities included scaling up evidence-based interventions and evaluating cross-sector, flexible funding models for services addressing childhood adversity. Policy priorities included developing evidence-based policies with evaluation and implementation plans and flexible funding models to support integrated care.

Conclusions

Our results provide detailed and actionable clarity on next steps to address family adversities.

Implications for Public Health

The priorities call for a focus on cross-sectoral approaches to preventing or mitigating the effects of family adversity. The current Australian policy environment provides a timely opportunity to action the proposed interventions.

本研究的目的是制定服务、研究和政策方面的优先事项,以预防家庭逆境对儿童心理健康的影响,并确定不同利益相关者与有逆境生活经验者的优先事项比较。方法:(i) 来自卫生、教育、司法和社会关怀部门的专业人士和有生活经验的专家参加全国研讨会,以确定家庭逆境和心理健康方面的优先事项;(ii) 随后进行资源分配调查,收集与会者和外部专家对研讨会优先事项的意见。服务优先事项包括建立儿童和家庭跨部门中心以及幼儿护士家访计划。研究优先事项包括推广循证干预措施,评估跨部门、灵活的筹资模式,以提供解决儿童逆境问题的服务。政策优先事项包括制定有评估和实施计划的循证政策以及灵活的资助模式,以支持综合护理。我们的研究结果为解决家庭逆境问题的下一步措施提供了详细而可行的说明。澳大利亚当前的政策环境为采取建议的干预措施提供了一个及时的机会。
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引用次数: 0
Traditional community-based knowledge for envisioning climate change action for the Torres Strait 基于传统社区知识的托雷斯海峡气候变化行动构想
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-29 DOI: 10.1016/j.anzjph.2024.100182
Francis Nona
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引用次数: 0
Lack of progress in physical activity in Australia: decades of national inertia? 澳大利亚体育活动缺乏进展:几十年的国家惰性?
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-23 DOI: 10.1016/j.anzjph.2024.100180
Adrian Bauman, Ding Ding
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引用次数: 0
Occupational exposure to welding fume in Australia: An online survey 澳大利亚焊接烟尘职业接触情况:在线调查。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 DOI: 10.1016/j.anzjph.2024.100165
Lin Fritschi , Timothy R. Driscoll , Ha Nguyen , Kamil Abdallah , Renee N. Carey

Objective

This survey aimed to investigate exposure to welding fume in Australian workplaces and the use of protective and control measures among workers.

Methods

Data were collected via a cross-sectional online survey of workers and employers involved in welding in Australia. Survey questions focused on the determinants of exposure to welding fume, welding experience and qualifications, and use of control measures.

Results

There were 634 respondents to the survey across Australia of whom 577 (91%) were assessed as being exposed to welding fume, most at high levels. Welders undertook a wide range of types of welding, and higher-risk welding such as in confined and restricted spaces was common. Most workplaces did not have any form of mechanical ventilation, and use of air-supplied respiratory protection was poor even when ventilation was not used.

Conclusion

Welders in Australia are exposed to several carcinogens, particularly welding fume, hexavalent chromium (CrVI) and nickel, and the use of control measures is sub-optimal.

Implications for Public Health

Higher-order controls are the best way to reduce exposure to carcinogens in the workplace. The lack of use of these controls by Australian welders is concerning and needs to be a focus of attention by regulators and companies.

调查目的本调查旨在调查澳大利亚工作场所的焊接烟尘暴露情况以及工人使用保护和控制措施的情况:通过对澳大利亚从事焊接工作的工人和雇主进行横向在线调查收集数据。调查问题主要涉及接触焊接烟尘的决定因素、焊接经验和资质以及控制措施的使用情况:澳大利亚全国共有 634 名受访者,其中 577 人(91%)被评估为暴露于焊接烟尘,大多数人的暴露程度较高。焊工从事各种类型的焊接工作,在密闭空间和受限空间等风险较高的焊接工作很常见。大多数工作场所没有任何形式的机械通风设备,即使不使用通风设备,也很少使用供气式呼吸保护装置:结论:澳大利亚的焊接工人暴露于多种致癌物质,尤其是焊接烟尘、六价铬 (CrVI) 和镍,而控制措施的使用情况并不理想:高阶控制是减少工作场所致癌物质暴露的最佳方法。澳大利亚焊工不使用这些控制措施的情况令人担忧,需要引起监管机构和公司的重视。
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引用次数: 0
Public health and prevention research within the Medical Research Future Fund 医学研究未来基金内的公共卫生和预防研究。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 DOI: 10.1016/j.anzjph.2024.100171
Benedicta Natalia Latif , Leanne Coombe , Tim Driscoll , Anita van Zwieten , Catherine Sherrington , Saman Khalatbari-Soltani

Objective

To explore the amount and type of research funded under relevant Medical Research Future Fund (MRFF) Initiatives that addressed public health and prevention from 2018 to July 2023.

Methods

Projects funded by six MRFF Initiatives, with objectives relevant to public health and public health nominated as “field of research” by >25% of applicants, were evaluated against a set of public health research criteria and were categorised based on levels of prevention.

Results

Fifty-seven per cent of 249 funded projects were categorised as public health research. Projects with curative features, focusing on tertiary (32%) and quaternary (4%) prevention, were as common as projects with earlier preventive features, focussed on primordial (7%) and primary (28%) prevention. The Preventive and Public Health Research Initiative had the lowest proportion of public health research (48%) of the six evaluated Initiatives and a dominance of curative (39%) and non-preventive (26%) research over preventive research (30%).

Conclusion

This study highlighted variable levels of public health research across public-health-relevant MRFF Initiatives and generally low proportions of primary and primordial prevention. A greater emphasis on primordial and primary prevention research in public-health-relevant Initiatives could advance prevention in Australia.

Implications for public health

There appears to be scope for improvement in the prioritisation of upstream prevention research in public-health-relevant MRFF Initiatives and projects. Addressing this may enhance the benefit of MRFF to Australian public health.

目的探讨 2018 年至 2023 年 7 月期间,由相关医学研究未来基金(MRFF)倡议资助的、涉及公共卫生和预防的研究数量和类型:根据一套公共卫生研究标准对六项 MRFF 计划资助的项目进行评估,这些项目的目标与公共卫生相关,且有超过 25% 的申请者将公共卫生提名为 "研究领域":结果:在 249 个资助项目中,57%被归类为公共卫生研究。具有治疗功能的项目(侧重于三级预防(32%)和四级预防(4%))与具有早期预防功能的项目(侧重于一级预防(7%)和一级预防(28%))同样常见。预防和公共卫生研究倡议的公共卫生研究比例(48%)在六个接受评估的倡议中最低,治疗性研究(39%)和非预防性研究(26%)比预防性研究(30%)占优势:本研究强调了与公共卫生相关的 MRFF 倡议的公共卫生研究水平参差不齐,初级和基本预防的比例普遍较低。在与公共卫生相关的倡议中更加重视初级和基层预防研究,可以促进澳大利亚的预防工作:对公共卫生的影响:在与公共卫生相关的 MRFF 倡议和项目中,上游预防研究的优先次序似乎还有改进的余地。解决这一问题可提高 MRFF 对澳大利亚公共卫生的益处。
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引用次数: 0
Altered epidemiological patterns of Respiratory Syncytial Virus and influenza detections in a tropical Australian setting 2020 to 2023 2020 至 2023 年澳大利亚热带地区呼吸道合胞病毒和流感检测流行模式的改变。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 DOI: 10.1016/j.anzjph.2024.100172
Joanne C. Nixon , Kevin Freeman , Rob W. Baird

Background

We describe the recent temporal patterns of respiratory syncytial virus (RSV) and influenza virus detections in the Northern Territory (NT) of Australia, between 2020 and 2023.

Methods

This retrospective analysis of patients presenting with respiratory diseases utilised a multiplex viral nucleic acid detection assay for RSV, influenza and SARS Cov2 (COVID-19) to determine the relative frequency of non-COVID-19 respiratory viral detections by age and month during the study period.

Results

During this period of the NT COVID-19 epidemic, disruption of the usual annual wet season RSV outbreak patterns occurred, and the yearly influenza peak was absent for two annual cycles. Our data also reveals that 25% of RSV infections were occurring in patients greater than 40 years of age, compared to 32% of influenza infections presenting in the same period, documenting a greater burden of adult disease than previously documented in the NT.

Conclusions

Loss of non-COVID-19 viral seasonality and a substantial unrecognised RSV adult burden were noted. We will continue to monitor seasonality, and the RSV burden and this will help to target the populations benefiting from recently released RSV vaccine.

背景:我们描述了2020年至2023年期间澳大利亚北部地区(NT)近期检测到的呼吸道合胞病毒(RSV)和流感病毒的时间模式:这项对呼吸道疾病患者的回顾性分析采用了RSV、流感和SARS Cov2(COVID-19)的多重病毒核酸检测方法,以确定研究期间按年龄和月份划分的非COVID-19呼吸道病毒检测的相对频率:结果:在 NT COVID-19 流行期间,通常每年雨季 RSV 爆发的模式被打乱,每年的流感高峰在两个年度周期内都没有出现。我们的数据还显示,25%的 RSV 感染发生在 40 岁以上的患者身上,而同期流感感染发生在 32% 的患者身上,这表明成人疾病的负担比以前在新界地区记录的更大:结论:我们注意到非COVID-19病毒季节性的丧失和大量未被发现的RSV成人负担。我们将继续监测季节性和 RSV 负担,这将有助于锁定从最近发布的 RSV 疫苗中受益的人群。
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引用次数: 0
Self-determination in programmes of perinatal health for Aboriginal Communities: A systematic review 土著社区围产期保健计划中的自决:系统综述。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 DOI: 10.1016/j.anzjph.2024.100169
Kim Ann Beadman , Juanita Sherwood , Paul Gray , John McAloon

Objective

The importance of self-determination in restoring the wellbeing of Australian First Nations peoples is becoming understood. For thousands of years, Aboriginal women gave birth on Country and Grandmothers’ Lore and Women’s Business facilitated the survival of the oldest living civilisations on earth. Following colonisation, however, Aboriginal and Torres Strait Islander practices of maternal and perinatal care were actively dismantled, and self-determination by Aboriginal people was destroyed. This had significant implications for the wellbeing of Aboriginal and Torres Strait Islander people and their Cultures and practices.

Methods

A Preferred Reporting Items for Systematic Reviews and Meta-Analyses–based systematic review of research about programmes of birthing and perinatal health care for Australian Aboriginal and Torres Strait Islander women and their children was undertaken. The review’s primary aim was to assess the Cultural context of programme development and delivery, its secondary aim was to assess the Cultural appropriateness of programme components. Electronic databases SCOPUS, PsycINFO, Medline, and CINAHL were searched for peer-reviewed studies published in English in Australia between 2000 and 2023.

Results

Twenty-eight publications met inclusion criteria. Included studies were assessed for their methodological characteristics, birthing-support characteristics, perinatal care and continuity of care characteristics. Overall, programmes were limited in meeting the Cultural needs of women, children, and individual Communities. The role of Aboriginal Communities in identifying, delivering, and reviewing programmes was also limited.

Conclusions

Findings articulate the importance of self-determination in maintaining strong Indigenous Cultures and informing the Culturally appropriate development and delivery of Culturally safe programmes of perinatal care for Aboriginal women, children, and Communities.

Implications for Public Health

Programmes and services for use by Aboriginal and Torres Strait Islander people must involve Aboriginal and Torres Strait Islander people and their Communities in processes of programme planning, delivery, and review. The evaluation of a programme or service as “Culturally safe” represents a determination that is most appropriately made by service users based on their experience of that programme or service.

目的:自决对恢复澳大利亚原住民福祉的重要性已逐渐为人们所了解。几千年来,原住民妇女在乡村生产,祖母的传说和妇女的事业促进了地球上最古老文明的生存。然而,在殖民化之后,原住民和托雷斯海峡岛民的孕产妇和围产期护理做法遭到了积极的破坏,原住民的自决权也遭到了摧毁。这对土著居民和托雷斯海峡岛民的福祉及其文化和习俗产生了重大影响:对澳大利亚土著居民和托雷斯海峡岛民妇女及其子女的分娩和围产期保健计划的研究进行了系统性回顾。综述的主要目的是评估计划制定和实施的文化背景,其次是评估计划组成部分的文化适宜性。研究人员在 SCOPUS、PsycINFO、Medline 和 CINAHL 等电子数据库中检索了 2000 年至 2023 年期间在澳大利亚用英语发表的经同行评审的研究报告:结果:28 篇出版物符合纳入标准。对纳入研究的方法特点、分娩支持特点、围产期护理和持续护理特点进行了评估。总体而言,这些计划在满足妇女、儿童和个别社区的文化需求方面受到了限制。土著社区在确定、实施和审查计划方面的作用也很有限:研究结果阐明了自决在维护强大的土著文化以及为土著妇女、儿童和社区制定和实施文化上安全的围产期保健计划提供信息方面的重要性:供土著居民和托雷斯海峡岛民使用的计划和服务必须让土著居民和托雷斯海峡岛民及其社区参与计划的规划、实施和审查过程。将某项计划或服务评价为 "文化安全",是由服务使用者根据他们对该计划或服务的体验做出的最恰当的决定。
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引用次数: 0
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Australian and New Zealand Journal of Public Health
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