Australian and New Zealand Journal of Public Health最新文献_第4页

Attitudes, perceptions, and experiences of Western Australians towards vaccine safety surveillance systems following COVID-19 vaccines: A qualitative descriptive study 西澳大利亚人在接种 COVID-19 疫苗后对疫苗安全监控系统的态度、看法和经验：定性描述性研究。

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

Australian and New Zealand Journal of Public Health

Pub Date : 2024-07-18 DOI: 10.1016/j.anzjph.2024.100177

Denis Liu Shiu Cheong , Jayden Tran , Wyitt Chong , Scott May , Samantha J. Carlson , Sandra M. Salter , Katie Attwell

Objective

Concerns regarding adverse events following immunisation (AEFI) are a barrier to vaccine uptake. Health professionals use vaccine safety surveillance systems (VSSS) to monitor vaccines and inform the public of safety data. With little known about public attitudes, perceptions, and experiences with VSSS, we examined them in the context of COVID-19 vaccinations in Western Australia.

Methods

Researchers conducted 158 qualitative interviews between March 2021 to May 2022 within the broader Coronavax project. Data regarding VSSS was coded in NVivo using deductive and inductive methods.

Results

Despite some not knowing about VSSS, participants expected follow-up post COVID-19 vaccination. Vaccine hesitant or refusing participants knew about VSSS and regarded these systems positively. Additional considerations concerned the reliability of data collected by VSSS.

Conclusion

Perceptions of VSSS signal a lack of understanding about how these systems work. Future studies should further explore the public’s understanding of VSSS, whether VSSS improves vaccine confidence, and how governments can better communicate to the public about VSSS.

Implications for public health

Lack of understanding of how VSSS operate may be stymying attempts to build public vaccine confidence. Healthcare providers and governments could build public knowledge and understanding of VSSS to mitigate concerns of AEFIs.

目的：对免疫接种后不良事件 (AEFI) 的担忧是疫苗接种的一个障碍。卫生专业人员使用疫苗安全监测系统 (VSSS) 来监测疫苗并向公众通报安全性数据。由于公众对 VSSS 的态度、看法和体验知之甚少，我们结合西澳大利亚州的 COVID-19 疫苗接种情况对其进行了研究：在 2021 年 3 月至 2022 年 5 月期间，研究人员在更广泛的 Coronavax 项目范围内进行了 158 次定性访谈。有关 VSSS 的数据采用演绎法和归纳法在 NVivo 中进行编码：尽管有些人不知道 VSSS，但参与者期望在接种 COVID-19 疫苗后进行跟踪。对疫苗犹豫不决或拒绝接种的参与者了解 VSSS，并对这些系统给予了积极评价。其他考虑因素涉及 VSSS 收集数据的可靠性：对 VSSS 的看法表明人们对这些系统的工作原理缺乏了解。未来的研究应进一步探讨公众对 VSSS 的理解、VSSS 是否提高了疫苗的可信度以及政府如何更好地向公众宣传 VSSS：对公共卫生的启示：对 VSSS 如何运作缺乏了解可能会阻碍建立公众疫苗信心的努力。医疗保健提供者和政府可以加强公众对VSSS的认识和了解，以减轻对AEFI的担忧。

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引用次数: 0

Public health audit of vaccine cold chain management in general practice and community pharmacy in Western Australia 西澳大利亚州全科诊所和社区药房疫苗冷链管理公共卫生审计

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

Australian and New Zealand Journal of Public Health

Pub Date : 2024-07-13 DOI: 10.1016/j.anzjph.2024.100168

Adeline Hillan , Li Pung , Susan Ridderhof , Jessica Ramsay , Rashmi Vinogradov , Darren Westphal , Mayli Foong , Alan Leeb , Benjamin Scalley , Anastasia Phillips

Objective

To support immunisation providers through a cold chain management audit.

Methods

An electronic audit survey using the National Vaccine Storage Guidelines as a gold standard was developed for general practice (GP) and community pharmacy. It included automated feedback, with individualised support from a clinical nurse specialist as required. Responses were analysed to determine the proportion of providers meeting criteria in four categories: procedures, refrigerators and equipment, temperature monitoring and emergency storage.

Results

Of 818 providers invited, 420 GPs (89.6%) and 276 pharmacies (82%) responded. Over 70% met all procedural and emergency storage criteria. Although most providers (98.1% GPs, 97.0% pharmacies) used a data logger, the proportion measuring at 5-minute intervals, reviewing data logger printouts weekly and manually recording minimum and maximum temperatures was lower. In total, 58% of providers required follow-up by the clinical nurse specialist, most regarding the need for equipment.

Conclusion

An electronic audit enabled public health to engage with a large number of immunisation providers. Most reported high compliance with the national guidelines although opportunities for education were identified and actioned.

Implications for Public Health

Electronic solutions can support public health units to engage with providers to ensure vaccines remain effective and wastage is limited.

方法以《国家疫苗储存指南》为黄金标准，为全科医生（GP）和社区药房开发了一项电子审核调查。它包括自动反馈，并根据需要由临床护理专家提供个性化支持。结果在受邀的 818 家医疗机构中，420 家全科医生（89.6%）和 276 家药房（82%）做出了回应。超过 70% 的医疗机构符合所有程序和紧急储存标准。虽然大多数医疗机构（全科医生占 98.1%，药房占 97.0%）都使用了数据记录仪，但每 5 分钟测量一次、每周查看数据记录仪打印输出以及手动记录最低和最高温度的比例较低。总计有 58% 的医疗机构需要临床护士专家的跟进，其中大部分与设备需求有关。对公共卫生的启示电子解决方案可支持公共卫生单位与疫苗接种提供者合作，以确保疫苗的有效性并减少浪费。

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引用次数: 0

Hotspots of kidney failure: Analysing Australian metropolitan dialysis demand for service planning 肾衰竭的热点地区：分析澳大利亚大都市透析需求以制定服务规划。

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

Australian and New Zealand Journal of Public Health

Pub Date : 2024-07-02 DOI: 10.1016/j.anzjph.2024.100161

Dominic Keuskamp , Christopher E. Davies , Shilpanjali Jesudason , Stephen P. McDonald

Objective

To locate incident hotspots of dialysis demand in Australian capital cities and measure association with prevalent dialysis demand and socioeconomic disadvantage.

Methods

A retrospective cohort study used Australia and New Zealand Dialysis and Transplant Registry data on people commencing dialysis for kidney failure (KF) resident in an Australian capital city, 1 January 2001 – 31 December 2021. Age-sex-standardised dialysis incidence was estimated by Statistical Area Level 3 (SA3) and dialysis prevalence by SA2.

Results

A total of 32,391 people commencing dialysis were referenced to SA3s within city metropolitan areas based on residential postcode. Incident hotspots were located in Western Sydney. The highest average annual change of standardised incidence was 8.3 per million people (false discovery rate-corrected 95% CI 1.0,15.7) in Mount Druitt, reflecting a 263% increase in absolute demand from 2001-3 to 2019-21. Incident dialysis for diabetic kidney disease contributed substantially to total growth. Incident hotspots were co-located with areas where prevalent dialysis demand was associated with socioeconomic deprivation.

Conclusions

Novel spatial analyses of geo-referenced registry data located hotspots of kidney failure and associated socio-demographic and comorbid states.

Implications for Public Health

These analyses advance current abilities to plan dialysis capacity at a local level. Hotspots can be targeted for prevention and slowing the progression of kidney disease.

目的确定澳大利亚首府城市的透析需求事件热点，并衡量与普遍透析需求和社会经济劣势之间的关联：这项回顾性队列研究使用了澳大利亚和新西兰透析与移植登记处的数据，这些数据涉及 2001 年 1 月 1 日至 2021 年 12 月 31 日期间居住在澳大利亚首府城市的肾衰竭（KF）透析患者。按统计区三级（SA3）估算年龄-性别标准化透析发病率，按统计区二级估算透析流行率：共有 32,391 人开始透析，根据居住地邮政编码参照了城市都市区内的 SA3。事件热点位于悉尼西部。德鲁伊特山的标准化发病率年均变化最高，为每百万人中有8.3人（误诊率校正后的95% CI为1.0,15.7），反映出从2001-3年到2019-21年，绝对需求量增加了263%。糖尿病肾病的发病透析对总增长贡献巨大。发病热点地区与普遍存在的透析需求与社会经济贫困相关联：结论：通过对地理参照登记数据进行新颖的空间分析，找到了肾衰竭的热点地区以及相关的社会人口和合并症状况：这些分析提高了目前在地方一级规划透析能力的能力。热点地区可作为预防和减缓肾脏疾病进展的目标。

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引用次数: 0

How racism plays out in contemporary public health practice (commentary) 种族主义在当代公共卫生实践中的表现（评论）。

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

Australian and New Zealand Journal of Public Health

Pub Date : 2024-06-29 DOI: 10.1016/j.anzjph.2024.100167

Belinda Loring , Elana Curtis

引用次数: 0

The challenges of living with Debilitating Symptom Complexes Attributed to Ticks (DSCATT) – A qualitative study 蜱虫引起的衰弱性症状综合征（DSCATT）的生活挑战--一项定性研究。

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

Australian and New Zealand Journal of Public Health

Pub Date : 2024-06-29 DOI: 10.1016/j.anzjph.2024.100163

Georgina Oliver , Valerie M.Z. Yap , Trudie Chalder , Victoria L. Oliver , Katherine B. Gibney , Anita Dharan , Sarah J. Wilson , Richard A.A. Kanaan

Objective

We sought to explore the lived experience of people with Debilitating Symptom Complexes Attributed to Ticks (DSCATT) to inform the development of a potential treatment intervention.

Methods

We conducted one-to-one in-depth, semi-structured interviews with 13 people living in Australia affected by DSCATT. Interviews were transcribed and analysed using thematic analysis.

Results

Although participants attributed the origin of their illness to tick bites, not all were adamant they had Lyme disease. Negative experiences in conventional healthcare were marked and were reported to exacerbate the impact of the illness and affect mental health. Further, these negative experiences propelled participants to seek unapproved treatments (by Australian standards). The desire for the illness to be acknowledged and causative agents identified was pronounced among the participant group.

Conclusions

Individuals with DSCATT experience significant challenges amid a contentious healthcare landscape surrounding chronic symptoms attributed to ticks in Australia. Our findings suggest the need for empathetic, supportive and patient-centred treatments for this cohort.

Implications for public health

DSCATT results in a considerable burden across multiple domains for those affected. Negative experiences with healthcare exacerbate the suffering of people with DSCATT in Australia. New approaches that acknowledge the illness experience of people with DSCATT, alongside evidence-based treatments that encompass biopsychosocial models of care, are needed to tackle this debilitating condition.

目的我们试图探究蜱虫引起的衰弱性症状综合征（DSCATT）患者的生活经历，为开发潜在的治疗干预措施提供信息：我们对居住在澳大利亚的 13 名 DSCATT 患者进行了一对一的半结构式深度访谈。访谈内容均已转录，并采用主题分析法进行了分析：结果：尽管参与者认为自己的病因是蜱虫叮咬，但并非所有人都坚持认为自己患有莱姆病。在传统医疗保健中的负面经历非常明显，据报告这些经历加剧了疾病的影响，并影响了心理健康。此外，这些负面经历还促使参与者寻求未经批准的治疗方法（按澳大利亚标准）。参与者明显希望疾病得到承认并找出致病因素：结论：在澳大利亚，蜱虫引起的慢性症状在医疗保健领域备受争议，罹患慢性蜱虫综合症的患者面临着巨大挑战。我们的研究结果表明，有必要对这一群体进行移情、支持和以患者为中心的治疗：对公共卫生的影响：DSCATT 给患者带来了多方面的沉重负担。在澳大利亚，负面的医疗经历加剧了DSCATT患者的痛苦。要解决这种使人衰弱的病症，就必须采取新的方法，承认 DSCATT 患者的患病经历，同时提供包含生物心理社会护理模式的循证治疗。

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引用次数: 0

The timing of local SARS-Cov-2 outbreaks and vaccination coverage during the Delta wave in Melbourne 墨尔本三角洲疫潮期间当地 SARS-Cov-2 爆发的时间和疫苗接种覆盖率。

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

Australian and New Zealand Journal of Public Health

Pub Date : 2024-06-29 DOI: 10.1016/j.anzjph.2024.100164

Mehr Gupta , Kat Bogatyreva , Kiran Pienaar , Hassan Vally , Catherine M. Bennett

Objective

This article presents a longitudinal analysis of COVID-19 infection and vaccination coverage in Melbourne metropolitan local government areas (LGAs) during the 2021 Delta wave.

Methods

COVID-19 vaccination and infection data from 12 July to 27 November 2021 were sourced from government websites. Summary statistics and associated 95% confidence intervals (95% CI) were compared by LGA ranked according to socioeconomic status: total “burden” (total infections per thousand), “peak” (highest weekly infection rate), “lag” (interval between peak and 70% double vaccination).

Results

LGAs in the bottom five deciles for social advantage experienced higher infection rates (39.0 per thousand [95% CI: 38.5, 39.5] vs. 14.8 [14.7, 14.9]), and had lower two-dose vaccination coverage (23.8% [23.6, 23.9] vs. 32.7% [32.6, 32.7]) compared with LGAs in the top five deciles. LGAs that achieved 70% coverage two weeks or more after the infection peak experienced nearly twice the total infection burden (27.7 per 1000 [27.3, 28.0] compared with 14.9 [14.7, 15.0]) than LGAs with a shorter lag.

Conclusions

Exposure and transmission risk factors cluster within disadvantaged LGAs. The potential for large local outbreaks is heightened if vaccination uptake trails in these communities.

Implications for Public Health

In a pandemic, decision-makers must prioritise disease control and harm reduction interventions for at-risk LGAs.

摘要本文纵向分析了墨尔本大都会地方政府辖区（LGAs）在 2021 年三角洲波期间的 COVID-19 感染和疫苗接种覆盖率：2021年7月12日至11月27日的COVID-19疫苗接种和感染数据来自政府网站。根据社会经济地位对各地方政府辖区的总 "负担"（每千人感染总人数）、"峰值"（每周最高感染率）、"滞后"（峰值与 70% 双倍疫苗接种率之间的间隔）进行了汇总统计和相关 95% 置信区间 (95 CI) 比较：与社会优势排名后五位的十等分地区相比，感染率较高（39.0%.[95% CI：38.5, 39.5] vs. 14.8 [14.7, 14.9]），两剂疫苗接种覆盖率较低（23.8% [23.6, 23.9] vs. 32.7% [32.6, 32.7]）。在感染高峰期两周或更长时间后达到 70% 覆盖率的 LGA 的总感染负担（27.7%.[27.3, 28.0]与 14.9%.[14.7, 15.0]）几乎是滞后时间较短的 LGA 的两倍：结论：暴露和传播风险因素集中在条件较差的地区。结论：暴露和传播风险因素集中在条件较差的地方社区，如果这些社区的疫苗接种率出现滞后，则当地大规模爆发的可能性就会增加：对公共卫生的影响：在大流行病中，决策者必须优先考虑对高风险地区采取疾病控制和减少危害的干预措施。

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引用次数: 0

Understanding anger with New Zealand-born Samoan youth: A Samoan qualitative exploration 了解新西兰出生的萨摩亚青年的愤怒：萨摩亚定性探索。

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

Australian and New Zealand Journal of Public Health

Pub Date : 2024-06-29 DOI: 10.1016/j.anzjph.2024.100162

Leueta Mulipola, Janine Wiles, Fuafiva Fa’alau

Objective

Understanding New Zealand-Samoan young people’s experiences and definitions of anger.

Methods

Focus group talanoa (discussions) with 12 New Zealand-born Samoan young people guided by ‘Teu le Va’ methodology. We used a culturally informed thematic analysis approach.

Results

Participants defined anger as a ‘bottled up’ emotion and emphasised understanding cultural contexts that normalised covert and passive ways of expressing anger. Other key themes around anger we identified included experiencing multiple layers of racism and disconnection in westernised social spaces and pressures to juggle traditional Samoan and western identities. Participants also explored gendered expressions of anger. Communicating anger was important, but not in ways that harm communal values.

Conclusions

Culturally appropriate qualitative research helps understand complex cultural determinants of mental health and wellbeing and suicidal behaviour.

Implications for Public Health

We must recognise the positive, polycultural capital of a generation that navigates many cultural spaces, including their emotional expressions. Anger should be understood in relation to cultural and societal pressures. Improved understanding of the cultural context of anger can inform systemic responses during crises in mental health and prevention of suicidality.

目的：了解新西兰-萨莫阿年轻人对愤怒的体验和定义：了解新西兰-萨摩亚年轻人对愤怒的体验和定义：在 "Teu le Va "方法的指导下，与 12 名在新西兰出生的萨摩亚年轻人进行了焦点小组塔拉诺阿（讨论）。我们采用了一种有文化背景的主题分析方法：结果：参与者将愤怒定义为一种 "闷在心里 "的情绪，并强调要了解将隐蔽和被动的愤怒表达方式正常化的文化背景。我们确定的有关愤怒的其他关键主题包括：在西方化的社会空间中经历多层次的种族主义和脱节，以及在传统萨摩亚人身份和西方人身份之间周旋的压力。参与者还探讨了愤怒的性别表达方式。表达愤怒很重要，但不能以损害社区价值观的方式表达：结论：与文化相适应的定性研究有助于了解心理健康和幸福以及自杀行为的复杂文化决定因素：我们必须认识到这一代人的积极、多元文化资本，他们在许多文化空间中游刃有余，包括他们的情感表达。应结合文化和社会压力来理解愤怒。加深对愤怒的文化背景的理解，可以为心理健康危机期间的系统应对措施和自杀预防提供依据。

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引用次数: 0

Compliance of Australian commercial foods for young children (<36 months) with an international nutrient and promotion profile model 澳大利亚幼儿（小于 36 个月）商业食品是否符合国际营养素和宣传资料模型。

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

Australian and New Zealand Journal of Public Health

Pub Date : 2024-06-01 DOI: 10.1016/j.anzjph.2024.100158

Maree Scully , Rachael Jinnette , Linh Le , Jane Martin , Andrea Schmidtke

Objective

To assess how Australian infant and toddler foods compare to a nutrient and promotion profile model (NPPM) developed by the World Health Organization to support the appropriate promotion of commercial food products for children aged 6-36 months.

Methods

A cross-sectional audit of infant and toddler foods found at three major Australian supermarkets was conducted in September/October 2022. Using nutrition and promotional data extracted from the packaging, products were classified according to NPPM categories and assessed against relevant compositional, front-of-pack labelling and promotional requirements.

Results

Of 330 eligible products identified, just 28% met all NPPM compositional requirements. Toddler foods were less compliant than infant foods overall (18% vs. 31%; p=0.021), and for specific nutrients such as sodium (75% vs. 89%; p=0.003). No products met all NPPM front-of-pack labelling/promotional requirements. Only two-thirds and two-fifths of products were compliant with product name and ingredient list requirements, respectively.

Conclusion

Australian infant and toddler foods do not fully comply with the NPPM requirements. While toddler foods performed comparatively worse in terms of their nutritional adequacy, there is considerable scope to improve the nutrient profile of both infant and toddler foods.

Implications for public health

To better support young children’s health and development, the introduction of mandatory nutrition standards for Australian toddler foods, and the improvement of nutrition standards for Australian infant foods, in line with the NPPM, is needed. To be most effective, these should be combined with regulations for the labelling and promotion of these foods in line with the NPPM.

目标：评估澳大利亚婴幼儿食品与世界卫生组织开发的营养素和推广模式（NPPM）的比较情况，该模式旨在支持为6-36个月大的儿童适当推广商业食品：方法：2022 年 9 月/10 月，对澳大利亚三大超市的婴幼儿食品进行了横向审核。利用从包装中提取的营养和促销数据，按照《国家婴幼儿食品标准》对产品进行分类，并根据相关成分、包装正面标签和促销要求对产品进行评估：结果：在确定的 330 种合格产品中，仅有 28% 符合所有 NPPM 成分要求。幼儿食品的总体达标率低于婴儿食品（18% 对 31%；p=0.021），在钠等特定营养素方面的达标率也低于婴儿食品（75% 对 89%；p=0.003）。没有任何产品符合《国家产品包装正面标签管理规范》的所有包装正面标签/促销要求。分别只有三分之二和五分之二的产品符合产品名称和配料表要求：结论：澳大利亚的婴幼儿食品并不完全符合 NPPM 的要求。幼儿食品在营养充足性方面的表现相对较差，但婴幼儿食品的营养成分还有很大的改善空间：为了更好地支持幼儿的健康和发展，有必要根据《国家营养标准》对澳大利亚幼儿食品实行强制性营养标准，并改进澳大利亚婴儿食品的营养标准。为达到最佳效果，这些标准应与符合《国家营养标准》的这些食品的标签和促销法规相结合。

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引用次数: 0

Ensuring greater utility of climate-related acute health impact data for health services and municipal public health planning in rural and regional Australia 确保与气候相关的严重健康影响数据在澳大利亚农村和地区的卫生服务和市政公共卫生规划中发挥更大作用

IF 3.5 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-06-01 DOI: 10.1016/j.anzjph.2024.100160

Jessie Adams , Kate Kloot , Susan Brumby

引用次数: 0

Sustainable diets: Empowering consumers in the face of regulatory tardiness 可持续饮食：在监管滞后的情况下为消费者赋权。

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

Australian and New Zealand Journal of Public Health

Pub Date : 2024-06-01 DOI: 10.1016/j.anzjph.2024.100151

Simone Pettigrew , Fraser Taylor , Chelsea Hunnisett , Michalis Hadjikakou

引用次数: 0