The latest medical research on Public Health Medicine
The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about public health medicine gathered by our medical AI research bot.
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Lessons Learned from a Medical Response Team 45 Days Post Hurricane Maria in Puerto Rico.Disaster Medicine and Public Health
ABSTRACTObjective:Describe the lived experience of a grassroots, non-governmental disaster medical team (DMT) through a research lens and share practical lessons learned, based on the DMT's experience to support and inform future response teams.
Forty-five days after Hurricane Maria, a non-governmental DMT provided primary medical care via community based pop-up clinics and home visitations in 5 different areas of Puerto Rico. Observational data, photo images, and debriefing notes were collected and documented in the response team's daily activity log. Field notes were coded using a descriptive coding method and then categorized into 2 domains specific to public health and medical diagnosis.
Medical aid was provided to nearly 300 (N = 296) residents. Field note observations identified exhaustion related to living conditions and the exacerbation of underlying conditions such as reactive airway diseases, diabetes, hypertension, and depression due to the compounding effects of multiple post-disaster triggers. During home visitations, feelings of sadness and helplessness were identified secondary to natural disaster trauma and current living conditions.
Our non-governmental DMT displayed similar characteristics demonstrated by federal DMTs post natural disaster. A number of strategic lessons learned emerged from the public health intervention important to future non-governmental DMTs.
Unhealthy sport sponsorship at the 2017 AFL Grand Final: a case study of its frequency, duration and nature.Australian and New Zealand Journal
To assess the frequency, duration and nature of unhealthy marketing during the highest-rating sporting event in Australia in 2017.
A content analysis of the 2017 Australian Football League (AFL) Grand Final television broadcast identified episodes of unhealthy food and sugary drink, alcohol and gambling marketing (and pro-health marketing as a comparison).
There were 559 unhealthy marketing episodes (47 minutes 17 seconds). Most (81%) were for unhealthy food and sugary drink products, while alcohol (9%) and gambling (10%) were less frequent. The total duration of unhealthy marketing was delivered primarily via fixed advertising (55%), dynamic advertising (32%) and branded objects (11%). For unhealthy food and sugary drinks, at least one episode was visible 25% of the time. For each of alcohol and gambling, at least one episode was visible 4% of the time. Unhealthy food and sugary drink marketing peaked in Quarter 2. Pro-health marketing was limited, with 26 episodes (2 minutes 59 seconds).
The 2017 AFL Grand Final broadcast featured a high frequency and extensive duration of unhealthy marketing, especially for unhealthy food and sugary drink brands. Implications for public health: Findings strengthen evidence supporting calls to increase regulation of sport sponsorship by unhealthy brands.
Migrants and disability following injury: findings from a prospective study in New Zealand.Australian and New Zealand Journal
To compare the prevalence of disability between migrants and non-migrants at three and 24 months post-injury, and to identify key predictors of post-injury disability among migrants.
Disability among 2,850 injured participants, including 677 migrants to New Zealand, was measured prospectively using the World Health Organization Disability Assessment Schedule.
Migrants experienced higher risk of disability than non-migrants at three months post-injury (aRR=1.14, 95%CI 1.03-1.26). Both groups had similar disability prevalence, but higher than pre-injury, at 24 months. For migrants, strong predictors of disability at three months post-injury were: higher injury severity, pre-injury obesity, and perceiving the injury as a threat of disability. Having multiple chronic conditions was a predictor of disability at both time points.
Disability was persistent for migrants and non-migrants to 24 months post-injury. The disability risk at three months was higher for migrants. Certain predictors associated with disability were identified. Implications for public health: Despite having accessed healthcare services for their injury, migrants (compared with non-migrants) had higher risks of disability at least in the first three months post-injury. Interventions should be focused during this critical period on identified key predictors to promote faster recovery and reduce disability.
Characteristics of recently arrived Asian men who have sex with men diagnosed with HIV through sexual health services in Melbourne and Sydney.Australian and New Zealand Journal
Asian men who have sex with men (MSM) who have recently arrived in Australia are an emergent risk group for HIV; however, little is known about how they compare to Australian MSM diagnosed with HIV. This study compared the characteristics of these two groups.
A retrospective, cross-sectional study of MSM diagnosed with HIV between January 2014 and October 2017 in Melbourne and Sydney public sexual health clinics. Asian MSM were those who had arrived in Australia within 4 years of diagnosis.
Among 111 Asian men, 75% spoke a language other than English, 88% did not have Medicare and 61% were international students. Compared with Australian men (n=209), Asian men reported fewer male sexual partners within 12 months (median 4 versus 10, p<0.001), were less likely to have tested for HIV previously (71% versus 89%, p<0.001) and had a lower median CD4 count (326 versus 520, p<0.001). Among Asian men, HIV subtype CRF01-AE was more common (55% versus 16%, p<0.001) and subtype B less common (29% versus 73%, p<0.001).
Asian MSM diagnosed with HIV reported lower risk and had more advanced HIV. Implications for public health: HIV testing and preventative interventions supporting international students are required.
Response to a Fire Incident in the Operation Room: A Cautionary Tale.Disaster Medicine and Public Health
ABSTRACTHealth care facilities are always seen as places of haven and protection for managing external incidents, but situations become difficult a...
The Challenge of Affordable Housing in Disasters: Western Iran Earthquake in 2017.Disaster Medicine and Public Health
ABSTRACTIn November 2017, a disruptive earthquake occurred in Western Iran. After the major earthquake in Kermanshah, most affordable buildings suc...
Testing the effectiveness of a general practice intervention to improve uptake of colorectal cancer screening: a randomised controlled trial.Australian and New Zealand Journal
Uptake of screening through the Australian National Bowel Cancer Screening Program remains low. General practice guidelines support the general practitioners' role to offer CRC screening. This study tests the effect that an intervention including point-of-care FOBT provision, printed screening advice and GP endorsement has on self-reported FOBT uptake.
A multisite, 1:1 parallel-arm, cluster-randomised controlled trial. Participants aged 50-74, at average risk of CRC and overdue for screening were recruited from four general practices in New South Wales, Australia, from September 2016 to May 2017. Self-report of FOBT up to eight weeks post baseline.
A total of 336 participants consented to complete a baseline survey (64% consent rate), of which 123 were recruited into the trial (28 usual care days and 26 intervention days). Follow-up data was collected for 114 participants (65 usual care and 49 intervention). Those receiving the intervention had ten times greater odds of completing screening compared to usual care (39% vs. 6%; OR 10.24; 95%CI 2.9-36.6, p=0.0006).
A multicomponent intervention delivered in general practice significantly increased self-reported FOBT uptake in those at average risk of CRC. Implications for public health: General practice interventions could serve as an important adjunct to the Australian National Bowel Cancer Screening Program to boost plateauing screening rates.
Participant profile and impacts of an Aboriginal healthy lifestyle and weight loss challenge over four years 2012-2015.Australian and New Zealand Journal
To explore participation, consistency of demographic and health profiles, and short-term impacts across six Aboriginal Knockout Health Challenge (KHC) team-based weight loss competitions, 2012 to 2015.
Data comprised one competition each from 2012 and 2013 and two per year in 2014 and 2015. We compared baseline and change (pre- to post-competition) in weight, fruit and vegetable consumption, physical activity and waist circumference (baseline only) across competitions using mixed models.
Numbers of teams and participants increased from 2012 to 2015 from 13 and 324 to 33 and 830, respectively. A total of 3,625 participants registered, representing 2,645 unique people (25.4% repeat participation). Participants were mainly female and >90% were classified obese at baseline. Baseline weight and weight lost (between 1.9% and 2.5%) were significantly lower in subsequent competitions compared with the first. Improvements in fruit and vegetable consumption and physical activity were comparable across competitions.
The KHC has increasing and sustained appeal among Aboriginal communities, attracting those at risk from lifestyle-associated chronic disease and effectively reducing weight and promoting healthy lifestyles in the short term. Implications for public health: Community-led programs generated by, and responsive to, Aboriginal Australians' needs can demonstrate consistent community reach and sustained program-level lifestyle improvements.
How do health practitioners in a large Australian public hospital identify and respond to reproductive abuse? A qualitative study.Australian and New Zealand Journal
Reproductive abuse is defined as a deliberate attempt to control or interfere with a woman's reproductive choices. It is associated with a range of negative health outcomes and presents a hidden challenge for health practitioners. There is a dearth of research on reproductive abuse, particularly qualitative research. This study aims to address this gap by exploring how health practitioners in a large Australian public hospital identify and respond to reproductive abuse.
We conducted semi-structured interviews with n=17 health practitioners working across multiple disciplines within a large metropolitan public hospital in Victoria. Data were analysed thematically.
Three themes were developed: Figuring out that something is wrong; Creating a safe space to work out what she wants; and Everyone needs to do their part.
Practitioners relied on intuition developed through experience to identify reproductive abuse. Once identified, most practitioners described a woman-led response promoting safety; however, there were inconsistencies in how this was enacted across different professions. Lack of clarity around the level of response required was also a barrier. Implications for public health: Our findings highlight the pressing need for evidence-based guidelines for health practitioners and a 'best practice' model specific to reproductive abuse.
New and old hotspots for rickettsial spotted fever acquired in Tasmania, 2012-2017.Australian and New Zealand Journal
To describe the epidemiology and clinical characteristics of Tasmania-acquired rickettsial disease notified to the Department of Health in Tasmania from 2012 to 2017 inclusive.
Data on rickettsiosis cases acquired and notified in Tasmania between 1 January 2012 and 31 December 2017 were analysed descriptively.
Eighteen cases of rickettsial infection notified in Tasmania 2012-17 and likely acquired in the state met one of three case definitions: 12 confirmed (67%), four probable (22%), and two possible (11%). The mean number of cases per year was 3.0 (population rate 0.6 per 100,000 population/year); 60% of cases occurred in November and December. Cases were more commonly older males. Fever, lethargy, and rash were commonly reported symptoms. Thirteen cases were likely acquired on Flinders Island, three around Great Oyster Bay and two in the Midlands.
This study extends our knowledge of the epidemiology of rickettsial disease in Tasmania. This is the first account including confirmed cases acquired in the Midlands of Tasmania. Implications for public health: Increased knowledge and awareness of epidemiology of rickettsial infection in Tasmania is essential for timely diagnosis and appropriate treatment. These findings bear wider relevance outside Tasmania because visitors may also be at risk.
Breast screening attendance of Aboriginal and Torres Strait Islander women in the Northern Territory of Australia.Australian and New Zealand Journal
To compare breast screening attendances of Indigenous and non-Indigenous women.
A total of 4,093 BreastScreen cases were used including 857 self-identified Indigenous women. Chi-squared analysis compared data between Indigenous and non-Indigenous women. Logistic regression was used for groupings based on visits-to-screening frequency. Odds ratios and 95% confidence intervals were calculated for associations with low attendance.
Indigenous women were younger and had fewer visits to screening compared with non-Indigenous women. Non-English speaking was mainly associated with fewer visits for Indigenous women only (OR 1.9, 95%CI 1.3-2.9). Living remotely was associated with fewer visits for non-Indigenous women only (OR 1.3, 95%CI 1.1-1.5). Shared predictors were younger age (OR 12.3, 95%CI 8.1-18.8; and OR 11.5, 95%CI 9.6-13.7, respectively) and having no family history of breast cancer (OR 2.1, 95%CI 1.3-3.3; and OR 1.8, 95%CI 1.5-2.1, respectively).
Factors associated with fewer visits to screening were similar for both groups of women, except for language which was significant only for Indigenous women, and remoteness which was significant only for non-Indigenous women. Implications for public health: Health communication in Indigenous languages may be key in encouraging participation and retaining Indigenous women in BreastScreen; improving access for remote-living non-Indigenous women should also be addressed.
Public Health Threats in Mass Gatherings: A Systematic Review.Disaster Medicine and Public Health
ABSTRACTMass gatherings (MGs) are held throughout the world. The aim of this review was to assess and identify the health threats based on the type...