Further observations on the epidemiology and spread of epizootic haematopoietic necrosis virus (EHNV) in farmed rainbow trout Oncorhynchus mykiss in southeastern Australia and a recommended sampling strategy for surveillance.
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Epizootic haematopoietic necrosis virus (EHNV) is an iridovirus confined to Australia and is known only from rainbow trout Oncorhynchus mykiss and redfin perch Perca fluviatilis. Outbreaks of disease caused by EHNV in trout populations have invariably been of low severity, affecting only 0+ post-hatchery phase fingerlings < 125 mm in length. To date the virus has been demonstrated in very few live in-contact fish, and anti-EHNV antibodies have not been found in survivors of outbreaks, suggesting low infectivity but high case fatality rates in trout. During an on-going study on an endemically infected farm (Farm A) in the Murrumbidgee River catchment of southeastern New South Wales, EHNV infection was demonstrated in 4 to 6 wk old trout fingerlings in the hatchery as well as in 1+ to 2+ grower fish. During a separate investigation of mortalities in 1+ to 2+ trout on Farm B in the Shoalhaven River catchment in southeastern New South Wales, EHNV infection was demonstrated in both fingerlings and adult fish in association with nocardiosis. A 0.7% prevalence of antibodies against EHNV was detected by ELISA in the serum of grower fish at this time, providing the first evidence that EHNV might not kill all infected trout. EHNV infection on Farm B occurred after transfer of fingerlings from Farm C in the Murrumbidgee river catchment. When investigated, there were no obvious signs of diseases on Farm C. 'Routine' mortalities were collected over 10 d on Farm C and EHNV was detected in 2.1% of 190 fish. Tracing investigations of sources of supply of fingerlings to Farm B also led to investigation of Farm D in Victoria, where the prevalence of anti-EHNV antibodies in 3+ to 4+ fish was 1.3%. The results of this study indicate that EHNV may be found in trout in all age classes, need not be associated with clinically detectable disease in the population, can be transferred with shipments of live fish, can be detected in a small proportion of 'routine' mortalities and may be associated with specific antibodies in a small proportion of older fish. Sampling to detect EHNV for certification purposes should be based on examination of 'routine' mortalities rather than random samples of live fish. Antigen-capture ELISA can be used as a cost effective screening test to detect EHNV on a farm provided that sampling rates conform with statistical principles. (+info)
Cancer mortality in East and Southeast Asian migrants to New South Wales, Australia, 1975-1995.
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Routinely collected data for New South Wales were used to analyse cancer mortality in migrants born in East or Southeast Asia according to duration of residence in Australia. A case-control approach compared deaths from cancer at particular sites with deaths from all other cancers, adjusting for age, sex and calendar period. Compared with the Australian-born, these Asian migrants had a 30-fold higher risk of dying from nasopharyngeal cancer in the first 2 decades of residence, falling to ninefold after 30 years, and for deaths from liver cancer, a 12-fold risk in the first 2 decades, falling to threefold after 30 years. The initial lower risk from colorectal, breast or prostate cancers later converged towards the Australian-born level, the change being apparent in the third decade after migration. The relative risk of dying from lung cancer among these Asian migrants was above unity for each category of duration of stay for women, but at or below unity for men, with no trend in risk over time. An environmental or lifestyle influence for nasopharyngeal and liver cancers is suggested as well as for cancers of colon/rectum, breast and prostate. (+info)
Asymmetry in optic disc parameters: the Blue Mountains Eye Study.
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PURPOSE: To examine asymmetry in vertical optic disc parameters among subjects classified as normal, as having ocular hypertension (OH), and as having open-angle glaucoma (OAG) in a population-based sample. METHODS: The Blue Mountains Eye Study examined 3654 people aged 49 to 97 years, including 2929 normal subjects, 118 with OH, and 79 with OAG in the groups of interest for the asymmetry study. Optic disc parameters were measured in a masked manner from stereo optic disc photographs. RESULTS: Vertical disc diameter asymmetry (the absolute value of left minus right disc diameters) was similar among normal, OH, and OAG groups (median, 0.07-0.08 mm). Vertical cup- disc ratio asymmetry was higher in patients with OAG (median, 0.11) than in normal subjects (median, 0.06; P < 0.0001) and in those with OH (median, 0.05; P < 0.0001) but was similar between normal subjects and patients with OH (P = 0.17). A cup- disc ratio asymmetry of 0.2 or more was found in 24% of patients with OAG, compared with 1% of patients with OH and 6% of normal subjects. Corresponding rates for cup- disc ratio asymmetry of 0.3 or more in these three groups were 10%, 0%, and 1%, respectively. Using multiple linear regression, cup-disc ratio asymmetry was associated with disc diameter asymmetry and intraocular pressure asymmetry. However, these two factors explained only 3% of the variability of cup- disc ratio asymmetry and 20% of cup diameter asymmetry. CONCLUSIONS: Despite differences between the OAG group and either the OH or normal groups, asymmetry alone was not useful in identifying patients with OAG. At all levels of asymmetry, subjects were more likely to be classified as normal than with OH or OAG. (+info)
The adaptability of the health promoting schools concept: a case study from Australia.
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The adoption of the concept of the health promoting school internationally indicates that it is a timely and flexible concept that can be utilized by different countries to accommodate their particular contexts. Political, economic and socio-cultural factors are powerful forces that shape the construction of health promoting schools globally. How some of these factors operate will be exemplified through a description of the health promoting school movement in Australia with commonalities and variations with activities in member countries of the European Network of Health Promoting Schools highlighted. The unique role globally of the Australian Health Promoting Schools Association, as a non-government organization specifically established to promote the concept of the health promoting school, is described. Its contribution is as a neutral body representing diverse interests that can advocate in different settings and at all levels of influence. Additionally it provides a mechanism for networking, awareness raising and information exchange. The structure of the health and education sectors in Australia has shaped the conceptualization of a health promoting school, one that accommodates the country's specific context. Barriers, facilitating factors and challenges that exist for future work in the area are described. (+info)
Bullying behaviour and psychosocial health among school students in New South Wales, Australia: cross sectional survey.
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OBJECTIVES: To examine the prevalence of bullying behaviours in schoolchildren and the association of bullying with psychological and psychosomatic health. DESIGN: Cross sectional survey. SETTING: Government and non-government schools in New South Wales, Australia. PARTICIPANTS: 3918 schoolchildren attending year 6 (mean age 11.88 years), year 8 (13.96), and year 10 (15.97) classes from 115 schools. MAIN OUTCOME MEASURES: Self reported bullying behaviours and psychological and psychosomatic symptoms. RESULTS: Almost a quarter of students (23.7%) bullied other students, 12.7% were bullied, 21.5% were both bullied and bullied others on one or more occasions in the last term of school, and 42.4% were neither bullied nor bullied others. More boys than girls reported bullying others and being victims of bullying. Bullying behaviour was associated with increased psychosomatic symptoms. Bullies tended to be unhappy with school; students who were bullied tended to like school and to feel alone. Students who both bullied and were bullied had the greatest number of psychological and psychosomatic symptoms. CONCLUSIONS: Being bullied seems to be widespread in schools in New South Wales and is associated with increased psychosomatic symptoms and poor mental health. Health practitioners evaluating students with common psychological and psychosomatic symptoms should consider bullying and the student's school environment as potential causes. (+info)
Can GP input into discharge planning result in better outcomes for the frail aged: results from a randomized controlled trial.
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OBJECTIVE: We aimed to assess whether GP input into discharge planning for high-risk aged in-patients admitted under the care of a geriatrician results in improved patient outcomes. METHODS: We conducted a prospective randomized controlled trial in Sydney, Australia. The subjects were 364 patients aged 60 years and over. The main outcome measures included community service referral, accommodation changes, length of stay, readmission rate, length of time to first readmission and patient satisfaction with discharge arrangements. RESULTS: No significant differences were found with regard to length of stay, readmission rates or time to first readmission. Test-group subjects were significantly more likely to be recommended for community services at discharge and to report that hospital personnel had discussed their discharge plan with them. Significantly more of the test group reported that their return home was well prepared. CONCLUSIONS: Although GP pre-discharge visits did not alter the likelihood of 'hard outcomes such as risk of readmission', the results suggest that quality of care is enhanced amongst patients receiving a pre-discharge visit and that GPs can perform a key role in planning post-discharge care with other services. (+info)
Multifaceted shared care intervention for late life depression in residential care: randomised controlled trial.
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OBJECTIVE: To evaluate the effectiveness of a population based, multifaceted shared care intervention for late life depression in residential care. DESIGN: Randomised controlled trial, with control and intervention groups studied one after the other and blind follow up after 9.5 months. SETTING: Population of residential facility in Sydney living in self care units and hostels. PARTICIPANTS: 220 depressed residents aged >/=65 without severe cognitive impairment. INTERVENTION: The shared care intervention included: (a) multidisciplinary consultation and collaboration, (b) training of general practitioners and carers in detection and management of depression, and (c) depression related health education and activity programmes for residents. The control group received routine care. MAIN OUTCOME MEASURE: Geriatric depression scale. RESULTS: Intention to treat analysis was used. There was significantly more movement to "less depressed" levels of depression at follow up in the intervention than control group (Mantel-Haenszel stratification test, P=0.0125). Multiple linear regression analysis found a significant intervention effect after controlling for possible confounders, with the intervention group showing an average improvement of 1.87 points on the geriatric depression scale compared with the control group (95% confidence interval 0.76 to 2.97, P=0.0011). CONCLUSIONS: The outcome of depression among elderly people in residential care can be improved by multidisciplinary collaboration, by enhancing the clinical skills of general practitioners and care staff, and by providing depression related health education and activity programmes for residents. (+info)
Hormone replacement therapy and risk of epithelial ovarian cancer.
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It has been suggested that oestrogen replacement therapy is associated with risk of epithelial ovarian cancer of the endometrioid type. Using data from an Australian population-based case-control study, the relation between unopposed oestrogen replacement therapy and epithelial ovarian cancer, both overall and according to histological type, was examined. A total of 793 eligible incident cases of epithelial ovarian cancer diagnosed from 1990 to 1993 among women living in Queensland, New South Wales and Victoria were identified. These were compared with 855 eligible female controls selected at random from the electoral roll, stratified by age and geographic region. Trained interviewers administered standard questionnaires to obtain detailed reproductive and contraceptive histories, as well as details about hormone replacement therapy and pelvic operations. No clear associations were observed between use of hormone replacement therapy overall and risk of ovarian cancer. Unopposed oestrogen replacement therapy was, however, associated with a significant increase in risk of endometrioid or clear cell epithelial ovarian tumours (odds ratio (OR) 2.56; 95% confidence interval (CI) 1.32-4.94). In addition, the risk associated with oestrogen replacement therapy was much larger in women with an intact genital tract (OR 3.00; 95% CI 1.54-5.85) than in those with a history of either hysterectomy or tubal ligation. Post-menopausal oestrogen replacement therapy may, therefore, be a risk factor associated with endometrioid and clear cell tumours in particular. Additionally, the risk may be increased predominantly in women with an intact genital tract. These associations could reflect a possible role of endometriosis in the development of endometrioid or clear cell ovarian tumours. (+info)