414 research outputs found

    Do Demographic Profiles of Listed and Unlisted Households Differ? Results of a Nationwide Telephone Survey

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    A growing number of households are not reachable through traditional directory-based samples, which can have important implications for the representativeness of telephone surveys. The current study aims to investigate the demographic differences between households which have their telephone numbers listed or not listed in the Australian White Pages telephone directory. A total of 5,023 eligible Australian residents who were currently in paid employment participated in this study. Each respondent’s telephone number was individually matched to the residential White Pages to determine its listed status, and demographic variables were compared between those with a listed and unlisted telephone number. Those with an unlisted number were significantly more likely to be younger, to have been born in a country outside of Australia, and to live in a lower socioeconomic area than those who were listed in the White Pages. These demographic differences should be considered when undertaking telephone surveys using a White Pages sample

    Current Understanding of Streptococcal Urinary Tract Infection

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    Group B streptococcus (GBS), also known as Streptococcus agalactiae is a Gram-positive, ÎČ-hemolytic, chain-forming bacterium and a commensal within the genital tract flora in approximately 25% of healthy adult women (Campbell et al., 2000). The organism is a leading cause of serious infection in newborns, pregnant women, and older persons with chronic medical illness (Baker et al., Edwards&Baker, 2005). In neonates GBS infection most commonly causes pneumonia, meningitis, and sepsis. In addition to maternal cervicovaginal colonization and neonatal infection that can result from vertical transmission of GBS from mothers to their infants, the bacterium can also cause urinary tract infection (UTI). The spectrum of GBS UTI includes asymptomatic bacteriuria (ABU), cystitis, pyelonephritis, urethritis, and urosepsis (Bronsema et al., 1993, Edwards&Baker, 2005, Farley et al., 1993, Lefevre et al., 1991, McKenna et al., 2003, Munoz et al., 1992, Ulett et al., 2009). GBS ABU is particularly common among pregnant women, although those most at risk for cystitis due to GBS appear to be elderly individuals (Edwards&Baker, 2005, Falagas et al., 2006, Muller et al., 2006). In addition to acute and asymptomatic UTI other invasive diseases caused by GBS infection include skin infections, bacteraemia, pneumonia, arthritis, and endocarditis (Liston et al., 1979, Patil & Martin, 2010, Tissi et al., 1997, Trivalle et al., 1998). Thus, GBS is considered unique in terms of its ability to cause a spectrum of diseases in newborns and adult humans and its ability to colonize the genital tract of healthy women in a commensal-type manner..

    The Australian Work Exposures Study: Occupational Exposure to Polycyclic Aromatic Hydrocarbons

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    INTRODUCTION: The aims of this study were to produce a population-based estimate of the prevalence of work-related exposure to polycyclic aromatic hydrocarbons (PAHs), to identify the main circumstances of exposure and to describe the use of workplace control measures designed to decrease those exposures. METHODS: The analysis used data from the Australian Workplace Exposures Study, a nationwide telephone survey which investigated the current prevalence and exposure circumstances of work-related exposure to 38 known or suspected carcinogens, including PAHs, among Australian workers aged 18-65 years. Using the web-based tool OccIDEAS, semi-quantitative information was collected about exposures in the current job held by the respondent. Questions were addressed primarily at tasks undertaken rather than about self-reported exposures. RESULTS: Of the 4,993 included respondents, 297 (5.9%) were identified as probably being exposed to PAHs in their current job [extrapolated to 6.7% of the Australian working population-677 000 (95% confidence interval 605 000-757 000) workers]. Most (81%) were male; about one-third were farmers and about one-quarter worked in technical and trades occupations. In the agriculture industry about half the workers were probably exposed to PAHs. The main exposure circumstances were exposure to smoke through burning, fighting fires or through maintaining mowers or other equipment; cleaning up ash after a fire; health workers exposed to diathermy smoke; cooking; and welding surfaces with a coating. Where information on control measures was available, their use was inconsistent. CONCLUSION: Workers are exposed to PAHs in many different occupational circumstances. Information on the exposure circumstances can be used to support decisions on appropriate priorities for intervention and control of occupational exposure to PAHs, and estimates of burden of cancer arising from occupational exposure to PAHs

    The Australian Work Exposures Study: Occupational Exposure to Lead and Lead Compounds.

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    INTRODUCTION: The aims of this study were to produce a population-based estimate of the prevalence of work-related exposure to lead and its compounds, to identify the main circumstances of exposures, and to collect information on the use of workplace control measures designed to decrease those exposures. METHODS: Data came from the Australian Workplace Exposures Study, a nationwide telephone survey which investigated the current prevalence and circumstances of work-related exposure to 38 known or suspected carcinogens, including lead, among Australian workers aged 18-65 years. Using the web-based tool, OccIDEAS, semi-quantitative information was collected about exposures in the current job held by the respondent. Questions were addressed primarily at tasks undertaken rather than about self-reported exposures. RESULTS: A total of 307 (6.1%) of the 4993 included respondents were identified as probably being exposed to lead in the course of their work. Of these, almost all (96%) were male; about half worked in trades and technician-related occupations, and about half worked in the construction industry. The main tasks associated with probable exposures were, in decreasing order: soldering; sanding and burning off paint while painting old houses, ships, or bridges; plumbing work; cleaning up or sifting through the remains of a fire; radiator-repair work; machining metals or alloys containing lead; mining; welding leaded steel; and working at or using indoor firing ranges. Where information on control measures was available, inconsistent use was reported. Applied to the Australian working population, approximately 6.3% [95% confidence interval (CI) = 5.6-7.0] of all workers (i.e. 631000, 95% CI 566000-704000 workers) were estimated to have probable occupational exposure to lead. CONCLUSIONS: Lead remains an important exposure in many different occupational circumstances in Australia and probably other developed countries. This information can be used to support decisions on priorities for intervention and control of occupational exposure to lead and estimates of burden of cancer arising from occupational exposure to lead

    Obesity‐Related Hormones in Low‐Income Preschool‐Age Children: Implications for School Readiness

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    Mechanisms underlying socioeconomic disparities in school readiness and health outcomes, particularly obesity, among preschool‐aged children are complex and poorly understood. Obesity can induce changes in proteins in the circulation that contribute to the negative impact of obesity on health; such changes may relate to cognitive and emotion regulation skills important for school readiness. We investigated obesity‐related hormones, body mass index ( BMI ), and school readiness in a pilot study of low‐income preschoolers attending Head Start (participating in a larger parent study). We found that the adipokine leptin was related to preschoolers' BMI z ‐score, the appetite‐regulating hormones ghrelin and glucagon‐like peptide 1 ( GLP ‐1), and pro‐inflammatory cytokines typically associated with early life stress; and that some of these obesity‐related biomarkers were in turn related to emotion regulation. Future work should evaluate how obesity may affect multiple domains of development, and consider modeling common physiological pathways related to stress, health, and school readiness.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/101799/1/mbe12034.pd

    Workplace psychosocial stressors experienced by migrant workers in Australia: A cross-sectional study

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    Objective: To explore work-related psychosocial stressors among people of Chinese, Vietnamese and Arabic-speaking backgrounds currently working in Australia. Methods: In 2015, a telephone survey of 585 Vietnamese, Chinese and Arabic-speaking workers asked about workplace bullying, ethnic discrimination, job complexity, degree of control, security and fairness of payment along with demographic and employment information. Estimates of job-related psychosocial stressors were derived and regression analyses used to identify significant associations. Results: At least one workplace stressor was reported by 83% of the workers in the study. Education was significantly associated with experiencing any psychosocial stressor and also with the total number of stressors. Workers aged 45 years and older were more likely to be bullied or experience racial discrimination compared with younger workers of any ethnicity. There was a greater likelihood of reporting low control over a job when the interview was conducted in a language other than English and the workers were either Chinese or Arabic. Workers on a fixed-term contract, independent of ethnicity were more likely to report a job with low security. Overall psychosocial job quality decreased with education and was associated with occupation type which interacted with ethnicity and gender. Conclusions: The results suggest that job-related psychosocial stressors are widespread but not uniform across ethnic groups. Further research into what drives differences in work experience for migrant groups would provide information to guide both employers and migrants in ways to reduce workplace psychosocial stressors

    Systems analysis and improvement to optimize pMTCT (SAIA): a cluster randomized trial

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    BACKGROUND: Despite significant increases in global health investment and the availability of low-cost, efficacious interventions to prevent mother-to-child HIV transmission (pMTCT) in low- and middle-income countries with high HIV burden, the translation of scientific advances into effective delivery strategies has been slow, uneven and incomplete. As a result, pediatric HIV infection remains largely uncontrolled. A five-step, facility-level systems analysis and improvement intervention (SAIA) was designed to maximize effectiveness of pMTCT service provision by improving understanding of inefficiencies (step one: cascade analysis), guiding identification and prioritization of low-cost workflow modifications (step two: value stream mapping), and iteratively testing and redesigning these modifications (steps three through five). This protocol describes the SAIA intervention and methods to evaluate the intervention’s impact on reducing drop-offs along the pMTCT cascade. METHODS: This study employs a two-arm, longitudinal cluster randomized trial design. The unit of randomization is the health facility. A total of 90 facilities were identified in Cîte d’Ivoire, Kenya and Mozambique (30 per country). A subset was randomly selected and assigned to intervention and comparison arms, stratified by country and service volume, resulting in 18 intervention and 18 comparison facilities across all three countries, with six intervention and six comparison facilities per country. The SAIA intervention will be implemented for six months in the 18 intervention facilities. Primary trial outcomes are designed to assess improvements in the pMTCT service cascade, and include the percentage of pregnant women being tested for HIV at the first antenatal care visit, the percentage of HIV-infected pregnant women receiving adequate prophylaxis or combination antiretroviral therapy in pregnancy, and the percentage of newborns exposed to HIV in pregnancy receiving an HIV diagnosis eight weeks postpartum. The Consolidated Framework for Implementation Research (CFIR) will guide collection and analysis of qualitative data on implementation process. DISCUSSION: This study is a pragmatic trial that has the potential benefit of improving maternal and infant outcomes by reducing drop-offs along the pMTCT cascade. The SAIA intervention is designed to provide simple tools to guide decision-making for pMTCT program staff at the facility level, and to identify low cost, contextually appropriate pMTCT improvement strategies. TRIAL REGISTRATION: ClinicalTrials.gov NCT0202365
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