Epidemiology and associated risk factors of giardiasis in a peri-urban setting in New South Wales Australia

© 2018 Cambridge University Press. Giardiasis is one of the most important non-viral causes of human diarrhoea. Yet, little is known about the epidemiology of giardiasis in the context of developed countries such as Australia and there is a limited information about local sources of exposure to inform prevention strategies in New South Wales. This study aimed to (1) describe the epidemiology of giardiasis and (2) identify potential modifiable risk factors associated with giardiasis that are unique to south-western Sydney, Australia. A 1:2 matched case-control study of 190 confirmed giardiasis cases notified to the South-Western Local Health District Public Health Unit from January to December 2016 was employed to investigate the risk factors for giardiasis. Two groups of controls were selected to increase response rate; Pertussis cases and neighbourhood (NBH) controls. A matched analysis was carried out for both control groups separately. Variables with a significant odds ratio (OR) in the univariate analysis were placed into a multivariable regression for each matched group, respectively. In the regression model with the NBH controls, age and sex were controlled as potential confounders. Identified risk factors included being under 5 years of age (aOR = 7.08; 95% confidence intervals (CI) 1.02-49.36), having a household member diagnosed with a gastrointestinal illness (aOR = 15.89; 95% CI 1.53-164.60) and having contact with farm animals, domestic animals or wildlife (aOR = 3.03; 95% CI 1.08-8.54). Cases that travelled overseas were at increased risk of infection (aOR = 19.89; 95% CI 2.00-197.37) when compared with Pertussis cases. This study provides an update on the epidemiology and associated risk factors of a neglected tropical disease, which can inform enhanced surveillance and prevention strategies in the developed metropolitan areas

Influenza vaccination during pregnancy: A qualitative study of the knowledge, attitudes, beliefs, and practices of general practitioners in Central and South-Western Sydney

Background: Pregnant women have an increased risk of influenza complications. Influenza vaccination during pregnancy is safe and effective, however coverage in Australia is less than 40%. Pregnant women who receive a recommendation for influenza vaccination from a health care provider are more likely to receive it, however the perspectives of Australian general practitioners has not previously been reported. The aim of the study was to investigate the knowledge, attitudes, beliefs, and practices of general practitioners practicing in South-Western Sydney, Australia towards influenza vaccination during pregnancy. Methods. A qualitative descriptive study was conducted, with semi-structured interviews completed with seventeen general practitioners in October 2012. A thematic analysis was undertaken by four researchers, and transcripts were analysed using N-Vivo software according to agreed codes. Results: One-third of the general practitioners interviewed did not consider influenza during pregnancy to be a serious risk for the mother or the baby. The majority of the general practitioners were aware of the government recommendations for influenza vaccination during pregnancy, but few general practitioners were confident of their knowledge about the vaccine and most felt they needed more information. More than half the general practitioners had significant concerns about the safety of influenza vaccination during pregnancy. Their practices in the provision of the vaccine were related to their perception of risk of influenza during pregnancy and their confidence about the safety of the vaccine. While two-thirds reported that they are recommending influenza vaccination to their pregnant patients, many were adopting principles of patient-informed choice in their approach and encouraged women to decide for themselves whether they would receive the vaccine. Conclusions: General practitioners have varied knowledge, attitudes, and beliefs about influenza vaccination during pregnancy, which influence their practices. Addressing these could have a significant impact on improving vaccine uptake during pregnancy. © 2014 Maher et al.; licensee BioMed Central Ltd

Hotspots of change in use of public transport to work: A geospatial mixed method study

Introduction: Several studies have supported the role of public transport in encouraging active transport through commuting. Investigating actual increases in public transport use within focussed local areas can help unravel what causes such increases. Methods: In this study, we investigated factors related to the increase in public transport use in focussed local areas (hotspots) through a geospatial mixed-method approach using data from South Western Sydney, Australia, spatial cluster detection, and local stakeholder interviews. We also examined areas with low levels of public transport use. Results: We found that while distance to train station is a significant predictor of usage, other important factors include the professional and socioeconomic profile of the neighbourhood around the train station, the train line's deemed attractiveness and parking availability. Conclusions: Thus, researchers and planners must consider a range of built environment factors when planning for changes that encourage public transport use. In addition, focusing on small local areas utilising geospatial mixed methods can provide important insights into the local drivers of public transport use

Forecasting carbon monoxide on a global scale for the ATom-1 aircraft mission: insights from airborne and satellite observations and modeling

The first phase of the Atmospheric Tomography Mission (ATom-1) took place in July–August 2016 and included flights above the remote Pacific and Atlantic oceans. Sampling of atmospheric constituents during these flights is designed to provide new insights into the chemical reactivity and processes of the remote atmosphere and how these processes are affected by anthropogenic emissions. Model simulations provide a valuable tool for interpreting these measurements and understanding the origin of the observed trace gases and aerosols, so it is important to quantify model performance. Goddard Earth Observing System Model version 5 (GEOS-5) forecasts and analyses show considerable skill in predicting and simulating the CO distribution and the timing of CO enhancements observed during the ATom-1 aircraft mission. We use GEOS-5's tagged tracers for CO to assess the contribution of different emission sources to the regions sampled by ATom-1 to elucidate the dominant anthropogenic influences on different parts of the remote atmosphere. We find a dominant contribution from non-biomass-burning sources along the ATom transects except over the tropical Atlantic, where African biomass burning makes a large contribution to the CO concentration. One of the goals of ATom is to provide a chemical climatology over the oceans, so it is important to consider whether August 2016 was representative of typical boreal summer conditions. Using satellite observations of 700&thinsp;hPa and column CO from the Measurement of Pollution in the Troposphere (MOPITT) instrument, 215&thinsp;hPa&thinsp;CO from the Microwave Limb Sounder (MLS), and aerosol optical thickness from the Moderate Resolution Imaging Spectroradiometer (MODIS), we find that CO concentrations and aerosol optical thickness in August 2016 were within the observed range of the satellite observations but below the decadal median for many of the regions sampled. This suggests that the ATom-1 measurements may represent relatively clean but not exceptional conditions for lower-tropospheric CO.</p

Global Assessment of the SMAP Level-4 Surface and Root-Zone Soil Moisture Product Using Assimilation Diagnostics

The Soil Moisture Active Passive (SMAP) mission Level-4 Soil Moisture (L4_SM) product provides 3-hourly, 9-km resolution, global estimates of surface (0-5 cm) and root-zone (0-100 cm) soil moisture and related land surface variables from 31 March 2015 to present with ~2.5-day latency. The ensemble-based L4_SM algorithm assimilates SMAP brightness temperature (Tb) observations into the Catchment land surface model. This study describes the spatially distributed L4_SM analysis and assesses the observation-minus-forecast (O-F) Tb residuals and the soil moisture and temperature analysis increments. Owing to the climatological rescaling of the Tb observations prior to assimilation, the analysis is essentially unbiased, with global mean values of ~0.37 K for the O-F Tb residuals and practically zero for the soil moisture and temperature increments. There are, however, modest regional (absolute) biases in the O-F residuals (under ~3 K), the soil moisture increments (under ~0.01 cu.m/cu.m), and the surface soil temperature increments (under ~1 K). Typical instantaneous values are ~6 K for O-F residuals, ~0.01 (~0.003) cu.m/cu.m for surface (root-zone) soil moisture increments, and ~0.6 K for surface soil temperature increments. The O-F diagnostics indicate that the actual errors in the system are overestimated in deserts and densely vegetated regions and underestimated in agricultural regions and transition zones between dry and wet climates. The O-F auto-correlations suggest that the SMAP observations are used efficiently in western North America, the Sahel, and Australia, but not in many forested regions and the high northern latitudes. A case study in Australia demonstrates that assimilating SMAP observations successfully corrects short-term errors in the L4_SM rainfall forcing

Does Consideration and Assessment of Effects on Health Equity Affect the Conclusions of Systematic Reviews? A Methodology Study

INTRODUCTION: Tackling health inequities both within and between countries remains high on the agenda of international organizations including the World Health Organization and local, regional and national governments. Systematic reviews can be a useful tool to assess effects on equity in health status because they include studies conducted in a variety of settings and populations. This study aims to describe the extent to which the impacts of health interventions on equity in health status are considered in systematic reviews, describe methods used, and assess the implications of their equity related findings for policy, practice and research. METHODS: We conducted a methodology study of equity assessment in systematic reviews. Two independent reviewers extracted information on the reporting and analysis of impacts of health interventions on equity in health status in a group of 300 systematic reviews collected from all systematic reviews indexed in one month of MEDLINE, using a pre-tested data collection form. Any differences in data extraction were resolved by discussion. RESULTS: Of the 300 systematic reviews, 224 assessed the effectiveness of interventions on health outcomes. Of these 224 reviews, 29 systematic reviews assessed effects on equity in health status using subgroup analysis or targeted analyses of vulnerable populations. Of these, seven conducted subgroup analyses related to health equity which were reported in insufficient detail to judge their credibility. Of these 29 reviews, 18 described implications for policy and practice based on assessment of effects on health equity. CONCLUSION: The quality and completeness of reporting should be enhanced as a priority, because without this policymakers and practitioners will continue lack the evidence base they need to inform decision-making about health inequity. Furthermore, there is a need to develop methods to systematically consider impacts on equity in health status that is currently lacking in systematic reviews

Is HIV Infection a Risk Factor for Multi-Drug Resistant Tuberculosis? A Systematic Review

BACKGROUND:Tuberculosis (TB) is an important cause of human suffering and death. Human immunodeficiency virus (HIV), multi-drug resistant TB (MDR-TB), and extensive drug resistant tuberculosis (XDR-TB) have emerged as threats to TB control. The association between MDR-TB and HIV infection has not yet been fully investigated. We conducted a systematic review and meta-analysis to summarize the evidence on the association between HIV infection and MDR-TB. METHODS AND RESULTS:Original studies providing Mycobacterium tuberculosis resistance data stratified by HIV status were identified using MEDLINE and ISI Web of Science. Crude MDR-TB prevalence ratios were calculated and analyzed by type of TB (primary or acquired), region and study period. Heterogeneity across studies was assessed, and pooled prevalence ratios were generated if appropriate. No clear association was found between MDR-TB and HIV infection across time and geographic locations. MDR-TB prevalence ratios in the 32 eligible studies, comparing MDR-TB prevalence by HIV status, ranged from 0.21 to 41.45. Assessment by geographical region or study period did not reveal noticeable patterns. The summary prevalence ratios for acquired and primary MDR-TB were 1.17 (95% CI 0.86, 1.6) and 2.72 (95% CI 2.03, 3.66), respectively. Studies eligible for review were few considering the size of the epidemics. Most studies were not adjusted for confounders and the heterogeneity across studies precluded the calculation of a meaningful overall summary measure. CONCLUSIONS:We could not demonstrate an overall association between MDR-TB and HIV or acquired MDR-TB and HIV, but our results suggest that HIV infection is associated with primary MDR-TB. Future well-designed studies and surveillance in all regions of the world are needed to better clarify the relationship between HIV infection and MDR-TB

The mechanics of housing collectivism: How forms and functions affect affordability

In countries worldwide, limited access to affordable housing is fuelling interest in collectivist solutions. Different organizational models are being developed to enable groups of people to own and control housing collectively. The benefits of such models have been widely promoted, not least in terms of delivering enhanced housing affordability for residents. However, evidence to support such claims is scarce and it remains unclear whether affordability is the product of collective forms and functions, or some other factor(s). To address this gap in knowledge, the paper presents findings from three case studies of English and Canadian housing collectives. Applying realist theories of causation, the processes affecting housing affordability are explained, conceptualizing two causal mechanisms which depict how organizational form, internal rules and regulatory activity, along with the unique role of the resident-owner, influence the setting of rents and prices. Further research is required to understand the prevalence of these mechanisms and their general application