Influenza control can be achieved in a custodial setting: pandemic (H1N1) 2009 and 2011 in an Australian prison

OBJECTIVES: Information on the effectiveness of interventions regarding control in closed institutional settings, including prisons, is limited. This study gathered evidence relating to influenza control in an Australian prison. STUDY DESIGN: This study built on a 2009 H1N1 outbreak investigation at the Alexander Maconochie Centre (AMC) in the Australian Capital Territory (ACT). METHODS: Influenza surveillance data, ACT 2010 Inmate Health Survey data, New South Wales 2001 and 2009 Inmate Health Survey data, ACT Department of Corrective Services administrative data, and ACT Health clinical data were analysed. RESULTS: In 2011, the AMC was exposed to influenza virus, resulting in a single case. Public health activities included exclusion of symptomatic cases from the health facility, isolation of cases, and quarantine of contacts. Contact between prisoners and the ACT community was maintained; the AMC detainee visitor rate was one visitor per prisoner every 10 days. CONCLUSIONS: The rehabilitative benefits of human contact for AMC detainees were not compromised during the surveillance period, despite the potential that a higher visitor rate may suggest. This highlights some features of the AMC which make its operational context different from many other correctional settings, but gives some indication of how good public health practice supports human rights.NHMRC (National Health and Medical Research Council of Australia

Structural evaluation of concrete expanded polystyrene sandwich panels for slab applications

Sandwich panels are being extensively and increasingly used in building construction because they are light in weight, energy efficient, aesthetically attractive and can be easily handled and erected. This paper presents a structural evaluation of Concrete-Expanded Polystyrene (CEPS) sandwich panels for slab applications using finite element modeling approach. CEPS panels are made of expanded polystyrene foam sandwiched between concrete skins. The use of foam in the middle of sandwich panel reduces the weight of the structure and also acts as insulation against thermal, acoustics and vibration. Applying reinforced concrete skin to both sides of panel takes the advantages of the sandwich concept where the reinforced concrete skins take compressive and tensile loads resulting in higher stiffness and strength and the core transfers shear loads between the faces. This research uses structural software Strand7, which is based on finite element method, to predict the load deformation behaviour of the CEPS sandwich slab panels. Non linear static analysis was used in the numerical investigations. Predicted results were compared with the existing experimental results to validate the numerical approach used

Experimental investigation on the flexural behaviour of pultruded GFRP beams filled with different concrete strengths

Glass fibre reinforced polymer (GFRP) pultruded profiles are being increasingly used in the construction industry due to their numerous advantageous over the conventional materials. However, most pultruded GFRP sections fail prematurely without utilising their high tensile strength due to their thin-walled sections. As a result, several hybrid systems made out of GFRP profiles and concrete as a filler material have been proposed in order to enhance their structural performance. Most of these studies utilised high strength concrete wherein the additional cost does not justify the enhancement in the stiffness and strength of the infilled GFRP profiles. This paper presents an experimental investigation on the effect of the compressive strength of concrete infill on the flexural behaviour of beams with a view to determine a lower cost infill for GFRP profiles. Pultruded GFRP square beams (125 mm x125 mm x 6.5mm) were filled with concrete having 10, 37 and 43.5 MPa compressive strength and tested under static four-point bending. The results showed that the capacity of the filled beam sections increased by 100 to 141% than the hollow sections. However, the compressive strength of the concrete infill has no significant effect on the flexural behaviour of the beams. The increase in concrete compressive strength from 10 to 43.5 MPa increased the ultimate moment by only 19% but exhibited an almost same flexural stiffness indicating that a low strength concrete is a practical solution to fill the GFRP profile

Transmission of Influenza on International Flights, May 2009

Understanding the dynamics of influenza transmission on international flights is necessary for prioritizing public health response to pandemic incursions. A retrospective cohort study to ascertain in-flight transmission of pandemic (H1N1) 2009 and influenza-like illness (ILI) was undertaken for 2 long-haul flights entering Australia during May 2009. Combined results, including survey responses from 319 (43%) of 738 passengers, showed that 13 (2%) had an ILI in flight and an ILI developed in 32 (5%) passengers during the first week post arrival. Passengers were at 3.6% increased risk of contracting pandemic (H1N1) 2009 if they sat in the same row as or within 2 rows of persons who were symptomatic preflight. A closer exposed zone (2 seats in front, 2 seats behind, and 2 seats either side) increased the risk for postflight disease to 7.7%. Efficiency of contact tracing without compromising the effectiveness of the public health intervention might be improved by limiting the exposed zone

Behavior of pultruded multi-celled GFRP hollow beams with low-strength concrete infill

The structural performance of multi-celled GFRP hollow beams is highly affected by the local buckling failure. Therefore, this study introduces pultruded multi-celled GFRP beams filled with low strength concrete. The flexural behaviour of beams made up of 1, 2 and 3 pultruded GFRP square sections (125 mm x125 mm x 6.5mm) and filled with concrete having low compressive strength was investigated. The composite beams were subjected to four-point static bending test to determine the strength, stiffness and failure mechanisms. The results of the experimental investigations showed that the failure stress of 2 and 3 cells beams is 98% and 85% compared with single cell beam, respectively. However, the filling percentages are 50% and 33%, respectively. All the tested beams were failed due to compression failure of the GFRP profile. Furthermore, the effective stiffness of 2 and 3 cells is 95% and 96%, respectively compared with single cell section

Embedding cultural competence in faculty : a mixed-methods evaluation of an applied Indigenous proficiency workshop

One of the most pressing issues in Australian society is the gap between Indigenous and non-Indigenous health and life expectancies (Marmot, 2017). Australia agreed with the World Health Organisation’s 2008 Closing the Gap in a Generation report (WHO, 2008), spending approximately 5.6% of government expenditure towards ameliorating this gap (Gardiner-Garden & Simon-Davies, 2012), yet there have been only minimal positive outcomes (Alford, 2015; Gannon, 2018). In applied terms, this means Indigenous people are still dying younger (Anderson et al., 2016), scoring higher on psychological distress (Markwick, Ansari, Sullivan, & McNeil, 2015) and suffering poorer indices on all chronic diseases (e.g. Walsh & Kangaharan, 2016; Thompson, Talley, & Kong, 2017). The level of complexity involved in addressing these “wicked” or seemingly “impossible to solve” health problems is made worse by the lack of any pan-national strategic planning and/or intervention evaluation (Lokuge et al., 2017), even though there has been a plethora of programs and projects designed to improve Indigenous health (see for example, AGPC, 2016). Leaders in health and educational institutions must consider why there is a lack of progress in closing the gap in Indigenous health and life expectancies. Addressing the inequities in Indigenous health requires a determinant of health approach (Mitrou et al., 2014), as 39% of the gap in health outcomes can be explained by social determinates (AIHW, 2017; Markwick, Ansari, Sullivan, Parsons, & McNeil, 2014). The social determinant considered to most reliably predict Indigenous poor health is racism (Kelaher, Ferdinand, & Paradies, 2014; Paradies, 2006; Paradies & Cunningham, 2009; Paradies et al., 2015; Paradies, Truong, & Priest, 2014)

The Mutant Form of Lamin A that Causes Hutchinson-Gilford Progeria Is a Biomarker of Cellular Aging in Human Skin

Hutchinson-Gilford progeria syndrome (HGPS, OMIM 176670) is a rare disorder characterized by accelerated aging and early death, frequently from stroke or coronary artery disease. 90% of HGPS cases carry the LMNA G608G (GGC>GGT) mutation within exon 11 of LMNA, activating a splice donor site that results in production of a dominant negative form of lamin A protein, denoted progerin. Screening 150 skin biopsies from unaffected individuals (newborn to 97 years) showed that a similar splicing event occurs in vivo at a low level in the skin at all ages. While progerin mRNA remains low, the protein accumulates in the skin with age in a subset of dermal fibroblasts and in a few terminally differentiated keratinocytes. Progerin-positive fibroblasts localize near the basement membrane and in the papillary dermis of young adult skin; however, their numbers increase and their distribution reaches the deep reticular dermis in elderly skin. Our findings demonstrate that progerin expression is a biomarker of normal cellular aging and may potentially be linked to terminal differentiation and senescence in elderly individuals

Conflict in the Indian Kashmir Valley II: psychosocial impact

ABSTRACT: BACKGROUND: India and Pakistan have disputed ownership of the Kashmir Valley region for many years, resulting in high level of exposure to violence among the civilian population of Kashmir (India). A survey was done as part of routine programme evaluation to assess confrontation with violence and its consequences on mental health, health service usage, and socio-economic functioning. METHODS: We undertook a two-stage cluster household survey in two districts of Kashmir (India) using questionnaires adapted from other conflict areas. Analysis was stratified for gender. RESULTS: Over one-third of respondents (n=510) were found to have symptoms of psychological distress (33.3%, CI: 28.3-38.4); women scored significantly higher (OR 2.5; CI: 1.7-3.6). A third of respondents had contemplated suicide (33.3%, CI: 28.3-38.4). Feelings of insecurity were associated with higher levels of psychological distress for both genders (males: OR 2.4, CI: 1.3-4.4; females: OR 1.9, CI: 1.1-3.3). Among males, violation of modesty, (OR 3.3, CI: 1.6-6.8), forced displacement, (OR 3.5, CI: 1.7-7.1), and physical disability resulting from violence (OR 2.7, CI: 1.2-5.9) were associated with greater levels of psychological distress; for women, risk factors for psychological distress included dependency on others for daily living (OR 2.4, CI: 1.3-4.8), the witnessing of killing (OR 1.9, CI: 1.1-3.4), and torture (OR 2.1, CI: 1.2-3.7). Self-rated poor health (male: OR 4.4, CI: 2.4-8.1; female: OR 3.4, CI: 2.0-5.8) and being unable to work (male: OR 6.7, CI: 3.5-13.0; female: OR 2.6, CI: 1.5-4.4) were associated with mental distress. CONCLUSIONS: The ongoing conflict exacts a huge toll on the communities' mental well-being. We found high levels of psychological distress that impacts on daily life and places a burden on the health system. Ongoing feelings of personal vulnerability (not feeling safe) were associated with high levels of psychological distress. Community mental health programmes should be considered as a way reduce the pressure on the health system and improve socio-economic functioning of those suffering from mental health problems

Health, ageing and private health insurance: baseline results from the 45 and Up Study cohort

Correction to Banks E, Jorm L, Lujic S, Rogers K. Health, ageing and private health insurance: baseline results from the 45 and Up Study cohort. ANZ Health Policy 2009; 6: 16