The epidemiology of the first wave of H1N1 influenza pandemic in Australia : a population-based study

Objectives: Following the recent H1N1 influenza pandemic we were able to describe seropositivity in a repre-sentative sample of adults prior to the availability of a specific vaccine.Methods: This cross-sectional serological study is set in the Barwon Statistical Division, Australia. Blood samples were collected from September 2009 through to May 2010, from 1184 individuals (569 men, 615 women; median age 61.7 years), randomly selected from electoral rolls. Serum was analysed for specific H1N1 immunity using a haemagglutina-tion inhibition test. A self-report provided information about symptoms, demographics and healthcare. Associations be-tween H1N1 infection, gender, households and occupation were determined using logistic regression, adjusting for age.Results: Of 1184 individuals, 129 (58 men, 71 women) were seropositive. Gender-adjusted age-specific prevalence was: 8.3% 20-29 years, 13.5% 30-39, 10.4% 40-49, 6.5% 50-59, 9.7% 60-69, 10.3% 70-79, 18.8% 80+. Standardised preva-lence was 10.3% (95%CI 9.6-11.0). No associations were detected between seropositivity and gender (OR=0.82, 95%CI 0.57-1.19) or being a healthcare worker (OR=1.43, 95%CI 0.62-3.29). Smokers (OR=1.86, 95%CI 1.09-3.15) and those socioeconomically disadvantaged (OR=2.52, 95%CI 1.24-5.13) were at increased risk. Among 129 seropositive individu-als, 31 reported symptoms that were either mild (n = 13) or moderate (time off work, doctor visit, n = 18). For age &lt;60, 39.6% of seropositive individuals reported symptoms, whereas the proportion was 13.2% for age 60+.Conclusions: Following the pandemic, the proportion of seropositive adults was low, but significant subclinical infection was found. Social disadvantage increased the likelihood of infection. The low symptom rate for older ages may relate to pre-existing immunity.<br /

Research Review: Changes in the prevalence and symptom severity of child posttraumatic stress disorder in the year following trauma – a meta-analytic study

Objective: Understanding the natural course of child and adolescent posttraumatic stress disorder (PTSD) has significant implications for the identification of, and intervention for, at-risk youth. We used a meta-analytic approach to examine longitudinal changes in youth PTSD prevalence and symptoms over the first 12 months posttrauma. Methods: We conducted a systematic review to identify longitudinal studies of PTSD in young people (5–18 years old), excluding treatment trials. The search yielded 27 peer-reviewed studies and one unpublished dataset for analysis of pooled prevalence estimates, relative prevalence reduction and standardised mean symptom change. Key moderators were also explored, including age, proportion of boys in the sample, initial prevalence of PTSD and PTSD measurement type. Results: Analyses demonstrated moderate declines in PTSD prevalence and symptom severity over the first 3–6 months posttrauma. From 1 to 6 months posttrauma, the prevalence of PTSD reduced by approximately 50%. Symptoms also showed moderate decline, particularly across the first 3 months posttrauma. There was little evidence of further change in prevalence or symptom severity after 6 months, suggesting that it is unlikely a child would lose a PTSD diagnosis without intervention beyond this point. Conclusions: The current findings provide key information about the likelihood of posttrauma recovery in the absence of intervention and have important implications for our understanding of child and adolescent PTSD. Results are discussed with reference to the timing of PTSD screening and the potential role of early interventions. Findings particularly highlight the importance of future research to develop our understanding of what factors prevent the action of normal recovery from the ‘acute’ posttrauma period

Morbid obesity in women on the rise : an observational, population-based study

Background The obesity epidemic is generally monitored by the proportion of the population whose body mass index (BMI) exceeds 30 kg/m2 but this masks the growing proportion of those who are morbidly obese. This issue is important as the adverse health risks amplify as the level of obesity increases. The aim of this study was to determine how the prevalence of morbid obesity (BMI &gt;= 40.0 kg/m2) has changed over a decade among women living in south-eastern Australia.Methods BMI was determined for women in the Geelong Osteoporosis study (GOS) during two time periods, a decade apart. Height and weight were measured for 1,494 women (aged 20--94 years) during 1993--7 and for 1,076 women (aged 20--93 years), 2004--8, and the BMI calculated as weight in kilograms divided by the square of the height in metres (kg/m2). Prevalence estimates were age-standardised to enable direct comparisons.Results Mean BMI increased from 26.0 kg/m2 (95%CI 25.7-26.3) in 1993--7, to 27.1 kg/m2 (95%CI 26.8-27.4) in 2004--8. During this period, the prevalence of morbid obesity increased from 2.5% to 4.2% and the standardised morbidity ratio for morbid obesity was 1.69 (95%CI 1.26-2.27). Increases in mean BMI and prevalence of morbid obesity were observed for all ages and across the socioeconomic spectrum.Conclusions These findings reveal that over a decade, there has been an increase in mean BMI among women residing in south-eastern Australia, resulting in a measurable increase in the prevalence of morbid obesity.<br /

The neural correlates of emotion processing in juvenile offenders

Individuals with severe antisocial behaviour often demonstrate abnormalities or difficulties in emotion processing. Antisocial behaviour typically onsets before adulthood and is reflected in antisocial individuals at the biological level. We therefore conducted a brain-based study of emotion processing in juvenile offenders. Male adolescent offenders and age-matched non-offenders passively viewed emotional images whilst their brain activity was recorded using electroencephalography. The early posterior negativity (EPN) and the late positive potential (LPP) components were used as indices of emotion processing. For both juvenile offenders and non-offenders, the EPN differentiated unpleasant images from other image types, suggesting that early perceptual processing was not impaired in the offender group. In line with normal emotion processing, the LPP was significantly enhanced following unpleasant images for non-offenders. However, for juvenile offenders, the LPP did not differ across image categories, indicative of deficient emotional processing. The findings indicated that this brain-based hypo-reactivity occurred during a late stage of cognitive processing and was not a consequence of atypical early visual attention or perception. This study is the first to show attenuated emotion processing in juvenile offenders at the neural level. Overall, these results have the potential to inform interventions for juvenile offending

Sex-differences in reasons for non-participation at recruitment : Geelong Osteoporosis Study

Background : Understanding reasons for non-participation in health studies can help guide recruitment strategies and inform researchers about potential sources of bias in their study sample. Whilst there is a paucity of literature regarding this issue, it remains highly plausible that men and women may have varied reasons for declining an invitation to participate in research. We aimed to investigate sex-differences in the reasons for non-participation at baseline of the Geelong Osteoporosis Study (GOS). Methods : The GOS, a prospective cohort study, randomly recruited men and women aged 20 years and over from a region in south-eastern Australia using Commonwealth electoral rolls (2001&ndash;06 and 1993&ndash;97, respectively). Reasons for non-participation (n=1,200) were documented during the two recruitment periods. We used the Pearson&rsquo;s chi squared test to explore differences in the reasons for non-participation between men and women. Results : Non-participation in the male cohort was greater than in the female cohort (32.9% vs. 22.9%; p&lt;0.001). Overall, there were sex-differences in the reasons provided for non-participation (p&lt;0.001); apparent differences related to time constraints (men 26.3% vs. women 10.4%), frailty/inability to cope with or understand the study (men 18.7% vs. women 30.6%), and reluctance over medical testing (men 1.1% vs women 9.9%). No sex-differences were observed for non-participation related to personal reason/disinterest, and language- or travel-related reasons. Conclusions : Improving participation rates in epidemiological studies may require different recruitment strategies for men and women in order to address sex-specific concerns about participating in research

Socioeconomic status, obesity and lifestyle in men : the Geelong Osteoporosis Study

Background : Although the association between lower socioeconomic status (SES) and obesity in women in developed countries is well-documented, current evidence regarding the relationship between obesity in men and area-based SES (equivalised for advantage and disadvantage) is inconsistent. Therefore, we aimed to examine obesity, lifestyle behaviours, physical activity in different domains and demographics in men using area-based SES.Methods : We performed a descriptive cross-sectional study of 1467 randomly selected white men (mean age 56 year (inter-quartile range (IQR) = 39&ndash;73 year)) recruited from the Barwon Statistical Division, South Western Victoria, Australia between 2001&ndash;06.Results : Age-adjusted BMI, waist circumference, % fat and lean mass and blood pressure were inversely associated with SES, with differences between low and upper SES (P for difference &lt;0.05), independent of country of birth. Age-adjusted lifestyle behaviours associated with obesity and/or adverse health (especially cardiovascular disease), were also associated with lower SES.Conclusions : Subjects from lower SES had greater measures of obesity despite being more physically active at work, but were less likely to be physically active in the domains of sports and/or leisure. These findings suggest the possible influence of lifestyle behaviours and occupation upon obesity in men and should be investigated further.<br /

Gastro oesophageal reflux disease (GORD)-related symptoms and its association with mood and anxiety disorders and psychological symptomology: a population-based study in women

Background: Psychopathology seems to play a role in reflux pathogenesis and vice versa, yet few population based studies have systematically investigated the association between gastro-oesophageal reflux disease (GORD) and psychopathology. We thus aimed to investigate the relationship between GORD-related symptoms and psychological symptomatology, as well as clinically diagnosed mood and anxiety disorders in a randomly selected, population-based sample of adult women.&nbsp;Methods:&nbsp;This study examined data collected from 1084 women aged 20-93 yr participating in the Geelong&nbsp;Osteoporosis Study. Mood and anxiety disorders were identified using the Structured Clinical Interview for DSM-IVTR Research Version, Non-patient edition (SCID-I/NP), and psychological symptomatology was assessed using the&nbsp;General Health Questionnaire (GHQ-12). GORD-related symptoms were self-reported and confirmed by medication&nbsp;use where possible and lifestyle factors were documented.Results: Current psychological symptomatology and mood disorder were associated with increased odds of&nbsp;concurrent GORD-related symptoms (adjusted OR 2.1, 95% CI 1.3-3.5, and OR 3.0, 95% CI 1.7-5.6, respectively). Current&nbsp;anxiety disorder also tended to be associated with increased odds of current GORD-related symptoms (p=0.1).&nbsp;Lifetime mood disorder was associated with a 1.6-fold increased odds of lifetime GORD-related symptoms (adjusted OR&nbsp;1.6, 95% CI 1.1-2.4) and lifetime anxiety disorder was associated with a 4-fold increased odds of lifetime GORD- related&nbsp;symptoms in obese but not non-obese participants (obese, age-adjusted OR 4.0, 95% CI 1.8-9.0).Conclusions: These results indicate that psychological symptomatology, mood and anxiety disorders are positively&nbsp;associated with GORD-related symptoms. Acknowledging this common comorbidity may facilitate recognition and&nbsp;treatment, and opens new questions as to the pathways and mechanisms of the association.</div