Differences in psychosocial distress among rural and metropolitan health care workers during the COVID-19 pandemic

Objective The Australian COVID-19 Frontline Healthcare Workers study examined the prevalence and severity of mental health symptoms during the second wave of the COVID-19 pandemic. This substudy examined the differences in psychological well-being between rural and metropolitan health care workers (HCWs). Design A nationwide survey conducted between August and October 2020. Setting and Participants Australian HCWs were recruited through multiple strategies. Main outcome measures Demographics, mental health outcomes (anxiety, depression, post-traumatic stress disorder [PTSD] and burnout). Results Complete responses were included from 7846 participants, with 1473 (18.8%) in regional or remote (‘rural’) areas and 81.2% in metropolitan areas. Rural participants were older, more likely to work in allied health, nursing or in health administration, and had worked longer in their profession than metropolitan participants. Levels of resilience were similar (p = 0.132), but there was significantly higher prevalence of pre-COVID-19 pandemic mental illness in the rural workforce (p < 0.001). There were high levels of current mental health issues: moderate–severe PTSD (rural 38.0%; metropolitan 41.0% p = 0.031); high depersonalisation (rural 18.1%; metropolitan 20.7% p = 0.047); and high emotional exhaustion (rural 46.5%; metropolitan 43.3% p = 0.002). Among rural participants, mental health symptoms were associated with younger age, worry about being blamed if they contracted COVID-19, fear of transmitting COVID-19 to their family, experiencing worsening relationships and working in primary care or allied health. Conclusion Despite having low COVID-19 case numbers in rural Australian health services compared with metropolitan counterparts over the course of 2020, there were widespread mental health impacts on the workforce. Rural health services need specific and flexible training, education, work policies and practices that support psychological well-being now in preparedness for ongoing or future crises

Improving traffic-related air pollution estimates by modelling minor road traffic volumes

Accurately estimating annual average daily traffic (AADT) on minor roads is essential for assessing traffic-related air pollution (TRAP) exposure, particularly in areas where most people live. Our study assessed the direct and indirect external validity of three methods used to estimate AADT on minor roads in Melbourne, Australia. We estimated the minor road AADT using a fixed-value approach (assuming 600 vehicles/day) and linear and negative binomial (NB) models. The models were generated using road type, road importance index, AADT and distance of the nearest major road, population density, workplace density, and weighted road density. External measurements of traffic counts, as well as black carbon (BC) and ultrafine particles (UFP), were conducted at 201 sites for direct and indirect validation, respectively. Statistical tests included Akaike information criterion (AIC) to compare models’ performance, the concordance correlation coefficient (CCC) for direct validation, and Spearman’s correlation coefficient for indirect validation. Results show that 88.5% of the roads in Melbourne are minor, yet only 18.9% have AADT. The performance assessment of minor road models indicated comparable performance for both models (AIC of 1,023,686 vs. 1,058,502). In the direct validation with external traffic measurements, there was no difference between the three methods for overall minor roads. However, for minor roads within residential areas, CCC (95% confidence interval [CI]) values were − 0.001 (− 0.17; 0.18), 0.47 (0.32; 0.60), and 0.29 (0.18; 0.39) for the fixed-value approach, the linear model, and the NB model, respectively. In the indirect validation, we found differences only on UFP where the Spearman’s correlation (95% CI) for both models and fixed-value approach were 0.50 (0.37; 0.62) and 0.34 (0.19; 0.48), respectively. In conclusion, our linear model outperformed the fixed-value approach when compared against traffic and TRAP measurements. The methodology followed in this study is relevant to locations with incomplete minor road AADT data

Improving traffic-related air pollution estimates by modelling minor road traffic volumes

Accurately estimating annual average daily traffic (AADT) on minor roads is essential for assessing traffic-related air pollution (TRAP) exposure, particularly in areas where most people live. Our study assessed the direct and indirect external validity of three methods used to estimate AADT on minor roads in Melbourne, Australia. We estimated the minor road AADT using a fixed-value approach (assuming 600 vehicles/day) and linear and negative binomial (NB) models. The models were generated using road type, road importance index, AADT and distance of the nearest major road, population density, workplace density, and weighted road density. External measurements of traffic counts, as well as black carbon (BC) and ultrafine particles (UFP), were conducted at 201 sites for direct and indirect validation, respectively. Statistical tests included Akaike information criterion (AIC) to compare models' performance, the concordance correlation coefficient (CCC) for direct validation, and Spearman's correlation coefficient for indirect validation. Results show that 88.5% of the roads in Melbourne are minor, yet only 18.9% have AADT. The performance assessment of minor road models indicated comparable performance for both models (AIC of 1,023,686 vs. 1,058,502). In the direct validation with external traffic measurements, there was no difference between the three methods for overall minor roads. However, for minor roads within residential areas, CCC (95% confidence interval [CI]) values were -0.001 (-0.17; 0.18), 0.47 (0.32; 0.60), and 0.29 (0.18; 0.39) for the fixed-value approach, the linear model, and the NB model, respectively. In the indirect validation, we found differences only on UFP where the Spearman's correlation (95% CI) for both models and fixed-value approach were 0.50 (0.37; 0.62) and 0.34 (0.19; 0.48), respectively. In conclusion, our linear model outperformed the fixed-value approach when compared against traffic and TRAP measurements. The methodology followed in this study is relevant to locations with incomplete minor road AADT data

Breastfeeding and the risk of dental caries: a systematic review and meta-analysis

Aim To synthesise the current evidence for the associations between breastfeeding and dental caries, with respect to specific windows of early childhood caries risk. Methods Systematic review, meta-analyses and narrative synthesis following searches of PubMed, CINAHL and EMBASE databases. Results Sixty-three papers included. Children exposed to longer versus shorter duration of breastfeeding up to age 12 months (more versus less breastfeeding), had a reduced risk of caries (OR 0.50; 95%CI 0.25, 0.99, I2 86.8%). Children breastfed > 12 months had an increased riskof caries when compared with children breastfed 12 months, those fed nocturnally or more frequently had afurther increased caries risk (five studies, OR 7.14; 3.14, 16.23, I2 77.1%). There was a lack of studies on children aged > 12 months simultaneously assessing caries risk in breastfed, bottle-fed and children not bottle or breastfed, alongside specific breastfeeding practices, consuming sweet drinks and foods, and oral hygiene practices limiting our ability to tease out the risks attributable to each. Conclusion Breastfeeding in infancy may protect against dental caries. Further research needed to understand the increased risk of caries in children breastfed after 12 month

Associations between Traffic-Related Air Pollution and Cognitive Function in Australian Urban Settings: The Moderating Role of Diabetes Status

Traffic-related air pollution (TRAP) is associated with lower cognitive function and diabetes in older adults, but little is known about whether diabetes status moderates the impact of TRAP on older adult cognitive function. We analysed cross-sectional data from 4141 adults who participated in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study in 2011–2012. TRAP exposure was estimated using major and minor road density within multiple residential buffers. Cognitive function was assessed with validated psychometric scales, including: California Verbal Learning Test (memory) and Symbol–Digit Modalities Test (processing speed). Diabetes status was measured using oral glucose tolerance tests. We observed positive associations of some total road density measures with memory but not processing speed. Minor road density was not associated with cognitive function, while major road density showed positive associations with memory and processing speed among larger buffers. Within a 300 m buffer, the relationship between TRAP and memory tended to be positive in controls (β = 0.005; p = 0.062), but negative in people with diabetes (β = −0.013; p = 0.026) and negatively associated with processing speed in people with diabetes only (β = −0.047; p = 0.059). Increased TRAP exposure may be positively associated with cognitive function among urban-dwelling people, but this benefit may not extend to those with diabetes

Boganmeldelser

Intet resum

Greenspace and Atopic Sensitization in Children and Adolescents-A Systematic Review

In the last decade, studies investigating greenspace have highlighted several benefits to human health. However, the effect of greenspace on allergies and atopic sensitization in children was not clear. While several studies have investigated this link, the evidence has not been systematically synthesized. We conducted a systematic search of eight databases. Study characteristics and findings were extracted from five articles covering 11 cohorts published between 2012 and 2016, and study quality assessments were performed. Due to significant heterogeneity, meta-analysis was not conducted. Findings were not consistent, possibly due to variations in exposure measurements, study populations and location, the specific allergens tested, and inclusion of confounders. Protective effects from greenspace were reported in four cohorts, while two cohorts showed an increase in sensitization related to greenspace. The other five cohorts found no significant effect of greenspace on atopic sensitization. There is limited understanding of the contributions of greenspace to specific allergens. Future research should consider amount and type of greenspace, as well as the specific allergens tested

Satori 2018

The Satori is a student literary publication that expresses the artistic spirit of the students of Winona State University. Student poetry, prose, and graphic art are published in the Satori every spring since 1970. The Satori 2018 editors are Sajda Omar (Editor-in-Chief), Kylie Hoff, Keyanna Hultman, Audrey Sitte, Elyse Hoffmann. Art Director and Designer by Elyse Hoffmann. The 2018 Faculty advisor is Dr. Elizabeth Oness, Professor of English.https://openriver.winona.edu/satori/1012/thumbnail.jp

Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

BACKGROUND: Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. METHODS/DESIGN: The evaluation framework aims to examine the health service over a six-year period in terms of: (a) Structural domains (health service performance; sustainability; and quality of care); (b) Process domains (health service utilisation and satisfaction); and (c) Outcome domains (health behaviours, health outcomes and community viability). Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. DISCUSSION: This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how; what benefits have been realised and for whom; the level of community satisfaction with the service; and the impact of a health service on community viability. While the need to reduce the rural-urban health service disparity in Australia is pressing, the evidence regarding how to move forward is inadequate. This comprehensive evaluation will add significant new knowledge regarding the characteristics associated with a sustainable rural primary health care service