This paper reports an investigation of new health problems reported by Queensland residents with a prior history of poliomyelitis. 126 people with a past history of paralytic poliomyelitis were recruited from the waiting list for the trial Post Polio Clinic at Queen Elizabeth II Hospital, Brisbane. A self-administered postal questionnaire was used to examine a number of variables including acute poliomyelitis histories; presence, duration and severity of new symptoms consistent with the late effects of poliomyelitis; changes in functional status between the maximal recovery period and the time of the survey and the impact of post-polio symptoms on lifestyle and employment. The most frequent new symptoms reported were muscle weakness (87 per cent), unusual tiredness (79 per cent), joint pain (79 per cent), muscle pain (61 per cent) and muscle cramps (71 per cent). Subjects reported an increased reliance on assistive devices and a decreased level of independence with activities of daily living, particularly with mobility-related tasks. Eight three per cent of subjects had made lifestyle changes as a result of post-polio symptoms and 67 per cent of those subjects in the workforce reported making changes to their employment, such as reduced hours of work. (author abstract)
This paper provides a reflection on some of the issues that have arisen while teaching two core epidemiology courses in the Masters of Public Health degree at the University of Auckland. One course focuses on public health and the other on clinical health. The courses have common components which could be considered as part of a core in a 'good' epidemiology course. These include measures of disease frequency, measures of effect, study design and bias, sample size, screening and diagnostic tests, meta-analysis and causation. Teaching issues include variable student experience and ability, online versus classroom teaching, and the process for choosing topics for student assignments. The passion and commitment of the teacher to the discipline of epidemiology is most important for a 'good' epidemiology course, and should convey the importance and centrality of epidemiology to the practice of public and clinical health.
The teaching of epidemiology and evidence based practice to undergraduate paramedic students is a relatively recent addition to the curriculum in many paramedic programs. This paper describes our experience teaching epidemiology to undergraduate paramedic students and explores the pedagogical challenges associated with these Units.
Biostatistics 1 is a core unit in the Deakin University Master of Public Health. In 2012 this unit was taught and assessed in a traditional way with formal face-to-face lectures, written assignments and an exam. In 2013 the unit moved to a flipped classroom format and the assessment tasks were revised to have a more authentic focus. This paper is a reflection on the implementation of these changes and the challenges and barriers encountered and an assessment of their impact on students' experience of the unit.
Knowledge of epidemiological and biostatical concepts, and skills to apply the concepts, are essential competencies required of all public health practitioners. Traditionally, in public health degrees epidemiology and biostatistics are taught as separate subjects/courses. However, graduates need to integrate epidemiological and biostatistical knowledge and skills in their public health practice, whether critiquing published papers and other evidence to inform policy, programs and practice; collecting and analysing quantitative data; or designing a research study. Some examples of interrelated core introductory concepts and skills usually taught in either epidemiology or biostatistics core subjects in public health degrees include epidemiological study designs, measures of frequency, association and health impact; descriptive statistics, hypothesis testing and inferential statistics, correct use of statistical tests, sample size calculation, sampling, selection bias, measurement error, confounding, and regression, to name a few.
Background: To examine the feasibility of linking individual records from three siloed health data sources, drawn from Victoria, Australia: data relating to drug and alcohol ambulance attendances, and associated emergency department presentations and hospital admissions. Methods: The cohort for data linkage consisted of all patients attended by ambulance for alcohol- and other drug-related events in metropolitan Melbourne, Victoria, from 01 July 2004 to 30 June 2009. Three population-level administrative datasets were linked using the deterministic approach for matching: ambulance records, emergency department presentations, and hospital admissions. The linkage of these datasets involved a series of processes designed to maximise the number of cases linked and minimise the risk of incorrectly linked unrelated cases. Results: Of the 97,433 drug and alcohol ambulance attendances for the 2004-05 to 2008-09 period, 69,912 (over 70%) of these were reported as being transported to an emergency department. We linked approximately 90% of transported ambulance cases with emergency department data. We then identified 25% of these cases as being admitted to hospital. Conclusion: These results are a cornerstone for future studies examining the pathways of care associated with drug and alcohol ambulance attendances. Exploration of these linked data will provide an excellent opportunity to examine the nature and extent of drug- and alcohol-related harms across acute care settings, and enhance the capability of the available data to identify involvement of alcohol and drugs.
Aims: More than 80,000 induced abortions - or one in four pregnancies - occur in Australia every year. Use of effective contraceptive methods is essential to prevent unintended pregnancy and abortion. The aim of this study was to examine contraceptive use among women who were at risk of unintended pregnancy. Methods: Data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey 2011 were analysed. Women who were fecund, in an intimate relationship and did not intend to have any more children in the next three years or ever were considered to be at risk of unintended pregnancy and were included in the analyses. Logistic regression models were used to identify factors associated with any contraceptive use and by what contraceptive method. Results: Around one in three women aged 18-44 years were at risk of unintended pregnancy (n=1,250; 30%). Of these women, one in six (n=191; 17%; 95% CI: 15-19%) did not use contraception. Women from a non-English speaking background were more likely to not use contraception than those from an English speaking background (OR: 3.8; 95% CI: 2.3-6.2). Women who had no children (OR: 2.4; 95% CI: 1.2-4.6) or had one child (OR 2.6; 95% CI: 1.2-5.3) were more likely to not use contraception than women who had three or more children. Among the 1,059 women who reported using some form of contraception, 138 women (12%) used a long-acting reversible contraceptive, 306 (30%) used a permanent method (e.g. tubal ligation) and 615 (58%) used other methods that were neither long acting nor permanent (e.g. condom). Conclusions: Efforts to promote contraceptive use should focus on women from a non-English speaking background, young women and women with less than three children.
In June 2014, an invited group of experienced teachers of epidemiology from universities in New Zealand and Australia met for two days to talk about teaching epidemiology at the undergraduate and postgraduate levels. This arose out of informal discussions that identified a series of emerging challenges we faced in teaching epidemiology. First, there are practical issues. We are increasingly teaching students who are highly heterogeneous in ability, backgrounds, and professional needs in relation to epidemiological knowledge; and in some cases it is not clear that our teaching of epidemiology meets the professional practice requirements of current students. Second, this heterogeneity combined with limited numbers of students make it difficult to provide classes to suit their diverse needs. For example, numbers of students are generally too small to sustain courses in advanced or specialist epidemiology methods. Third, there is a lack of research on the best pedagogical approaches to teaching epidemiology, and a lack of supporting resources for teachers of epidemiology. Fourth, given numerous recent methodological, technological and conceptual advances in epidemiology, epidemiology teachers are facing challenges about how and when to incorporate these advances, and how to keep up with these concepts and methods.
Behavioural epidemiology in health promotion has been defined as having five phases: establishing links between behaviours and health; developing measures of the behaviour; identifying influences on the behaviour; evaluating interventions to change the behaviour; and translating the research into practice. This article outlines some recent developments in the application of behavioural epidemiology to the issue of sport participation in Australia and its consequential health benefits.
The 1918-19 Spanish influenza was the first pandemic for which official records were compiled in South Australia. This followed the recognition of the disease as notifiable under the Public Health Act and the establishment of a surveillance system by the then South Australia Central Health Board (a precursor to the current South Australian Health Department). This is the first paper to describe the Spanish influenza epidemic for South Australia from an epidemiological and geographical perspective. Notification numbers were retrieved from the South Australian Central Health Board meeting records. Data were entered into an Excel spreadsheet and Epi info 7 software to enable a geographical analysis. There were 8,839 influenza notifications: of these, 4,854 (55.0%) originated from metropolitan areas (Attack Rate 9.9 per 1,000 population) and 3,985 notifications (45.0%) originated from regional areas (Attack Rate 8.0 per 1,000 population). There was a lack of comprehensive epidemiological data due to the still developing surveillance system. This restrained more in-depth analysis of risk factors and geological spread.
Originally, the term sarcopenia (derived from the Greek sarx and penia meaning u0027lack of fleshu0027) was proposed to describe the age-related loss of skeletal muscle mass thought to contribute substantially to functional decline. However, research over the past 25 years has demonstrated that muscle mass is a relatively poor predictor of functional decline compared with muscle strength, and that muscle mass decline during aging may explain less than 10% of strength loss. Disparities in the pathophysiology of muscle mass and strength decline have led some to propose a separate term for muscle strength declines (u0027dynapeniau0027), but in general, sarcopenia is now considered as age-related loss of muscle function in addition to muscle mass. The most widely accepted recent definition was developed by the European Working Group on Sarcopenia in Older People (EWGSOP) which describes sarcopenia as low muscle mass combined with low handgrip strength and/or gait speed.
The website of the Australasian Epidemiological Association cites three main aims of the branch of medical science known as 'epidemiology': to describe patterns of disease in human populations; to identify the causes of diseases (also known as aetiology); and to provide data essential for the management, evaluation and planning of services for the prevention, control and treatment of disease. In veterinary epidemiology our aims are identical to those cited above: the only difference of course is that the word 'human' in item is replaced with 'animal'. Indeed, veterinary epidemiology considers the health states of populations of both human and non-human animals (including mammals, birds, fish and 'small livestock' bees and other farmed insects) which are linked through food and other environmental systems. Veterinary epidemiology is often taught and practiced alongside the discipline of 'veterinary public health' which encompasses the contributions that veterinary science makes to human health.
This study aims to present a new approach towards the analysis of intervention time-series studies in the context of sports-related injury data. We used Victoria-wide hospital admission injury data associated with the sport of Australian football during the period 2006 to 2013. To estimate the state-wide effect of an implemented exercise training intervention that aimed to reduce the number of football-related injuries, time-series analysis was performed using a generalised least square (GLS) method. We show how the GLS method can be used to evaluate the impact of the intervention. Trend and seasonal patterns time series were also assessed using the 'Seasonal and Trend decomposition using Loess' nonparametric seasonal decomposition procedure. The model identified a decreasing trend in the seasonally adjusted number of injuries after the implementation of the intervention in the hospital admission data. The seasonal decomposition plots also indicate strong seasonal patterns in the injury time series.
There have been limited epidemiological studies that delve into injuries sustained during fitness activities, and fewer that have explored injury prevention strategies and evaluated their success. Popular individual and team sports such as athletics, swimming, basketball and various codes of football have enjoyed extensive epidemiological attention for years, and due to the sports' popularity and public profile, will continue to be highly researched areas. Other epidemiological research has focused on sports injuries more generally, or on specific injury types such as concussion, anterior cruciate ligament injury and hamstring injury. According to the Australian Bureau of Statistics' Exercise Recreation and Sport Survey (ERASS), fitness/gym is the second most popular recreation or sport activity participated in by Australians aged 15+ years. Considering the number of people who participate in fitness activities, and the devastating impact that injuries can have on the individual, their family and friends, and society, it is necessary to devote some research to preventing these.
This Round Table on The Epidemiology of Fitness, Sport and Physical Recreation makes for compelling reading. Australia has long been regarded as a sports-mad nation and one that has achieved major international sporting achievements because of its long-term investment in sports medicine and sports science research. Sports spectatorship is also a major pastime in Australia, underpinning the value of using sport to promote a range of health promotion messages (e.g. in relation to tobacco, alcohol, social tolerance and most recently violence prevention). People of all ages now enjoy participating in a wide range of activities from general physical activity to fitness training to cycling to team ball sports such as Australian football to combat sports. All of these feature in papers in this issue.
In order to develop effective strategies to prevent sports injuries, we need to have an understanding of the people and populations who are most at risk of injury as well as the risk factors associated with sustaining injury. Spatial epidemiology is a method used to address questions of when, where, to whom and how health outcomes such as sports injuries occur at a population level, taking into account geographic variation. The aim of this article is to outline the potential application of spatial epidemiology to achieve a better understanding of sports injuries to inform prevention strategies.
