http://localhost:8080/xmlui/handle/123456789/5733 2026-04-09T23:16:54Z http://localhost:8080/xmlui/handle/123456789/5756 Title: Population vulnerability to heat: A case crossover analysis of heat health alerts and hospital morbidity data in Victoria, Australia Authors: N. Thomson, Tilda; Rupasinghe, Rayiky; Hennessy, Daneeta Abstract: Population vulnerability to heat: A case crossover analysis of heat health alerts and hospital morbidity data in Victoria, Australia Tilda N. Thomson,1,2, * Rayiky Rupasinghe,2 Daneeta Hennessy,2 Marion Easton,2 Tony Stewart,1 Vanora Mulvenna2 1 National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia 2 Public Health Division, Victorian Department of Health, Melbourne, Australia Submitted: 19 May 2023; Revision requested: 21 August 2023; Accepted: 5 September 2023 Abstract Objective: From 2010 to 2022, the Victorian Department of Health operated a heat health alert system. We explored whether changes to morbidity occurred during or directly after these alerts, and how this differed for certain population groups. Methods: We used a space-time-stratified case-crossover design and conditional logistic regression to examine the associations between heat health alerts and heat-related and all-cause emergency department (ED) presentations and hospital admissions at the state-wide level, with models created for the whole population and subgroups. Data were included for the warm season (November-March) from 2014 to 2021. Results: Increases occurred in heat-related ED presentations (OR 1.73, 95% CI: 1.53-1.96) and heat-related hospital admissions (OR 1.23, 95% CI: 1.16-1.30) on days on or after heat health alerts. Effect sizes were largest for those 65 years and older, Aboriginal and Torres Strait Islander people, and those living in the most disadvantaged areas. Conclusions: We confirm that increases in morbidity occurred in Victoria during heat health alerts and describe which population groups are more likely to require healthcare in a hospital. Implications for Public Health: These findings can inform responses before and during periods of extreme heat, data-driven adaptation strategies, and the development of heat health surveillance systems. Key words: environmental epidemiology, heat-related illness, case-crossover study, extreme heat 2023-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/5755 Title: Evaluation outcomes of a Western Australian campaign designed to reduce alcohol use in pregnancy Authors: Pettigrew, Simone; Booth, Leon; McCausland, Tahnee Abstract: Evaluation outcomes of a Western Australian campaign designed to reduce alcohol use in pregnancy Simone Pettigrew,1, * Leon Booth,1 Tahnee McCausland,2 Kelly Kennington,2 Danica Keric3 1 The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia 2 Mental Health Commission, Western Australian Government, Perth, Western Australia, Australia 3 Cancer Council Western Australia, Perth, Western Australia, Australia Submitted: 22 June 2023; Revision requested: 28 August 2023; Accepted: 4 October 2023 Abstract Objective: To assess (i) the effectiveness of a mass media campaign communicating the potential harms associated with consuming even small amounts of alcohol in pregnancy and (ii) changes in females’ intentions to abstain during pregnancy after campaign exposure. Methods: Independent samples of ∼400 Western Australian adults (18-45 years) were recruited at two time points (before and after the ‘One Drink’ campaign) to complete online surveys. Attitudinal and behavioural intention outcomes were assessed at both time points. Descriptive analyses and generalised linear models were used to assess outcomes. Results: Three-quarters (76%) of the post-campaign sample members reported awareness of the campaign. In the descriptive analyses there were significant improvements in three of the seven attitudinal items. The regression models yielded significant increases in agreement that pregnant women should not drink alcohol (assessed among females and males) and intentions to abstain during pregnancy (assessed among females only). Conclusions: The results indicate favourable understanding and behavioural intention effects from exposure to a campaign promoting alcohol abstinence during pregnancy. Implications for public health: This study demonstrates that investment in campaigns warning about alcohol use in pregnancy is likely to be a worthwhile approach to reduce the burden of alcohol-related harms to individuals and society. Key words: alcohol, pregnancy, campaigns, behaviour change 2023-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/5754 Title: Transdisciplinary stakeholder understandings of antimicrobial resistance: An integrative approach in Aotearoa New Zealand Authors: Mitchell Alexandra Macmillan, Sarah; C Morgaine Patricia Priest, Kate Abstract: Transdisciplinary stakeholder understandings of antimicrobial resistance: An integrative approach in Aotearoa New Zealand Sarah Mitchell Alexandra Macmillan,* Kate C Morgaine Patricia Priest Department of Preventive and Social Medicine, University of Otago, New Zealand Submitted: 13 February 2023; Revision requested: 21 August 2023; Accepted: 5 September 2023 Abstract Objective: Antimicrobial resistance (AMR) is a complex public health issue, with a range of influences across human, animal, and environmental health. Given the complexity of the problem, the diversity of stakeholders, and the failure of current policies to curb AMR worldwide, integrative approaches are needed to identify effective actions. Underpinned by systems thinking and One Health principles, this qualitative study explored how diverse AMR experts in Aotearoa New Zealand perceive the main drivers and effects of AMR. Methods: Semi-structured interviews with clinical, academic, policy, community, and industry representatives were designed to elicit mental models of the causes and outcomes of AMR across dimensions. Results: Thematic analysis revealed contrasting understandings of AMR causes across four domains: food-producing animals (livestock), healthcare, community, and environment. AMR was often framed as a problem of individual behaviour, despite many implicit references to underlying structural economic influences. The politics of collaboration was a further major underlying theme. The interviews highlighted fundamental connections between AMR and other complex issues, including poverty and environmental pollution. Implications for public health: This study brings together the understandings of AMR of transdisciplinary stakeholders, providing some immediate insights for policy makers and setting the foundation for developing a collaborative system model of AMR as a basis for decision making. Key words: antimicrobial resistance, antibiotic resistance, New Zealand, qualitative, stakeholders, one health 2023-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/5753 Title: Aboriginal peoples’ lived experience of household overcrowding in the Kimberley and implications for research reciprocity in COVID-19 recovery Authors: Clements, Chicky; Hoy, Christine; Bin-Maarus, Louis Abstract: Aboriginal peoples’ lived experience of household overcrowding in the Kimberley and implications for research reciprocity in COVID-19 recovery Chicky Clements,1 Christine Hoy,2, * Louis Bin-Maarus,3 Sarah Morris,4 Ray Christophers5 1 Bard Man and Senior Aboriginal Environmental Health Supervisor, Nirrumbuk Environmental Health and Services, BROOME, WA, 6725, Australia 2 Bard Woman and General Manager (commencing October 2021), Nirrumbuk Environmental Health and Services, BROOME, WA, 6725, Australia 3 Nyul Nyul Man and Chairman, Nirrumbuk Environmental Health and Services, BROOME, WA, 6725, Australia 4 Non-Indigenous Woman and Previous General Manager (to October 2021), Nirrumbuk Environmental Health and Services, BROOME, WA, 6725, Australia 5 Bard Man and Chief Executive Officer, Nirrumbuk Environmental Health and Services, BROOME, WA, 6725, Australia Submitted: 26 January 2023; Revision requested: 13 October 2023; Accepted: 16 October 2023 Abstract Objective: Household overcrowding was identified early in the COVID-19 pandemic as a risk factor increasing transmission and worsening outcomes. Nirrumbuk Environmental Health and Services designed this project to deepen understanding of Aboriginal peoples’ experiences of overcrowding in social housing. Methods: Our household survey explored overcrowding, capacity to respond to COVID-19 directives and the Canadian National Overcrowding Standard (CNOS). Results: For 219 participating Aboriginal households, usual number of residents per household ranged from 1 to 14, increasing with short- and long-term visitors. 17.8% had occupants who themselves were on waiting lists for their own home. Nearly one-third of houses had three generations under one roof. 53.4% indicated isolation of COVID-19 cases as ‘extremely’ difficult. 33.8% indicated their community could not manage COVID-19 at scale. Overcrowding was defined by interpersonal dynamics or consequences such as plumbing blockages or conflict rather than the number or people or ratio of people to bedrooms. 64.8% welcomed CNOS to determine acceptable and healthy occupancy levels. Participants encouraged research about environmental health in Aboriginal hands. Conclusions: Cultural obligations, poverty and social housing waitlist management impose extreme demand on remote housing. CNOS relevance was endorsed but tempered by lived experience. Implications for Public Health: Aboriginal-led research is directly accountable to communities through reciprocity and kinship. Nirrumbuk has already modified service planning. Key words: aboriginal environmental health, aboriginal-led research, housing, remote public health 2023-01-01T00:00:00Z