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  • Publication
    Journal Article
    Suspected exertional heat stroke; A case study of worker cooling in a hot and humid field environment.
    (2024-07-04)
    Rogerson, Shane
    ;
    Brearley, Matt
    In the event of a severe occupational heat-related illness, paramedic assistance may not be immediately available. A worker's survival may depend on their co-workers access to efficacious field-based cooling modalities. One cooling method that has been claimed to be practical in field-based settings is the ice towel method.This case study assessed the practicality of the ice towel method in an industrial setting, where criteria for use include cost effectiveness, portability, scalability, and implementation by a single worker under the stress of an emergency.This case study describes the emergency application of the ice towel method while awaiting paramedics, for a worker suffering suspected exertional heat stroke on a remote job site.Ice towels were able to be transported to a remote field site and applied successfully by a single worker under the stress of a potentially life-threatening emergency.The ice towel method was cost effective, scalable, transportable, and rapidly applied in a field-based emergency. This case study demonstrates the importance of organizations assessing their heat-related risks, and determining controls based upon their efficacy and practicality for their unique setting.
  • Publication
    Journal Article
    Decomposing the gaps in healthy and unhealthy life expectancies between Indigenous and non-Indigenous Australians: a burden of disease and injury study.
    The gaps in healthy life expectancy (HLE) between Indigenous and non-Indigenous Australians are significant. Detailed and accurate information is required to develop strategies that will close these health disparities. This paper aims to quantify and compare the causes and their relative contributions to the life expectancy (LE) gaps between the Indigenous and non-Indigenous population in the Northern Territory (NT), Australia.The age-cause decomposition was used to analyse the differences in HLE and unhealthy life expectancy (ULE), where LE = HLE + ULE. The data was sourced from the burden of disease and injury study in the NT between 2014 and 2018.In 2014-2018, the HLE at birth in the NT Indigenous population was estimated at 43.3 years in males and 41.4 years in females, 26.5 and 33.5 years shorter than the non-Indigenous population. This gap approximately doubled the LE gap (14.0 years in males, 16.6 years in females) at birth. In contrast to LE and HLE, ULE at birth was longer in the Indigenous than non-Indigenous population. The leading causes of the ULE gap at birth were endocrine conditions (explaining 2.9-4.4 years, 23-26%), followed by mental conditions in males and musculoskeletal conditions in females (1.92 and 1.94 years, 15% and 12% respectively), markedly different from the causes of the LE gap (cardiovascular disease, cancers and unintentional injury).The ULE estimates offer valuable insights into the patterns of morbidity particularly useful in terms of primary and secondary prevention.
  • Publication
    Journal Article
    Tracking trends in the Top End: clindamycin and erythromycin resistance in Group A Streptococcus in the Northern Territory, 2012-2023.
    This retrospective study reviewed the macrolide resistance rates of Group A Streptococcus (GAS) isolates in the Northern Territory from 2012 to 2023. Clindamycin and erythromycin resistance rates peaked in 2021, at 6.0% and 12.2% respectively, and then returned to near baseline at 1-2% in 2023. Increased resistance rates were identified in the Top End of Australia from mid-2020, followed 15 months later by high rates in central Australia in 2022. Factors associated with resistant isolates were living in a rural region and of age 18 years and older. Possible explanations include a transient clonal introduction of a resistant GAS strain to the Northern Territory from 2020 to 2022. Ongoing surveillance is required to monitor regional trends and identify temporal variations in resistant isolates.
  • Publication
    Journal Article
    High level of genomic divergence in orf-I p12 and hbz genes of HTLV-1 subtype-C in Central Australia.
    (2024-07-17)
    Hirons, Ashley
    ;
    Yurick, David
    ;
    Jansz, Natasha
    ;
    Ellenberg, Paula
    ;
    Franchini, Genoveffa
    ;
    ;
    Khoury, Georges
    ;
    Purcell, Damian F J
    Human T cell lymphotropic virus type 1 (HTLV-1) infection remains a largely neglected public health problem, particularly in resource-poor areas with high burden of communicable and non-communicable diseases, such as some remote populations in Central Australia where an estimated 37% of adults are infected with HTLV-1. Most of our understanding of HTLV-1 infection comes from studies of the globally spread subtype-A (HTLV-1a), with few molecular studies reported with the Austral-Melanesian subtype-C (HTLV-1c) predominant in the Indo-Pacific and Oceania regions.Using a primer walking strategy and direct sequencing, we constructed HTLV-1c genomic consensus sequences from 22 First Nations participants living with HTLV-1c in Central Australia. Phylogenetic and pairwise analysis of this subtype-C proviral gDNA showed higher levels of genomic divergence in comparison to previously published HTLV-1a genomes. While the overall genomic homology between subtypes was 92.5%, the lowest nucleotide and amino acid sequence identity occurred near the 3' end of the proviral genome coding regulatory genes, especially overlapping hbz (85.37%, 77.46%, respectively) and orf-I product p12 (82.00%, 70.30%, respectively). Strikingly, the HTLV-1c genomic consensus sequences uniformly showed a defective translation start codon for the immune regulatory proteins p12/p8 encoded by the HTLV-1A orf-I. Deletions in the proviral genome were detected in many subjects, particularly in the structural gag, pol and env genes. Similarly, using a droplet digital PCR assay measuring the copies of gag and tax per reference host genome, we quantitatively confirmed that provirus retains the tax gene region at higher levels than gag.Our genomic analysis of HTLV-1c in Central Australia in conjunction with earlier Melanesian HTLV-1c sequences, elucidate substantial differences with respect to the globally spread HTLV-1a. Future studies should address the impact these genomic differences have on infection and the regionally distinctive frequency of associated pulmonary disease. Understanding the host and virus subtype factors which contribute to the differential morbidity observed, is crucial for the development of much needed therapeutics and vaccine strategies against this highly endemic infection in remote First Nations communities in Central Australia.
  • Publication
    Journal Article
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