http://nova.newcastle.edu.au/vital/access/services/Feed ${session.getAttribute("locale")} 5 http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:10727 Paramedics play a pivotal role in the response to major emergencies. Recent evidence indicates that their confidence and willingness to respond to chemical, biological, radiological, nuclear, and explosives-related (CBRNE) incidents differs from that relating to their ‘‘routine’’ emergency work. To further investigate the factors underpinning their readiness to respond to CBRNE incidents, paramedics in New South Wales (NSW), Australia, were asked to complete a validated online survey instrument. Univariate and multivariate analyses were performed to examine associated factors determining readiness. The sample of 663 respondents was weighted to reflect the NSW paramedic population as a whole. The univariate analysis indicated that gender, length of service, deployment concern, perceived personal resilience, CBRNE training, and incident experience were significantly associated with perceived CBRNE response readiness. In the initial multivariate analysis, significantly higher response readiness was associated with male gender, university education, and greater length of service (10-15 years). In the final multivariate model, the combined effect of training/incident experience negated the significant effects observed in the initial model and, importantly, showed that those with recent training reported higher readiness, irrespective of incident experience. Those with lower concern regarding CBRNE deployment and those with higher personal resilience were significantly more likely to report higher readiness (Adjusted Relative Risk [ARR]¼0.91, 95% CI: 0.84-0.99; ARR¼1.40, 95% CI: 1.11-1.72, respectively). These findings will assist emergency medical planners in recognizing occupational and dispositional factors associated with enhanced CBRNE readiness and highlight the important role of training in redressing potential readiness differences associated with these factors. 2012-05-03T03:01:44.916Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:6941 Background: Adequate nutrition is needed to ensure optimum growth and development of infants and young children. Understanding of the risk factors for stunting and severe stunting among children aged less than five years in North Maluku province is important to guide Indonesian government public health planners to develop nutrition programs and interventions in a post conflict area. The purpose of the current study was to assess the prevalence of and the risk factors associated with stunting and severe stunting among children aged less than five years in North Maluku province of Indonesia. Methods: The health and nutritional status of children aged less than five years was assessed in North Maluku province of Indonesia in 2004 using a cross-sectional multi-stage survey conducted on 750 households from each of the four island groups in North Maluku province. A total of 2168 children aged 0-59 months were used in the analysis. Results: Prevalence of stunting and severe stunting were 29% (95%CI: 26.0-32.2) and 14.1% (95%CI: 11.7-17.0) for children aged 0-23 months and 38.4% (95%CI: 35.9-41.0) and 18.4% (95%CI: 16.1-20.9) for children aged 0-59 months, respectively. After controlling for potential confounders, multivariate analysis revealed that the risk factors for stunted children were child's age in months, male sex and number of family meals per day (≤2 times), for children aged 0-23 months, and income (poorest and middle-class family), child's age in months and male sex for children aged 0-59 months. The risk factors for severe stunting in children aged 0-23 months were income (poorest family), male sex and child's age in months and for children aged 0-59 months were income (poorest family), father's occupation (not working), male sex and child's age in months. Conclusion: Programmes aimed at improving stunting in North Maluku province of Indonesia should focus on children under two years of age, of male sex and from families of low socioeconomic status. 2012-01-30T05:07:05.496Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:7880 Purpose: To assess tobacco, alcohol, cannabis and benzodiazepine use in methadone maintenance treatment (MMT) as potential sources of variability in methadone pharmacokinetics. Methods: Trough plasma (R)- and (S)-methadone concentrations were measured on 77 Australian and 74 Swiss MMT patients with no additional medications other than benzodiazepines. Simple and multiple regression analyses were performed for the primary metric, plasma methadone concentration/dose. Results: Cannabis and methadone dose were significantly associated with lower 24-h plasma (R)- and (S)-methadone concentrations/dose. The models containing these variables explained 14–16% and 17–25% of the variation in (R)- and (S)-methadone concentration/dose, respectively. Analysis of 61 patients using only CYP3A4 metabolised benzodiazepines showed this class to be associated with higher (R)-concentration/dose, which is consistent with a potential competitive inhibition of CYP3A4. Conclusion: Cannabis use and higher methadone doses in MMT could in part be a response to — or a cause of — more rapid methadone clearance. The effects of cannabis and benzodiazepines should be controlled for in future studies on methadone pharmacokinetics in MMT. 2011-06-15T23:40:03.737Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:956 The study aimed to validate the Environmental Distress Scale (EDS), a new index of the bio–psycho–social cost of ecosystem disturbance. Informed by qualitative fieldwork in the open-cut mining area of Australia’s Upper Hunter Valley, the EDS combines dimensions of hazard perception, threat appraisal, felt impact of changes, "solastalgia" (loss of solace), and environmental action. EDS discriminant validity was tested by randomly mailing the instrument to Upper Hunter residents living in a high disturbance open-cut mining area and to a comparable sample in a nearby farming area; 203 respondents returned the survey (41% response rate). As predicted, the high disturbance group had significantly higher environmental distress scores across all six EDS subscales, including solastalgia. Psychometric analyses found the EDS subscales were highly intercorrelated (r = 0.36–0.83), and they demonstrated both strong internal consistency reliability (Cronbach’s alpha = 0.79–0.96) and test–retest reliability (ICC = 0.67–0.73). Descriptively, the high disturbance group experienced greater exposure to dust, landscape changes, vibrations, loss of flora and fauna, and building damage, as well as greater fear of asthma and other physical illnesses due to local pollution. The EDS successfully measured and validated Albrecht’s innovative concept of "solastalgia" — the sense of distress people experience when valued environments are negatively transformed. While the EDS addresses the power and mining industries, it can be adapted as a general tool to appraise the distress arising from people’s lived experience of the desolation of their home and environment. Ideally, it can be used as an aid for those working to ameliorate that distress and restore ecosystem health. 2010-04-27T06:40:35.017Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:4614 Introduction. Use of opiates/opioids is associated with hypoactive sexual desire, erectile and orgasmic dysfunction. Aim. To determine prevalence and investigate etiology of sexual dysfunction in men on methadone or buprenorphine maintenance treatment (MMT, BMT). Main Outcome Measures. International Index of Erectile Function (IIEF), hormone assays, Beck Depression Inventory. Methods. A total of 103 men (mean age 37.6 ± 7.9) on MMT (N = 84) or BMT (N = 19) were evaluated using the IIEF, hormone assays, Beck Depression Inventory, body mass index (BMI), demographic, and other substance use measures. Results. Mean total IIEF scores for partnered men were lower for MMT (50.4 ± 18.2; N = 53) than reference groups (61.4 ± 16.8; N = 415; P < 0.0001) or BMT (61.4 ± 7.0; N = 14; P = 0.048). Among partnered men on MMT, 53% had erectile dysfunction (ED) compared with 24% of reference groups; 26% had moderate to severe ED, 12.1% in under 40s and 40.0% among those 40+ years. On multiple regression, depression, older age, and lower total testosterone were associated with lower IIEF and EF domain; on multivariate analysis, there were no significant associations between IIEF or EF and free testosterone, opioid dose, cannabis or other substance use, viral hepatitis, or BMI. Total testosterone accounted for 16% of IIEF and 15% of EF variance. Men without sexual partners had lower Desire and Erection Confidence scores and less recent sexual activity, suggesting potentially higher prevalence of sexual dysfunction in this group. Conclusion. Men on MMT, but not BMT, have high prevalence of ED, related to hypogonadism and depression. Practitioners should screen for sexual dysfunction in men receiving opioid replacement treatment. Future studies of sexual dysfunction in opioid-treated men should examine the potential benefits of dose reduction, androgen replacement, treatment of depression, and choice of opioid. 2010-04-27T05:10:15.012Z ]]>