Public Health Commons^™

Cannabinoid Impacts On Ethnic Modulation Of Atrial Septal Defect Prevalence Usa, Albert Stuart Reece, Gary Kenneth Hulse

Research outputs 2022 to 2026

Objective: To conduct a detailed epidemiological exploration of the relative contributions of cannabis and ethnicity to US atrial septal defect (ASD) rates (ASDR). Study design: State-based ASDR data from the US National Births Defects Prevention Network, substance use, income and ethnicity data analyzed in RStudio. Results: Ethnic effects were significant with relative risks amongst African Americans and American Indians and Alaskan Natives of 2·40 (95%C.I. 2·27, 2·54) and 2·31 (2·19, 21·43), Cohen’s D of 1·44 and 1·46 and P values of 2·94 × 10⁻¹⁶⁸ and 3·01 × 10⁻¹⁷² compared to others, respectively. In general, additive models inclusion of …

The Basis For Recommending The Selection Of Samplers In Determining Occupational Exposures To Aerosols, Martin Harper, Pieter Bertier, Marcus Cattani, Karen Galea, Darrah Sleeth, Steven Verpaele

Research outputs 2022 to 2026

Measurements are considered to be the basis of exposure assessments used to determine risks to workers. Inhalation exposure poses the greatest risk for most airborne chemicals, and measurements are based on collecting (sampling) and analyzing air samples. Samplers have been developed for more than 120 years. Each new design has been intended to address flaws perceived in earlier designs. Users are faced with a varied array of samplers from which to choose. Comparisons are difficult to make because tests of sampler performance were not standardized until recently and have not been applied consistently. The existing large body of work does …

The Best Practice Guide For Early Childhood Education And Care Food Environment: Module 5: Sustainable Food Practices (Version 1.0), Ros Sambell, Audrey Elford, Connie N. Ihlein, Lochie Clark, Amanda Devine, Helen Alexiou, Lennie Barblett, Caterina Benati, Fiona Champion, Bek Clancy, Penelope Clark, Kathy Cologon, Wendy Cook, Katie Dix, Kirsty Elliott, Leanne Elliston, Amanda Ferguson, Ricky Gelman, Jodie Gray, Natalie Gulberti, Lorraine Hingston, Karen Krist, Deana Leahy, Rebecca Lindberg, Stacey Mckenzie, Merryn Netting, Ciara O’Flaherty, Asha Rojahn, Blake Stewart, Leah Stuart-Douglas, Aimee Sullivan, Suzanne Tamone, Henry Tan, Sandra Vale, Jill Whelan

Research outputs 2022 to 2026

ECEC food environments are uniquely positioned to support sustainability by implementing practices that can reduce environmental impacts while creating meaningful opportunities for children to experience and explore the interconnections between people, animals, plants, lands and water through food.

The Early Years Learning Framework (EYLF) (Version 2.0) recognises sustainability as an important consideration for children’s learning and development and that educators and children have active roles to play in contributing to more sustainable communities.1 Through the food provided, mealtimes, and food education, ECEC services can provide meaningful opportunities for children to experience and engage with sustainable food practices.

This Sustainable Food …

The Best Practice Guide For Early Childhood Education And Care Food Environment: Module 1: Mealtime Environment And Practices (Version 1.0), Ros Sambell, Audrey Elford, Connie N. Ihlein, Lochie Clark, Amanda Devine, Helen Alexiou, Lennie Barblett, Rebecca Byrne, Fiona Champion, Laine Chilman, Penelope Clark, Kathy Cologon, Wendy Cook, Kirsty Elliott, Leanne Elliston, Amanda Ferguson, Ricky Gelman, Jodie Gray, Natalie Gulberti, Shae Haylen, Judith Howard, Karen Krist, Deana Leahy, Eloise Litterbach, Jodie Mcgough, Stacey Mckenzie, Merryn Netting, Ciara O’Flaherty, Gabrielle Orr, Asha Rojahn, Hilary Smith, Aimee Sullivan, Suzanne Tamone, Henry Tan, Sandra Vale, Jill Whelan, Sally Whitaker

Research outputs 2022 to 2026

Mealtimes in early learning settings are more than a routine to help children eat. They are important opportunities for connection, learning and development, and for supporting children’s confidence and comfort around food and eating. At the same time, services must balance safety, regulatory requirements, diverse developmental and cultural needs, family expectations and practical constraints such as time and staffing.

The Mealtime Environment and Practices (MEP) module has been developed to support Early Childhood Education and Care settings (ECEC), for children from birth to 5 years, to create mealtimes that are safe, calm, inclusive and responsive to each child, while reflecting …

Baseline Body Mass Index Category And Incident Treated Hypertension In Australian Men: A Linked Prospective Cohort Study Using Pbs/Mbs Data, Ebenezer Afrifa-Yamoah

Research outputs 2022 to 2026

Background: Excess adiposity is a major modifiable risk factor for hypertension; however, the incremental prognostic value of body mass index (BMI) beyond standard predictors remains unclear. We examined the associations between baseline BMI category and incident treated hypertension, and assessed whether BMI improved risk prediction.

Methods: Data were obtained from the Ten to Men longitudinal study (2013–2024) linked to Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) records. The cohort comprised 12,742 men aged ≥ 18 years without treated hypertension at baseline, followed for 133,038 person-years. Adjusted Cox proportional hazards models were fitted. Discrimination, calibration, decision curve analysis, E-values, …

Knowledge, Intentions And Attitudes Towards Osteoporosis And Other Health Conditions Among Older Australians, Phuong Dung Lam, Satvinder S. Dhaliwal, Christina M. Pollard, Jonine M. Jancey, Richard L. Prince, Deborah A. Kerr

Research outputs 2022 to 2026

Background: Osteoporosis burden is underdiagnosed and undertreated. While increasing community awareness and education are recognised priorities, research on how older adults view osteoporosis is limited. The aim was to assess osteoporosis-related knowledge, intentions and attitudes in relation to other health conditions in Australian adults aged 50 years and older.

Methods: A validated online questionnaire, developed with an expert panel, was administered to 1432 healthy volunteers, (64.3 ± 9.5 years). The questionnaire assessed knowledge of osteoporosis risk factors, attitudes and intentions. Multivariable logistic regression identified factors associated with low knowledge.

Results: Knowledge score across six topics was 29.5 ± 14.5 (100 …

Machine Learning Prediction Of Incident Hypertension In Australian Men: Integrating Survey, Pharmaceutical And Healthcare Utilisation Data From The Ten To Men Cohort, Ebenezer Afrifa-Yamoah, Emmanuel Peprah-Yamoah, Victor Opoku-Yamoah, Eric Adua

Research outputs 2022 to 2026

Background: Hypertension is a leading modifiable contributor to cardiovascular disease. We developed and evaluated machine learning models to predict incident hypertension in Australian men using baseline survey data linked to pharmaceutical (PBS) and healthcare utilisation (MBS) administrative records from the Ten to Men cohort.

Methods: Among 13,519 men free of hypertension at baseline (2014), incident hypertension over 10 years was ascertained from PBS antihypertensive dispensing. Twenty-five baseline features spanning sociodemographic, anthropometric, lifestyle, clinical and administrative domains were used to train logistic regression, random forest, gradient boosting and XGBoost models, evaluated by five-fold cross-validation with out-of-fold prediction. Discrimination, calibration and threshold-based …

Pharmacist-Led Educational Intervention To Improve Knowledge, Medication Adherence, And Asthma Control Among Asthma Patients At Ayder Comprehensive Specialized Hospital: A Protocol For Randomized Controlled Trial, Mekuriaw Dereje Tekele, Goitom Belay Kassa, Yainu Welegerima Welekidane, Derbew Fikadu Berhe, Abadi Kahsu Gebre, Afewerki Gebremeskel Tsadik

Research outputs 2022 to 2026

Objective: To evaluate the effect of a pharmacist-led educational intervention on medication knowledge, adherence, and asthma control among adult asthma patients at Ayder Comprehensive Specialized Hospital, Ethiopia.

Methods: A single-blind, parallel-group randomized controlled trial will be conducted. All eligible adult asthma patients on active follow-up at the chest clinic of Ayder Comprehensive Specialized Hospital will be included. Participants will be randomly assigned via a computer-generated sequence to an intervention group (structured pharmacist-led education using teach-back, illustrated pamphlets, a follow-up phone call and SMS) or a control group (routine care). Outcome assessors will be blinded to group allocation. Outcomes will be …

Restricting Outdoor Advertising Of Unhealthy Food: Feasibility Of Using A Nutrition Classification System In Australia, Claire E. Pulker, Frith Klug, Georgina S.A. Trapp, Ainslie Sartori, Michelle Mcintosh, Alexia Bivoltsis, Catrina Mcstay, Clare Whitton

Research outputs 2022 to 2026

Objective: Exposure to food advertising is associated with consumption. Globally, most outdoor food advertisements feature unhealthy foods or beverages. As Australian local government areas (LGAs) begin developing restriction policies, the feasibility of applying nutrient-based Nutrition Classification Systems to outdoor advertising requires evaluation.

Design: Observational study on 1) types of food business advertisements outdoors and 2) availability of quantitative nutrition and/or ingredient information for featured products. 178 outdoor advertisements were analysed, from a 500m audit around schools in 16 stratified LGAs (2019), along with bus shelter audits in four LGAs (2022). Advertisements were categorised as featuring ‘branded packaged products’, ‘food service …

A Qualitative Analysis To Identify Implementation Strategies For A Deprescribing Clinical Practice Guideline Using The Cfir-Eric Matching Tool: Perspectives From Consumers And Professional Stakeholders, Hui Wen Quek, Xisco Reus, Kenneth Lee, Veronika Seda, Leon Adams, Osvaldo P. Almeida, Gillian E. Caughey, Jennifer Gowan, Kerryn Hart, Andrew Heredia, Anne Marie Hill, Lisa Kalisch Ellett, Dina Logiudice, Arduino A. Mangoni, Anthony Marinucci, Treasure Mcguire, Nilufeur Mckay, Vasi Naganathan, Christopher Ng, Maz Osborne, Kevan R. Polkinghorne, Constance D. Pond, Sepehr Shakib, Angela Shiu, Andrew Stafford, Tim Whitmore, Christopher Etherton-Beer, Amy Page

Research outputs 2022 to 2026

Introduction: Deprescribing is the planned withdrawal or dose reduction of medicines when harms outweigh benefits or when they are no longer required. Following publication of the Clinical Practice Guideline for Deprescribing in Older People in September 2025, supporting its uptake into routine practice is a critical next step.

Aim: This study aimed to identify implementation strategies, informed by stakeholder-perceived barriers, to support the implementation of deprescribing guidelines.

Method: A qualitative analysis was undertaken of open-text responses collected during the guideline public consultation (24 April–31 May 2025). Inductive thematic analysis identified implementation barriers, which were then deductively mapped to the Consolidated …

The Role Of Participant–Clinician Relationality And Intervention Source In A Violence Reduction Trial: A Qualitative Study, Paul Leslie Simpson, Freya Stephenson, Patricia Morgan, Emaediong I. Akpanekpo, Jocelyn Jones, Peter William Schofield, Lee Knight, Tony Butler

Research outputs 2022 to 2026

Violence and domestic violence are global public health problems with prevention programs showing limited effectiveness. The form of delivery of such programs can influence their utility yet delivery characteristics are often poorly described. We analysed interviews with clinicians (n = 5) and participants (n = 12) involved in ReINVEST, a violence reduction clinical trial, to identify key elements of delivery. Three themes were identified: (1) clinician accessibility; (2) clinicians as participant advocates; and (3) humane care, reflecting participant–clinician ‘relationality’ as a central component of program delivery. We propose that this relationality is more likely to emerge in interventions delivered independently …

Implementation Strategies For Evidence-Based Healthcare Interventions In Rural And Remote Settings: A Scoping Review, Anna Chapman, Cadeyrn J. Gaskin, Hannah Beks, Charlene Wright, Skye Marshall, Elizabeth A. Johnston, Rebecca J. Bergin, Sharina Riva, Fiona Crawford-Williams, Camille E. Short, Nicole Kiss, Sze Lin Yoong, Nicolas H. Hart, Anna Wong Shee, Helena Rodi, Hannah Jongebloed, Anna Ugalde

Research outputs 2022 to 2026

Globally, people living in rural and remote areas experience poorer healthcare access and outcomes than urban populations. Applying implementation strategies that support the translation of evidence-based healthcare interventions may help reduce these inequities; however, real-world implementation is complex, and it remains unclear how strategies are applied and tailored to rural and remote contexts. This scoping review synthesised evidence on implementation strategies for healthcare interventions in rural and remote settings of high-income countries. Five databases (Ovid MEDLINE, Embase, Cochrane CENTRAL, CINAHL, Web of Science) were searched for peer-reviewed studies published between 1/1/2000 and 25/10/2024. Extracted data were synthesised using a descriptive …

Alcohol Advertising At The Beach: Insights From Young People In Western Australia, Renee N. Carey, Gemma Crawford, Nicola D'Orazio, Gina S.A. Trapp, Lauren Nimmo, Tina Lam, Jonine Jancey, Justine E. Leavy

Research outputs 2022 to 2026

Background: Advertising and marketing by the alcohol industry serve to normalise alcohol use, with exposure to alcohol advertising linked to earlier and riskier drinking among young people. Advertising that portrays alcohol use in and around waterways is of particular concern, with one in five fatal drownings being associated with alcohol. Objective: This study aimed to explore the types of alcohol advertising that young people were exposed to, and to determine whether exposure to alcohol advertising was related to their alcohol use in aquatic environments. Methods: We surveyed 102 young people aged 18 to 25 years attending a free event at …

Barriers And Facilitators To Recruiting Older Adult Care Homeresidents Into Clinical Trials Of Medicines And Vaccines: A Scoping Review, Selvarani Subbarayan, Imogen A. Smith-Dodd, Gabriel Nicolson, Jennifer K. Burton, Janet T. Scott, Seshadri S. Vasan, Susan D. Shenkin, Roy L. Soiza, The Watch Consortium

Research outputs 2022 to 2026

Introduction: Excluding Care Home (CH) residents from clinical trials of medicines and vaccines has led to an evidence gap. Findings from younger adults may not be generalisable to CH residents with frailty and dementia. Therefore, it is essential to evaluate pharmacological treatments directly in CH residents to assess their safety and efficacy.

Methods: As part of the Widening Access to Trials in Care Homes project, we conducted a scoping review using Joanna Briggs Institute methodology to identify barriers and facilitators to recruiting CH residents into clinical trials of medicinal products. We searched EMBASE, MEDLINE, PsycINFO, CINAHL, and the Cochrane Library …

Participatory Development Of Innovation And Implementation Strategy: An Action-Oriented Approach, Miae Lee, Lesley A. Anderson, Emilia Piltonen, Abha Maheshwari, Julian Griffin, Seshadri S. Vasan

Research outputs 2022 to 2026

Background: Healthcare and academic institutions face growing challenges in strategic planning due to rapid advances in medicine and technology, alongside fiscal and workforce constraints that limit traditional consultation. Participatory approaches offer a way to integrate diverse stakeholder perspectives under these constraints, generating contextually relevant strategies that can indicate whether current directions are appropriate or whether priorities have been overlooked.

Methods: A structured, time-limited participatory workshop was conducted at the 10th Grampian Research Conference (June 2025), that brought together National Health Service (NHS) staff, academia, industry and patients and public communities. Participants engaged in 14 parallel roundtable discussions, with contributions captured …

Longitudinal Prediction Of Bmi Using Explainable Ai: Integrating Polygenic Scores, Maternal, Early-Life And Familial Factors, Fuling Chen, Phillip E. Melton, Kevin Vinsen, Trevor Mori, Lawrence Beilin, Rae Chi Huang

Research outputs 2022 to 2026

Background/objectives: This study aimed to predict body mass index (BMI) trajectories from childhood to early adulthood using explainable artificial intelligence, integrating adult BMI polygenic scores (PGS), maternal, early-life, and familial factors to identify key predictors of obesity risk and inform prevention strategies. Subjects/methods: We analyzed longitudinal data from the Raine Study Gen2 cohort, recruiting 2868 participants. This observational study, without randomization or case-control design, collected BMI measurements at ages 8, 10, 14, 17, 20, 23, and 27 years. We applied Kolmogorov–Arnold Networks (KAN) alongside conventional machine learning models, integrating epidemiological variables (maternal and paternal anthropometrics, parental education, early-life skinfold measurements) …

Sexuality Education In An Age Of Resistance: Reflections At The Nexus Of Education, Health And Rights, Sarah Vrankovich, Katrina Marson, Giselle Woodley, Jordina Quain, Hanna Saltis

Research outputs 2022 to 2026

Comprehensive sexuality education (CSE) is internationally recognised as essential to public health and young people’s rights. Yet its implementation in Australia and globally is increasingly undermined by conservative backlash, moral panic and political interference. This paper offers a critical reflection on the current landscape of CSE, drawing on insights from a panel discussion at the 2025 World Association for Sexual Health congress, and collaborative analysis. As early-career researchers, sexologists and practitioners working across education, communications, public health and sexual violence prevention, we utilise our collective experience to examine how various influences shape and constrain the delivery of CSE. We map …

Thorium Lung Burdens Of Norm Workers Revisited, Gregory S. Hewson, Martin I. Ralph, Marcus Cattani

Research outputs 2022 to 2026

Historical thorium bioassay data collected from Australian mine workers in the 1990s, including in vivo lung counting and thoron-in-breath (TIB) measurements, were re-evaluated using current dosimetric and biokinetic models. Revised daily thorium intakes from bioassay were compared with previous estimates to assess changes in the dose profile and potential implications for contemporary operations. Reanalysis revealed lower estimates of annual dose, including the number of workers assessed as exceeding 20 mSv. However, it was found that intakes derived from industry personal air sampling (PAS) underestimated intake by up to three-fold. This study determined that sensitive bioassay techniques, such as TIB using …

Sugar Consumption In Aboriginal Children Explored From A Social Practice Perspective, Amy Budrikis, Angela Durey, Dan Mcaullay, Paul Ward, Hanny Calache, Thierry Ng, Roma Winmar, Linda Slack-Smith

Research outputs 2022 to 2026

Australian Aboriginal children have higher sugar intake and are disproportionately affected by sugar-related diseases such as obesity, diabetes and dental caries than non-Aboriginal children. The intention of this paper was to highlight the need for approaches that can capture the complexity of health practices without reducing them to either individual choice or structural determination. We explore sugar consumption in Aboriginal children from a social practice perspective. Here, the unit of analysis is the practice, not the individual, where the elements of a social practice (competence, materials and meanings) are integrated into its performance. We conducted qualitative research using elements of …

The Development And Pilot Evaluation Of An Out-Of-Hospital Immersive Birthing Simulation Training Application For Paramedics And Ambulance Officers Using Virtual-Reality Technology, Michella Hill

Theses: Doctorates and Masters

Out-of-hospital births (OOHBs) are births which occur outside a hospital setting. This includes planned home births attended by midwives, or unplanned OOHBs where the intention was to birth in a hospital or maternity centre, however, occurs in an unintended location. Prehospital clinicians, inclusive of registered paramedics and volunteer ambulance officers (VAOs) infrequently attend OOHBs, as most births occur in maternity wards as anticipated. OOHBs comprises < 1% of emergency ambulance requests and requires specialised skills for prehospital clinicians to competently manage birthing and potential complications. As exposure to birthing is so rare, these specialised skills and knowledge are underutilised and subject to rapid decay. Compounding the problem, obstetrics is infrequently taught across undergraduate education, in-service training, or within individual clinician’s continuing professional development. Placements shadowing midwives are scarce due to nursing and medical students receiving priority. Previous research regarding OOHBs is limited, nonetheless suggests prehospital clinicians are underprepared to manage an OOHB, which has serious patient safety implications. The present research sought to explore prehospital clinicians’ preparedness and confidence in managing OOHBs. It also investigates whether a digital training solution such as virtual reality (VR) simulation may reduce the theory-practice gap and assist in competency retention.

Publication one provides a comprehensive methodology outline which is applied to Study One; a scoping review of prehospital clinician and birth parent experiences with OOHBs. Risk factors, complications and interventions provided by prehospital clinicians, as …

Forced Oscillation Technique In Pneumothorax (Pneumofot) Study, Niranjan Ananda Setty, Carolyn J. Mcintyre, John Blakey, Yun Chor Gary Lee

Research outputs 2022 to 2026

Forced Oscillation Technique in Pneumothorax (PneumoFOT) study A single-centre prospective pilot feasibility study designed to assess the feasibility of performing FOT measurements in patients with pneumothorax. STATISTICAL ANALYSIS PLAN Version 24.05.2026

On Burden Of Diseases, Prevention, Medical Research And Health Service Delivery: Grampian Case Study, Seshadri S. Vasan, Sudarshan Anand, Miae Lee, Nicholas C. Fluck

Research outputs 2022 to 2026

Burden of diseases measured as disability-adjusted life years (DALYs) per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions, and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified that selected cancers, ischaemic heart disease, Alzheimer’s disease and other dementias …

Overview Of Aboriginal And Torres Strait Islander Health Status 2025, Australian Indigenous Healthinfonet

Research outputs 2022 to 2026

This Overview provides a summary of the most recent indicators of the health and wellbeing of Aboriginal and Torres Strait Islander people (of all ages, where data are available). The topics included in the Overview cover chronic health conditions which are featured on the HealthInfoNet website. Over the years as additional funding has been obtained and in consultation with HealthInfoNet networks, more topics have been covered on the website and are now included in the Overview. The topics aim to reflect the status of Aboriginal and Torres Strait Islander health over this period and going forward.

Reflecting On Themes From Telehealth Consultations Early In The Pandemic: An Opportunity To Learn From Multiprofessional Colleagues, Maggie Meeks, Laura R. Joyce, John Dean, Lorna Davies, Tika Ormond, Philippa Seaton, Dale Sheehan, Dean Sutherland, Melanie Welfare, Arindam Basu

Research outputs 2022 to 2026

Aims: This study is aimed at documenting the reflections of New Zealand healthcare professionals on the use of synchronous telehealth consultations. Methods: A qualitative narrative inquiry was conducted to explore the practice of telehealth in New Zealand. Purposive sampling was used to identify clinicians from multiple professions who used telehealth during the initial phase of the COVID-19 pandemic. Fifteen semistructured interviews were conducted between October 2020 and May 2021 with clinicians from primary and secondary care, including multiple professional backgrounds. Interview transcripts were analysed thematically. Results: Six themes were identified: (1) equitable access: There were concerns regarding equitable access to …