Garry Stevens

Pandemic influenza in Australia: Using telephone surveys to measure perceptions of threat and willingness to comply

BackgroundBaseline data is necessary for monitoring how a population perceives the threat of pandemic influenza, and perceives how it would behave in the event of pandemic influenza. Our aim was to develop a module of questions for use in telephone health surveys on perceptions of threat of pandemic influenza, and on preparedness to comply with specific public health behaviours in the event of pandemic influenza.MethodsA module of questions was developed and field tested on 192 adults using the New South Wales Department of Healths in-house Computer Assisted Telephone Interviewing (CATI) facility. The questions were then modified and re field tested on 202 adults. The module was then incorporated into the New South Wales Population Health Survey in the first quarter of 2007. A representative sample of 2,081 adults completed the module. Their responses were weighted against the state population.ResultsThe reliability of the questions was acceptable with kappa ranging between 0.25 and 0.51. Overall 14.9% of the state population thought pandemic influenza was very or extremely likely to occur; 45.5% were very or extremely concerned that they or their family would be affected by pandemic influenza if it occurred; and 23.8% had made some level of change to the way they live their life because of the possibility of pandemic influenza. In the event of pandemic influenza, the majority of the population were willing to: be vaccinated (75.4%), be isolated (70.2%), and wear a face mask (59.9%). People with higher levels of threat perception are significantly more likely to be willing to comply with specific public health behaviours.ConclusionWhile only 14.9% of the state population thought pandemic influenza was very or extremely likely to occur, a significantly higher proportion were concerned for self and family should a pandemic actually occur. The baseline data collected in this survey will be useful for monitoring changes over time in the populations perceptions of threat, and preparedness to comply with specific public health behaviours.

Struggle in the Studio: A Bourdivin Look at Architectural Pedagogy

This article seeks to establish two propositions. First, architectural education, although obviously intended as vocational training, is also intended as a form of socialization aimed at producing a very specific type of person. It is contended that the effects of this process have been considerably underestimated by architectural educators. Second, this process favors certain types of students—those from well-to-do, cultivated families—at the expense of others. The sociological framework of Pierre Bourdieu is enlisted to conduct the analysis.

Factors influencing psychological distress during a disease epidemic: Data from Australia's first outbreak of equine influenza

BackgroundIn 2007 Australia experienced its first outbreak of highly infectious equine influenza. Government disease control measures were put in place to control, contain, and eradicate the disease; these measures included movement restrictions and quarantining of properties. This study was conducted to assess the psycho-social impacts of this disease, and this paper reports the prevalence of, and factors influencing, psychological distress during this outbreak.MethodsData were collected using an online survey, with a link directed to the affected population via a number of industry groups. Psychological distress, as determined by the Kessler 10 Psychological Distress Scale, was the main outcome measure.ResultsIn total, 2760 people participated in this study. Extremely high levels of non-specific psychological distress were reported by respondents in this study, with 34% reporting high psychological distress (K10 > 22), compared to levels of around 12% in the Australian general population. Analysis, using backward stepwise binary logistic regression analysis, revealed that those living in high risk infection (red) zones (OR = 2.00; 95% CI: 1.57–2.55; p < 0.001) and disease buffer (amber) zones (OR = 1.83; 95% CI: 1.36–2.46; p < 0.001) were at much greater risk of high psychological distress than those living in uninfected (white zones). Although prevalence of high psychological distress was greater in infected EI zones and States, elevated levels of psychological distress were experienced in horse-owners nationally. Statistical analysis indicated that certain groups were more vulnerable to high psychological distress; specifically younger people, and those with lower levels of formal educational qualifications. Respondents whose principal source of income was from horse-related industry were more than twice as likely to have high psychological distress than those whose primary source of income was not linked to horse-related industry (OR = 2.23; 95% CI: 1.82–2.73; p < 0.001).ConclusionAlthough, methodologically, this study had good internal validity, it has limited generalisability because it was not possible to identify, bound, or sample the target population accurately. However, this study is the first to collect psychological distress data from an affected population during such a disease outbreak and has potential to inform those involved in assessing the potential psychological impacts of human infectious diseases, such as pandemic influenza.

Population risk perceptions of global warming in Australia

INTRODUCTION According to the World Health Organisation (WHO), global warming has the potential to dramatically disrupt some of lifes essential requirements for health, water, air and food. Understanding how Australians perceive the risk of global warming is essential for climate change policy and planning. The aim of this study was to determine the prevalence of, and socio-demographic factors associated with, high levels of perceived likelihood that global warming would worsen, concern for self and family and reported behaviour changes. METHODS A module of questions on global warming was incorporated into the New South Wales Population Health Survey in the second quarter of 2007. This Computer Assisted Telephone Interview (CATI) was completed by a representative sample of 2004 adults. The weighted sample was comparable to the Australian population. Bivariate and multivariate statistical analyses were conducted to examine the socio-demographic and general health factors. RESULTS Overall 62.1% perceived that global warming was likely to worsen; 56.3% were very or extremely concerned that they or their family would be directly affected by global warming; and 77.6% stated that they had made some level of change to the way they lived their lives, because of the possibility of global warming. After controlling for confounding factors, multivariate analyses revealed that those with high levels of psychological distress were 2.17 (Adjusted Odds Ratio (AOR)=2.17; CI: 1.16-4.03; P=0.015) times more likely to be concerned about global warming than those with low psychological distress levels. Those with a University degree or equivalent and those who lived in urban areas were significantly more likely to think that global warming would worsen compared to those without a University degree or equivalent and those who lived in the rural areas. Females were significantly (AOR=1.69; CI: 1.23-2.33; P=0.001) more likely to report they had made changes to the way they lived their lives due to the risk of global warming. CONCLUSIONS A high proportion of respondents reported that they perceived that global warming would worsen, were concerned that it would affect them and their families and had already made changes in their lives because of it. These findings support a readiness in the population to deal with global warming. Future research and programs are needed to investigate population-level strategies for future action.

Terrorism in Australia : factors associated with perceived threat and incident-critical behaviours

BackgroundTo help improve incident preparedness this study assessed socio-demographic and socio-economic predictors of perceived risk of terrorism within Australia and willingness to comply with public safety directives during such incidents.MethodsThe terrorism perception question module was incorporated into the New South Wales Population Health Survey and was completed by a representative sample of 2,081 respondents in early 2007. Responses were weighted against the New South Wales population.ResultsMultivariate analyses indicated that those with no formal educational qualifications were significantly more likely (OR = 2.10, 95%CI:1.32–3.35, p < 0.001) to think that a terrorist attack is very or extremely likely to occur in Australia and also more likely (OR = 3.62, 95%CI:2.25–5.83, p < 0.001) to be very or extremely concerned that they or a family member would be directly affected, compared to those with a university-level qualification. Speaking a language other than English at home predicted high concern (very/extremely) that self or family would be directly affected (OR = 3.02, 95%CI:2.02–4.53, p < 0.001) and was the strongest predictor of having made associated changes in living (OR = 3.27, 95%CI:2.17–4.93, p < 0.001). Being female predicted willingness to evacuate from public facilities. Speaking a language other than English at home predicted low willingness to evacuate.ConclusionLow education level is a risk factor for high terrorism risk perception and concerns regarding potential impacts. The pattern of concern and response among those of migrant background may reflect secondary social impacts associated with heightened community threat, rather than the direct threat of terrorism itself. These findings highlight the need for terrorism risk communication and related strategies to address the specific concerns of these sub-groups as a critical underpinning of population-level preparedness.

Public health measures during an anticipated influenza pandemic: Factors influencing willingness to comply

This research assessed factors associated with willingness to comply with vaccination, isolation, and face mask wearing during an anticipated influenza pandemic. Data were collected from 2081 adults (16+) using a module of questions incorporated into the NSW Health Adult Population Health Survey. High levels of willingness to comply were reported with 73% either very or extremely willing to receive vaccination, 67% willing to isolate themselves, 58% willing to wear a face mask, and 48% willing to comply with all three behaviors. Further analysis indicated concern for self and family and higher levels of education were associated with high levels of willingness to comply. Younger people (16–24) were the least willing to comply; especially with wearing a face mask. Those with children reported higher levels of willingness to receive vaccination, and respondents who speak a language other than English at home were less willing to isolate themselves or comply with all behaviors. These findings provide a baseline measure of anticipated public compliance with key public health behaviors in the event of an influenza pandemic in the Australian population, and help to identify groups that may be more resistant to individual measures and may require additional attention in terms of risk communication strategies or health education.

Factors associated with population risk perceptions of continuing drought in Australia

OBJECTIVE To determine factors associated with risk perception of continuing drought in Australia. DESIGN AND SETTING Computer Assisted Telephone Interview survey. The sample was weighted to the New South Wales population. PARTICIPANTS A total of 2004 adults aged 16 years and over. RESULTS Overall 55.9% of the respondents thought drought was extremely or very likely to continue, 60.1% were extremely or very concerned that they or their family would be affected, and 86.3% reported that they had made some level of change to the way that they lived their lives because of the perceived risk of continuing drought. After controlling for confounding factors, the odds of perceived drought being extremely or very likely to continue, concern for self or family and making changes to behaviour because of the possibility of continuing drought were significantly higher in women than men by 43%, 59% and 86%, respectively. Compared with those who lived in highly accessible geographical areas, respondents who lived in remote or very remote geographical areas were 3.22 (adjusted odds ratios = 3.22; 95% CI, 1.69-6.14) times more likely to think that drought would continue and were 3.72 (adjusted odds ratios = 3.72; 95% CI, 1.10-12.56) times more likely to have changed the way they lived their lives because of the possibility of continuing drought. CONCLUSION Over half of the New South Wales population thought drought was very or extremely likely to continue. The baseline data collected in this survey will be useful for monitoring changes over time in the populations perceptions of continuing drought.

Determinants of suboptimal complementary feeding practices among children aged 6-23 months in four anglophone West African countries

Suboptimal complementary feeding practices have a detrimental impact on a childs growth, health and development in the first two years of life. They lead to child malnutrition, which contributes to the high prevalence of stunting (38%) and underweight (28%) reported for children <5 years of age in Sub-Saharan Africa. This study analysed complementary feeding practices in four anglophone West African countries (Ghana, Liberia, Nigeria and Sierra Leone) using the most recent Demographic and Health Surveys. The study covered 12 623 children aged 6-23 months from four anglophone West African countries (Ghana: 822 children: Liberia: 1458 children, Nigeria: 8786 children and Sierra Leone: 1557 children). Four complementary feeding indicators were examined against a set of individual-, household- and community-level factors, using multiple regression analysis. Multivariate analyses found that lack of post-natal contacts with health workers, maternal illiteracy and geographical region were common determinants of delayed introduction of solid, semi-solid or soft foods across all four countries. Predictors for minimum dietary diversity, minimum meal frequency and minimum acceptable diet included children aged 6-11 months, administrative/geographical region, poorer household income and limited access to media. The authors recommend that the four anglophone West African countries studied should prioritise efforts to improve complementary feeding practices in order to reduce child morbidity and mortality. Interventional studies on complementary feeding should target those from poor and illiterate households.

Depression and Posttraumatic Stress Disorder in Temporary Settlement Residents 1 Year After the Sichuan Earthquake

The authors sought to determine the prevalence and risk factors for major depressive disorder and posttraumatic stress disorder (PTSD) among survivors living in temporary accommodation in the Yongxing settlement in Mianyang city 1 year after the Sichuan earthquake for further interventions. They interviewed 182 residents, using the Structured Clinical Interview for DSM-IV Axis I Disorders and a self-report questionnaire. The 12-month prevalence of depressive disorder and PTSD were 48.9% and 39.6%, respectively. Multivariate analysis indicated that bereaved survivors were 5.51 times (adjusted odds ratio [AOR] = 5.51; 95% confidence interval [CI] =2.14-14.22) more likely to report PTSD and 2.42 times (AOR = 2.42; 95%CI =1.00-5.48) more likely to report depressive disorder than nonbereaved survivors. Older age and receipt of government financial support were significantly associated with 12-month PTSD. Depressive disorder 12 months after the earthquake was associated with receipt of government financial support, pre-earthquake physical illness, single marital status, being currently employed, and Han ethnicity

Determinants of Early Introduction of Solid, Semi-Solid or Soft Foods among Infants Aged 3–5 Months in Four Anglophone West African Countries

This study was conducted to explore and identify factors associated with the practice of early introduction of solid, semi-solid or soft foods among infants aged 3–5 months in four Anglophone West African countries. Data sources for the analyses were the latest Demographic and Health Survey datasets of the 4 countries, namely Ghana (GDHS, 2008), Liberia (LDHS, 2007), Nigeria (NDHS, 2013) and Sierra Leone (SLDHS, 2008). Multiple logistic regression methods were used to analyze the factors associated with early introduction of solid, semi-solid or soft foods among infants aged 3–5 months, using individual-, household- and community-level determinants. The sample consisted of 2447 infants aged 3–5 months from four Anglophone West African countries: 166 in Ghana, 263 in Liberia, 1658 in Nigeria and 360 in Sierra Leone. Multivariable analyses revealed the individual factors associated with early introduction of solid, semi-solid or soft foods in these countries. These included increased infant’s age, diarrhea, acute respiratory infection and newborns perceived to be small by their mothers. Other predictors of early introduction of solid, semi-solid or soft foods were: mothers with no schooling, young mothers and fathers who worked in an agricultural industry. Public health interventions to improve exclusive breastfeeding practices by discouraging early introduction of solid, semi-solid or soft foods are needed in all 4 countries, targeting especially mothers at risk of introducing solid foods to their infants early.