Kevin A. Parton

Family self-medication and antibiotics abuse for children and juveniles in a Chinese city.

To identify the determinants of self-medication and antibiotics abuse by parents treating their children aged between 2 and 18 over the previous year, an investigation was conducted in Hefei City, China in April, 1995. A total of 1596 students from a kindergarten, a primary school and a high school were included in the study, and 1459 completed questionnaires were collected (the response rate: 91.4%). The results showed the rate of parental self-medication for their children in the sample was 59.4%. It increased with childrens age; about 51% of children had received parental self-medication on six or more occasions during the 1-year period and 32.8% on four to five occasions; there were associations between parental self-prescribers and sources of medicine and severity of disease. The rate of antibiotics abuse was 35.7%. Logistic regression analysis showed that there were significant associations between self-medication and payment of the mothers medical fees by employers, severity of diseases as well as the mothers educational level.

Climatic variables and transmission of malaria: A 12-year data analysis in Shuchen County, China

OBJECTIVE The objective of this study was to explore the impact of climate variability on the transmission of malaria, a vector-borne disease, in a county of China and provide suggestions to similar regions for disease prevention. METHODS A time-series analysis was conducted using data on monthly climatic variables and monthly incidence of malaria in Shuchen County, China, for the period 1980-1991. RESULTS Spearmans correlation analysis showed that monthly mean maximum and minimum temperatures, two measures of monthly mean relative humidity, and monthly amount of precipitation were positively correlated with the monthly incidence of malaria in the county. Regression analysis suggested that monthly mean minimum temperature and total monthly rainfall, with a one-month lagged effect, were significant climatic variables in the transmission of malaria in Shuchen County. Seasonality was also significant in the regression model and there was a declining secular trend in the incidence of malaria. CONCLUSION The results indicate that climatic variables should be considered as possible predictors for regions with similar geographic, climatic, and socioeconomic conditions to those of Shuchen County.

Heat and health in Adelaide, South Australia: Assessment of heat thresholds and temperature relationships

BACKGROUND Climate change projections have highlighted the need for public health planning for extreme heat. In Adelaide, South Australia, hot weather is characteristic of summer and heatwaves can have a significant health burden. This study examines the heat thresholds and temperature relationships for mortality and morbidity outcomes in Adelaide. METHODS Daily maximum and minimum temperatures, daily mortality, ambulance call-outs, emergency department (ED) presentations and hospital admissions were obtained for Adelaide, between 1993 and 2009. Heat thresholds for health outcomes were estimated using an observed/expected analysis. Generalized estimating equations were used to estimate the percentage increase in mortality and morbidity outcomes above the threshold temperatures, with adjustment for the effects of ozone (O(3)) and particulate matter<10 μm in mass median aerodynamic diameter (PM(10)). Effect estimates are reported as incidence rate ratios (IRRs). RESULTS Heat-related mortality and morbidity become apparent above maximum and minimum temperature thresholds of 30 °C and 16 °C for mortality; 26 °C and 18 °C for ambulance call-outs; and 34 °C and 22 °C for heat-related ED presentations. Most health outcomes showed a positive relationship with daily temperatures over thresholds. When adjusted for air pollutants, a 10 °C increase in maximum temperature was associated with a 4.9% increase in daily ambulance call-outs (IRR 1.049; 95% CI 1.027-1.072), and a 3.4% increase in mental health related hospital admissions (IRR 1.034; 95% CI 1.009-1.059) for the all-age population. Heat-related ED presentations increased over 6-fold per 10 °C increase in maximum temperature. Daily temperatures were also associated with all-cause and mental health related ED presentations. Associations between temperature over thresholds and daily mortality and renal hospital admissions were not significant when adjusted for ozone and PM(10); however at extreme temperatures mortality increased significantly with increasing heat duration. CONCLUSIONS Heat-attributable mortality and morbidity are associated with elevated summer temperatures in Adelaide, particularly ambulance call-outs, mental health and heat-related illness.

The status of wetlands and the predicted effects of global climate change: the situation in Australia

The condition of many wetlands across Australia has deteriorated due to increased water regulation and the expansion and intensification of agriculture and increased urban and industrial expansion. Despite this situation, a comprehensive overview of the distribution and condition of wetlands across Australia is not available. Regional analyses exist and several exemplary mapping and monitoring exercises have been maintained to complement the more general information sets. It is expected that global climate change will exacerbate the pressures on inland wetlands, while sea level rises will adversely affect coastal wetlands. It is also expected that the exacerbation of these pressures will increase the potential for near-irreversible changes in the ecological state of some wetlands. Concerted institutional responses to such pressures have in the past proven difficult to sustain, although there is some evidence that a more balanced approach to water use and agriculture is being developed with the provision of increasing funds to purchase water for environmental flows being one example. We identify examples from around Australia that illustrate the impacts on wetlands of long-term climate change from palaeoecological records (south-eastern Australia); water allocation (Murray-Darling Basin); dryland salinisation (south-western Australia); and coastal salinisation (northern Australia). These are provided to illustrate both the extent of change in wetlands and the complexity of differentiating the specific effects of climate change. An appraisal of the main policy responses by government to climate change is provided as a basis for further considering the opportunities for mitigation and adaptation to climate change.

RISK ATTITUDE, PLANTING CONDITIONS AND THE VALUE OF SEASONAL FORECASTS TO A DRYLAND WHEAT GROWER*

The value of a seasonal forecasting system based on phases of the Southern Oscillation was estimated for a representative dryland wheat grower in the vicinity of Goondiwindi. In particular the effects on this estimate of risk attitude and planting conditions were examined. A recursive stochastic programming approach was used to identify the growers utility-maximising action set in the event of each of the climate patterns over the period 1894-1991 recurring in the imminent season. The approach was repeated with and without use of the forecasts. The choices examined were, at planting, nitrogen application rate and cultivar and, later in the season, choices of proceeding with or abandoning each wheat activity. The value of the forecasting system was estimated as the maximum amount the grower could afford to pay for its use without expected utility being lowered relative to its non-use.

The impact of summer temperatures and heatwaves on mortality and morbidity in Perth, Australia 1994–2008

Climate change projections have drawn attention to the risks of extreme heat and the importance of public health interventions to minimise the impact. The city of Perth, Western Australia, frequently experiences hot summer conditions, with recent summers showing above average temperatures. Daily maximum and minimum temperatures, mortality, emergency department (ED) presentations and hospital admissions data were acquired for Perth for the period 1994 to 2008. Using an observed/expected analysis, the temperature thresholds for mortality were estimated at 34-36°C (maximum) and 20°C (minimum). Generalised estimating equations (GEEs) were used to estimate the percentage increase in mortality and morbidity outcomes with a 10°C increment in temperature, with adjustment for air pollutants. Effect estimates are reported as incidence rate ratios (IRRs). The health impact of heatwave days (three or more days of ≥35°C) was also investigated. A 9.8% increase in daily mortality (IRR 1.098; 95%CI: 1.007-1.196) was associated with a 10°C increase in maximum temperature above threshold. Total ED presentations increased by 4.4% (IRR 1.044; 95%CI: 1.033-1.054) and renal-related ED presentations by 10.2% (IRR 1.102; 95%CI: 1.071-1.135) per 10°C increase in maximum temperature. Heatwave days were associated with increases in daily mortality and ED presentations, while total hospital admissions were decreased on heatwave days. Public health interventions will be increasingly important to minimise the adverse health impacts of hot weather in Perth, particularly if the recent trend of rising average temperatures and more hot days continues as projected.

Weather and notified Campylobacter infections in temperate and sub-tropical regions of Australia: An ecological study

BACKGROUND The relationship between weather and food-borne diseases has been of great concern recently. However, the impact of weather variations on food-borne disease may vary in different areas with various geographic, weather and demographic characteristics. This study was designed to quantify the relationship between weather variables and Campylobacter infections in two Australian cities with different local climatic conditions. METHODS An ecological-epidemiological study was conducted, using weekly disease surveillance data and meteorological data, over the period 1990-2005, to quantify the relationship between maximum and minimum temperatures, rainfall, relative humidity and notifications of Campylobacter infections in Adelaide, with a temperate Mediterranean climate, and Brisbane, with a sub-tropical climate. Spearman correlation and time-series adjusted Poisson regression analyses were performed taking into account seasonality, lag effects and long-term trends. RESULTS The results indicate that weekly maximum and minimum temperatures were inversely associated with the weekly number of cases in Adelaide, but positively correlated with the number of cases in Brisbane, with relevant lagged effects. The effects of rainfall and relative humidity on Campylobacter infection rates varied in the two cities. CONCLUSION Weather might have different effect on Campylobacter infections in different cities. Further studies are needed for a better understanding of these relationships for they may indicate epidemiologic factors important for control of these infections.

Climate Variability and Transmission of Japanese Encephalitis in Eastern China

A time-series analysis was conducted to study the impact of climate variability on the transmission of Japanese encephalitis in eastern China. Correlation and regression analyses were used to examine the relationship between monthly climatic variables and monthly incidence of Japanese encephalitis in Jieshou County, China over the period 1980-96. Spearmans correlation analysis showed that maximum and minimum temperatures and rainfall were all associated with the transmission of Japanese encephalitis in the county. Regression analysis suggested that monthly mean minimum temperature and monthly precipitation had a significant relationship with the transmission of Japanese encephalitis, with a 1-month lag effect. The results indicated that these climatic variables might be treated as possible predictors for regions with similar geographic, climatic, and socio-economic conditions to Jieshou County.

A comparison between attitudes to climate change in Australia and the United States

Australian public support for climate change policies has not risen, despite recent media campaigns run by the Australian government. This failure suggests a need for more targeted media campaigns. Maibach identified six segments within the US population with different attributes towards climate change which could be used as the basis for a targeted media campaign in the US. We replicated the US survey for Australian respondents and found the segments are significantly different within the Australian population. We report characteristics of the Australian segments which could be used to design targeted media campaigns on climate change within Australia.

At-Home Meat Consumption in China: An Empirical Study

The remarkable economic changes occurring within China since 1978 have resulted in a striking alteration in food consumption patterns, and one marked change is the increasing consumption of meat. Given China’s large population, a small percentage change in per capita meat consumption could lead to a dramatic impact on the production and trade of agricultural products. Such changes have major implications for policy makers and food marketers. This paper concentrates on meat consumption patterns in the home in China. A censored linear approximate almost ideal demand system model was employed in the study, and major economic parameters were estimated for different meat items. Data used in this study were collected from two separate consumer surveys – one urban and one rural in 2005.