Mapping Problematic Drinking Trends over Time in Urban, Semi-Urban, and Rural Populations

Current alcohol public health policy in Australia is not uniform but is generally focused on restricting access and early prevention of problematic alcohol use. Semi-urban and rural populations are at greater risk of disease and other poor health outcomes due to a variety of factors. Little is known about problematic drinking patterns over time in semi-urban and rural populations. This study aims to assess patterns of problematic drinking defined as both long-term risky and heavy episodic drinking over time by age, sex, and mental health status among urban, semi-urban and rural populations). Four waves (2004 to 2016) of the Australian NDSHS (National Drug Strategy Household Survey) were analyzed to assess problematic drinking of participants over 18 years of age. We used regression models and predictive margins to identify trends in problematic drinking over time based on age, sex, and mental health status. Our results show young adults across all regions, males, and mentally well individuals in urban areas have reductions in the risk of problematic drinking over time. Middle-aged adults across all regions, females, and those with varying mental health presentations in rural areas have some increases in risk of problematic drinking over time. The general conclusion is that targeted alcohol-related public health policy may need to change and focus on females, middle-aged individuals, and those living in rural areas. Programs to support problematic drinking in people with mental health disorders may also need to be a priority.

An Argument for Simple Tests of Treatment of Alzheimer’s Disease

Two potential disease-modifying approaches for dementia are being vigorously tested: the early targeting of the neuropathology of Alzheimer’s disease (AD) and multi-domain lifestyle interventions to promote resilience to neuropathology. We apply the “web of information” model of clinical translation to both approaches to argue firstly that tests of treatments aiming to achieve clinically meaningful outcomes should remain simple, and secondly, that building clinically-meaningful treatments should be kept separate from public health policy which means promoting wide-reaching action against risk factors now with available information.

COVID-19 and the Hospitality Industry

The ongoing coronavirus (COVID-19) pandemic and the ensuing public health policy measures to contain its spread have inevitably had profound effects on businesses throughout the world. While the pandemic has impacted every industry in all countries, hospitality is clearly the worst hit. This chapter explores the impact of the pandemic on the hospitality industry by focusing on accommodation and food service businesses in Turkey. By looking at government policies and changes in business activities in these sectors in response to the crisis, the authors discuss the measures policymakers and firms can take to mitigate the devastating impacts of the pandemic. Findings suggest that focusing on creating novel products and processes, collaboration and open innovation, informational and corporate advertising, as well as investment in quality and health security measures and trust building via communication are effective in moving forward with the new normal.

Are ‘Behaviour Change’ Approaches to Obesity and Health Effective? A case Study from Samoa

‘Behaviour Change’ approaches in public health strategies have been used in Pacific Island countries to address the problem of dietary and lifestyle changes that are believed to be the cause of rising rates of obesity and associated NCDS. We consider the limitations of this approach in the context of Samoa’s socioeconomic situation and public health policy and propose that an ‘obesogenic’ environment and structural factors are causational and require policy measures that go beyond the scope of responsibilities of the Samoa Ministry of Health

One Health Approach: A Data-Driven Priority for Mitigating Outbreaks of Emerging and Re-Emerging Zoonotic Infectious Diseases

This paper discusses the contributions that One Health principles can make in improving global response to zoonotic infectious disease. We highlight some key benefits of taking a One Health approach to a range of complex infectious disease problems that have defied a more traditional sectoral approach, as well as public health policy and practice, where gaps in surveillance systems need to be addressed. The historical examples demonstrate the scope of One Health, partly from an Australian perspective, but also with an international flavour, and illustrate innovative approaches and outcomes with the types of collaborative partnerships that are required.

SARS-CoV-2 seroprevalence in Kaduna State, Nigeria during October/November 2021, following three waves of infection and immediately prior to detection of the Omicron variant

Nigeria is the most populated country in Africa with an estimated ~213 million inhabitants. As of November 2021 there have been three waves of SARS-CoV-2 infection in Nigeria but there has been only one seroprevalence survey conducted to assess the proportion of a population that have been infected, which was performed in December 2020 after the first wave of infection. To provide an update on seroprevalence in Nigeria, we conducted survey at one urban site (n=400) and one rural site (n=402) in Kaduna State, Nigeria during October and November 2021 following the third wave of infection. Seroprevalence for the urban and rural sites was 42.5% and 53.5% respectively (mean 48.0%). Symptoms associated with seropositivity were identified for each site. The overall seroprevalence among unvaccinated individuals was 45.4%. The data indicates an infection rate in Kaduna State at least 387 times greater than that derived from cases confirmed by PCR. Extrapolating to the whole of Nigeria, it would suggest there has been at least 96.7 million infections (compared to 206,138 confirmed cases at the time of surveillance). The work presented here will inform public health policy and deployment strategies for testing, treatment, and vaccination in Nigeria, and provide a baseline for SARS-CoV-2 seroprevalence in Nigeria immediately prior to the spread of the Omicron variant.

Nature-Based Citizen Science as a Mechanism to Improve Human Health in Urban Areas

The world is becoming increasingly urbanised, impacting human interactions with natural environments (NEs). NEs take a number of forms, ranging from pristine, modified, to built NEs, which are common in many urban areas. NEs may include nature-based solutions, such as introducing nature elements and biological processes into cities that are used to solve problems created by urbanisation. Whilst urbanisation has negative impacts on human health, impacting mental and physical wellbeing through a number of mechanisms, exposure to NEs may improve human health and wellbeing. Here, we review the mechanisms by which health can be improved by exposure to NEs, as explained by Stress Reduction Theory, Attention Restoration Theory, and the ‘Old Friends’/biodiversity hypothesis. Such exposures may have physiological and immunological benefits, mediated through endocrine pathways and altered microbiota. Citizen Science, which often causes exposure to NEs and social activity, is being increasingly used to not only collect scientific data but also to engage individuals and communities. Despite being a named component of scientific and environmental strategies of governments, to our knowledge, the intrinsic health benefits of Citizen Science in NEs do not form part of public health policy. We contend that Citizen Science programs that facilitate exposure to NEs in urban areas may represent an important public health policy advance.

A framework to guide policymakers on the use of science to inform public health policy and law: Immunisation as a case study

<p>This thesis examines the incorporation of science into public health policy/law. The key problem that the thesis tackles is the blurring of science and values arguments in the creation of policy/law. To overcome this problem, a decision-making framework is proposed that draws a distinction between arguments based on science and those based on values. The framework suggests categorising science as information obtained by adherence to the scientific method. Values, then, are those legally protected rights, freedoms and principles that do not follow scientific methodology. Examples include public health as a community value, informed consent, freedom of choice, and religious beliefs. The idea is that the acquisition of scientific knowledge through the scientific process provides the platform from which debate about values can begin. It is acknowledged that scientific methodology does not entail an absence of values, and the reality may be the separation is more of a continuum than two distinct groups. The shorthand labels (values and science) are used for functional purposes to describe the stages of the proposed framework. There are three stages to the framework. The first stage acts as a gatekeeper, preventing non-scientific components being confused with science. The second stage addresses values, particularly rights and freedoms protected by law. The third stage looks at whether a health policy option (which could involve new law) that restricts existing rights protected by law can nevertheless be justified. Examples relating to the immunisation of children are used to help describe how the framework could work when applied to a real-world public health policy issue.</p>