The epidemiology workforce : are we planning for the future?

Epidemiology has a central role in public health practice, education and research, and is arguably the only discipline unique to public health. A strong perception exists among epidemiologists in Australia that there is a substantial shortage in epidemiological capacity within the health workforce and health research, and that there are few graduates with sufficient high-level epidemiological training to fill the educational and leadership roles that will be essential to building this capacity. It was this concern that led the Australasian Epidemiological Association (AEA)--the peak professional body for epidemiologists in Australia and New Zealand--to convene a working group in 2007 to assess and address these concerns. This article summarises the key training challenges and opportunities discussed within this group, and the larger organisation, with the intention of stimulating greater public debate of these issues.

Descriptive epidemiology of Australian football injuries presenting to sports medicine clinics

Sports injury prevention has been the focus of a number of recent public health initiatives due to the acknowledgement that sports injuries are a significant public health problem in Australia Whilst Australian football is one of the most popular participation sports in the country, only very limited data is available about football injuries The majority of sports injury data available for this sport is from hospital emergency departments and elite-level injury surveillance Overall there is a paucity of data from treatment settings other than hospitals In particular, there is a lack of information about the injuries sustained by community-level, junior and recreational Australian football participants. One good potential source of football injury data is sports medicine clinics. Analysis of injury presentations to sports medicine clinics was undertaken to provide a detailed description of the epidemiology of Australian football injuries that present to this treatment setting and to determine the implications for injury prevention in this sport. In addition, the data from sports medicine clinics was compared with existing sources of Australian football injury data to determine how representative sports medicine clinic data is of other football injury data sources and to provide recommendations for future injury surveillance n Australian football. The results contained in this thesis show that Australian football is the sport most associated with injury presentation at sports medicine clinics. The majority of injured Australian football players presenting to sports medicine clinics are community-level or junior participants which suggests that sports medicine clinics are a good source of information on the injuries sustained by sub-elite football participants. Competition is the most common context in which Australian football players presenting to sports medicine clinics are injured. The major causes of injuries to Australian football players are being struck by another player, collisions and overuse. Injuries to Australian football players predominantly involve the lower limb. Adult players, players who stopped participating immediately after noticing their injury and players with overuse injuries are the most likely to sustain a more severe injury (i.e. more than four weeks before a full return to football participation and a moderate/significant amount of treatment expected). The least experienced players (five or less years of participation) are more likely to require a significant amount of treatment than the more experienced players. The prevention of lower limb injuries, injuries caused by body contact and injuries caused by overuse should be a priority for injury prevention research in Australian football due to the predominance of these injury types in the pattern of Australian football injuries Additionally, adult players, as a group, should be a focus of injury prevention activities in Australian football due to the association between age and injury severity. Overall, the pattern of Australian football injuries presenting to sports medicine clinics appears to be different than reported by club-based and hospital emergency department injury surveillance activities. However, detailed comparison of sports medicine clinic Australian football data with other sources of Australian football injury data is difficult due to the variable methods of collecting and reporting injury information used by hospital emergency department and club-based injury surveillance activities. The development of a standardised method for collecting and reporting injury data in Australian football is strongly recommended to overcome the existing limitations of data collection in this sport. In summary, sports medicine clinics provide a rich source of Australian football injury data, especially from the community and junior levels of participation. The inclusion of sports medicine clinic data provides a broader epidemiological picture of Australian football injuries. This broader understanding of the pattern of Australian football injuries provides a better basis for the development of injury prevention measures in this sport.

Scapegoating, self-confidence and risk comparison : the functionality of risk neutralisation and lay epidemiology by injecting drug users

This paper investigates the competing rationalities of scientific and lay epidemiology and how the tension between the two impacts on the efficacy of health promotion messages for injecting drug users (IDUs). It proposes that behaviours, which may be difficult to understand when viewed at an individual level, are, in fact, rational within particular cultural contexts. The study used qualitative semi-structured interviews with 60 heroin users. A number of different types of risk neutralisation were observed in this group of interviewees, including: scapegoating, self-confidence and risk comparison. Interviewees commonly used lay epidemiology to justify and rationalise their risk neutralisation strategies. The paper provides concrete examples of the ways in which this group of IDUs neutralise risk through the use of these strategies. The findings illustrate how many of the psychological constructs surrounding the perception of risk which focus on individual behaviour are fundamentally simplistic and often unhelpful in understanding the behaviours of this group of people. It is concluded that some ‘risk’ behaviours are often functional and rational within the context of prohibitionist drug policies which create an environment in which the IDU often has little real agency to reduce the risks associated with their drug use.

Psychosocial epidemiology of colorectal cancer

The research explored the role played by personality and stress in the development and progress of colorectal cancer. Personality type was related to health outcomes following diagnosis, and to participation in bowel cancer screening. The personality types also differed in terms of their capacity to deal with stress.

Epidemiology and management of Penaeus monodon farms in Andhra Pradesh, India

Disease outbreaks on shrimp farms studied in Andhra Pradesh were caused mainly by white spot syndrome virus (WSSV) significantly reducing yield. Shrimp seed was the major source of WSSV but several risk factors were also involved. Implementation of better management practices (BMPs) at farm and farm cluster level through formation of Self-Help Groups could significantly improve crop outcomes in farms.

Obesity epidemiology

Although recognised clinically for some time as an important condition that increases risk of ill-health in affected individuals, it is only recently that obesity had been recognised as a population-wide problem that requires preventive action. Obesity is a major contributor to diseases and disability, the associated health costs are enormous and obesity has already reached epidemic proportions in many countries, and incidence is continuing to increase in children and adults. Disturbingly the epidemic is not confined to developed countries, with many developing countries and those in transition affected. While recognised as a major population health problem, our understanding of the causes of the epidemic is poor, there has been relatively little population-based research that has focused on the prevention of unhealthy weight gain, and as a consequence knowledge regarding how and where best to intervene is limited.Revised and updated and now part of the From Aetiology to Public Health series, Obesity Epidemiology provides a scholarly text that assists those concerned with understanding prevalence and trends in obesity; its health, social and economic consequences, the underlying causes of the obesity epidemic, the existing evidence regarding strategies to prevent obesity, and the potential of public health initiatives to impact on the population prevalence of obesity. This edition not only provides a thorough update of the material presented in the previous edition (entitled Obesity Prevention and Public Health), but also includes twelve new chapters that cover the epidemiology of obesity in children and adults, and the potential of public health approaches to its prevention. This book will be of interest to all those working in public health and epidemiology; health policy makers, and clinicians and health practitioners working in the related fields of nutrition, exercise and diabetes.About the seriesBy looking at public health issues from a unique condition-based approach, the innovative From Aetiology to Public Health series examines top public health issues from aetiology through to public health and prevention

The epidemiology of ecstasy use and harms in New South Wales, Australia

Aims:This paper examines the epidemiology of ecstasy use and harm in Australia using multiple data sources.

Design: The data included (1) Australian Customs Service 3,4-methylenedioxymethamphetamine (MDMA) detections; (2) the National Drug Strategy Household and Australian Secondary Student Alcohol and Drug Surveys; (3) data from Australia's ecstasy and Related Drugs Reporting System; (4) the number of recorded police incidents for ecstasy possession and distribution collated by the N.S.W. Bureau of Crime Statistics and Research; (5) the number of calls to the Alcohol and Drug Information Service and Family Drug Support relating to ecstasy; (6) the Alcohol and Other Drug Treatment Services National Minimum Dataset on number of treatment episodes for ecstasy, and (7) N.S.W. Division of Analytical Laboratories toxicology data on number of deaths where MDMA was detected.

Findings: Recent ecstasy use among adults in the general population has increased, whereas among secondary students it has remained low and stable. The patterns of ecstasy consumption among regular ecstasy users have changed over time. Polydrug use and use for extended periods of time (>48 h) remain common among this group. Frequent ecstasy use is associated with a range of risk behaviours and other problems, which tend to be attributed to a number of drugs along with ecstasy. Few ecstasy users present for treatment for problems related to their ecstasy consumption.

Conclusions: Messages and interventions to reduce the risks associated with polydrug use and patterns of extended periods of use are clearly warranted. These messages should be delivered outside of traditional health care settings, as few of these users are engaged with such services.