Assessment of the health impacts of the 2011 summer floods in Brisbane

Background: During December 2010 and January 2011, torrential rainfall in Queensland resulted in the worst flooding in over 50 years. We carried out a community-based survey to assess the health impacts of this flooding in the city of Brisbane. Methods: A community-based survey was conducted in 12 flood-affected electorates using postal questionnaires. A random sample of residents in these areas was drawn from electoral rolls. Questions examined sociodemographic information, the direct impact of flooding on the household, and perceived flood-related health impacts. Outcome variables included perceived flood-related effects on overall and respiratory health, along with mental health outcomes measured by psychosocial distress, reduced sleep quality and probable post-traumatic stress disorder (PTSD). Multivariable logistic regression was used to examine the association between flooding and health outcome variables, adjusted for current health status and socioeconomic factors. Results: 3000 residents were invited to participate in this survey, with 960 responses (32%). People whose households were directly impacted by flooding had a decrease in perceived overall health (OR 5.3, 95% CI: 2.8–10.2), along with increases in psychological distress (OR 1.9, 1.1–3.5), decreased sleep quality (OR 2.3, 1.2–4.4), and probable PTSD (OR 2.3, 1.2–4.5). Residents were also more likely to increase usage of both tobacco (OR 6.3, 2.4–16.8) and alcohol (OR 7.0, 2.2–22.3) after flooding. Conclusions: There were significant impacts of flood events on residents’ health, in particular psychosocial health. Improved support strategies may need to be integrated into existing disaster management programs to reduce flood-related health impacts.

Principles on assessment of costs on standard basis – necessary or proper

The judgement in Hennessey Glass and Aluminium Pty Ltd v Watpac Australia Pty Ltd [2007] QDC 57 McGill DCJ provides valuable guidance for practitioners as to whether a range of particular costs items should be permitted on an assessment on the standard basis, and the amounts which should be allowed for such items. The items in issue included counsel’s fees and fees paid to expert witnesses. The decision also examined GST implications for the recovery of legal costs.

Court Based Psychiatric Assessment: A Case for an Integrated and Diversionary Public Health Role

This article describes a follow-up study of 232 individuals who underwent psychiatric assessment by a Criminal Justice Mental Health Team (CJMHT) in 2001/2002, and also draws upon in-depth interviews conducted with 26 of the cohort. At assessment many people are identified with substance misuse problems, as homeless and with a history of psychiatric contact but in the main their problems are of insufficient severity to merit diversion to psychiatric hospital. The study mapped service contact, housing and offending in the 12 months following assessment and compared this to the 12 months prior to assessment, and found increased levels of service contact but also increased levels of offending and no decrease in homelessness. Thus assessment by the CJMHT brought few discernible advantages for the majority of clients. This was also the perception of the 26 clients who were interviewed. Their own perceptions of their lifestyle and the support that they deemed most valuable are described to identify means of enhancing the efficacy of court assessment.

Towards determining soft tissue properties for modelling spine surgery : current progress and challenges

Current complication rates for adolescent scoliosis surgery necessitate the development of better surgical planning tools to improve outcomes. Here we present our approach to developing finite element models of the thoracolumbar spine for deformity surgery simulation, with patient-specific model anatomy based on low-dose pre-operative computed tomography scans. In a first step towards defining patient-specific tissue properties, an initial 'benchmark' set of properties were used to simulate a clinically performed pre-operative spinal flexibility assessment, the fulcrum bending radiograph. Clinical data for ten patients were compared with the simulated results for this assessment and in cases where these data differed by more than 10%, soft tissue properties for the costo-vertebral joint (CVJt) were altered to achieve better agreement. Results from these analyses showed that changing the CVJt stiffness resulted in acceptable agreement between clinical and simulated flexibility in two of the six cases. In light of these results and those of our previous studies in this area, it is suggested that spinal flexibility in the fulcrum bending test is not governed by any single soft tissue structure acting in isolation. More detailed biomechanical characterisation of the fulcrum bending test is required to provide better data for determination of patient-specific soft tissue properties.

Assessment of tumor prevention in Type 1 Neurofibromatosis using a nitroxide compound

Background Type 1 Neurofibromatosis (NF1) is a genetic disorder linked to mutations of the NF1 gene. Clinical symptoms are varied, but hallmark features of the disease include skin pigmentation anomalies (café au lait macules, skinfold freckling) and dermal neurofibromas. Method These dermal manifestations of NF1 have previously been reported in a mouse model where Nf1+/− mice are topically treated with dimethylbenz[a]anthracene (DMBA) and 12-O-tetradecanoylphorbol-13-acetate (TPA). We adopted this mouse model to test the protective effects of a nitroxide antioxidant, 5-carboxy-1,1,3,3-tetramethylisoindolin-2-yloxyl (CTMIO). Antioxidants have previously been shown to increase longevity in nf1-deficient fruitflies. Doses of 4 μM and 40 μM CTMIO provided ad libitum in drinking water were given to Nf1-deficient mice. Results Consistent with previous reports, Nf1-deficient mice showed a 4.7-fold increase in papilloma formation (P < 0.036). However, neither dose of CTMIO had any significant affect on papilloma formation. A non-significant decrease in skin pigmentation abnormalities was seen with 4 μM but not 40 μM CTMIO. Subsequent analysis of genomic DNA isolated from papillomas indicated that DMBA/TPA induced tumors did not exhibit a local loss of heterozygosity (LOH) at the Nf1 locus. Conclusion These data reveal that oral antioxidant therapy with CTMIO does not reduce tumor formation in a multistage cancer model, but also that this model does not feature LOH for Nf1.