Climate Change, Drought and Rural Suicide in New South Wales, Australia: Future Impact Scenario Projections to 2099.
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SUBMITTER: Hanigan IC
PROVIDER: S-EPMC9266200 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:There is concern in Australia that droughts substantially increase the incidence of suicide in rural populations, particularly among male farmers and their families. We investigated this possibility for the state of New South Wales (NSW), Australia between 1970 and 2007, analyzing data on suicides with a previously established climatic drought index. Using a generalized additive model that controlled for season, region, and long-term suicide trends, we found an increased relative risk of suicide of 15% (95% confidence interval, 8%-22%) for rural males aged 30-49 y when the drought index rose from the first quartile to the third quartile. In contrast, the risk of suicide for rural females aged >30 y declined with increased values of the drought index. We also observed an increased risk of suicide in spring and early summer. In addition there was a smaller association during unusually warm months at any time of year. The spring suicide increase is well documented in nontropical locations, although its cause is unknown. The possible increased risk of suicide during drought in rural Australia warrants public health focus and concern, as does the annual, predictable increase seen each spring and early summer. Suicide is a complex phenomenon with many interacting social, environmental, and biological causal factors. The relationship between drought and suicide is best understood using a holistic framework. Climate change projections suggest increased frequency and severity of droughts in NSW, accompanied and exacerbated by rising temperatures. Elucidating the relationships between drought and mental health will help facilitate adaptation to climate change.
| S-EPMC3435226 | biostudies-literature
Project description:BackgroundClinical analytics is a rapidly developing area of informatics and knowledge mobilisation which has huge potential to improve healthcare in the future. It is widely acknowledged to be a powerful mediator of clinical decision making, patient-centred care and organisational learning. As a result, healthcare systems require a strategic foundation for clinical analytics that is sufficiently directional to support meaningful change while flexible enough to allow for iteration and responsiveness to context as change occurs.MethodsIn New South Wales, the most populous state in Australia, the Clinical Analytics Working Group was charged with developing a five-year vision for the public health system. A modified Delphi process was undertaken to elicit expert views and to reach a consensus. The process included a combination of face-to-face workshops, traditional Delphi voting via email, and innovative, real-time iteration between text re-formulation and voting until consensus was reached. The six stage process engaged 35 experts - practising clinicians, patients and consumers, managers, policymakers, data scientists and academics.ResultsThe process resulted in the production of 135 ideas that were subsequently synthesised into 23 agreed statements and encapsulated in a single page (456 word) narrative.ConclusionThe visioning process highlighted three key perspectives (clinicians, patients and managers) and the need for synchronous (during the clinical encounter) and asynchronous (outside the clinical encounter) clinical decision support and reflective practice tools; the use of new and multiple data sources and communication formats; and the role of research and education.
| S-EPMC7650225 | biostudies-literature
Project description:Chiropractic and osteopathy form a significant part of the healthcare setting in rural and regional Australia, with national registration of practitioners, public subsidies for services and high utilisation by the Australian public. However, despite their significant role in rural and regional Australia, there has been little exploration of the interface between chiropractic and osteopathy and conventional primary health care practitioners in this area. The study aim was to examine the referral practices and factors that underlie referral to chiropractors and osteopaths by rural and regional Australian general practitioners (GPs), by drawing on a sample of GPs in rural and regional New South Wales.A 27-item questionnaire was sent to all 1486 GPs currently practising in rural and regional Divisions of General Practice in New South Wales, Australia.A total of 585 GPs responded to the questionnaire, with 49 questionnaires returned as "no longer at this address" (response rate: 40.7%). The majority of GPs (64.1%) referred to a chiropractor or osteopath at least a few times per year while 21.7% stated that they would not refer to a chiropractor or osteopath under any circumstances. Patients asking the GP about CAM (OR=3.59; CI: 1.12, 11.55), GP's use of CAM practitioners as a major source of information (OR=4.39; 95% CI: 2.04, 9.41), lack of other treatment options (OR=2.41; 95% CI: 1.18, 5.12), access to a wide variety of medical specialists (OR=12.5; 95% CI: 2.4, 50.0), GP's belief in the efficacy of chiropractic and osteopathy services (OR=3.39; 95% CI: 2.19, 5.25) and experiencing positive results from patients using these services previously (OR=1.67; CI: 1.02, 2.75) were all independently predictive of increased referral to chiropractic and osteopathy services amongst the rural GPs.There is a significant interface between chiropractic and osteopathy and Australian rural and regional general practice in New South Wales. Although there is generally high support for chiropractic and osteopathy among Australian GPs, this was not absolute and the heterogeneity of responses suggests that there remain tensions between the professions. The significant interface between chiropractic and osteopathy may be due in part to the inclusion of these professions in the publicly subsidised national healthcare delivery scheme. The significant impact of chiropractic and osteopathy and general practice in rural and regional Australian healthcare delivery should serve as an impetus for increased research into chiropractic and osteopathy practice, policy and regulation in these areas.
| S-EPMC3599860 | biostudies-other
Project description:Introduction: Many studies have been conducted on how physicians view outreach health services, yet few have explored how rural patients view these services. This study aimed to examine the patient experience and satisfaction with outreach health services in rural NSW, Australia and the factors associated with satisfaction. Methods: A cross-sectional study was conducted among patients who visited outreach health services between December 2020 and February 2021 across rural and remote New South Wales, Australia. Data on patient satisfaction were collected using a validated questionnaire. Both bivariate (chi-squared test) and multivariate analyses (logistic regression) were performed to identify the factors associated with the outcome variable (patient satisfaction). Results: A total of 207 participants were included in the study. The mean age of respondents was 58.6 years, and 50.2% were men. Ninety-three percent of all participants were satisfied with the outreach health services. Respectful behaviours of the outreach healthcare practitioners were significantly associated with the higher patient satisfaction attending outreach clinics. Conclusions: The current study demonstrated a high level of patient satisfaction regarding outreach health services in rural and remote NSW, Australia. Further, our study findings showed the importance of collecting data about patient satisfaction to strengthen outreach service quality.
| S-EPMC9332042 | biostudies-literature
Project description:BackgroundThe impact of climate change on mental health largely remains to be evaluated. Although growing evidence has reported a short-term association between suicide and temperature, future projections of temperature-attributable suicide have not been thoroughly examined.ObjectivesWe aimed to project the excess temperature-related suicide mortality in Japan under three climate change scenarios until the 2090s.MethodsDaily time series of mean temperature and the number of suicide deaths in 1973-2015 were collected for 47 prefectures in Japan. A two-stage time-stratified case-crossover analysis was used to estimate the temperature-suicide association. We obtained the modeled daily temperature series using five general circulation models under three climate change scenarios from the latest Coupled Model Intercomparison Project Phase 6 (CMIP6) Shared Socioeconomic Pathways scenarios (SSPs): SSP1-2.6, SSP2-4.5, and SSP5-8.5. We projected the excess temperature-related suicide mortality until 2099 for each scenario and evaluated the net relative changes compared with the 2010s.ResultsDuring 1973-2015, there was a total of 1,049,592 suicides in Japan. Net increases in temperature-related excess suicide mortality were estimated under all scenarios. The net change in 2090-2099 compared with 2010-2019 was 1.3% [95% empirical confidence interval (eCI): 0.6, 2.4] for the intermediate-emission scenario (SSP2-4.5), 0.6% (95% eCI: 0.1, 1.6) for a low-emission scenario (SSP1-2.6), and 2.4% (95% eCI: 0.7, 3.9) for the extreme scenario (SSP5-8.5). The increases were greater the more extreme the scenarios were, with the highest increase under the most extreme scenario (SSP5-8.5).DiscussionThis study indicates that Japan may experience a net increase in excess temperature-related suicide mortality, especially under the intermediate and extreme scenarios. The findings underscore the importance of mitigation policies. Further investigations of the future impacts of climate change on mental health including suicide are warranted. https://doi.org/10.1289/EHP11246.
| S-EPMC10666824 | biostudies-literature
Project description:This paper describes three datasets of seamless bathymetry and coastal topography for Sydney Harbour (Port Jackson), Botany and Bate Bays, and the Hawkesbury River. The datasets used to form these compilations were the most recent and highest quality available to the authors and were originally collated using the software ESRI ArcGIS. The original compilation of this data was undertaken to support tsunami modelling research by the authors of this paper. Before processing, all data were adjusted and/or reprojected to conform to the vertical datum Australian Height Datum (AHD) and horizontal projection WGS84 UTM zone 56. Data resolution and density was highly variable and grid resolutions of the final datasets were selected as the highest resolutions possible using the most sparse data in the compilation in question. For areas where no data were available, the ESRI ArcGIS interpolation tool, Topo to Raster, was used to provide a best estimate. These dastasets of three important Australian waterways provide a useful tool for coastal research and scientific interest.
| S-EPMC6007089 | biostudies-literature
Project description:Illness caused by pathogenic strains of Vibrio bacteria incurs significant economic and health care costs in many areas around the world. In the Chesapeake Bay, the two most problematic species are V. vulnificus and V. parahaemolyticus, which cause infection both from exposure to contaminated water and consumption of contaminated seafood. We used existing Vibrio habitat models, four global climate models, and a recently developed statistical downscaling framework to project the spatiotemporal probability of occurrence of V. vulnificus and V. cholerae in the estuarine environment, and the mean concentration of V. parahaemolyticus in oysters in the Chesapeake Bay by the end of the 21st century. Results showed substantial future increases in season length and spatial habitat for V. vulnificus and V. parahaemolyticus, while projected increase in V. cholerae habitat was less marked and more spatially heterogeneous. Our findings underscore the need for spatially variable inputs into models of climate impacts on Vibrios in estuarine environments. Overall, economic costs associated with Vibrios in the Chesapeake Bay, such as incidence of illness and management measures on the shellfish industry, may increase under climate change, with implications for recreational and commercial uses of the ecosystem.
| S-EPMC7007099 | biostudies-literature
Project description:BACKGROUND: Molecular epidemiology of Mycobacterium tuberculosis, its transmission dynamics and population structure have become important determinants of targeted tuberculosis control programs. Here we describe recent changes in the distribution of M. tuberculosis genotypes in New South Wales (NSW), Australia and compared strain types with drug resistance, site of disease and demographic data. METHODS: We evaluated all culture-confirmed newly identified tuberculosis cases in NSW, Australia, from 2010-2012. M. tuberculosis population structure and clustering rates were assessed using 24-loci Mycobacterial interspersed repetitive unit (MIRU) analysis and compared to MIRU data from 2006-2008. RESULTS: Of 1177 tuberculosis cases, 1128 (95.8%) were successfully typed. Beijing and East African Indian (EAI) lineage strains were most common (27.6% and 28.5%, respectively) with EAI strains increasing in relative abundance from 11.8% in 2006-2008 to 28.5% in 2010-2012. Few cases of multi-drug resistant tuberculosis were identified (18; 1.7%). Compared to 12-loci, 24-loci MIRU provided improved cluster resolution with 695 (61.6%) and 227 (20.1%) clustered cases identified, respectively. Detailed analysis of the largest cluster identified (an 11 member Beijing cluster) revealed wide geographic diversity in the absence of documented social contact. CONCLUSIONS: EAI strains of M. tuberculosis recently overtook Beijing family as a prevalent cause of tuberculosis in NSW, Australia. This lineage appeared to be less commonly related to multi-drug resistant tuberculosis as compared to Beijing strain lineage. The resolution provided by 24-loci MIRU typing was insufficient for reliable assessment of transmissions, especially of Beijing family strains.
| S-EPMC4262242 | biostudies-other
Project description:BackgroundNaturopathy forms an increasingly significant part of the Australian healthcare setting, with high utilisation of naturopaths by the Australian public and a large therapeutic footprint in rural and regional Australia. However, despite these circumstances, there has been little exploration of the interface between naturopathy providers and conventional primary health care practitioners in rural and regional Australia. The study reported here examined the referral practices and factors that underlie referral to naturopaths amongst a sample of rural and regional Australian general practitioners (GPs).MethodsA 27-item questionnaire was sent to all 1,486 GPs currently practising in rural and regional Divisions of General Practice in New South Wales, Australia.ResultsA total of 585 GPs responded to the questionnaire, with 49 questionnaires returned as "no longer at this address" (response rate: 40.7%). One-quarter of GPs (25.8%) referred to a naturopath at least a few times per year while nearly half (48.8%) stated that they would not refer to a naturopath under any circumstances. GPs were more likely to refer to a naturopath if the GP: was not initially from a rural area (OR=1.78; 95% CI: 0.95, 3.33); believes in the efficacy of naturopathy (OR=5.62; 95% CI: 2.42, 11.36); has seen positive results from naturopathy previously (OR=2.61; 95% CI: 1.35, 5.05); perceives a lack of other treatment options for their patient (OR=5.25; 95% CI: 2.42; 11.36); uses peer-reviewed literature as their major source of CAM information (OR=3.03; 95% CI: 1.65, 5.55); uses CAM practitioners as a major source of CAM information (OR=6.09; 95% CI: 2.91, 12.72); and does not have an existing relationship with any CAM provider (OR=3.03; 95% CI: 1.53, 6.25).ConclusionsThere is little interaction (both via referrals as well as the development of professional relationships) between the naturopathic and GP communities in rural and regional Australia, with significant levels of both support and opposition for naturopathic referral amongst GPs. The significant presence and high utilisation of naturopathy in rural primary health care, which appears to work in parallel to conventional medical care rather than in conjunction with it, should serve as an impetus for increased research into naturopathy practice, policy and regulation in rural and regional health.
| S-EPMC4226969 | biostudies-literature
Project description:Projections of future climate depend critically on refined estimates of climate sensitivity. Recent progress in temperature proxies dramatically increases the magnitude of warming reconstructed from early Paleogene greenhouse climates and demands a close examination of the forcing and feedback mechanisms that maintained this warmth and the broad dynamic range that these paleoclimate records attest to. Here, we show that several complementary resolutions to these questions are possible in the context of model simulations using modern and early Paleogene configurations. We find that (i) changes in boundary conditions representative of slow "Earth system" feedbacks play an important role in maintaining elevated early Paleogene temperatures, (ii) radiative forcing by carbon dioxide deviates significantly from pure logarithmic behavior at concentrations relevant for simulation of the early Paleogene, and (iii) fast or "Charney" climate sensitivity in this model increases sharply as the climate warms. Thus, increased forcing and increased slow and fast sensitivity can all play a substantial role in maintaining early Paleogene warmth. This poses an equifinality problem: The same climate can be maintained by a different mix of these ingredients; however, at present, the mix cannot be constrained directly from climate proxy data. The implications of strongly state-dependent fast sensitivity reach far beyond the early Paleogene. The study of past warm climates may not narrow uncertainty in future climate projections in coming centuries because fast climate sensitivity may itself be state-dependent, but proxies and models are both consistent with significant increases in fast sensitivity with increasing temperature.
| S-EPMC3761583 | biostudies-literature