This research assessed factors associated with willingness to comply with vaccination, isolation, and face mask wearing during an anticipated influenza pandemic. Data were collected from 2081 adults (16+) using a module of questions incorporated into the NSW Health Adult Population Health Survey. High levels of willingness to comply were reported with 73% either very or extremely willing to receive vaccination, 67% willing to isolate themselves, 58% willing to wear a face mask, and 48% willing to comply with all three behaviors. Further analysis indicated concern for self and family and higher levels of education were associated with high levels of willingness to comply. Younger people (16–24) were the least willing to comply; especially with wearing a face mask. Those with children reported higher levels of willingness to receive vaccination, and respondents who speak a language other than English at home were less willing to isolate themselves or comply with all behaviors. These findings provide a baseline measure of anticipated public compliance with key public health behaviors in the event of an influenza pandemic in the Australian population, and help to identify groups that may be more resistant to individual measures and may require additional attention in terms of risk communication strategies or health education.
Objective To evaluate three birth‐weight (BW) standards (Australian population‐based, Fenton and INTERGROWTH‐21st) and three estimated‐fetal‐weight (EFW) standards (Hadlock, INTERGROWTH‐21st and WHO) for classifying small‐for‐gestational age (SGA) and large‐for‐gestational age (LGA) and predicting adverse perinatal outcomes in preterm and term babies. Methods This was a nationwide population‐based study conducted on a total of 2.4 million singleton births that occurred from 24 + 0 to 40 + 6 weeks' gestation between 2004 and 2013 in Australia. The performance of the growth charts was evaluated according to SGA and LGA classification, and relative risk (RR) and diagnostic accuracy based on the areas under the receiver‐operating‐characteristics curves (AUCs) for stillbirth, neonatal death, perinatal death, composite morbidity and a composite of perinatal death and morbidity outcomes. The analysis was stratified according to gestational age at delivery (< 37 + 0 vs ≥ 37 + 0 weeks). Results Following exclusions, 2 392 782 singleton births were analyzed. There were significant differences in the SGA and LGA classification and risk of adverse outcomes between the six BW and EFW standards evaluated. For the term group, compared with the other standards, the INTERGROWTH‐21st BW and EFW standards classified half the number of SGA (< 10th centile) babies (3–4% vs 7–11%) and twice the number of LGA (> 90th centile) babies (24–25% vs 8–15%), resulting in a smaller cohort of term SGA at higher risk of adverse outcome and a larger LGA cohort at lower risk of adverse outcome. For term SGA (< 3rd centile) babies, the RR of perinatal death using the two INTERGROWTH‐21st standards was up to 1.5‐fold higher than those of the other standards (including the WHO‐EFW and Hadlock‐EFW), while the INTERGROWTH‐21st‐EFW standard indicated a 12–26% reduced risk of perinatal death for LGA cases across centile thresholds. Conversely, for the preterm group, the WHO‐EFW and Hadlock‐EFW standards identified a higher SGA classification rate than did the other standards (18–19% vs 10–11%) and a 20–65% increased risk of perinatal death in term LGA babies. All BW and EFW charts had similarly poor performance in predicting adverse outcomes, including the composite outcome (AUC range, 0.49–0.62) for both preterm (AUC range, 0.58–0.62) and term (AUC range, 0.49–0.50) cases and across centiles. Furthermore, specific centile thresholds for identifying adverse outcomes varied markedly by chart between BW and EFW standards. Conclusions This study addresses the recurrent problem of identifying fetuses at risk of morbidity and perinatal mortality associated with growth disorders and provides new insights into the applicability of international growth standards. Our findings of marked variation in classification and the similarly poor performance of prescriptive international standards and the other commonly used standards raise questions about whether the prescriptive international standards that were constructed for universal adoption are indeed app...
Background: This study investigates the relationships between health and lifestyle factors, age and private health insurance (PHI) in a large Australian population-based cohort study of people aged 45 years and over; the 45 and Up Study. Unlike previous Australian analyses of relationships between health, lifestyle and PHI, it incorporates adjustment for multiple confounding socioeconomic and demographic factors. Recruitment into the 45 and Up Study began in February 2006 and these analyses relate to the first 103,042 participants who joined the study prior to July 2008. Results:The proportion with PHI decreased with increasing age. The factors independently and most strongly associated with having PHI were: higher income; higher educational attainment; not holding a health care concession card; not being of Aboriginal/Torres Strait Islander origin; being a non-smoker; high levels of self-rated health and functional capacity; and low levels of psychological distress. These factors increased the probability of having PHI by 16% to 125%, compared to individuals without these characteristics. PHI coverage was significantly but only marginally higher in people reporting non-melanoma skin cancer (adjusted RR 1.04, 95%CI 1.03-1.05), prostate cancer (1.09, 1.06-1.11) or an enlarged prostate (1.07, 1.06-1.09), those reporting a family history of a range of conditions (e.g. 1.02, 1.01-1.03 for a family history of heart disease; 1.03, 1.02-1.04 for a family history of prostate cancer) and lower in people reporting diabetes (0.92, 0.91-0.94) or stroke (0.91, 0.88-0.94), compared to people who did not have these medical or family histories. PHI was higher in those reporting certain surgical procedures with RRs (95%CI) of 1.12 (1.09-1.15) for hip replacement, 1.10 (1.08-1.13) for knee replacement and 1.12 (1.09-1.15) for prostatectomy, compared to those not reporting these interventions. Conclusion:Compared to the rest of the study population, those with PHI are richer, better educated, more health conscious, in better health and more likely to use certain discretionary health services. Hence, PHI use is generally highest among those with the least need for health care. Whether or not people have PHI is more strongly associated with demographic and lifestyle factors than with health status.
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