The implementation of public health measures to control the current COVID-19 pandemic (such as wider lockdowns, overseas travel restrictions and physical distancing) is likely to have affected the spread of other notifiable diseases. This is a descriptive report of communicable disease surveillance in Central Queensland (CQ) for six months (1 April to 30 September 2020) after the introduction of physical distancing and wider lockdown measures in Queensland. The counts of notifiable communicable diseases in CQ in the six months were observed and compared with the average for the same months during the years 2015 to 2019. During the study’s six months, there were notable decreases in notifications of most vaccine-preventable diseases such as influenza, pertussis and rotavirus. Conversely, notifications increased for disease groups such as blood-borne viruses, sexually transmitted infections and vector-borne diseases. There were no reported notifications for dengue fever and malaria which are mostly overseas acquired. The notifications of some communicable diseases in CQ were variably affected and the changes correlated with the implementation of the COVID-19 public health measures.

BackgroundElevated waist circumference (WC) is an important risk factor for cardiovascular disease (CVD). Aboriginals in Australia are at higher risk of CVD compared to non-Aboriginals. We examined the association between waist circumference and CVD, and developed a model for projecting absolute risk of cardiovascular disease using WC and age in one high risk Australian Aboriginal community.MethodsWe followed up 920 (470 men, 450 women) participants (more than 80% of the eligible population) aged 18 to 76 years, without CVD at baseline, for up to 20 years. Hazard ratios were estimated using Cox proportional hazards models adjusting for potential confounding factors. Absolute risk was estimated using the Weibull regression model.ResultsOf 920 study participants, 156 males and 177 females developed CVD in the follow-up period. Incidence rates for males and females in the 4th WC quartile (Q4) were 38.3 (95% CI 29.6, 49.7) and 47.2 (95% CI 37.1, 60.3) respectively. Crude hazard ratios of CVD for Q4 WC group using Q1 (quartile 1) as the referent quartile were 2.9 (95% CI 1.8- 4.6) for males and 3.5 (95% CI 2.2- 5.5) for females. Association remained after controlling for age, smoking status and alcohol drinking status (HR = 1.8 for males and HR = 3.1 for females). At 45 years of age with baseline waist circumference of 100 cm, a male had an absolute CVD risk of 32.5%, while a female had a 30.6% risk of the disease.ConclusionsRisk of CVD among participants increased with increasing WC, and the relationship was accentuated with increasing age. The prediction model provides a tool for understanding the combined effects of WC with age on CVD events in the Australian Aboriginal community. It is simple and easily understood and will assist in identifying individuals at risk of CVD in relation to waist circumference values.

ObjectiveAlthough obesity is recognized as an important risk of mortality, how the amount and distribution of body fat affect mortality risk is unclear. Furthermore, whether fat distribution confers any additional risk of mortality in addition to fat amount is not understood.MethodsThis data linkage cohort study included 16415 participants (8554 females) aged 18 to 89 years from National Health and Nutrition Examination Survey III (1988–1994) and its linked mortality data (31 December 2011). Cox proportional hazard models and parametric survival models were used to estimate the association between body fat percentage (BF%), based on bioelectrical impedance analysis, and waist-hip ratio (WHR) with mortality.ResultsA total of 4999 deaths occurred during 19-year follow-up. A U-shaped association between BF% and mortality was found in both sexes, with the adjusted hazard ratios for other groups between 1.02 (95% confidence interval: 0.89, 1.18) and 2.10 (1.47, 3.01) when BF% groups of 25–30% in males and 30–35% in females were used as references. A non-linear relationship between WHR and mortality was detected in males, with the adjusted hazard ratios among other groups ranging from 1.05 (0.94, 1.18) to 1.52 (1.15, 2.00) compared with the WHR category of 0.95–1.0. However in females, the death risk constantly increased across the WHR spectrum. Joint impact of BF% and WHR suggested males with BF% of 25–30% and WHR of 0.95–1.0 and females with BF% of 30–35% and WHR <0.9 were associated with the lowest mortality risk and longest survival age compared with their counterparts in other categories.ConclusionsThis study supported the use of body fat distribution in addition to fat amount in assessing the risk of all-cause mortality.

ObjectivesTo predict in an Australian Aboriginal community, the 10-year absolute risk of type 2 diabetes associated with waist circumference and age on baseline examination.MethodA sample of 803 diabetes-free adults (82.3% of the age-eligible population) from baseline data of participants collected from 1992 to 1998 were followed-up for up to 20 years till 2012. The Cox-proportional hazard model was used to estimate the effects of waist circumference and other risk factors, including age, smoking and alcohol consumption status, of males and females on prediction of type 2 diabetes, identified through subsequent hospitalisation data during the follow-up period. The Weibull regression model was used to calculate the absolute risk estimates of type 2 diabetes with waist circumference and age as predictors.ResultsOf 803 participants, 110 were recorded as having developed type 2 diabetes, in subsequent hospitalizations over a follow-up of 12633.4 person-years. Waist circumference was strongly associated with subsequent diagnosis of type 2 diabetes with P<0.0001 for both genders and remained statistically significant after adjusting for confounding factors. Hazard ratios of type 2 diabetes associated with 1 standard deviation increase in waist circumference were 1.7 (95%CI 1.3 to 2.2) for males and 2.1 (95%CI 1.7 to 2.6) for females. At 45 years of age with baseline waist circumference of 100 cm, a male had an absolute diabetic risk of 10.9%, while a female had a 14.3% risk of the disease.ConclusionsThe constructed model predicts the 10-year absolute diabetes risk in an Aboriginal Australian community. It is simple and easily understood and will help identify individuals at risk of diabetes in relation to waist circumference values. Our findings on the relationship between waist circumference and diabetes on gender will be useful for clinical consultation, public health education and establishing WC cut-off points for Aboriginal Australians.

c4b-796f-49bd-87eb-5a111 35956 f5/16934.pdf. aspx?inlin e=true (viewed May 2021). ■Understanding the professional experience of both the rural physician workforce and junior physician trainees and the impact of their training or working location is vital. Given the lack of empirical evidence on the experience of rural physicians across all career stages, the aim of our study was to assess differences in the demographic characteristics, professional profile and professional satisfaction of rural and metropolitan junior physicians and physician consultants in Australia. MethodsOur study used data from the Medicine in Australia: Balancing Employment and Life (MABEL) study, a large longitudinal (annual cohort) survey of the Australian medical workforce. Specialty was self-identified, with only "physicians" included, using the Royal Australasian College of Physicians (RACP) definition (adult internal medicine, paediatric and child health) (Box 1). For junior doctors, due to small annual counts in MABEL, cross-sectional data were pooled between wave 1 (2008) and wave 9 (2016); however, only the first record (at each career stage) over the 9 years was included for analysis. In contrast, cross-sectional