1. health and fitness

TABLE OF CONTENTS
Foreword
2
Director’s Report
3
Special Events
5
Staff
10
Adjunct Appointments
13
Guest Lecturers
15
Education and Training
16
Doctoral Students
19
Student Achievements
20
Research Activities
22
Tropical Infectious Diseases
22
Indigenous Health
33
Cancer
39
Tropical Public Health
46
Injury and Occupational Health
47
Chronic Diseases
53
Other Research
54
Grants and Consultancies
60
Research Collaborators
63
Awards/Certificates
68
Peer-Reviewed Publications
73
Publications In Press
77
CD, Books, Monographs & Other Professional Publications
78
Reports
80
Conference Presentations
81
Editorial Board Membership & Manuscript Review
84
Refereeing Grant Applications
85
Leadership in Professional Organisations
86
Financial Report
86
Acknowledgements
87
Abbreviations
88
Mission Statement
The Anton Breinl Centre for Public Health and Tropical Medicine seeks to undertake high quality
and relevant teaching, research and training in population health, with a special focus on Northern
Australia, Indigenous Australia and Australia’s near neighbours
Please note that throughout this document the following applies:
* Staff are indicated in bold text
* Students are indicated in underlined text
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 1
Foreword
also plays a key role in undergraduate
education across the growing range of
health professional programs taught at
James Cook.
The centre, very appropriately, is
positioning itself in new and evolving
areas of public health including disaster
management, obesity research and biosecurity and continues to be the national
pace setter on training in indigenous
public health.
The year under review has been
remarkably productive. Rick Speare and
the team are to be warmly congratulated
on maintaining the momentum of the
Centre and expanding its research and
teaching activities.
As an occasional visitor to the Centre
who understands what is required to
achieve these things, I am full of
admiration for the ongoing contribution
which the ABC team is making.
A perusal of the annual report reveals the
breadth and genuine depth of the
contribution which the Centre is making at
regional, national and global levels to
public health research and training.
The topics range from common parasitic
infestations
to
serious
mosquito
transmitted diseases, antenatal care,
many aspects of indigenous health, skin
and breast cancer, community safety,
disaster
management,
occupational
health and safety, travel health, and HIV.
The Centre's performance in attracting
prestigious grants is particularly pleasing.
Peer reviewed publications are flowing
freely, not only from the academic staff
but also at a remarkable rate from the
centre’s doctoral students.
Graduate numbers from its diverse
postgraduate teaching programs rank the
centre near the top of the national
performance stakes. Anton Breinl Centre
Bob Douglas
Emeritus Professor Bob Douglas
• Chair of the Advisory Board, Anton
Breinl
Centre,
James
Cook
University
• Visiting Fellow at the National
Centre
for
Epidemiology
and
Population
Health,
Australian
National University.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 2
Director’s Report
graduates. This has had encouraging
outcomes. Already two of the first cohort of
medical graduates from JCU have enrolled
part time in our MPHTM. This mirrors an
interesting trend we have noted in the fall of
the average age of commencing students in
public health masters. Many more students
are recent graduates.
Training Public Health Researchers
2005 was a good year for the Anton Breinl
Centre with continued high numbers of
postgraduate students, good research
productivity, steady expansion into the
disaster and biosecurity area and renewal of
PHERP support.
Training the Public Health Workforce
The Anton Breinl Centre continues to play a
major role in Australia in training the public
health workforce at all levels, from rural
clinicians that now practice with a public
health perspective to key decision makers in
public health in central offices in health
departments. The figures on postgraduates
trained under the PHERP programme
showed that the Anton Breinl Centre was
positioned third in terms of masters
graduated over 1987-2003, with the
University of Sydney and University of NSW
in first and second position respectively out of
the 19 PHERP funded institutions. This was a
surprising result for a non-capital city
university, but highlighted the relevance of
our postgraduate masters to the workforce.
The Centre is also playing an increasing role
in bringing public health to the undergraduate
area. We now teach in all the School’s allied
health programmes (BOccThy, BSpExSc,
BPhysio, BSpPath), from first year to final
year. Staff also teach into the JCU MBBS.
Our input is mainly in health promotion,
research methods and health systems and,
for the medical course, tropical medicine. The
increase in numbers of undergraduate
students taught by the Anton Breinl Centre
has raised the profile of public health in new
Research training has also blossomed at the
Anton Breinl Centre. Doctoral students are
increasingly attracted to our Doctor of Public
Health although we do continue to enrol PhD
students. Our doctoral students are
encouraged to publish their work prior to
submission of the thesis and this is actively
supported by supervisors and the Centre. A
recent analysis of peer-reviewed journal
articles published per doctoral thesis showed
a high productivity. Of the 9 PhDs and 8
DrPH theses completed by 2004, the average
number of papers were 8.3 and 8.7
respectively. Medians were 7 and 7.5
respectively. Some candidates had an
amazing output; Lee Berger scooped the pool
with a maximum of 23 papers! The DrPH
thesis is equivalent to a PhD thesis, but DrPH
students also have additional requirements
that embed them as experts in their chosen
area of public health. One challenge within
the university environment is to achieve
recognition that the professional doctorate is
of equivalent academic standard to a PhD.
The good publication record of our DrPH
students helps to argue for this.
Research
The Anton Breinl Centre is a highly research
active unit. Research productively per
academic in terms of peer-reviewed
publications is above average for JCU.
Research on public health continues to be
applied with a focus on providing evidence for
decisions makers. Researchers also become
actively involved in implementation of actions
arising from their research findings. For
example, the skin cancer unit organises the
Skin Cancer Awareness Week in North
Queensland and the JCU head lice
information site on the WWW is referenced in
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 3
pamphlets and web sites from many health
and education departments. The Anton Breinl
Centre through the WHO Collaborating
Centre on Lymphatic Filariasis continues to
play a key role in WHO’s Pacific Programme
to Eliminate Lymphatic Filariasis by providing
research evidence to guide control strategies
and through expert advice input into TAGs.
The Centre recently became a member of
WHO’s Partners for Parasite Control and has
been active in control of soil transmitted
parasites in Tuvalu and East Timor, and has
recently started collaborating with World
Vision in this area. Research on Indigenous
health was given a significant boost in 2005
by the arrival of Dr Komla Tsey with his
innovative
research
on
empowering
communities. He joined the highly active
research group in Cairns working on health in
Indigenous
communities
in
North
Queensland.
The international competitiveness of the
Centre’s research was recognised in 2005
with the award of our first Gates Grand
Challenges in Global Health grant. Dr Scott
Ritchie and Dr Peter D’Abbs at the Anton
Breinl Centre’s Cairns campus were part of a
team to secure a grant to research a novel
method of control of dengue vectors.
Developments and Strategic Directions
The Centre’s infrastructure had a massive
boost with the opening of the teaching centre
by the Governor of Queensland, Quentin
Bryce, in early 2005. This is a dedicated
centre which allows us to offer our one and
two week block courses. It has also been
extensively used by the Faculty’s Indigenous
Support Unit. The Anton Breinl Centre
continues to have three physically separated
nodes; the main one in Medical Building 3 on
the Douglas campus, one in the Townsville
Hospital also at Douglas and a node on
JCU’s Cairns campus at Smithfield. All are
pressed for space. The critical deficiency,
however, is lack of a dedicated laboratory for
infectious disease work in Townsville. The
decision to combine with the School of
Veterinary
and
Biomedical
Sciences
(SVBMS) in building a new parasitology
laboratory has not proceeded quickly.
Evidently, tenders have been called, but we
still continue to use a small temporary
laboratory in SVBMS.
An area of major interest for us is disaster
health management and biosecurity. Our
Postgraduate Certificate of Disaster and
Refugee Health is very attractive to students.
Both core courses, Disaster Health
Management and Refugee Health, are
usually oversubscribed. The Centre has
established a productive working relationship
in disasters and biosecurity with the Health
Protection branch of WA Health via Dr Andy
Robertson, one of Australia’s practical
experts in this field. The recent publication of
the Centre’s first research paper on
bioterrorism has established some academic
credibility in the field of biosecurity. Our
subject, Public Health and Bioterrorism, our
first attempt at formally training the health
workforce in this topic, was also offered for
the first time in 2005.
We have always wanted to facilitate our
students’ learning experiences in a resource
poor tropical country in a safe environment
with good academic outcomes. Clinical
Tropical Paediatrics will be offered in Sri
Lanka in November 2006. Dr John Whitehall
is leading this development. Our minimal
target of 10 students has already been
exceeded, illustrating that this model may be
relevant for similar subjects such as tropical
medicine.
Thanks to the Team
The Anton Breinl Centre team has worked
well in 2005 with harmonious and productive
relationships between academics and
administrative staff. I would like to take this
opportunity to thank all staff for their
contributions to our success.
Rick Speare
Rick Speare
Acting Director
Anton Breinl Centre
James Cook University
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 4
Special Events
OFFICIAL OPENING OF
ANTON BREINL CENTRE ANNEX
Pictured from left to right: Prof Ian Wronski, Pro
Vice Chancellor (FMHMS), Prof Harry Hyland,
Deputy Vice Chancellor and Quentin Bryce,
Governor of Qld.
The Governor of Queensland, Her Excellency
Ms Quentin Bryce officially opened the new
Anton Breinl Centre on the 7th of March 2005.
Construction of the $1.5m centre started in
August 2004.
of health professionals in these regions.
The Anton Breinl Centre is dedicated to
specialising in public health issues in tropical
Australia as well as rural and remote
Indigenous communities.
The Anton Breinl Centre started in 1910
when concern was mounting about the health
of white workers in northern Australia. It was
then called the Australian Institute of Tropical
Medicine.
The Centre’s research, along with the
postgraduate and undergraduate teaching
programmes are designed to serve the needs
The Centre took on its current name in 1988,
named after the inaugural director of the
centre, Dr Anton Breinl.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 5
HOOKWORM INFESTATION
TO HELP CROHN’S DISEASE
ª
HOOKWORM
When Professor Rick Speare and Dr John Croese
infected themselves with hook worm to do a proof
of concept study on the impact of hook worm
infestation on Crohn’s disease, it caused wide
spread media coverage.
The Courier Mail – Science Hooks NQ
Pair
The research has been the first time the
hookworm’s progress through the human body
was captured on camera, with what is known as
the “pill cam”.
Professor Speare said his worms were still strong
& would live for 5 to 10 years. “We want to keep
the hookworms in us because we want to see if
they are useful for treating some diseases,” he
said.
ª
Townsville Bulletin - Cartoon
ª
Age – Scientist Sucker for Worms
It resulted in a variety of interesting articles:
ª
Sydney Morning Herald – Professor’s
resident hookers generate a gut reaction.
The stomach cramps Dr Speare experience after
the worms first took up residence have subsided
but there is still one downside, he said: “I came
home very excited and told my wife, ‘I’m producing
80’000 eggs a day’, and she said: ‘You filthy animal,
I’m not sleeping with you.’”
ª
The Sunday Mail – Hooked on true
sacrifice
Renee piling on the kilos to play Bridget Jones,
Russell bulking up for Gladiator, Angelina working
out for 12 hours a day so she could play Lara Croft.
Instead of talking about so called real sacrifices,
lets talk about Prof Speare and Dr Croese who, in
their quest to learn more about the conditions such
as Crohn’s disease, actually placed live hookworm
larvae on their skins in order to infect themselves.
ª
Townsville Bulletin – Eat Some Worms –
Researches swallow hookworms to monitor
human body’s reaction
Prof Speare has recorded an explicit home video
of himself with 39 friends. But his subject is a
different sort of intimacy to the Paris or Pamela
variety.
Look closely at the grainy black-and-white images
and you will see a colony of hookworms hanging
on to the walls of Prof Speare’s small intestine.
Far from reaching for the worming tablets, Prof
Speare plans to play host to the toothy
bloodsuckers for at least another five or six years.
ª
Sunday Telegraph - Why I’m Hooked on
the Real Sacrifices in Life
Humans appear to have a shared arrangement with
the parasite as the gut managed the number of
parasites present to best suit the infected person
and the hookworm’s survival.
If this control mechanism fails, hookworm disease
occures which cause excessive blood loss.
ª
Launceston Examiner - Scientists Eat
Worms in Name of Research
Queensland scientists are walking around with
the blood-suckers in their gut all in the name of
science.
Nobody likes me, everybody hates me, think I’ll eat
some worms. Remember that popular child hood
chant?
Well two scientists in North Queensland have taken it
further by infecting themselves with hookworms.
For the full story on the Hookworm
investigation go to page 59 of the Anton
Breinl Centre Annual Report.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 6
ABC ACQUIRES PORTABLE ALTITUDE CHAMBER
The Anton Breinl Centre recently acquired a
TrekSafe Portable Altitude Chamber (PAC)
for teaching in our subject, Travel Medicine.
The PAC is a new item of medical equipment
used on high altitude expeditions, and is used
in the emergency management of altitude
sickness. Severe altitude illness (including
high altitude cerebral oedema and high
altitude pulmonary oedema) is a life
threatening illness for which descent is the
main treatment. For occasions where
immediate descent is not possible, the PAC
works by increasing the pressure inside the
chamber, using a foot pump, simulating
descent. The design of the PAC incorporates
technology developed by NASA for space
missions. The PAC was used for the first time
in October by students and staff of our
postgraduate Travel Medicine programme.
RESEARCH SHOWCASE DAY
The 2005 Research Showcase is an initiative
by the School of Public Health, Tropical
Medicine and Rehabilitation Sciences. The
event is designed to give researchers within
the School opportunity to present work in
progress to their colleagues.
Byron Bay and the Townsville areas, to
present a variety of very informative material.
It was a great opportunity for all staff within
the school to discover the breadth of
research carried out by their colleagues.
This year’s event was a great success with
colleagues traveling from Cairns, Mackay,
Audience interaction during the SPHTMRS Research
Showcase day, 2005.
Peter d’Abbs reports on the research on Indigenous
health carried out by the Cairns group.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 7
REVISED THIRD EDITION
(2005) PRIMER OF TRAVEL MEDICINE
The Primer of Travel Medicine was first
published in 1996 with a second edition in
1998 and a third edition in 2002. The revised
third edition was published in late 2005 under
the continued editorship of Associate
Professor Peter Leggat from the Anton Breinl
Centre and Professor John Goldsmid from
the University of Tasmania. The book is
published by the Australasian College of
Tropical Medicine. It has been a popular
publication for the College and has been
used in several countries for their travel
medicine programs.
The Primer of Travel Medicine aims to give
concise, practical information for the general
practitioner or health professional, who
advises or manages people who travel,
particularly to more exotic destinations, as
well as for those studying travel medicine. As
the name suggests, it applies a “primer” or
framework upon which to build with further
reading,
training
and
experience.
NEW PROGRAMMES
LAUNCH OF PUBLIC HEALTH AND BIOTERRORISM SUBJECT
This subject is an elective
offering
for
those
undertaking postgraduate
programmes in public
health
and
tropical
medicine. The events of
the past 3 years and the resulting geopolitical state of affairs have created a need
for those in the public health sector to be well
versed in bioterror preparedness and
understanding. It is essential in this sociopolitical
climate
that
public
health
professionals have a rational approach to
managing public perceptions regarding
bioterrorism and are able to lead an
appropriate response to
suspected bioterror events.
James Cook University is
well placed to respond to
this niche.
Particular
expertise in the biological
agents that constitute the greatest threat and
the sociology of terror exist within the School
of Public Health, Tropical Medicine and
Rehabilitation Sciences. Consultation has
been undertaken with key organisations
involved in bioterror awareness in Australia
including the Department of Defence,
Department of Health and Ageing, and the
Australasian College of Tropical Medicine.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 8
PHYSIOTHERAPY AND SPEECH PATHOLOGY DEGREE
The Anton Breinl Centre service teaching into
undergraduate
programmes
saw
the
introduction of Physiotherapy and Speech
Pathology degree programmes in 2005.
From 1st to 4th year levels, staff teach public
health perspectives with all of the Allied
Health programmes. As a consequence of
these two new programmes there has been a
large increase in the undergraduate teaching
load which has led to an increase in staff.
DIVINE WORD UNIVERSITY/MODILON GENERAL HOSPITAL
The Anton Brienl Centre began partnerships
with Divine Word University (DWU) and
Modilon General Hospital (MGH) in Madang,
Papua New Guinea.
The Centre’s role is to assist DWU to develop
the research skills of its staff and students
and to stimulate research activities at MGH.
Library of Divine Word University, Madang.
Several joint initiatives included:
ª
ª
A/Prof Reinhold Müller and Dr Petra
Büttner conducted an interactive
workshop introducing staff of Divine
Word University to statistical analysis
using SPSS, a statistical package for
quantitative data analysis.
ª
ª
MGH supervised by David Reeve from
the Anton Breinl Centre.
Alan Hauquitz collaborated on two
HIV/AIDS projects in Madang.
Alan Hauquitz collaborated with PNG
Institute of Medical Research on a
survey of socio-economic indicators in
rural Madang district.
Placements
for JCU Biomedical
Sciences students were undertaken at
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 9
Staff
DIRECTOR
PROFESSOR
ª
Tropical Medicine and Rehabilitation
Sciences
Rick Speare
BVSc(Hons) Qld
MBBS(Hons) Qld PhD
Qld FAFPHM FACTM
MACVS
Acting Head - School of Public Health,
ª
Acting Director - Anton Breinl Centre
for Public Health and Tropical Medicine
ª
Coordinator - Tropical Infectious and
Parasitic Diseases Group
ª
Coordinator - DrPH/PhD programme
ASSOCIATE PROFESSORS
Peter d’Abbs BA(Hons) Melb MA Exe PhD
ª
Melb
ª
Academic Advisor - Public Health and
Tropical Medicine
Coordinator - Cairns Research Group
ª
Chair and Monitor - JCU Human Ethics
Committee
Peter Leggat BMedSc Qld MB BS Qld MMedEd
Dundee MPH Otago MHSc(AvMed) Otago DrPH
JamesCook PhD SAust MD Qld PGDipClinNutr IAN
GDipEd(Tert) DDIAE DTM&H Mahidol DIH Otago
GDip(CDA) NE PGCertTravelMed JamesCook
GCertAeSpaceMed Griff PGCertAeMedEvac Otago
GCertAstron JamesCook FAFPHM FACTM FFTM
FACRRM FSIA FAICD MACE ACPHM(CMSA)
HonMNZSTM WSO-CSE/CSM/CSS(OSH)/CSSD
JP(Qual)
ª
ª
Member - James Cook University 14th
Council
ª
Coordinator - MPH, MPH&TM, DTM&H
Programmes
Reinhold Müller MSc Erlangen PhD Heidelberg
ª
Coordinator - Occupational Health
Research Group
Deputy Director - Anton Breinl Centre
SENIOR LECTURERS
Petra Büttner MSc Erlangen-Nuremberg PhD
Berlin
Deon
Canyon BScF PNGTech BSc(Hons)
JamesCook PhD JamesCook GCertEd JamesCook
MPH JamesCook
ª
Web Manager
Alan Hauquitz AssocSc NY State BA NY State
MHlthSc Johns Hopkins ScD Johns Hopkins
Chris Kennedy MBBS Adel MPH&TM JamesCook
GDipHlthAdmin SATech DRCOG FRACGP FRACMA
Wayne Melrose BAppSci RMIT ThDip
AustCollTheology MPH&TM JamesCook DrPH
JamesCook FAIMS FACTM MNZIMLS JP(Qual)
ª
Director, WHO Lymphatic Filariasis
Collaborating Centre
ª
Laboratory Manager
ª
Workplace Health & Safety Officer
Adrian Miller BA JamesCook
Mark Wenitong MBBS Newcastle DipClinLabTech
DDIAE
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 10
LECTURERS
Monika Buhrer-Skinner DipGenNurs Germ RN
Anaes Switz Endorse for Sexual & Reproductive Health
Griff Endorsement for Immunisation RHTU
CertFamPlan FPQ BNSc JamesCook
Sue Devine MPH&TM JamesCook GCertEd
JamesCook GDipHlthProm Curtin RN RM
SENIOR PRINCIPAL RESEARCH FELLOW
Scott Ritchie BASc Iowa State MSc Iowa State
ª
PhD Flor
Coordinator – Vector Borne disease
Research in Cairns
PRINCIPAL RESEARCH FELLOW
Simone Harrison BSc JamesCook MPH&TM
JamesCook PhD JamesCook FACTM
ª
ª
Janice Smith BSc(Hons) Adel MSc Adel
PhD JamesCook
Coordinator - Skin Cancer Research
Group
PRINCIPAL RESEARCH OFFICERS
Dallas Young GDipIndHlthProm Syd
Sandy Campbell MAE ANU
ª
Field Research Coordinator – Cairns
ª
Barbara Schmidt MBA UNE BBusHlthAdmin QUT
Manager – Public Health Field Research
Programmeme, Cairns
SENIOR RESEARCH FELLOW
Madeleine Nowak BSc Syd DipNutrDiet Syd PhD
Anthony Carter BAppSc Syd GDipEpi
JamesCook
Newcastle MMSc Newcastle DrPH JamesCook
ª John McCaffrey Research Fellow
ª WMC Occupational Health Research
(QCF)
Fellow
Lee Berger PhD JamesCook
ª
ARC Post Doctoral – Research
Fellow
RESEARCH FELLOWS
Dale Hanson MBBS Flinders MPH&TM James
Cook FRACGP FACEM
ª
Komla Tsey
ª
NHMRC Research Fellow
Tom & Dorothy Cook Fellow
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 11
RESEARCH OFFICERS
Donald Barlow Cert IV Ind PHC
David MacLaren BAppSci MPH
Fiona Barnett MB ChB(Hons)
Stephanie O’Brien BN
Lynne Bartlett MPH JamesCook DrPH Scholar
Rohan Pratt BSc(Hons) Syd
Margaret Glasby RN Oamaru Hosp
Vicki Lea Saunders BPsych JamesCook
BHSc(Nursing) UCQ GradCertOncology Nursing NSW
Coll Nursing
MPH&TM JamesCook
David Reeve BSc (Hons) PGDipDevStud
Frances Leggat BSc(Hons) Qld PhD Qld MASM
MACTM
Craig Williams BSc(Hons) Adel GradDipEd Adel
PhD SAust
Diana Méndez BVSc
RESEARCH ASSISTANTS
Georgia Babatsikos BA MPH
Margot Morrisson BSc
Ruth Campbell
Kathryn Sloots RN BSc(Hons)
Jane Connell
Max Tinkana DipNurs DipHlthManagement
Jacqueline Harris BPsych
Rebecca Webb
Cindy McCutchan
Judy Woosnam
Adrian McInman BPsych MSc (Clin Psych)
ADMINISTRATIVE STAFF
Marcia Croucher
ª
Senior Student Officer
Belinda Menz
ª
Patricia Emmanuel
ª
Administrative Officer
Arianne Gardner
ª
Personal Assistant - Head of School
and Director, Anton Breinl Centre
Resource Officer- School of Public
Health, Tropical Medicine & Rehabilitation
Sciences
Judy Woosnam
ª
Student Officer
Ingrid Yamaoka
ª
Administrative Officer - Cairns
Margaret McDonald
ª
Human Resources and Finance
Manager - School of Public Health,
Tropical Medicine & Rehabilitation Sciences
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 12
Adjunct Appointments
PROFESSORS
Claus Garbe MSc(SocSc) MD PhD
Robert MacLennan MBBS DTM&H DCH MSEpi
MRCP FRACP
Virginia Hood MBBS MPH MRACP FRACP FACP
Eric Otteson MD
Wendy Hoy BScMed MBBS ABIM(Med)
Ian Ring MBBS MPH MSc FAFPHM DLSHTM
ABIM(Nephrol) FRACP
FACRRM
John Lowe DrPH MPH
ASSOCIATE PROFESSORS
Mary Deeble MAppEpid GDPH BMus MASM
John McBride MBBS DTM&H PhD FRCPA FRACP
David Durrheim MBChB Pretoria DTM&H
Arun Menon MBBS MRCP MTropMed MPH
FAFPHM FACTM FACSHP
Witwatersrand DcommHlth Pretoria MPH&TM
JamesCook DrPH JamesCook
Richard Murray MBBS DipRACOG MPH&TM
Peter Fenner AM MBBS MD MRCS DRCOG
MRCGP FACTM FRCGP
Gboyega Ogunbanjo MBBS MFGP MFamMed
FACRRM
Lynton Giles PhD MSc DC
Leonie Segal BEcon MEcon PhD
Geoffrey Gordon MBBS FFARACS DTM&H
MPH&TM PhD MACTM
Marc Shaw BMedSc MBChB DipTravMed DCH
DRCOG FRNZCGP FFTM FACTM
Jon Hodge MBBS MHA FRACMA MACTM
Ross Spark PhD MSc(PH) BA BEd
Bernie Hudson MBBS DTPH FRACP FRCPA
FACTM
Tukutau Taufa MD MPH MMed(O&G) DObst DMS
FACTM
Steven Larkin BSocW MSocSc
John Whitehall MBBS DCH BA MRCP FRACP
SENIOR PRINCIPAL RESEARCH FELLOWS
Moses Bockarie PhD Liverpool MscParasitology &
MedEntomology Liverpool MScZoology Sierra Leone
BSc(Hons)Zoology Sierra Leonie
John Govere MSc PhD
Tom Burkot BSc MSc PhD
David Podger BA PhD
Peter Gies PhD
Brian Reid BA MB BCh BAO MRCP
Alex Hyatt BSc(Hons) PhD DipEd
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 13
SENIOR LECTURERS
Peter Aitken MBBS FACEM
Stephanie Hodson BPsych JamesCook PhD
Macquarie
Trevor Barnes PhD Deakin GradDipTESOL SA
GradDipSocialScience New England BA Adelaide
Jack Maguire MBBS DRACOG FRACGP
Elizabeth Chalmers MBChB MPH FAFPHM
John Piispanen CTrain&Dev ADSH MPH&TM
FACRRM FAChAM
John Putland BA MBBS MPH&TM DipAvMed
Sophia Couzos MPH&TM DipObs MBBS BAppSc
MACTM FFTM
DipRACOG FRACGP FAFPHM
Darryl Krook PhD UQ MEd OK
BEd BCAE DipTeach MGCAE
Mark Elcock MBBS FACEM
PRINCIPAL RESEARCH FELLOWS
Aurel Moise MSc PhD
Scott Kitchener MBBS MPH FAFPHM FACTM
FRACMA
Jeffrey Hii BSc DAPE PhD FACTM
Billy Selve MBBS DipA DipTh MPH&TM
SENIOR RESEARCH FELLOWS
JP Chaine DrPH MSPH(Epid) BA
Derek Smith BSc Griffith MHSc QUT MPH
JamesCook DrPH USQ DrMed Yamanashi
Ashim Sinha MDMBBS(Hons) MD FRACP FACE
Ian Tassan MB ChB
LECTURERS
Marlize Booman DipPH MPH&TM
Rosemary Kennedy BA GDipSocSc GDipTESOL
Scott McLaren Bachelor of Social Science (Psyc)
PhD
CSU
Traven Lea MAE DipPH&TM
Kathryn Panaretto MBBS MPH GDipBioMedEng
Brad McCulloch BSc GDipCompSc MPH
David Rowlands BEcon(Hons) GDipBusAdmin
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 14
Guest Lecturers
Alison Abbot BSc(PH)
Andrew Johnson MBBS MHA FRACMA
Peter Aitken MBBS FACEM
Anne Jones BSc (Physio); MPhysio (Rural and
Remote Area Studies); Grad Cert in HSc (Ed)
Amanda Allen MPsych
Darryl Krook Bed DipT(SpecEd) MEdPsy
Glenda Bannan Cert IV(Assess WP Training)
Jose Antonio Bastos
MCounPsy
Stephen Leeder AO BSc (Med) MB PhD FRACP
FAFPHM FFPH(UK)
Anne Bent DipPhysio BAppSc(Physio)
GradCertPSM
Bronwen Blake
Diane Longstreet MPH APED
Kylie Fulwood BSc(Environ Health) Grad Cert
Health Prom
Suzanne Birch Assoc Dip Welfare St BHSc Grad
Cert Adult Learning & Tert Teach
Anton Maas
Yvonne Cadet-James RN
Arun Menon MBBS MRCP
FAFPHM FACTM FACSHP
Anthony Carter BAppSc Syd GDipEpi Newcastle
MTropMed
MMSc Newcastle DrPH JamesCook
Brad McCulloch MPH JamesCook
Marie Claude Brown
Anna Morgan MPH&TM MBBS
Tracy Cheffins MBBS FAFPHM FRACGP
Jim O’Brien
Jane Connell
MPH
Gboyega Ogunbanjo MBBS MFGP MFamMed
FACRRM
Megan Counahan BNurSc MPH&TM
Bill Doherty MSc
David Dürrheim MBChB Pret DTM&H WitW
DCH Pret MPH&TM JamesCook DrPH JamesCook
FFTM FACTM FARPHM
Debra Phillips BOccThy UQ
John Piispanen CTrain&Dev ADSH MPHTM
Robyn Preston BA(Hons) MHSc(Health Prom)
David Pitt BVs
Craig Edwards
Paul Reiter PhD
Lee Gasser Cert IV(Assess WP Training)
Andre Renzaho
Heather Ginard BNSc
Scott Ritchie PhD
Rai Gonsalkorale BS MBA
Andy Robertson MBBS
Brenda Green MPH&TM
Jenny Ryder DipAppSc(Nurs)
Dale Hanson MBBS Flinders MPH&TM
JamesCook FRACGP FACEM
Essam Shaalan PhD
Christine Hauff BPsych(Hons)
Ross Spark BEd BA MSc(PH) PhD
Deanne Heath PhD
Joanne Symons BSc (Hons) (Physio)
Debra Hedlef BPhys UQ
Penny Thompson BAppSc RN
Tamara Hogan BOccThy
Theo Vos MSc MD
Tambri Housen DiplomaTropicalNursing LonSHTM
John Whitehall MBBS MPH&TM
BNSc Curtin UT
Glenn Withers PhD
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 15
Education and Training
POST GRADUATE SUBJECTS OFFERED IN 2005
1ST SEMESTER
BLOCK MODE
ª
ª
ª
ª
ª
LIMITED MODE
ª Medical Entomology
EXTERNAL MODE
ª
ª
ª
ª
ª
ª
ª
ª
ª
Health Promotion
Tropical Paediatrics
Theory & Practice of Public Health
Biostatistics for Public Health
Communicable Disease Control
International Health Agencies & Development
Infectious Diseases
GIS, Writing & Computer Skills for Public Health
Clinical Travel Medicine
Independent Project
Project
Rural & Remote Environmental Health
Tropical Medicine
Dissertation
2ND SEMESTER
BLOCK MODE
LIMITED MODE
EXTERNAL MODE
ª
ª
ª
ª
ª
ª
ª
ª
Epidemiology for Public Health
Public Health Management
Disaster Health Management
Refugee Health
Tropical Medicine
Travel Medicine
Tropical Marine & Diving Medicine
Human Parasitology
ª
ª
ª
ª
ª
ª
ª
ª
ª
ª
Biostatistics for Public Health
Project
Human Health & Environmental Change
Managing Effective Health Programmes
Independent Project
Tropical Public Health
Public Health & Bioterrorism
Infection Control in Health Care Settings
Dissertation
Social Science in Public Health
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 16
COLLABORATIVE TEACHING
Petra Büttner
ª
Peter Leggat
Divine Word University, PNG
Introduction to Statistics using SPSS
-
ª
University of the Witwatersrand, South
Africa – South African Travel Medicine
Course – Visiting Professor
ª
Prince of Songkla University Hat Yai,
Thailand, Faculty of Dentistry – Visiting
Professor
Dale Hanson
ª
Melbourne University, Australia –
Postgraduate programme – Social
Network Analysis School of Psychology
ª
James Cook University, Townsville –
School of Medicine, Yr 3, Emergency
Medicine
ª
ª
ª
Madeleine Nowak
ª
James Cook University School of
Medicine - Yr 3 Preventive Medicine
and Addiction Studies
James Cook University, Mackay
Campus – School of Medicine, Yr 6,
Critical and Crisis Care
Wayne Melrose
Advanced Paediatric Life Support
(APLS) Australia – APLS Courses,
Monash Medical Centre (Melbourne),
Mackay
Reinhold Müller
ª
James Cook University
Laboratory Science
-
Medical
ª
Divine Word University, PNG Introduction to Quantitative Research
Methodology
ª
Universitaetsmedizin Berlin, Germany Workshop
on
quantitative
epidemiological methods in cardiology
Medical Workforce Qld, Australia –
Emergency Medicine Week
ENROLMENTS
Doctor of Public Health (Studies)
2
Doctor of Public Health (Thesis)
15
Master of Public Health and Tropical Medicine
182
Master of Public Health
96
Master of Public Health and Business Administration
5
Postgraduate Diploma of Tropical Medicine and Hygiene
14
Postgraduate Diploma of Public Health and Tropical Medicine
36
Diploma of Public Health and Tropical Medicine
2
Postgraduate Certificate in Travel Medicine
17
Postgraduate Certificate of Infection Control
6
Postgraduate Certificate of Disaster and Refugee Health
35
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 17
TM5501 TROPICAL MEDICINE COHORT 2005
Front Row (L to R): Jon Hodge (Adjunct
Associate Professor), Peter Leggat (Coordinator), Sally Munday, Priscilla Zulu,
Kate Stock, Phillippa Smith, Christine
Leon, Mark Hill-Ling.
Middle Row (L to R): James Daly, Bill
Troung,
Anna
Whitehead,
Briony
Hazelton, Barbara Villona, Melissa
McRae, Michelle Daly, Lorraine Moore.
Back Row (L to R): David Holford, Anil
Paichur,
Siobain
Fisher,
Fariba
Saadvandi,
Edward
Ricketts,
Uli
Terheggen, Nicky Harrison.
Absent: Rick Speare (Co-ordinator),
Wayne Melrose (Co-ordinator), Peter
Aitken, Jane Barrelle and Robyn
Mckenzie-Smith.
GRADUATES
Doctor of Public Health
2
Master of Public Health
13
Master of Public Health and Tropical Medicine
21
Graduate Diploma of Research Methods
1
Postgraduate Certificate of Infection Control
1
Postgraduate Certificate of Travel Medicine
2
Postgraduate Certificate in Disaster and Refugee Health
2
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 18
DOCTORAL STUDENTS
DOCTOR OF PUBLIC HEALTH
Modifications on Physical Activity
Levels of Community Members in the
Tropics
Peter Aitken
ª
Developing Disaster Health Education
and Training in Australia
Rosalyn Glazebrook
Fiona Barnett
ª
Faecal
Incontinence
Queensland
in
ª
North
Kelvin Billinghurst
ª
The Development and Evaluation of
Home Based Care as an appropriate
and
Sustainable
Community
Intervention in the Context of HIV in
Southern Africa
Len Brennan
ª
ª
ª
Development of an Evidence-Based,
Sustainable C Trachomatis control
Programme in a Primary Health Care
Setting Responsive to the Needs of the
Local Community
Models
for
Pharmacovigiliance
Countries
in
Effective
Developing
Peter Nasveld
ª
The Role of Tafenoquine in the
Prophlaxis and Treatment of Malaria in
Australian Defence Force Personnel
David Reeve
ª
Eliminating Lymphatic Filariasis
Addressing Remaining Questions
–
Marc Shaw
Treatment and Control of Head Lice
ª
Sue Devine
ª
Contributions to the surveillance of
infectious disease in the South Pacific
Ushma Mehta
Prevention, Risk Minimisation and
Control
of
the
Importation
of
Communicable Diseases by Military
Personnel
Returning
to
North
Queensland from Overseas Service
Megan Counahan
ª
Critical Evaluation of an Emergency
Department Injury Surveillance System
and Community Safety Promotion
Project in the Mackay/Whitsunday
Region and Implications for Rural
Injury Prevention
Sonia Harmen
Monika Buhrer-Skinner
ª
Continuing Professional Development,
Medical
Education
and
Quality
Asssurance of Rural and Remote
Medical Practitioners
Dale Hanson
Lynne Bartlett
ª
ª
Envenomation in Northern Australia –
Epidemiology and Clinical Effects with
implications for Clinical Management
and Public Health
Health Advice Provided for Travellers
and Expeditioners in New Zealand
Get Active Thuringowa: The Impact of
Recreational
Environmental
DOCTOR OF PUBLIC HEALTH STUDIES
Teresa O’Connor
ª
Models of Undergraduate Training for
Rural Nurses
Desiree Yap
ª
Premature
Menopause
Clinic:
Development of a New Hospital Service
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 19
DOCTORAL THESIS AWARDED
ª
Dr Sanjay
Patole
TITLE OF THESIS
Prevention of Feeding Intolerance and
Necrotising Enterocolitis in Preterm Neonates
TITLE OF THESIS
ª
Dr Scott Kitchener
The Efficient and Effective Use of Japanese
Encephalitis Vaccination in the Australian
Defence Force
TITLE OF THESIS
ª
Assoc/Prof
Peter Leggat
Health Issues, Health Advice & Malaria
Prophylaxis for Travelers in Australia & the
Region
Student Achievements
ACTM MEDAL 2005
AWARDED TO
ª
Dr David Ward MB
ChB MPH&TM
This Medal is awarded for the best overall
performance in the MPH&TM and is sponsored by
The Australasian College of Tropical Medicine.
PREVIOUS ACTM MEDALISTS
1998 Dr Carmel Nelson MBBS MPH&TM
1999 Dr David Dürrheim MBChB DTM&H DCH
MPH&TM FACTM
2000 Dr Robyn Lucas MBBS MPH&TM
2001 Dr Sally Murray MBBS MPH&TM
2002 Dr Christopher Butler MBBSMPH&TM
FANZCA
2003 Dr Susanna Fleck-Hanley MD MPHTM
PGCTravelMed
2004 Dr Elizabeth MacKinnon MBBS FACRRM
MPH&TM
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 20
SIDNEY SAX MEDAL 2005
AWARDED TO
ª
Dr Deon
Canyon BScF
PNGTech BSc
PhD GCertEd
MPH
ª
Dr John
Rawstron
This Medal is awarded for the best overall
performance in the MPH and is sponsored by
the School of Public Health, Tropical
Medicine and Rehabilitation Sciences and is
endorsed by the Sax Family.
MBBS MPH
PREVIOUS SIDNEY SAX MEDALISTS
2002
2003
Brendan Gray MBChB MIR MPH
John Philip Piispanen CTrain&Dev ADSH
MPH
2004
Dr Clare Huppatz MBBS BSc MPH&T
MASTA MEDAL 2005
AWARDED TO
ª
Dr Dorothy
Dowd MB ChB
Musculoskeletal
Medicine PG
DipPH & TM
PGCertTravMed
This Medal is awarded for outstanding overall
achievement in the PGCTravelMed and is
sponsored by the Medical Advisory Service
for Travellers Abroad.
PREVIOUS MASTA MEDALISTS
2002 Dr Susanna Fleck-Hanley MD
PGCTravelMed
2004 Ross McLean Hutton BHlthSci
PGCTravelMed
2003 Not awarded
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 21
Research Activities
TROPICAL INFECTIOUS DISEASES
STRENGTHENING SUB-NATIONAL COMMUNICABLE DISEASE
SURVEILLANCE IN REMOTE PACIFIC ISLAND COUNTRIES
The most pertinent lesson learnt from the
severe acute respiratory syndrome epidemic
was that inadequate surveillance and
response capacity in any country jeopardises
the public health security of the entire world.
Regrettably, developing countries with the
greatest risk for epidemics of communicable
diseases also generally have environments
most conducive to disease transmission,
particularly faecal-oral transmission. This is
the case for many Pacific Island Countries
and Territories (PICT) where large-scale
migration considerably increases the risk of
disease importation. Sustained efforts have
been made to strengthen PICT regional and
national outbreak capacity with support from
the Secretariat of the Pacific Community.
There is a growing realisation, however, that
unless
sub-national
surveillance
is
strengthened, prompt effective containment
will not be possible.
Tuvalu, a remote Pacific Island country with a
population of approximately 11,000 residents,
has experienced a number of devastating
communicable disease outbreaks and has
many features that make it vulnerable to
future outbreaks. This includes the relative
remoteness of the nine individual islands,
limited
clinical
and
public
health
infrastructure, unsatisfactory waste disposal,
regular destructive cyclonic activity, and a
large proportion of Tuvaluan males are seafarers
with
an
ongoing
threat
of
communicable disease importation. The
Ministry
of
Health
recognised
this
vulnerability and weaknesses of the existing
passive notification system, and embarked on
a
process
of
building
sub-national
surveillance capacity.
Through an incremental operational research
strategy, ongoing evaluation has allowed
refinement of this surveillance system,
resulting in regular zero-reporting from all
Island clinics, enhanced feedback to
reporters and alternate strategies for
notification when communication proves
difficult or impossible. The system allowed
effective containment of a dysentery
outbreak, with cases comparatively few when
compared with similar previous outbreaks.
Investigators: DN Dürrheim, T Nelesone,
R Speare, T Kiedrzynski, WD Melrose.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 22
BIOLOGICAL CONTROL OF MOSQUITOES
EFFECTS OF SUB LETHAL CONCENTRATIONS
OF SYNTHETIC INSECTICIDES AND CALLITRIS GLAUCOPHYLLA
EXTRACTS ON THE DEVELOPMENT OF AEDES AEGYPTI
Synthetic and botanical insecticides can have
a profound effect on the developmental
period, growth, adult emergence, fecundity,
fertility and egg hatching resulting in effective
control at sub lethal concentrations. This
paper investigated sub lethal concentrations
of fenitrothion, lambda-cyhalothrin and
Callitris glaucophylla Joy Thomps. & L.P.
Johnson
(Cupressaceae)
extract
to
characterize their effects on the development
of Aedes aegypti L. (Diptera: Culicidae)
mosquito larvae. The LC25, LC50 and LC75 (4
replicates) were used for each synthetic
insecticide and the LC25 and LC75 (4
replicates) were used for C. glaucophylla.
Observations of larval mortality, duration of
larval stage, pupal mortality, duration of pupal
stage, adult emergence, sex ratio and
malformations were recorded over 14 days. A
dose-response effect was observed for all
insecticides. Although C. glaucophylla extract
doses were higher than synthetic insecticide
doses, the LC75 treatment outperformed
synthetics by completely prohibiting adult
emergence. Consequently, this botanical is
recommended for field application either in
combination with synthetic or natural
insecticides or alone.
Investigators: D Canyon, E Shaalan.
SYNERGISTIC EFFICACY OF BOTANICAL BLENDS WITH AND WITHOUT
SYNTHETIC INSECTICIDES AGAINST AEDES AEGYPTI AND
CULEX ANNULIROSTRIS MOSQUITOES
Increasing insecticide resistance requires
strategies to prolong the use of highly
effective vector control compounds. The use
of combinations of insecticides with other
insecticides and phytochemicals is one such
strategy that is suitable for mosquito control.
In bioassays with Aedes aegypti and Culex
annulirostris mosquitoes, binary mixtures of
phytochemicals with or without synthetic
insecticides produced promising results when
each was applied at a LC25 dose. All mixtures
resulted in 100% mortality against Cx.
annulirostris larvae within 24 hours rather
than the expected mortality of 50%. All
mixtures acted synergistically against Ae.
aegypti larvae within the first 24 hours except
for one mixture that showed an additive
effect. We concluded that mixtures are more
effective than insecticides or phytochemicals
alone and that they enable a reduced dose to
be applied for vector control potentially
leading to improved resistance management
and reduced costs.
Investigators: D Canyon, E Shaalan.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 23
A REVIEW OF BOTANICAL PHYTOCHEMICALS
WITH MOSQUITOCIDAL POTENTIAL
Identification
of
novel
effective
mosquitocidal
compounds is essential to
combat
increasing
resistance rates, concern
for the environment and
food
safety,
the
unacceptability of many
organophosphates
and
organochlorines and the
high cost of synthetic
pyrethroids. An increasing
number of researchers are reconsidering
botanicals containing active phytochemicals
in their efforts to address some of these
problems. To be highly competitive and
effective, the ideal phytochemical should
possess a combination of toxic effects and
residual capacity. Acute toxicity is required at
doses comparable to some commercial
synthetic insecticides while
chronic or sub-chronic toxicity
is required to produce growth
inhibition,
developmental
toxicity
and
generational
effects. In this article, we
review the current state of
knowledge on larvicidal plant
species,
extraction
processes,
growth
and
reproduction
inhibiting
phytochemicals,
botanical
ovicides,
synergistic,
additive
and
antagonistic joint action effects of mixtures,
residual capacity, effects on non-target
organisms,
resistance,
screening
methodologies, and discuss promising
advances made in phytochemical research.
Investigators: D Canyon, E Shaalan.
MOSQUITO-BASED SURVEILLANCE SYSTEMS FOR
JAPANESE ENCEPHALTIS AND WEST NILE VIRUS, WITH
A RISK ASSESSMENT FOR WEST NILE VIRUS IN EASTERN AUSTRALIA
Japanese encephalitis (JE) is an emerging
arboviral disease that is a threat to human
and animal health in Australia. Outbreaks in
1995 and 1998 resulted in five human cases
in the Torres Strait, necessitating a costly
vaccination programme. The presence of JE
in Australia could have profound animal
trade, as well as human health, impacts, as it
can be fatal to equines and result in stillborne swine. Surveillance systems for JE in
Australia have involved herds of sentinel
pigs. While effective at detecting JE activity,
pigs are important amplifying hosts, thus
putting humans near the pig herds at risk.
Trials have been initiated to develop a
mosquito-based surveillance system utilising
remote mosquito traps.
Remote, propane-fueled traps and real-time
PCR can detect JE virus in dead mosquitoes
collected and housed within the trap for up to
2 weeks post collection. However, traditional
traps are cumbersome and expensive, and
so a new updraft trap (the Banks trap) is
being used in operational trials in the Torres
Strait, run in parallel with sentinel pigs on
Badu Island. We have shown that both such
traps can successfully detect JE virus, with
positive detections in each year from 20022005.
Since its arrival in 1999, West Nile Virus
(WNV) has caused annual major epidemics
in the USA, with thousands of human cases,
hundreds of deaths and a severe impact on
wildlife and agriculture, particularly horses.
Field and laboratory studies are being
conducted to quantify the receptivity of
eastern Australia to WNV should it arrive.
This involves testing mosquitoes for their
capacity to vector WNV and establishing if
epizootics of WNV that could cause human
epidemics are likely in urban areas. We have
conducted field trials using bird-baited traps
in the canopy to see if bird-feeding
mosquitoes are common. These mosquitoes
could be capable of initiating transmission of
WNV in birds should WNV arrive in Australia.
Investigators: S Ritchie, A van den Hurk,
G Smith, J Mackenzie.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 24
DEVELOPMENT OF “LURE AND KILL”
TECHNOLOGIES FOR THE CONTROL OF DENGUE VECTORS
Dengue is the leading cause of mortality and
morbidity due to arboviruses in the world, and
recent outbreaks have increased in North
Queensland,
Australia.
Dengue
is
transmitted by the mosquito Aedes aegypti
and, because there is no available vaccine,
vector control is important for effective
dengue control. Currently, dengue control
consists of killing Aedes aegypti by larviciding
and the interior spraying of premises with
persistent insecticides
to
kill
adult
mosquitoes.
It
is
laborious
and
intrusive, and people
and other non-target
organisms are at high
risk of exposure to
insecticides.
Lure
and
kill
strategies offer an
excellent opportunity
to control dengue
vectors
while
minimising nontarget
exposure
to
insecticides.
It
consists of a lure baited with chemicals
selectively attractive to the target organism,
and a lethal target or trap that kills the
attracted
animals.
Chemical
cues
(kairomones) used by female Ae. aegypti to
find bloodmeal hosts and oviposition sites are
coupled with killing agents (insecticides,
adhesives). This ‘lure and kill’ strategy being
trialed in North Queensland will have
application throughout the tropics where
dengue is a problem. It may also serve as a
valuable surveillance tool and have
application to other viruses such as West Nile
virus.
In recent studies, new sampling methods for
the Ae. aegypti were assessed in Cairns. The
newly available BG-Sentinel was found to be
more effective than the previous ‘gold
standard’ CDC backpack aspirator and other
carbon dioxide baited traps. BG-Sentinels
capture, blood-fed, gravid and nulliparous Ae.
aegypti and show great promise as a rapid
monitoring tool.
A comparison of sticky ovitrap designs was
also carried out in the field, allowing us to
determine the optimum trap and lure design
for catching Ae. aegypti trying to oviposit. The
effect of abiotic factors
such as height, wind and
shade on sticky ovitrap
performance has now
been
assessed.
This
information will directly
influence the work of
vector control officers in
North Queensland.
Kairomones
for
hostseeking Ae. aegypti from
Cairns were assessed in ytube
olfactometers
in
Germany, allowing us to
determine the optimum
lures for field use. Efforts
to refine ‘lure and kill’
technology against Ae. aegypti in North
Queensland continues in the form of fieldtesting.
We are also developing a biodegradable
lethal ovitrap in collaboration with colleagues
at Plantic Technologies. This project, funded
by Ausindustry’s Biotechnology Innovation
Fund, hopes to use biodegradable starches
to make a bucket that will biodegrade within
4-8 weeks.
The bucket can house
insecticidal strips used in the lure and kill
project above. Thus, staff can simply set out
the traps, let them do their work, and not
have to retrieve them.
Investigators: S Ritchie, C Williams,
R Russell.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 25
MODIFYING MOSQUITO POPULATION AGE
STRUCTURE TO ELIMINATE DENGUE TRANSMISSION
Dengue Fever (DF) and the more severe
Dengue Haemorrhagic Fever (DHF) have
been identified by the World Health
Organization (WHO) as among the most
significant
newly
emerging
infectious
diseases facing public health authorities. The
disease is now endemic in more than 100
countries, with South-East Asia and the
Western Pacific the most seriously affected
regions. An estimated 500,000 cases of DHF
require hospitalisation each year, many of
them children, and at least 2.5% of cases are
fatal. In Australia, Dengue occurs only in
North Queensland, where the mosquito
vector Aedes aegypti is common. Both the
frequency and intensity of outbreaks have
increased since the early 1990s.
The JCU team comprises an entomological
component, in which the population attributes
of Aedes aegypti will be studied in selected
sites in North Queensland, and a sociological
component, involving a study of perceptions,
beliefs and actions of key stakeholders –
including residents in at-risk localities –
relevant to prevention and control of DF/DHF.
There is no specific treatment for Dengue
Fever. The only method of preventing
DF/DHF at present is to combat the vector
mosquitoes. In order to transmit DF/DHF to
humans, vector mosquitoes must first carry
the virus for 10-12 days.
A team from James Cook University is part of
a multi-disciplinary, international project
funded by the Bill and Melinda Gates
Foundation,
combining
biological,
epidemiological, and social science research
in order to:
• develop a technique for modifying
mosquito populations to make them
incapable of transmitting dengue virus, by
introducing a life-shortening bacterium
(Wollbachia) into populations of the main
mosquito vector: Aedes aegypti;
• develop, in partnership with communities
and public health authorities in three
locations (North Queensland, Thailand,
Vietnam) a framework to integrate the
biological control strategy into existing
dengue control programmes, and
Pictured:
Researchers
from
Mahidol
University
(Thailand), University of Queensland and
James Cook University meet with public
health officials in Koh Chang, Thailand, to
plan field research for an international study
designed to improve control of dengue virus.
Investigators: S O’Neill, A Hoffman,
S Ritchie, P d’Abbs, B Kay, T Sasaki,
T Fukatsu, S Dobson, P Kittayapong,
P Butraporn, VS Nam.
• in one site (Thailand), field-test the new
strategy.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 26
BIOLOGY, ECOLOGY AND TRANSMISSION OF HEAD LICE
QUANTIFICATION OF BLOOD
INTAKE OF THE HEAD LOUSE, PEDICULUS HUMANUS CAPITIS
Although head lice, Pediculus humanus
capitis, are globally prevalent blood-sucking
ectoparasites, the amount of blood imbibed
by head lice has not been determined. This
study investigated this parameter, as regular
loss of a small quantity of blood may lead to
an iron deficiency and anaemia. Adult female
lice (66), adult males (46), and nymphs (152)
were weighed before and after feeding in
groups of 17–109 lice. The average amounts
of blood imbibed at a single feed were: adult
female louse (0.0001579 ml), adult
male (0.0000657 ml) and nymph
(0.0000387 ml). Assuming three
feeds per day by an average
infection of 30 lice (10 females, 10
males, and 10 nymphs), the
average
child
with
active
pediculosis would loose 0.008 ml
of blood per day. This amount of
blood loss is of no clinical
significance even in iron-deficient
children. The most heavily infected
child observed with 2657 lice
could be expected to loose 0.7
ml/day or 20.8 ml/month, which
may be of clinical importance in a
child on an adequate diet, and would be
significant in an iron-deficient child. However,
if head lice feed more often than three times
a day, a heavy infestation would have a
greater potential to lead to iron deficiency.
The frequency of feeding of head lice on the
head of the human host needs to be
determined.
Investigators:
WD Melrose.
R
Speare,
D
Canyon,
CONTROL OF HEAD LICE,
PEDICULUS HUMANUS CAPITIS IN PRIMARY SCHOOLS
Individual and community prevalence studies
have been conducted. These showed that
head lice are common in North Queensland
and Victorian primary school children, with
point prevalences of 19% and 13%,
respectively.
children. Parents submitted reports and children
were then examined at the school by skilled
head lice diagnosticians. The correlation
between written parental reports and the degree
of pediculosis was poor. Written reports were of
little value as monitoring tools for schools.
Written parental reports were trialled as a
technique to assist schools in assessing the
prevalence of pediculosis in primary school
Investigators: M Counahan, R Speare,
D Canyon, C Cahill.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 27
DO HEAD LICE SPREAD IN SWIMMING POOLS?
This study investigated the potential for
Pediculus humanus capitis (head lice)
transmission in swimming pools using an in
vitro experiment and a field trial. In the former
study, head lice (10 reps) were submerged
for 20 minutes in aqueous solutions:
deionised water, sea water, salt solutions (30,
60, 120 and 240 g/L), and chlorinated water
(0.2, 2 and 5.0 mg/L). In all trials, lice located
on cut hairs became immobile and did not
respond to physical prodding. After entering
stasis, no movement was observed until after
rescue from submersion and a brief recovery
period (0-1 min). Upon recovery, all lice fed
on blood and no associated mortality was
observed within the next 4 hours. In the latter
trial, 4 naturally infested individuals (3 reps)
swam in a chlorinated pool for 30 mins. No
loss of lice or head-to-head transfer was
observed. These results indicate that
although head lice survive immersion, head
lice transmission does not occur via the water
of swimming pools.
Investigators: D Canyon, R Speare.
DELOUSE –
INTERACTIVE ONLINE WEBSITE FOR HEAD LICE MANAGEMENT
Head
lice
(Pediculus
humanus var capitis DeGeer
Phthiraptera:
Pediculidae), are globally
prevalent obligate parasites
of humans that result in
pediculosis. Head lice are
an extremely successful
ectoparasite and have a
long history of association
with the human species.
The oldest record of head
lice on humans (Egyptian
mummies)
is
between
6900-6300 BC. Head lice
are
making
a
global
comeback in a big way and
it is not uncommon to find
infection rates of 5-20
% in schools in developed
countries. Two major reasons for this are
insecticide resistance and increased travel.
This interactive website presents the best
advice from Dr Deon Canyon and Professor
Rick Speare and synthesizes information
from other leading head lice experts around
the world. The website was designed for
people having trouble managing head lice. Its
step-by-step approach will provide a clear
guide to lice free heads! Some people will
remain lice infested no matter what they do
because the louse is an insect that
specialises in taking advantage of social
interaction which is a necessary part of
human life. You can get deloused at:
www.delouse.envirointel.com.
Investigators: D Canyon, R Speare.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 28
MELIOIDOSIS AND ADAPTIVE IMMUNITY
Melioidosis is a potentially fatal disease
caused by the environmental bacterium
Burkholderia pseudomallei. In humans,
infection with B. pseudomallei can range from
acute fulminating septicaemia to a subclinical
form identified only by seroconversion in an
infected individual. The main endemic foci of
melioidosis are in Southeast Asia and
northern Australia. Melioidosis is also
regarded as an emerging health problem in
certain developing countries, such as Papua
New Guinea (PNG). Individuals with
subclinical melioidosis have no apparent
clinical signs or symptoms, and are identified
only by positive serology. An investigation
was conducted on lymphoproliferation and
interferon-gamma production in response to
in vitro stimulation with B. pseudomallei
antigens in peripheral blood mononuclear
cells, collected under field conditions from
individuals with previous exposure to B.
pseudomallei in PNG.
Lymphocyte proliferation and interferongamma production was significantly greater
in individuals with previous exposure to B.
pseudomallei
when
compared
to
seronegative controls. Within the group of
individuals with previous exposure to B.
pseudomallei,
significantly
greater
proliferation
and
interferon-gamma
production was demonstrated in lymphocytes
from seropositive individuals with subclinical
disease compared to individuals who had
experienced clinical disease. Thus the
specific cell-mediated immune response
generated to B. pseudomallei in seropositive
individuals may be essential for protection
against disease progression in individuals
exposed to B. pseudomallei.
Investigators: JL Barnes, J Warner,
WD Melrose, DN Dürrheim, R Speare,
JC Reeder, N Ketheesan.
STRONGYLOIDIASIS
General practitioners who care for Aboriginal
patients in rural and remote communities
from tropical Australia must be aware of
strongyloidiasis. The prevalence of this
parasitic infection is high and occasional
cases have a fatal outcome. Other groups in
Australia at high risk of strongyloidiasis are
immigrants
from
endemic
countries,
particularly from southeast Asia, and military
personnel who have served overseas in
endemic areas. Elimination programmes for
enteric parasites in rural Australian
Indigenous communities are so important that
a nationally coordinated approach has been
advocated. Wisely used, cost-effective
diagnostic tests are a critical component of
an elimination programme. Strongyloidiasis
must be confirmed by laboratory diagnosis
and the strongyloides ELISA, although not
ideal, is a useful test that can be used to
diagnose strongyloidiasis and to monitor
cure. A cost analysis using direct costs to
investigate the cost-effectiveness of the
strongyloides ELISA proved more economic
per true positive case detected in
communities with a higher prevalence of
strongyloidiasis. In a typical rural Aboriginal
community in tropical Australia with
prevalence of strongyloidiasis at 20% each
true positive case detected by the
strongyloides ELISA was estimated to cost
approximately $590 for diagnosis and
management until cured.
Investigators: R Speare, DN Dürrheim.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 29
PREVALENCE OF CHLAMYDIA TRACHOMATIS IN DIFFERENT
SECTIONS OF THE TOWNSVILLE/ THURINGOWA COMMUNITY
Chlamydia is a highly infectious sexually
transmissible infection (STI), which is usually
asymptomatic and persistent in nature.
Chlamydia is a major cause of pelvic
inflammatory disease (PID), chronic pelvic
pain and tubal infertility in women. In men it
causes epididymo- orchitis and prostatitis and
possibly infertility. Highly sensitive and
specific tests are available for non invasive
testing. Treatment is a single dose of
antibiotics. The Townsville Thuringowa
community is disproportionately affected by
genital Chlamydia infection. Population based
data on prevalence and risk factors do not
exist.
This cross sectional study investigates the
prevalence of Chlamydia in different
segments of the population including risk
behaviours and socio- economic factors.
Investigator: M Buhrer-Skinner, R Müller in
collaboration with the Townsville Sexual
Health Service.
CHART AUDIT AND SUMMARY ANALYSIS OF
ROUTINELY COLLECTED, ANONYMOUS HEALTH SERVICE DATA OF
CHLAMYDIA TRACHOMATIS CASES BETWEEN 1 JUL 02 AND 30 JUN 04
Chlamydia is a highly infectious sexual
transmissible infection. High treatment rates
and short treatment intervals are important
strategies to reduce the transmission of
Chlamydia infection in the community.
This retrospective chart review investigates
the treatment rates and treatment intervals
for Chlamydia infection which was diagnosed
at the Sexual Health Service.
Investigator: M Buhrer-Skinner, R Müller in
collaboration with the Townsville Sexual
Health Service.
HOME TESTING FOR CHLAMYDIA TRACHOMATIS
Chlamydia is the most prevalent STI and is
mostly asymptomatic. Consequently affected
people don’t seek health care and
management for the infection which puts
them at risk of the long term sequelae. The
advent of new and improved testing methods
for Chlamydia infection makes it feasible to
use home testing as a strategy to increase
access to Chlamydia testing.
A cross sectional study on the acceptability of
home testing for Chlamydia infection will be
conducted.
Investigator: M Buhrer-Skinner, R Müller in
collaboration with the Townsville Sexual
Health Service.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 30
CONTROL OF SOIL TRANSMITTED NEMATODES – TUVALU
A baseline study to guide control
programmes for soil transmitted nematodes
in Tuvalu found a high prevalence of
parasitism on Nukufetau, one of the isolated
coral islands in this nation. Two hundred and
sixty faecal specimens from residents of all
ages living on Nukutefau were examined for
intestinal helminths. Seventy percent had
parasitic
nematodes,
with
whipworm
(Trichuris) at a prevalence of 68% being the
predominant parasite. Hookworm occurred in
12% of residents, most as a dual infection
with Trichuris. Prevalences of both parasites
were similar for both sexes, and for
whipworm was roughly the same across age
categories. Hookworm was less common in
the first two decades of life, being most
prevalent from 30 to 59 years.
The survey demonstrated that whipworm and
hookworm infection on Nukutefau is a
community-wide problem involving all ages,
not only primary school children as originally
suggested by a 2001 WHO survey. Control
strategies should adopt a community-wide
approach to reduce parasite burden and
intensity of infection by mass drug
administration (MDA) using mebendazole,
reduce faecal contamination of soil, reduce
contamination of food with soil containing
whipworm eggs, and reduce ingestion,
presumably inapparent, of soil containing
whipworm egg not associated with eating.
Investigators: R Speare, F Latasi, T Nelesone,
W Melrose, D Dürrheim, S Harmen,
J Heukelbach
ADVOCACY RESEARCH
ACUTE ADENOLYMPHANGITIS AS
Various qualitative research methods were
used to determine community members'
perceptions and knowledge regarding the
programme for Lymphatic Filariasis (LF)
elimination in the Misima area of Papua New
Guinea.
This included 650 household
surveys, in four villages.
It was found that LF is no longer considered a
problem in these communities. The majority
of people knew that LF was caused by
mosquito bites. People were generally willing
to take treatment again if necessary, but a
couple of focus groups reported declining
compliance.
In general, islanders were
happy with the drug distribution programme
and felt it was a benefit to the community as
LF was no longer a major concern and
people were healthy. Preventative measure
against the vectors of malaria, dengue and
LF were seldom used.
The findings from this project will be used to
design a health education campaign in Papua
New Guinea.
Investigators: P Leggat, G Hiawalyer.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 31
AN ELIMINATION SURVEILLANCE TOOL
Currently available LF surveillance strategies
are not ideal for ongoing monitoring postelimination for detection of residual or new
foci of disease. The periodic Lot Quality
Sampling recommended by the World Health
Organization to confirm LF elimination could
result in delayed detection of ongoing
transmission.
The utility of ongoing monitoring of episodic
acute adenolymphangitis (ALA), an important
clinical manifestation of LF, is being
investigated in collaboration
Tuvaluan Health Ministry.
with
the
Currently a cross-sectional serological survey
is being conducted in all nine islands to
describe the epidemiology of LF on Tuvalu.
The results of this survey will be compared to
the distribution of known ALA cases.
Investigators: DN Dürrheim, T Nelesone,
R Speare, WD Melrose, S Harmen.
FILARIAL EXPOSURE IN
AUSTRALIAN DEFENCE PERSONNEL RETURNING FROM EAST TIMOR
Lymphatic filariasis was a major problem
for the defence forces in the central Pacific
during World War II but very little has been
done to estimate the threat it poses today.
IgG1 and IgG4 antibodies are being
performed on troops before and after
deployment. Indications are that a small
number of troops had significant exposure to
the parasite and a paper has been prepared
for publication
Investigators: WD Melrose, P Leggat.
DIPSTICK FOR BRUGIA DIAGNOSIS
A rapid cassette test for the detection of
Brugia antibodies has been developed by the
University of Malaysia. The Anton Breinl
Centre field-tested it in Timor-Leste during
2005 and found to be effective and reliable
and a report has been prepared for WHO and
other stakeholders recommending its use in
filariasis control programmes.
Investigators: WD Melrose, D Reeve,
R Noordin.
CONTROL OF LYMPHATIC FILARIASIS,
INTESTINAL PARASITES AND YAWS IN TIMOR-LESTE
During the latter half of 2004, an innovative,
integrated disease control plan for lymphatic
filariasis, intestinal parasites and yaws was
developed for Timor-Leste. Epidemiological
information for the control plan was gathered
during JCU/WHO sponsored surveys during
2001-2003.
The
programme,
“Lumbriga…mak lae duni!” was implemented
in 2004 and continued in 2005. This is the
first time that an integrated approach to
controlling these three important diseases
has been developed and evaluation is
ongoing.
Investigators:
M Counahan.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
WD
Melrose,
D
Reeve,
Page 32
INDIGENOUS HEALTH
DOES A COLLABORATIVE APPROACH TO SHARED ANTENATAL CARE
SERVICES MAKE A DIFFERENCE IN URBAN INDIGENOUS WOMEN?
The purpose of this study, the Mums and
Babies Programme, was to evaluate the
impact of a community based collaborative
approach to shared antenatal care (ANC)
services on 1) access to services, 2) quality
of care and 3) pregnancy outcomes in
Indigenous women in Townsville.
This was a prospective quality improvement
intervention, in a cohort of women attending
Townsville Aboriginal and Islander Health
Services (TAIHS) for shared ANC between
January 1 2000 and December 31 2003 (MB
group), with a historical control group (PreMB
group).
The project resulted in a reduction in the
proportion of women having inadequate ANC,
an increase in the proportion of women
undertaking key antenatal screening, and a
reduction in preterm births.
The number of ANC visits per pregnancy
increased from 3 (interquartile (IQ) range 2-6)
in the pre programme group to 7 (IQ range 410,) in the programme group (p < 0.001).
There were significant improvements in care
planning, completion of cycle of care and
antenatal education activities throughout the
study period. Approximately 90% of all
women attending for ANC were screened for
STI, the proportions of women having a
minimum screen of haemoglobin, hepatitis B
and syphilis serology increased from 77% to
92% (p = 0.022). In the intervention group
(MB) compared to the PreMB group, there
was a significant reduction in preterm births
(8.7% cf 17.6%, p = 0.044) and improvement
in birthweight (3239 +/- 713gm cf 3043 +/831gm, p = 0.027). There was no statistically
significant improvement in perinatal mortality.
There were significantly less preterm births in
the MB group compared to recent state data.
A community based collaborative approach to
shared ANC services has significantly
increased access to improved antenatal care
and improved perinatal outcome amongst
Indigenous women in Townsville. The model
may be adaptable in other urban centres with
multiple ANC providers and significant
Indigenous communities across Australia.
Investigators: KS Panaretto, H Lee,
M Mitchell, S Larkins, V Manessis,
P
Büttner,
D
Watson.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 33
FIVE YEAR FOLLOW-UP STUDY OF INDIGENOUS ADULTS IN NORTH
QUEENSLAND: CHRONIC DISEASE AND SEXUAL HEALTH
This study aims to follow up a cohort of
Indigenous adults in rural and remote North
Queensland communities who participated in
the “Well Persons Health Check” (WPHC)
during 1998-2000. A follow-up study is being
conducted for consenting WPHC participants
(and any other adults who wish to
participate), which will give approximately
12,500 person-years of follow-up. This study
aims to:
• estimate the incidence rate of chronic
disease
conditions
(diabetes,
renal
disease, Cardio Vascular Disease (CVD))
and the main determinants of these in the
North Queensland cohort,
• estimate the change over a five year
period in risk factors (nutrition, tobacco
smoking, alcohol consumption, weight,
physical activity) and complications
(including hospitalisations) of those with
existing chronic conditions,
• at
community
level,
evaluate
the
effectiveness of local interventions aimed
at health improvement (for example, one
community has drastically changed rules
about
alcohol
availability,
other
communities have significantly improved
the supply of fresh fruit and vegetables, still
others have commenced family savings
programmes which improve the availability
of money over the week and enable
savings to buy fridges),
• determine whether the early detection of
chlamydia and gonorrhoea (using routine
urine PCR testing) has lowered the
community prevalence of bacterial STIs,
and
• evaluate the effectiveness of local health
promotion programmes (for example,
tobacco control initiatives, healthy weight
programmes).
Adult Health Check plus has been
undertaken in nine communities during 2005
with approximately 550 people attending.
Individual health results have been returned
to participants.
Investigators: R McDermott, P d’Abbs,
D Young, S Campbell.
SUSTAINING IMPROVED
DIABETES CARE IN REMOTE INDIGENOUS COMMUNITIES
This project built upon a successful
collaboration between JCU and the Health
Service in the Torres Strait which proved, in a
randomised cluster trial, that a communitybased system of managing basic diabetes
care in remote communities, led by properly
supported local Indigenous health workers,
improved diabetes care processes and
significantly
reduced
preventable
hospitalisations
from
complications
of
diabetes. The current project assessed the
sustainability and transferability of the chronic
care model over 4 years, looking at 3
domains of policy and resources, clinical
systems (including registers, recall and
reminder systems) and community and
patient perceptions of quality of care. The
study showed that while a sustained
improvement in diabetes care processes and
outcomes was achievable across the health
region, qualitative research also identified a
number of barriers to more effective
implementation. These were associated with
workforce retention and training in remote
areas, the need to clarify and optimise the
respective roles of nurses and Indigenous
health workers, lack of understanding about
the application of computerised client recall
systems, and dilemmas generated by the
continuing need to attend to acute as well as
chronic care.
Investigators: R McDermott, P d’Abbs.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 34
INDIGENOUS MEN TAKING THEIR RIGHTFUL PLACE IN SOCIETY? A
PARTICIPATORY ACTION RESEARCH PROCESS
Indigenous male groups are increasingly
being accepted as an important strategy in
improving
health
and
well-being
in
Indigenous communities. However it is hard
to find systematic documentation and
evaluation of such initiatives in the literature.
This project documents using a participatory
action research process, the evolving stages
of the Yarrabah Men’s Group in planning,
implementing and evaluating their activities.
Investigators: K Tsey,
Y Cadet-James, A Wilson.
M
Wenitong,
PUBLIC HEALTH WORKFORCE DEVELOPMENT IN
CHRONIC DISEASE PREVENTION, EARLY DETECTION AND
MANAGEMENT IN RURAL, REMOTE AND INDIGENOUS COMMUNITIES
The Northern Territory Department of Health
and Community Services and Queensland
Health have developed strategies to address
chronic disease prevention and management.
The NT strategy is Territory-wide, with
emphasis on Indigenous communities; the
North Queensland strategy specifically
targets Indigenous health, especially in
remote settings.
The Northern Territory
commenced
implementation
of
their
Preventable Chronic Disease Strategy in
1999 and Queensland Health commenced
implementation in 2001. Effective chronic
disease prevention and management has
required a change in policy, service delivery,
information
systems
and
workforce
development by health service funders and
providers to implement the evidence based
strategies required to prevent and reduce the
illness, disability and socio-economic impacts
caused by chronic disease.
(i)
Develop training courses which
provide workers with the skills to
deliver
primary
health
care
component of the Northern Territory
Department of Health and Community
Services
Preventative
Chronic
Disease
Strategy
(PCDS)
and
Queensland
Health’s
North
Queensland
Indigenous
Chronic
Disease Strategy;
(ii)
Develop research capacity in northern
Australia (in both research institutions
and service delivery personnel) which
can be applied to evaluate progress in
the implementation of the chronic
disease strategies
(iii)
Develop an evaluation framework for
Chronic Disease Strategies in rural
and remote populations.
James Cook University and Menzies School
of Health Research (Darwin) received funding
under the PHERP Innovations grant in
2002/03 for 3 years. In addition to these two
institutions, the project involves collaboration
with University of Queensland, Apunipima
Cape York Health Council, Aboriginal Medical
Services Alliance of the Northern Territory
(AMSANT), Queensland Health and the
Northern Territory Department of Health and
Community Services (NTDHCS).
The
objectives of the project are to:
The collaboration has produced the
outcomes expected from the PHERP grant
within the original timeframe proposed. A
Curriculum Development Framework has
been developed and was launched at the 9th
Rural and Remote Health conference in Alice
Springs in March 2005. An evaluation
framework for chronic disease strategies in
rural and remote areas has been prepared,
and is currently being piloted in both the NT
and North Queensland.
Investigators: R McDermott, P d’Abbs,
B Schmidt, J Smith, K O’Dea,
P Kelly, M Haswell-Elkings.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 35
WUCHOPPEREN SKIN STUDY
This study aims to identify the types of
bacteria causing skin infections at a large
urban Aboriginal and Torres Strait Islander
Health Service in Cairns, North Queensland,
and, explores the efficacy of current
treatment. It also contributes to a QIMR
project mapping out serotypes of Group A
Streptococcus in North Queensland.
Investigators: M Wenitong,
A Berger, J McCarthy, P Valery.
J
Stirling,
CLINICAL AUDIT OF WUCHOPPEREN HEALTH
SERVICE DIABETIC AND HYPERTENSIVE PATIENT MANAGEMENT
This study is a clinical chart audit of
hypertensive and Type 2 diabetic patients
treated at Wuchopperen Health service in the
last 12 months. It is part of the evaluation and
monitoring of an ongoing Continuous
Improvement Process for chronic diseases at
this health service.
Investigators: M Wenitong, D Young.
A TALE OF THREE DOCUMENTS
As background to the PHERP Review an
analysis was conducted to explore how the
ANAPHI network had contributed to priority
areas in public health in Australia in relation
to three cross-cutting themes:
ª
Workforce development
ª
Research
ª
Engagement with policy and health
service delivery.
Aboriginal and Torres Strait Islander health
was selected as one of four case studies
because of the pre-eminence of health
problems in that community, the wellrecognised failings of the Australian health
system and the importance of a population
health approach in addressing the problem.
Three recent national documents, which
directly relate to the themes for this case
study were analysed:
Public health workforce development:
Aboriginal and Torres Strait Islander health
workforce national strategic framework
(AHMAC, 2002)
Public health research: The NHMRC road
map: A strategic framework for improving
Aboriginal and Torres Strait Islander health
through research (NHMRC, 2003)
Public health policy development: national
strategic framework for Aboriginal and Torres
Strait Islander health (NATSIHC, 2003)
The resulting case study was presented to
the PHERP Review team.
Investigators: P Kelly, A Miller, R Chenhall,
B Genat, J Finn, I Anderson.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 36
CLUSTER RANDOMIZED TRIAL OF A
MULTI-STRATEGY TOBACCO CONTROL PROGRAMME
•
a school based tobacco education
programme,
•
a workplace smoke-free policy guide
for organisations,
•
a tobacco brief intervention in health
clinics,
•
support for Quit groups, and
•
monitoring of Queensland tobacco
laws in communities.
Expected outcomes include: greater
community awareness of tobacco risks,
more individuals contemplating changing
smoking behaviour with assistance from
health service staff, less recruitment of
younger smokers, lower tobacco sales,
more smoke-free environments and
greater compliance with tobacco laws in
participating communities.
Tobacco smoking represents the major risk to
life and health within Australian Indigenous
communities. Survey data suggest that
prevalence rates for the Indigenous
community are more than twice those of the
non-Indigenous population.
The Tobacco Project aims to implement and
examine the impact of a multi-intervention
anti-smoking
strategy
developed
by
Queensland Health in response to smoking
statistics. The strategy has six components:
•
an event support programme designed to
raise awareness about smoking risks,
The Tobacco Project is a three-year
randomised controlled cluster trial in eight
Indigenous
communities
in
North
Queensland. A number of the anti-smoking
interventions have embedded in them an
evaluation of implementation using a mix of
quantitative and qualitative methods. The
remainder of expected outcomes will be
measured at baseline, at midpoint and at the
end of the study. Midline data has now been
collected and analysed and community
reports will be disseminated in early 2006.
Investigators: R McDermott, D Young,
S Campbell, Y Cadet-James,
A Swinbourne, J Lloyd.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 37
POLICY RESPONSE TO INDIGENOUS PETROL SNIFFING
For more than 30 years, petrol sniffing by
youths
in
some
remote
Indigenous
communities has continued to generate
harms not only for the individuals involved,
but also for their families and communities,
and for health and welfare authorities
struggling to cope with inhalant-related
disabilities.
Throughout this period, despite the formation
of numerous inquiries, working parties and
intergovernmental committees, there has
been little accumulation of knowledge about
the nature and causes of sniffing, or about
the effectiveness of interventions. Policies
are fragmentary; programmes are rarely
evaluated, and most rely on short-term
funding. This project draws on case studies
of past policy responses to explain why this
should be so. We show that a number of
structural factors combine to marginalise
petrol sniffing as an issue, and to encourage
reliance on short-term, one-off interventions
in place of a sustained policy commitment. In
particular, petrol sniffing in Indigenous
communities appears episodically on the
public policy agenda thanks mainly to media
accounts; unsupported by any sustained
lobbying, however, the issue vanishes almost
as quickly as it appears. From the vantage
point of government bureaucracies, it tends
to be crowded out by other, more pressing
issues. As a policy issue, it tends to fall
between levels of government and, within
levels of government, between departmental
‘silos’. Within discourses of drug treatment
and policy, petrol sniffing—along with
inhalants generally—is marginalised further.
Finally, government responses have been
shaped by a policy discourse in which
Aboriginal ‘self-determination’ has been
conflated with notions of ‘community
responsibility’ in a manner that pays no heed
to the capacities or resources available to
most communities.
In the last few years, in part in response to a
series of highly critical coronial inquests,
several governments have begun to make a
more serious effort to address petrol sniffing
and other forms of inhalant misuse. These
developments are reviewed.
We argue,
however, that a number of outstanding issues
remain, namely: the need for government
agencies to devise more effective strategies
for engaging both with NGOs and Indigenous
community organisations; the need to
develop appropriate and effective treatment
and rehabilitation options; the need to
integrate police, health and welfare
responses to inhalant misuse, and the need
for effective means of monitoring inhalantrelated morbidity and mortality.
Investigators:
P d’Abbs, M Brady.
PHASE 1 EVALUATION OF BP AUSTRALIA:
3D STRATEGY FOR PREVENTION OF PETROL SNIFFING
BP Australia, in consultation with Australian
Government agencies, has developed a
programme to address petrol sniffing in
Indigenous communities. The programme,
known as the “3D Strategy”, comprises
components of Deterrence (roll-out of Opal
non-sniffable fuel), Diversion (funding for
diversionary activities) and Development (a
“return to school” programme). While the
rollout of Opal fuel is occurring on a national
basis, the other components of the 3D
Strategy are focused on Papunya, where
implementation commenced in February
2004.
A JCU-led research team has been engaged
by the Commonwealth Department of Family
and Community Services to conduct an
evalution of Phase 1 of the 3D Strategy.
The project involves conducting (1) a
retrospective
evaluation
of
Strategy
implementation; (2) establishing a baseline
dataset for ongoing evaluation of the
Strategy, and (3) developing a data collection
toolkit suitable for documenting petrol sniffing
and its effects at local and regional levels.
Fieldwork commenced late in 2005.
Investigators: P d’Abbs, G Shaw.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 38
THE POLICING IMPLICATIONS OF PETROL SNIFFING
AND OTHER INHALANT MISUSE IN
ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLES’ COMMUNITIES
Petrol sniffing and other forms of inhalant
misuse, such as the sniffing of aerosol paints
(‘chroming’), pose distinctive challenges for
law enforcement agencies, for a number of
reasons.
Firstly, use of most of the
substances involved is not, in itself, a criminal
offence, and the substances themselves are
readily available; secondly, in most places
where inhalant misuse occurs its prevalence
fluctuates, making it difficult to mount a
consistent response appropriate to needs,
especially given the presence of competing
demands upon police resources; thirdly, most
inhalant misusers are responding to
pervasive socio-economic disadvantage and
marginalisation; many come from families
with a history of involvement with police and
welfare agencies, and a high proportion are
Indigenous Australians.
The objective of this project is to conduct a
series of case studies and to review existing
literature in order to develop an evidencebase of law enforcement best practice for
addressing
inhalant
misuse
among
Indigenous communities.
Investigators: D Gray, P d’Abbs, A Mosey,
G Shaw, C Spooner.
CANCER
RANDOMISED CONTROLLED TRIAL OF SUN PROTECTIVE CLOTHING
whether it is possible to prevent or delay the
development of naevi that develop in early
childhood.
A randomised controlled intervention trial is
underway in 25 daycare centres in
Townsville, which have separate baby units
(n=12 control centres; n=13 intervention
centres).
The study aims to determine
All intervention centres have been provided
with sun-protective clothing for children in
their baby units. Naevus development
(number, size, and location of naevi) is being
monitored regularly for 3 years. Total and
site-specific naevus frequencies in the two
groups will then be compared. All naevus
examinations were completed in July 2005
and data analysis is ready to commence. The
design and baseline results of this study were
published in the American Journal of
Epidemiology this year.
Investigators: SL Harrison, P Büttner,
R MacLennan, J Woosnam.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 39
DEVELOPMENT OF NAEVI IN CHILDREN
In collaboration with Dr Juergen Bauer, a
German dermatologist currently based in
California, the natural development of naevi
in
children
was
investigated.
An
understanding of the natural development of
naevi is important as the number of naevi is
the strongest risk factor for cutaneous
melanoma.
A total of 173 children were followed for one
year and the development (growth or
regression) of 1929 single naevi was
assessed. Specific naevi characteristics were
noted. In addition, information on sun
exposure and sun protective behaviour of the
children and their parents was collected.
Statistical analyses were conducted on the
level of the child and on the level of the single
nevus,
applying
cluster
sampling
adjustments.
The results showed that the development of a
nevus was dependent on a mixture of nevus
specific characteristics (for example, body
site, atypical naevi, internal structures of
naevi) and sun exposure characteristics.
Investigators: J Bauer, P Büttner . E Andrä,
D Berner, A Blum, C Garbe.
THE RELATIONSHIP BETWEEN SOLAR UVR,
VITAMIN D, AND CANCERS IN NORTH QUEENSLAND
Non-melanocytic skin cancer is the most
frequently diagnosed malignancy in Australia,
and costs the health system an estimated
$278 million per year, which is considerably
more than any other form of cancer. Australia
also has an extremely high incidence of
melanoma and Caucasian children raised
here develop melanocytic naevi (moles: the
strongest phenotypic risk marker for
melanoma) earlier and in higher numbers
than children from elsewhere. As UV-B
radiation is expected to rise due to ozone
depletion, the risk of developing skin cancers
among Australians is likely to be further
increased. For the past 20 years, health
authorities, the various Australian Cancer
Councils and in particular the Queensland
Cancer Fund have promoted the importance
of sun safe behaviour to reduce the risk of
skin cancer in the Australian population.
However, recent reports of low levels of
vitamin D among some subsections of the
population, have raised concerns about the
associated osteoporosis risks and lead to
suggestions that “some” intentional UV
exposure is required. It is not possible to
counter these comments while the vitamin D
status of the Northern Australian population is
unknown. This study aims to provide such
information by measuring the vitamin D
status of selected subgroups in the
Townsville population.
Investigators: M Nowak, SL Harrison,
P Büttner, M Kimlin.
HUMAN PAPILLOMA VIRUS (HPV) AND
CUTANEOUS SQUAMOUS CELL CARCINOMA (SCC)
HPV appears to be associated with skin
cancer, particularly SCC. If HPV is related to
SCC, preventive vaccines or anti-viral
medications could be developed for high-risk
patients. A multi-centre study coordinated by
a
European
steering
committee
is
investigating this association, in collaboration
with QIMR in Brisbane and the Anton Breinl
Centre in Townsville. Both Australian centres
are conducting case-control studies with an
anticipated total recruitment of 300 cases
with sex and age matched controls. Data
collection includes a questionnaire, count of
solar keratoses, and samples of blood and
eyebrow hairs. Laboratory analyses are
currently underway in the Netherlands.
Investigators: SL Harrison, B Raasch,
P Büttner, A Green, R Neale, M Glasby.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 40
GEOGRAPHICAL VARIATIONS OF
CUTANEOUS MELANOMA IN QUEENSLAND
In 1991 MacLennan (unpublished) found large
geographic variation, based on four quadrants
of the State, in the incidence of melanoma first
diagnosed in 1987. The quadrants were
defined on the basis of postcode information
on residence at the time of diagnosis reported
to the Queensland Cancer Registry, and were
North and South of the Tropic of Capricorn and
East and West of the Great Dividing Range.
For invasive melanoma, the highest agestandardised rates in males were in the
subtropical coastal population, while the
highest in females were in the subtropical
inland population. The male and female rates
of invasive melanoma were almost reversed in
these two populations – coastal rates were
52.8 in males and 39.5 in female, whereas
inland rates were 43.8 in males and 51.7 in
females. Inland males did not differ in tropical
and subtropical populations, and had similar
rates to tropical coastal males. All three
populations had substantially lower rates in
males than subtropical coastal males.
These previous analyses raise interesting
hypotheses about possible geographical
differences in lifestyle, sun exposure and
melanoma. This project is set up to repeat
these analyses for all years for which data are
available from the Queensland Cancer
Registry. We also wish to extend the analyses
to include pathology variables, body site of
melanoma, survival, and other relevant
geographical classifications. In March 2005,
the investigators were gazetted to conduct the
proposed research.
Investigators: R MacLennan, PG Büttner.
AN EDUCATIONAL INTERVENTION TO CHANGE
RISKY BELIEFS AND PRACTICES OF MIDWIVES RECOMMENDING
THERAPEUTIC SUN EXPOSURE DURING INFANCY
The use of sunlight for medicinal purposes
dates back to ancient Rome and Greece.
However, it is assumed that our more
recently acquired knowledge of the
detrimental effects of sun exposure, such as
skin neoplasias have put an end to such
practices. The purpose of this project was to
develop, pilot and evaluate a targeted
educational intervention designed to address
risky beliefs about therapeutic sun exposure
held by a considerable proportion of the
nursing staff working in maternity hospitals in
North Queensland.
The project was
developed in response to earlier research
that identified the nature and extent of such
risky beliefs. Pre and post intervention
comparisons involved structured interviews
and
self-administered
questionnaires.
Midwives from three maternity hospitals in
North Queensland have participated in this
research. Data collection is now complete
and a draft manuscript is in preparation.
Investigators: SL Harrison, S Devine,
V Saunders, J Woosnam, M Morrison.
SAFETY AND LONG-TERM CLINICAL EFFICACY OF IMIQUIMOD 5% CREAM
The objective of this study is to determine
whether treatment with Imiquimod 5% cream
once daily, 7 days a week for 6 weeks to treat
basal cell carcinoma < 2cm is effective, and
to determine the safety and cosmetic
outcome of this treatment.
Eight of the nine initial participants continue
to participate in the 5-year follow-up review
schedule.
Investigators: B Reid, B Raasch, J Maguire,
R Miller, M Glasby.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 41
NORTH QUEENSLAND NON-MELANOMA SKIN CANCER PROJECT:
A MOLECULAR EPIDEMIOLOGICAL
STUDY OF RISK FACTORS AND AETIOLOGY
The Skin Cancer Research Group
has
started to establish two case-control studies
with newly excised basal cell carcinomas
(BCC) and squamous cell carcinomas (SCC)
from the high risk population of Townsville,
North Queensland. Nested in these casecontrol studies will be a longitudinal study
following the previous cases and controls for
three years. These studies will be conducted
to:
2) determine the aetiologic differences
between BCC and SCC with respect to
genetic mutation and HPV infection
(taking into account sun exposure and
host factors).
1) investigate the role of mutations in the
TP53 and PTCH tumour suppressor
genes and human papilloma virus (HPV)
infection in the development of BCC and
SCC (taking into account sun exposure
and host factors).
4) study the role of mutations in the TP53
and PTCH tumour suppressor genes and
HPV infection in the development of
incident and multiple non-melanoma skin
cancer (NMSC) (taking into account sun
exposure and host factors).
3) establish the relationships of mutations in
the tumour suppressor genes and HPV
infection to sun exposure and host
factors.
Investigators: SL Harrison, C Garbe,
PG Büttner, BA Raasch, T Iftner, O Riess.
EFFECT OF SUNSCREEN AND CLOTHING ON THE NUMBER OF
MELANOCYTIC NEVI IN 1812 GERMAN CHILDREN ATTENDING DAY-CARE
The number of melanocytic nevi is the most
important
risk
factor
for
cutaneous
melanoma. The present study analysed the
protective effect of sunscreens and clothing
on the number of melanocytic nevi in
children. A cross-sectional study was
conducted with 1812 children aged two to
seven years from 78 day-care centres in
Germany. Total body nevus counts in
children and assessment of pigmentary
features were performed. Parents underwent
a standardised interview concerning sun
exposure and sun-protective behavior.
Almost 95% of the children had previously
used sunscreen. Children who used
sunscreen and wore more clothing, were
significantly longer on holidays in sunny
climates (p<0.001 and p=0.006, respectively),
and had a higher outdoor activity score at
home (p<0.001 and p=0.012, respectively).
Multivariate
analysis
adjusted
for
confounders showed no significant protective
effects
of
applying
sunscreen.
An
examination of the potential protective effect
of clothing revealed an inverse doseresponse correlation between the number of
clothes worn at the beach or outdoor
swimming pool and the number of MN (p <
0.001;
adjusted
for
confounding).
Randomised controlled trials are needed to
confirm these results. Meanwhile public
education should aim to primarily protect
children by sun avoidance and protective
clothing while sunscreen should be
additionally used.
Investigators: J Bauer, P Büttner, T Sander
Wiecker, H Luther, C Garbe.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 42
AN INTERVENTIONAL STUDY IN 1232 YOUNG GERMAN CHILDREN TO
PREVENT THE DEVELOPMENT OF MELANOCYTIC NAEVI
Sunscreens have been proposed as
protective
measures
to
inhibit
the
development of melanocytic nevi in childhood
and, thereby, decreasing the long term risk
for cutaneous melanoma development. The
present study was planned to investigate the
influence of sunscreen use and education on
the number of incident melanocytic nevi.
1812 children in 78 public nursery schools in
two German cities were randomised to three
study arms: A) Parents were informed on
study purpose and sun protection measures
only at an initial educational meeting, B)
parents received educational material thrice
yearly, and C) education and 800 ml free
broad spectrum sunscreens with sun
protection factor 25 yearly. 1232 children (68
%) were available for the final assessment
after three years follow-up. Changes of sun
protection habits including sunscreen use
were sparse, without any differences
attributable to the intervention efforts. As a
consequence, there were no significant
differences between the three study arms for
the main outcome measure, the number of
incident melanocytic nevi. Analysis of the
sunscreen use in the entire cohort
irrespective of the study arms did not reveal
any impact on incident nevus numbers
neither in bivariate nor in multivariate
analysis. In conclusion, intervention with
educational letters and free sunscreens
seemingly had no additional effect on sunprotection for German children. High
prevalence of sunscreen use at study
commencement, social desirability, and
inadequate application of sunscreens might
have partially covered their effect.
Investigators: J Bauer, P Büttner, T Sander
Wiecker, H Luther, C Garbe.
RISK FACTORS OF INCIDENT MELANOCYTIC NEVI:
A LONGITUDINAL STUDY IN A COHORT OF 1232 YOUNG GERMAN
CHILDREN
The number of melanocytic nevi is the most
important independent risk factor for
cutaneous melanoma. Aim of the study was
to add information to the controversial
discussion on the role of chronic moderate
and intermittent high sun exposure and
sunburns for the development of melanocytic
nevi by the use of a large longitudinal study.
A longitudinal study with a three years followup was conducted in 1232 young German
children aged two to seven years. Total body
nevus counts, assessment of pigmentary
features, and nevus counts on arms of
parents were performed. Parents underwent
a standardised interview concerning sun
exposure, sunburns, and sun-protective
behavior.
Applying multiple linear regression analysis
higher numbers of incident nevi were
associated with host factors like light skin
complexion (skin type II vs. IV, p=0.022) and
freckling of the face (p<0.001), with parental
factors like nevus counts on mothers’
(p<0.001) and fathers’ (p=0.004) arms and at
least one parent being of German descent
(p=0.006), and with environmental factors like
intermittent high sun exposure during
holidays (p<0.001) and chronic moderate
ultraviolet radiation at home (p=0.007).
Sunburns were a significant risk factor for
nevus development (p=0.005).
Total cumulative sun exposure seems to be
the crucial environmental risk factor for the
development of nevi, whether the child is
exposed to chronic moderate or intermittent
high ultraviolet light doses. Public health
education should primarily focus on avoiding
sun exposure especially in children with fair
skin and parents with high nevus counts.
Investigators: J Bauer, P Büttner, T Sander
Wiecker,
H
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Luther,
C
Garbe.
Page 43
BASAL CELL CARCINOMA – HISTOLOGICAL
CLASSIFICATION AND BODY-SITE DISTRIBUTION
Basal cell carcinoma (BCC) is the most
common cancer worldwide in Caucasian
populations. Recent studies suggest that
BCC is not a single entity and that different
histological sub-types show different clinical
behaviour and might have different aetiology.
To provide information on the incidence of
BCC by histo-pathological sub-types and
body-site, a case-series of BCC will be
analysed from a prospective population-
based
register
like
study
collecting
information on all excised and histologically
confirmed skin cancers in Townsville, north
Australia between 1997 and 1999. This will
be the first study that provides sub-type
specific incidence rates for BCC.
Investigators: BA Raasch, PG Büttner,
C Garbe.
AUSTRALIAN WOMEN’S PRE-DIAGNOSTIC VALUES AND
INFLUENCING SOCIO-DEMOGRAPHIC VARIABLES RELATING
TO TREATMENT CHOICES FOR EARLY TREATMENT
Today in most western countries such as in
Australia, women are asked by their doctors
to choose from two equally effective
treatment alternatives as their preferred
treatment option for early breast cancer.
Evidence shows that many women are
distressed and confused about how to make
this treatment decision, and frequently seek
help from nurses, about the decision process
they should use to choose this treatment.
Unfortunately, very little is known about the
factors, which are important (values) to
women when choosing medical treatments.
Before evidence based decision support
interventions can be further developed and
evaluated, it is essential to obtain an
understanding of what factors are important
to women in their process of decisionmaking, before and after being diagnosed
with an early stage of the disease.
This cross sectional descriptive survey
investigated the pre-diagnostic decisionmaking values of Australian women in regard
to their influencing socio-demographic
variables relating to treatment choices for
early breast cancer.
The data were collected using the PreDecision Portfolio Questionnaire (PDPQ) by
Pierce (1996), and were gathered from 377
women
before
undergoing
routine
mammography screening.
Women identified that expected treatment
outcomes were the most important factor if
choosing early breast cancer treatment. The
majority of women reported that it was very
important that a treatment would reduce the
chances the cancer would return (95.6%),
increase the length of their life (82.1%) and
lead them to being healthy (80.4%). Also in
addition, women indicated that it was
important, or very important, that the
emotional consequences of the treatment did,
“not make you depressed” (88.6%) or sad
(90.4%) and should, “keep you from
worrying” (97%) and, “give you peace of
mind” (98.6%). Other factors, such as a
treatment’s side effects, were identified as
less important than the above factors to these
women. Age, employment, education and
having a family history of breast cancer were
found to be significant influencing variables
on women’s values.
Understanding early breast cancer treatment
outcomes is very important to women when
attempting to choose between treatment
alternatives. Nurses need to provide
information about treatment outcomes in a
clear format that women can process and
understand to help them make informed
decisions which are value–centred and suit
their lifestyles.
Investigators: LM Budden,
PF Pierce, PG Büttner.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
BA
Hayes,
Page 44
TREATMENT OF GASTRO-OESOPHAGEAL REFLUX DISEASE
BY GENERAL PRACTITIONERS IN NORTH QUEENSLAND
This study was designed to determine
whether and to what extent local general
practitioners use lifestyle modification in the
treatment of this disease, and to
ascertain
their
assessment
of
its
effectiveness.
Data were collected by questionnaire from
136 general practitioner members of the
Townsville Division of General Practice and
the Northern Queensland Rural Division of
General Practice (since renamed North &
West Queensland Primary Health Care). The
response rate was 70.5%. Most participants
saw <5 adult patients/week presenting with
GORD for the first time (87.2%). 24.3%
recommended the use of proton pump
inhibitors daily, 17.6% gave diet and postural
advice, 17.6% prescribed H2 antagonists
daily, 9.6% suggested antacids, 6.6%
referred for endoscopy, 5.9% recommended
H2 antagonists as required and 3.7%
prescribed proton pump inhibitors as
required. Older GPs (≥55 years) gave diet
and postural advise as a first line of treatment
more often than younger GPs (p=0.036).
These GPs recommended the following
lifestyle changes for the treatment of GORD:
postural advice (89.7%); avoiding known
precipitants (86.0%);
reducing weight if
overweight (79.4%); eating a diet low in fat
(45.6%); stopping smoking (17.6%); exercise
related advice (8.8%); limiting meal size
(7.4%); reducing caffeine (7.4%); and
reviewing medication (6.6).
Most GPs thought lifestyle changes beneficial
in GORD, but did not believe their patients
would change. Most GPs recommended
fewer than half the lifestyle changes their
peers believed to be effective in the treatment
of GORD. A manuscript from this work was
published in Therapeutics and Clinical Risk
Management in 2005.
Investigators: M Nowak, B Raasch,
K Daniell, SL Harrison, P Büttner,
C McCutchan.
TREATMENT OF GASTRO-OESOPHAGEAL
REFLUX DISEASE BY AUSTRALIAN DIETITIANS
This study examined the beliefs of dietitians
about lifestyle modification in the treatment of
GORD and collated the anecdotal experience
of these health professionals. All Australian
accredited practicing dietitians (APDs) were
invited to participate by answering a mailed
questionnaire which was distributed using the
Dietitians Association of Australia mailing
house.
Preliminary analysis of the data from the 797
respondents (response rate 65%) shows that
689 worked in positions where they consulted
patients either individually or in groups. Of
those, 56.2% did not usually see patients
who presented specifically for GORD, while
30.5% saw 1-2 such patients and 12.4% saw
≥3 such patients per month. Those who saw
patients made the following lifestyle
recommendations for the treatment of GORD
symptoms: reduce weight if overweight
(87.7%); avoid eating before lying down
(90.1%); elevate the head of the bed (75.3%);
avoid alcohol (69.5%); avoid spicy food
(72.96%); and eat a low fat diet (75.5%). In
addition,
60.5%
made
further
recommendations ranging from avoiding
large meals, caffeine, smoking, carbonated
beverages and known precipitants, to
increasing protein intake and considering
food sensitivity.
Ninety-eight percent of participants thought
that their patients with GORD would benefit
from lifestyle changes, with 81.2% believing
their patients were prepared to make the
required changes. A manuscript from this
work is being prepared
Investigators: M Nowak, SL Harrison,
P Büttner, C McCutchan.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 45
LIFESTYLE MEASURES IN THE TREATMENT
OF GASTRO-OESOPHAGEAL REFLUX DISEASE: A CASE SERIES
Gastro-oesophageal Reflux Disease (GORD)
is a common disorder with the classical
symptoms being heartburn and regurgitation.
It affects about 40% of adults and is most
often treated with medication.
Such
treatment is long-term and expensive.
Lifestyle modification is considered helpful,
but the effectiveness of this treatment has not
been established. This study retrospectively
examined the treatment outcomes from 23
consecutive GORD patients attending a
dietetic clinic for lifestyle modification
counselling.
Twenty two (45% females) reported an
improvement in symptoms with 11/18 taking
GORD medication at presentation reducing it
following treatment.
These results suggest that a more thorough
investigation of lifestyle modification for the
treatment of GORD is warranted. A
manuscript from this work is currently in
review with Therapeutics and Clinical Risk
Management.
Investigators: M Nowak, P Büttner,
K Daniell, B Raasch, SL Harrison,
R Speare.
TROPICAL PUBLIC HEALTH
E-LEARNING FOR PUBLIC HEALTH
ANY-DEPTH DIALOGUE TREES – BUILDING A WEB-BASED CASE STUDY GENERATOR
Software that allows any depth of interactive
dialogue to take place on the web can
provide an effective experiential learning
environment. In the simple case of a web site
delivering advice on head lice, for instance, a
visitor to the site can be asked a series of
questions where the form and content of
each question asked depends on responses
made to earlier questions. Immediately, there
is a focus on the visitor’s problem rather than
just information pages to wade through.
Unfortunately, however, delivering this
modality of paying attention to and
responding to a visitor’s needs requires an
intense programming effort, beyond the
capacity of most web developers. There are
very few examples of declarative, general
purpose solutions to interactive dialogue.
This project aims to remedy this lack.
The first phase of work on a solution is to
represent dialogue in a computer window as
an any-depth tree. The dialogue is divided
into Scripts which are, in turn, divided into
Questions, allowed Responses, executable
expressions (Actions), Decision points and
allowed Conditions. The general form of the
chosen solution is shown in the following
screen shot:
A prototype solution (Project 3: DeLOUSE )
has been completed for the head lice. The
next phase of the project will be to upload an
entered tree onto a MySQL database from
which it will be executed by generated
JavaScript code. The first phase of the work
has been successfully completed and the
results published in a three-part article, A
Tree in a Page Loaded Browse: the Sequel
by David Podger and Deon Canyon, in the
peer-reviewed e-journal Clarion Magazine
(27 Oct, 4 Nov and 11 Nov, 2005) that sets
out the method used. The next phase of the
work will depend on funding to engage an
expert JavaScript programmer.
Investigators: D Canyon, DN Podger.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 46
INJURY AND OCCUPATIONAL HEALTH
CAPACITY BUILDING AUDIT
The Mackay Whitsunday Safe Communities
Project has been developed using a capacity
building model in an attempt to build
community resources (people, organisations,
infrastructure & financial) which can be used
to promote and sustain safety.
how successful the project has been in
developing community capacity and to
undertake a formative assessment of project
sustainability. The utility of the tool is also
being assessed.
Investigator: D Hanson.
A Community Capacity Index has been used
by the Project Management Team to audit
ECOLOGICAL SAFETY PROMOTION
William Haddon, the “father” of modern injury
prevention, prophetically introduced the
concept of ecological injury prevention with
his foundational paper, “On the Escape of
Tigers: an Ecological Note”. Now, 30 years
later, Health Promotion has embraced an
ecological understanding of health and
safety, but with an emphasis on both the
physical and social environments. However,
Injury Prevention is a biomedical construct,
where injury is perceived to be a physical
event resulting from the sudden release of
environmental energy that produces tissue
damage in an individual. This reductionist
perspective overlooks the importance of
psychological and sociological determinants
of injury. Safety has physical, psychological
and sociological dimensions and can only be
understood within its ecological context.
The transition from researching “what works”
(efficacy) to researching “how to make it
work” in a complex social setting
(effectiveness) is not as straightforward as
many assume.
The Injury Iceberg – used with permission © Health Promotion Journal of Australia – April 2005
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 47
To illustrate this ecological construct of safety
promotion the “injury iceberg” is proposed.
The individual is just the “tip of the iceberg”,
the most visible and identifiable component of
a complex system in which the individual
interacts with his or her physical and social
environment. The most enduring means to
reduce an individual’s risk of injury in such a
system is to systematically address the
physical and social environmental factors
hidden beneath the water line, which
ultimately shape individual and social
behaviors that give rise to injury.
A comprehensive archival analysis and
literature review was conducted to develop
this theoretical construct.
Investigators: D Hanson, DN Dürrheim,
R Müller.
DOCUMENTING THE GROWTH AND STRUCTURE OF A
COMMUNITY SAFETY COALITION USING SOCIAL NETWORK ANALYSIS
Mackay Whitsunday WHO Safe Communities
(MWSC) was established in February 2000 to
address high levels of injury documented in
the region. By involving the community in
finding its own solutions, the MWSC hopes to
be a catalyst for structural, social and political
change necessary to promote safety in the
community. This study used Social Network
Analysis to document and analyse the
growth, structure and function of this
coalition.
A questionnaire regarding the nature and
quality of relationships was distributed
throughout the network. Respondents were
asked to name other individuals with whom
they interact in their work of promoting safety
in the community. Using a snowballing
methodology the chain of social relationships
was tracked beginning with the MWSC
Coordination Team (MWSC-CT).
In February 2000, the seven founding
members of the MWSC-CT had a direct
sphere of influence of 78 actors. By 2004
this had increased to include a network of
152 members, who in turn had contact with a
further 16 actors, creating a total network of
168 members. Since the project launch the
number of relationships has doubled from
500 in February 2000 to 1002 by December
2004. The average number of relationships
maintained by network members increased
from 3.0 to 5.9 (p<0.000). Not only has the
number of relationships improved but also the
quality of relationships. Fifty six percent of
relationship were said to be better as a
consequence of the project and in 36% the
depth of collaboration had increased. The
average
distance
separating
network
members decreased from 3.3 to 2.5,
achieved by improving links between well
connected members of the network (median
in-closeness centrality increasing from 2.25 in
2000 to 3.4 in 2004 (p<0.000), but more
importantly by better engaging poorly
connected members of the network (35% in
2000 decreasing to 8% in 2004).
The
network had become more cohesive with a
doubling of relational density [0.02 in Feb
2000 cf 0.04 by Dec 2004 (p < 0.0002)].
Relationships are now centralised around a
small group of key actors, all members of the
MWSC-CT.
The
Centralisation
index
increased from 16% to 43%. The network
now has a core periphery structure centred
on the MWSC-CT with the density of the core
group increasing from 0.24 in 2000 to 0.53 in
2004.
This affords the MWSC-CT a
structural opportunity to better co-ordinate the
network.
Social Network Analysis proved itself a
powerful tool for documenting the growth and
structure of the MWSC, offering some insight
into how the coalition works. Not only is the
MWSC more cohesive but the quality of
relationship has improved as has the
structural
efficiency
of
network
communication. This study suggests the
coalition has effectively developed the social
resources necessary to promote safety in its
community.
Investigator: D Hanson.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 48
MANAGEMENT OF IRUKANDJI SYNDROME IN NORTHERN AUSTRALIA
Irukandji syndrome, a
potentially
lifethreatening
condition
that follows the sting of
small carybdeid jellyfish,
occurs
along
the
northern
Australian
coastline from Broome,
Western Australia in the
west to Rockhampton,
Queensland in the east.
A telephone survey of
the
clinicians
responsible for Irukandji
syndrome
patient
management
at
34 coastal
northern
Australian health facilities
that might encounter this patient presentation
was conducted.
Basic clinical monitoring (blood pressure,
pulse, respiratory rate and oxygen saturation)
was generally adequately practised. Topical
application of vinegar as a first aid measure
was described by 79% of respondents, with
spontaneous mention of vinegar significantly
associated with increasing remoteness
(p = 0.023). Intravenous opiate analgesia was
administered at 91% of facilities, and
magnesium sulphate, a treatment that is still
being evaluated for its role in Irukandji
syndrome-related pain and hypertension, was
mentioned by 12% of respondents for pain
relief. Twelve different pharmacological
treatments were used for syndromeassociated hypertension, with magnesium
sulphate being mentioned by 21% of
respondents. Of the 22 facilities with
guidelines, 14 used either the Primary
Clinical Care Manual or the Central
Australian Rural Practitioners Association
Standard
Treatment
Manual. The remaining
guidelines
were
independently produced
protocols.
The
availability of guidelines
was associated with
appropriate use of intravenous
opiate for adequate pain
relief (p = 0.037). Although all urban
health centres and 75% of health
facilities
<50 km
away
had
guidelines, only 56% of more remote
or island facilities reported the
availability
of
guidelines.
Although monitoring and pain
management of patients with Irukandji
syndrome were generally appropriate, a
variety of inappropriate first aid and
hypertension management approaches were
found. In general, appropriate practice was
associated with the presence of guidelines
but, unfortunately, guidelines were less often
present in remote health facilities. This is
particularly important because the majority of
respondents who reported no experience of
managing Irukandji syndrome were located in
more remote settings. There is a need for
uniform, evidence-based guidelines, and
mechanisms for effective dissemination of
these guidelines with training for all health
staff who may be required to manage
Irukandji syndrome, particularly in remote
areas of northern Australia.
Investigators: F Barnett,
R Speare, R Müller.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
D
Dürrheim,
Page 49
ENVIRONMENTAL AND PERSONAL CHEMICAL MONITORING
Two rounds of intensive environmental
chemical sampling (hydrogen fluoride,
ammonia, sulfuric and phosphate acid)
covering all operations at the Phosphate Hill
site and incorporating more than 200 8-hour
averaged environmental measurements,
produced credible evidence that there is no
significant risk to human health under routine
operating conditions.
The focus of chemical sampling has now
shifted to the personal monitoring of
hydrogen fluoride (HF) exposure under nonroutine working conditions. Personal HF
monitors, combined with a post-task analysis
of urinary HF and a comprehensive
questionnaire are used to assess exposure to
HF, the effectivity protective equipment and
the role of physical activity on the
incorporation of HF during these non-routine
tasks. This research will produce guidelines
for safe exposure periods and suitable
protective equipment for specific non-routine
tasks.
Investigators: R Müller, A Carter, M Ridd,
S Devine, T Woolley.
BIOLOGICAL MONITORING AT PHOSPHATE HILL
Annual health surveys have been conducted
at the WMC Fertilizers Phosphate Hill plant
since 2001. These health surveys are part of
the core monitoring programme and take
specific operational occupational health risks
into account. The main components are a
basic physical examination (weight, height,
blood pressure, visual acuity, respiratory
function and joint laxity), laboratory tests (full
blood count, liver function test, ACR urine
test)
and
a
health
questionnaire
(demographics, work and medical history,
risk factors, former and current medication,
and various symptoms).
Identification of common health complaints
has initiated the design of a variety of more
specific studies (fatigue, dehydration) and
facilitated the design of specific health
promotion and prevention programmes.
Investigators: R Müller, A Carter, M Ridd,
S Devine, T Woolley.
HYDRATION STATUS AND NEEDS
Cross-sectional mining studies on hydration
status assisted in establishing evidencebased fluid intake guidelines per shift for
different segments of the workforce. Water
taste was identified as a primary cause of
dehydration in the workforce.
Following
improvements in water quality at camp, a
study of fluid intake between shifts was
conducted during both the cooler and warmer
times of the year to establish at-camp fluid
intake targets. A multivariate model of
recommended fluid intake has been
developed based on body mass, work
location, and at-camp physical activity
duration and alcohol intake.
Investigators: R Müller,
A Carter, M Ridd, S Devine, T Woolley.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 50
THE OCCUPATIONAL HEALTH RESEARCH GROUP
The Occupational Health Research Group
based at the Anton Breinl Centre within the
School of Public Health and Tropical
Medicine of JCU conducts, in collaboration
with mostly industry partners, independent
research in mainly “tropical aspects” of
occupational health.
Much of existing occupational health is based
on routine organisational data collections
where the unit of observation is the
organisation and information collected
typically uses indirect or proxy measures.
The endeavor of the Occupational Health
Research Group is to change this culture and
to introduce stringent scientific methodology.
In all research collaborations exclusively
evidence-based methodology is used,
implying specific data collections at the
individual staff member level using direct
measurements. Only this approach is able to
deliver unambiguous results, that is, causeeffect relationships, and therefore tangible
outcomes in a practically relevant time-frame.
With this approach, the Research Group was
able to establish substantial collaborations
with different partners such as the Australian
Institute of Marine Sciences, Safe Community
Councils of Townsville/Thuringowa and
Mackay, Queensland Mining Council and,
most substantially, with different operations of
the mining industry of the Northern mineral
provinces. The group was able to secure a
senior
level
post-doctoral
research
scholarship (WMC Research Fellowship).
Since 2001 a major epidemiological and
environmental study is underway at the
operations of WMC Fertilizers at Phosphate
Hill covering health surveys, environmental
and
personal
chemical
monitoring
programmes, focus group research into
perceptions of health risks and specific
dehydration and fatigue studies. A similar
major project has now been implemented at
the operations of Zinifex at Century Mine and
the Kurumba Port facilities, who also
committed themselves to a long-term
collaboration with the Research Group.
Investigators:
R Müller, A Carter,
M Ridd, S Devine, T Woolley, J Porter.
STUDY ON WORKPLACE ENVIRONMENT AND
HEALTH AT THE ZINIFEX CENTURY MINE AND KARUMBA PORT
An epidemiological study on Workplace
Environment and Health is currently being
conducted at the Zinifex Century Mine and
Karumba Port facilities. The overall study to
date has consisted of the detailed projects
listed
and
will
also
establish
the
methodologies for core monitoring activities
and identification of priority areas for future
intervention strategies.
HEALTH SURVEILLANCE
The routine pre-employment and ongoing
medical assessments have been redesigned
to collect data of the known chemical hazards
at the Century Mine and Karumba sites. The
assessments consists of a basic physical
examination (weight, height, blood pressure,
visual acuity, respiratory function), laboratory
tests (full blood count, liver function test, ACR
urine test) and a health questionnaire
(demographics, work and medical history,
risk factors, former and current medication,
and various symptoms). The data will be
analysed on an annual basis to monitor the
ongoing health of staff at the Zinifex
operations.
CHEMICAL MONITORING
Routinely collected data of staff lead and
cadmium serum samples, and personal
ambient dust and silica have been analysed.
The results will be used to refine the data
collection methods to ultimately determine
the risk profiles of specific sub-groups of the
workforce.
HYDRATION
A study of the fluid hydration status of staff
was conducted during July to determine their
needs during the cooler months of the year.
The results indicate that while hydration
behaviours and facilities on site may be
adequate to maintain a satisfactory fluid
balance, the observed fluid intake at camp is
insufficient to maintain adequate hydration.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 51
Further
dedicated
research
of
the
predisposing, reinforcing and enabling factors
contributing to hypohydration and especially
also to fatigue is planned for the next phase
of the study.
INJURY
A detailed analysis of the existing Zinifex
injury data collection has been completed. As
a result, the routine injury data collection
system will be upgraded to level II of the
National
Data
Standards
for
Injury
Surveillance (NDS-IS) so the data can be
used to identify emerging trends, monitor
previously identified themes, and predict and
prevent injury incidents. The activity
mechanism of injury fields will be upgraded,
and part of plant, external cause, and
protective equipment fields will be added.
Subsequent analytical studies with specific
intervention strategies will then be developed,
implemented and evaluated.
QUALITATIVE
RESEARCH
OF
OCCUPATIONAL HEALTH AND SAFETY
A baseline round of qualitative research of
occupational health and safety has provided
essential
information
of
employee
perceptions of general hazards, solutions to
health and safety issues and the performance
of the health and safety department. The
main outcome is the identification of the
specific
perceived
and
measured
occupational health and safety issues of the
workforce. The initial qualitative approach will
be expanded to examine additional specific
themes such as chemical exposures,
hydration, fatigue and injury.
Investigators: R Müller, A Carter, M Ridd,
S Devine, T Woolley.
FATIGUE MANAGEMENT
Fatigue has been identified as a contributing
factor to occupational injury in industrial
settings.
A
comprehensive
needs
assessment, as the starting point for
developing an evidence-based fatigue
management plan, has been conducted at
WMC Fertilizers’ Phosphate Hill site with the
four production crews from July to October
2004 and, after a change of shifts again in
August/September 2005. The full site-specific
diagnosis of the workforce represents the
most comprehensive for any mining industry
anywhere in the world and encompasses the
following components. Throughout the 28 day
production roster a baseline questionnaire
detailing demographics, lifestyle factors and
signs and symptoms of fatigue-related health
events; an assessment of the prevalence of
individual components (i.e. energy, exertion,
discomfort, motivation, sleepiness) of fatigue
by direct measurement using the Swedish
Occupational Fatigue Inventory; reaction time
tests at the start and finish of each shift; and
a diary of work, rest, leisure and physical
activity are completed.
The severity of fatigue in different segments
of the workforce and specific priority areas for
intervention strategies have been identified
for intervention.
Investigators: R Müller, A Carter, M Ridd,
S Devine, T Woolley.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 52
BACKPAIN: THE MULTIDISCIPLINARY APPROACH
The ABC has been involved extensively in
multi-disciplinary randomised studies of the
relative benefit of different treatment
regimens for managing chronic back pain
since 1998. Back pain is an important public
health burden in Australia with considerable
attendant cost to the health system and
individuals.
During the past three years, two randomised
trials were conducted that have clearly shown
the
benefit
of
a
multi-disciplinary
management plan and also established an
evidence base for the relative benefit of
different treatment approaches.
Investigators: R Müller, L Giles.
CHRONIC DISEASES
NUTRITION-RELATED KNOWLEDGE,
BELIEFS AND PRACTICES OF AUSTRALIAN NURSING STAFF
This work is the nutrition-related component
of a larger study examining the health beliefs
and related practices of health professionals
attending women in the immediate post
partum period. The purpose of the study was
to establish current beliefs and behaviours,
determine how often nutrition-related advice
was given by these nursing staff, and identify
knowledge gaps that could be addressed to
improve the quality of the information these
health professionals provide to their patients.
Data were collected by questionnaire from
362 nursing staff from 11 hospitals in
Queensland and the ACT.
Almost all
participants (97.8%) were confident they
could give good advice to young mothers
about a healthy balanced diet. The majority
(65.5%) provided such advice at least
weekly, 27.9% provided such information
daily, and only 19.5% rarely or never gave
nutritional advice. However, their knowledge
of core food requirements for adults was
inadequate with only 0.6% giving the correct
answers to all four food intake questions,
16.8% giving three correct answers, 62.0%
two and 20.7% one correct answer. The most
commonly
cited
source
of
nutrition
information
was
professional
training
(51.4%), followed by reading (38.7%), media
(14.9%), self education and work related
experience (10.8%); dietitian (10.5%); school
(7.5%); family (6.4%); and dieting (5.0%).
Nursing staff frequently provide nutritional
advice to post-partum women. However,
there is a need to ensure such information is
accurate. A manuscript from the work is
being submitted to Nutrition and Dietetics.
Investigators: M Nowak, SL Harrison,
L Hutton.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 53
OTHER RESEARCH
FEEDING INTOLERANCE AND
NECROTISING ENTEROCOLITIS IN PRETERM NEONATES
Feeding intolerance
and
necrotising
enterocolitis (NEC)
are the two main
obstacles to enteral nutrition in preterm
neonates. A variety of studies has been
carried out including randomised controlled
trials to study the developmental basis for
intolerance and the value of current
strategies for preventing feeding intolerance.
Further studies examine the impact of NEC
on enteral nutrition in preterm neonates and
the strategies for preventing this devastating
illness. The results so far highlight the
importance of an evidence-based standard
feeding regimen to minimize both feeding
intolerance and the incidence of NEC.
Investigators:
S
Patole,
R
Müller.
ANTENATAL AND POSTNATAL DEPRESSION IN PRIMIPAROUS WOMEN
The
prevalence
of
postnatal
depression
(10-15%) renders it a
major
public
health
problem, not only for the
depressed mother but
also the infant.
A
prospective,
randomised controlled
trial of an education
intervention
was
conducted
after
enrolling more than 200
women from three sites in Australia.
Changes of mood were measured by the
Scale for Assessment of Depression and
Schizophrenia.
The main results indicate that women are
less depressed post-natally than pre-natally.
Comparisons between the control and
intervention groups show that the educational
intervention did not have an effect. The
prenatal period is clearly distinct from the
postnatal period, and nurses and midwives
should screen, refer and manage prenatal
maternal mood as an entity in its own right
rather than as a window into the postnatal
period. In the future, the interaction between
mother and their babies will be taken into
account in this multi-faceted equation of
antenatal and postnatal depression.
Investigators: B Hayes, R Müller.
EVIDENCE-BASED
GYNAECOLOGICAL SURGERY
This
collaboration
with The Townsville
Hospital
aims
at
establishing
an
evidence base for the
relative benefit of a
variety
of
new
techniques in gynaecological surgery. One
study is considering whether the use of
surgical meshes reduces recurrence rates
after repairs of hernias and anterior vaginal
wall prolapse. Another clinical trial compares
the
vaginal
configuration
following
transvaginal sacrospinous fixation, posterior
intravaginal
slingplasty
(infracoccygeal
sacropexy) and sacrocolpopexy.
Investigators: A Rane, Y Lim, R Müller.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 54
FOOD AND WEIGHT
RELATED BEHAVIOURS OF ADOLESCENTS
Western societies are faced
with
two
diametrically
opposed weight-related
problems. Firstly, the
average weight of
their populations is
rising, together with the
health,
social
and
economic
problems
associated with overweight
and obesity. The rise in
weight is probably due to
a combination of: time constraints; readily
available inexpensive prepared foods,
beverages and snack foods; and lower
activity levels due to energy saving devices
and more sedentary leisure activities.
Secondly, the slim image, prevalent in these
societies, results in weight loss measures
even among those who are not overweight.
This unnecessary and unrealistic ‘striving for
slimness’ may result in poor eating habits,
inadequate
dietary
intake,
needless
psychological pressure, and eating disorders.
Preoccupation with a slim body image and
restrictive eating practices is not solely an
issue among adult populations, but is also
alarmingly prevalent in adolescents.
In order to better understand some of these
issues, we examined the food, nutrition,
weight and shape-related beliefs and
behaviours of a group of adolescents in
Northern Australia. And found that beliefs of
adolescents predict their weight loss
behaviour and that beliefs are a better
predictor of food choice than nutrition
knowledge. In addition we developed a model
for food and weight related behaviour, which
incorporates the individual’s beliefs into the
well established Transtheoretical Model of
Change.
Investigators: M Nowak, P Büttner,
D Woodward, A Hawkes.
QUANTITATIVE METHODS IN
RISK STRATIFICATION IN PATIENTS
WITH SUSPECTED ACUTE CORONARY SYNDROME
Multiple markers in
addition to cardiac
troponins have been
identified
as
predictors of death
and major cardiac
events in the clinical
course of patients
with suspected acute
coronary syndrome.
The specific combination of markers that
maximises the prognostic power when state
of the art coronary care (including coronary
angiography in troponin
performed remains unclear.
positives)
is
This research is a collaboration with major
cardiology centres in Germany and
introduced the CART (Classification and
Regression Trees) method to cardiology to
study the relative benefit of the different
markers and to determine a combination of
optimal predictors.
Investigators: M Moeckel, R Müller,
T Stoerk.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 55
PHYSICAL ACTIVITY PROGRAMMES IN THE WORKPLACE
– EMPLOYEE PERCEPTIONS
A QUALITATIVE STUDY EXAMINING THURINGOWA CITY COUNCIL EMPLOYEES’
PERCEPTION OF HOW TO PROMOTE PHYSICAL ACTIVITY WITHIN THE WORKPLACE
Over the last 30 years there has been strong,
consistent epidemiological evidence that
defines a range of health and social benefits
for participation in regular, moderate intensity
physical activity.
The workplace is one
setting where there is a potential for health
promotion physical activity programmes to
influence the health, productivity and quality
of life of employees. The overall aim of this
research was to explore a local Council
employees’ perceptions about the role of the
workplace in promoting physical activity. In
particular the research explored employees’
perceptions regarding:
• Physical activity as an issue
generally;
• What the perceived barriers to
physical activity were; and
•
What might be some possible ways
that the workplace could promote the
physical activity of employees.
Semi-structured in-depth phone interviews
were conducted with senior Council
managers and focus groups were conducted
with indoor and outdoor staff members.
Results indicated that physical activity in the
workplace is of interest to Council employees
(in particular those who work indoors) and as
a result of this research there are a number
of recommendations regarding potential
intervention approaches which may be
appropriate. The findings of the research will
be used to further explore and develop a
workplace physical activity intervention
programme.
Investigators:
S
Devine,
P
Büttner.
THE IMPACT OF RECREATIONAL ENVIRONMENTAL MODIFICATIONS ON
PHYSICAL ACTIVITY LEVELS OF COMMUNITY MEMBERS IN THE TROPICS
In Australia, physical inactivity
is recognised as one of the
most
important
population
health risk factors and is
considered a significant public
health issue. There is evidence
that changes to physical environments have
the potential to influence the physical activity
behaviours of significant numbers of people.
This project will assess the overall impact of
environmental modifications being conducted
by a local City Council, on neighbourhood
physical activity levels. Surveys, observation
studies and focus groups will be used.
Baseline data collection has been completed
and follow up research is planned for 2006.
Investigatosr:
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
S
Devine,
K
Mummery.
Page 56
FAECAL INCONTINENCE IN NORTH QUEENSLAND
WHAT PREVENTS PATIENTS FROM DISCLOSING FAECAL INCONTINENCE?
Initial hospital outpatient-based studies on
faecal incontinence (FI), the inability to
control the passage of gas, liquid or solid
through the anus, have demonstrated a high
prevalence in North Queensland of 21%
using one survey tool and 23.4% using
another.
This study explored reasons for nondisclosure of FI in adults attending the
Urogynaecology (n=135 (F)) and Colorectal
clinics (n=148 (M=60, F=88)) at The
Townsville Hospital in 2004 using selfadministered
Faecal
Incontinence
questionnaire (SAFIQ) and a doctor-
administered survey instrument (Wexner) and
semi-structured interviews.
The prevalence of FI was 25.6% using the
SAFIQ and 29.9% using the Wexner. 262
patients completed both questionnaires, 24%
disclosed FI on both, 3.1% on SAFIQ only,
and 6.1% on Wexner only.
Major reasons for non-disclosure were:
historical FI versus current; problem not
considered as FI by patient; SAFIQ too long;
condition embarrassing; and a one-off bout of
uncontrollable diarrhoea was not FI.
Investigators: L Bartlett, M Nowak, YK Ho.
BIOFEEDBACK FOR THE TREATMENT OF FAECAL INCONTINENCE
Biofeedback is the first-line therapy in cases
of mild to moderate FI which has not
responded to simple dietary advice or
medication. Biofeedback was first reported to
be an effective treatment for FI in 1974.
Recent studies have reported symptomatic
improvement in 40-70% of patients.
Biofeedback has no known side effects and is
considered a safe conservative treatment.
This study aims to conduct a randomised
controlled intervention to determine whether
the
alternative
biofeedback
controlled
exercise regimen provides a medically
relevant difference when compared with the
standard exercise regimen. Also to assess
the impact of the FI disclosure session on
subjective symptom rating.
The intervention is in progress, 49 patients
from a sample size of 68 have been enrolled
of whom 41 have completed the treatment
regime.
Investigators: L Bartlett, M Nowak, YK Ho.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 57
MANAGEMENT OF AMPHIBIAN DISEASES
A series of research projects provided
evidence to assist wildlife managers to make
informed decisions on management of
threatened species of native amphibians.
The national Threat Abatement Plan (TAP)
for infection of amphibians with the chytrid
fungus used much of this evidence and is
now available for public comment.
Other projects have provided data on frogs
and chytridiomycosis in banana plantations in
North Queensland, causes of amphibian
deaths, disinfection techniques for B.
dendrobatidis,
and
survival
of
B.
dendrobatidis in the environment. Training
scientists and veterinarians in the diagnosis
of chytridiomycosis has been an important
educational activity.
Investigators:
D Méndez, M
R Müller.
R Speare, L Berger,
Johnson, K McDonald,
COST OF CARING FOR HIV+ INPATIENTS
At this stage of the HIV epidemic in PNG
there is no information regarding the cost of
caring for HIV+ hospital inpatients.
Retrospective and concurrent data collection
from patient records for 2005 is being
undertaken. A time motion study for clinical
care is being implemented. Interviews with
persons providing patient support are
conducted to determine their financial
contribution to the patient’s care. A cost
analysis from the community perspective will
be undertaken.
Data collection is in progress. It appears that
the number of HIV+ inpatients will triple in
2005 compared to 2004.
Investigators: A Hauquitz, J Usurup.
IMPLEMENTATION EVALUATION OF BETHANY VOLUNTEER
COUNSELLING AND TESTING CENTRE, MADANG, PNG
PNG has begun to establish volunteer
counselling and testing (VCT) centres for HIV
around the country. This implementation
evaluation is being conducted at the first
centre established 1 year after start up.
Lessons learned from this evaluation will
inform the continuing roll out of VCT centres
in PNG.
The method of obtaining data was via semistructured interviews with Centre staff,
questionnaires about the service provided
from customers, cost analysis for services
and demographic analysis for customers.
The interviews have been completed and the
questionnaires obtained from customers of
the service. Analysis is underway.
Investigators: A Hauquitz, B Selve.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 58
HOOKWORM AND CROHN’S DISEASE
This pilot study evaluated the effect of human
hookworm,
Necator
americanus,
on
downregulating the immune response in
Crohn’s disease. N. americanus was obtained
from the UK with patients and controls infected
by percutaneous penetration of infective larvae.
In an open pilot trial involving 9 Crohn’s disease
cases given 25, 50 or 100 infective larvae, we
demonstrated that the technique was safe in
Crohn’s cases and no significant side effects
were noted. Patients not in remission improved
after 20 weeks. In addition, capsule endoscopy
A hookworm seen with the pill camera.
The worm is attached to the lining of the small intestine.
was demonstrated to be a useful tool to count
worms, determine the distribution of worms in
the small intestine, and to quantify local effects.
Reinfection of one control case showed that
arrival of a new crop of hookworms initiated an
allergic response in the intestine which resulted
in elimination of the more recent arrivals, but
preservation of the established hookworms.
Investigators: J Croese, R Speare, J Masson,
J O’Neil, WD Melrose, D Reeve.
Mouth of the Hookworm,
Necator americanus
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 59
GRANTS AND CONSULTANCIES
Funding Body
Recipient/s
Project Title
3M Pharmaceuticals
Reid B, Raasch B,
Maguire J, Glasby M.
Multi-centre phase III clinical trial –
Imiquimod & BCC.
Australian Biosecurity
Cooperative Research
Centre
Australian Research
Council
Ritchie S, van den Hurk A,
Smith G, Mackenzie J.
Mosquito-based surveillance systems for
Japanese Encephalitis and West Nile
virus, with a risk assessment for West
Nile virus in Eastern Australia.
Duration
Funding
20012006
$29,000
20042007
$237,000
20042005
$70,000
20042005
$74,800
20042005
$109,000
McCullum H, Speare R,
Hyatt A, Freed L, Daszak P.
Modelling of infectious diseases of wildlife.
Speare R, Berger L,
Skerratt L.
Epidemiology of chytridiomycosis in
amphibians.
Australian Research
Council: LIEF Grant
Burgess G, Speare R,
et al.
Molecular diagnostics based on real-time
polymerase chain reactions for emerging
tropical infectious diseases aimed at
protecting Australia from invasive
diseases.
Biotechnology
Innovation Fund
(AusIndustry)
Fink M, Ritchie S,
Halley P.
A biodegradable mosquito lethal ovitrap
for control of dengue.
20042006
$243,000
d’Abbs P, Shaw G.
Phase 1 evaluation of BP Australia 3D
Strategy for prevention of petrol sniffing.
20052006
$81,562
McDermott R, O’Dea K,
d’Abbs P.
Public health workforce development in
chronic disease prevention, early
detection and management in rural,
remote and Indigenous communities.
20032005
$300,000
Pilot survey to map the distribution of
chytridiomycosis (caused by the
amphibian chytrid fungus) in Australian
frogs.
20042005
$90,000
Development of hygiene protocols for the
control of diseases in Australian frogs.
20042005
$77,550
Experimental research to obtain a better
understanding of the epidemiology,
transmission and dispersal of amphibian
chytrid fungus in Australian ecosystems.
20052007
$975,662
Australian Research
Council
Commonwealth Dept
of Family &
Community Services
Commonwealth
Department of Health
& Ageing - PHERP
Innovations
Department of
Environment and
Heritage
Speare R, Berger L,
Skerratt L, Hyatt A,
Hines H, Hero J-M,
Marantelli G, Woods R.
Department of
Environment and
Heritage
Marantelli G, Speare R,
Berger L, Hines H,
Pergolotti D, Skerratt L.
Department of
Environment and
Heritage
Skerratt L, Speare R,
Berger L, Alford R.
Department of
Environment and
Heritage
Alford R, Skerratt L,
Speare R, Berger L.
Experimental research to obtain a better
understanding of the pathogenesis of
chytridiomycosis, and the susceptibility
and resistance of key amphibian species
to chytridiomycosis in Australia.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
20052007
$800,618
Page 60
GRANTS AND CONSULTANCIES
Funding Body
Recipient/s
Project Title
Duration
Funding
GlaxoSmithKline
Dürrheim DN, Speare R,
Nelesone T, Melrose WD.
Evaluation of ALA surveillance for
confirming Lymphatic Filariasis
elimination, Tuvalu.
20032005
$102,000
Modifying mosquito population age
structure to eliminate dengue
transmission.
20052010
$US6.7
million (JCU
component
$US832,340)
2005
$25,000
20022005
$300,000
20042005
$5,000
Grand Challenges in
Global Health Initiative
(Bill & Melinda Gates
Foundation)
O’Neill S, Hoffman A,
Ritchie S, Kay B,
d’Abbs P, et al.
JCU Programme
Grant
Ho Y, Raasch B, Saleh S,
Büttner PG.
La Roche
Moeckel M, Stork T,
Müller R.
Lions Foundation
Barnett F, Sadleir B,
Corkeron M, Müller R.
Marine & Tropical
Science Research
Facility
Speare R, Berger L,
Skerratt L, Pergolotti D.
Emerging Disease of Amphibians in the
Wet Tropics.
20052006
$50,000
National Drug Law
Enforcement
Research Fund
Gray D, d’ Abbs P,
Mosey A, Shaw G,
Spooner C.
The policing implications of petrol sniffing
and other inhalant misuse in Aboriginal
and Torres Strait Islander peoples’
communities.
20042005
$126,166
National Heritage
Trust
Speare R.
Management of diseases of Australian
amphibians.
20042005
$80,000
NHMRC
Ritchie S, Russell R.
Lure and kill methods for dengue
control.
20042005
$192,475
NHMRC
McDermott R.
Cluster randomised trial of a multistrategy tobacco control programme.
20032006
$555,000
NHMRC
McDermott R, d’Abbs P,
Young D.
Five year follow-up study of Indigenous
adults in north Queensland: chronic
disease and sexual health.
20032007
$1,467,138
NHMRC
d’Abbs P, Brady M.
The policy response to Indigenous petrol
sniffing in Australia.
20032005
$105,000
NHMRC
McDermott R, d’Abbs P.
Sustaining improved diabetes care in
remote communities.
20032005
$207,171
Parkes Bequest
Ho Y, Büttner PG,
Harrison SL, Lam A,
Raasch B, Garbe C.
North Queensland Centre for Cancer
Control and Research molecular
epidemiology of non-melanoma skin
cancer.
20052007
$285,000
The Clinicopathological Significance of
Telomerase Activity in the Pathogenesis
of Colorectal & Skin Cancer.
Laboratory parameters for risk
stratification in patients with suspected
acute coronary events.
A randomised controlled trial to assess
the efficacy of magnesium in Irukandji
syndrome.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 61
GRANTS AND CONSULTANCIES
Funding Body
Recipient/s
Project Title
PNG National HIV/AIDS
Support Programme
Selve B, Hauquitz A.
Implementation Evaluation of Bethany
VCT.
2005
$2,500
PNG National HIV/AIDS
Support Programme
Usurup J, Hauquitz A.
Cost of Caring for HIV+ Inpatients.
2005
$6,500
Queensland Cancer Fund
- Capacity Funding Grant
Ho Y, Dürrheim DN,
Raasch B, Lam A,
Harrison SL, Büttner PG,
Veitch C.
The North Queensland Centre for Cancer
Control and Research (NQCCCR) – a
collaborative tropical Queensland cancer
research initiative.
20042008
$500,000
Queensland Cancer Fund
Nowak M.
The relationship between solar UVR,
vitamin D and cancers in North
Queensland.
20042006
$20,500
Queensland Health
Bührer Skinner M.
Prevalence of Chlamydia Trachomatis in
different segments of the Townsville/
Thuringowa community.
2005
$10,000
Queensland Health
Torres Strait & Nothern
Peninsula Area Health
Service District
Hauquitz A.
Primary Health Care Access Programme.
2005
$15,840
Leggat P.
Evaluation of Clinical Data for Ciloxan.
20052006
$5,520
Hodge J.
Evaluation of Clinical Data for Rabipur.
2005
$5,415
Croese J, Speare R,
Melrose WD.
Immunological implications of Necator
americanus infection in subjects with
Crohn’s Disease and healthy volunteers.
20042005
$49,552
Western Australian
Government
Aitken P, Leggat P,
Speare R, Hodge J,
Canyon D.
Disaster Medical Assistance Teams.
2005
$1,650
WMC Fertilizers
Müller R.
Epidemiological study on workplace
environment and health.
20012006
$250,000
WMC Fertilizers
Müller R, Carter A.
The WMC Research Fellowship:
Development of evidence-based fatigue
and hypohydration management
strategies.
20042005
$180,000
World Health
Organization – Tropical
Disease Research
Melrose WD, Burgess G.
Development of novel Lymphatic
Filariasis diagnostics.
20042005
$122,800
World Health
Organization
Melrose WD, Reeve D.
Evaluation of the Brugia Rapid test.
2005
$18,000
Zinifex Ltd
Müller R, Carter A.
Epidemological study on workplace
environment and health.
20052006
$140,000
Therapeutic Goods
Administration, Australian
Government
Therapeutic Goods
Administration
Townsville Hospital
Foundation
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Duration
Funding
Page 62
Research Collaborators
CANCER
Australian Radiation Protection & Nuclear
Safety Agency [ARPANSA], Ultraviolet
Radiation Section, Non Ionizing Radiation
Branch, Victoria
ª Dr Peter Gies
Bureau of Meteorology, Melbourne
ª Dr Aurel Moise
Monash University, Melbourne
ª A/Prof John Kelly
Plastic and Reconstructive Surgeon,
Townsville
ª Dr Ian Tassan
National Heart Foundation
ª Dr Anna Hawkes
Dermatologists, Townsville
ª Dr Rob Miller
ª Dr Brian Reid
Queensland University of Technology,
Brisbane
ª Dr Michael Kimlin
Eberhard-Karls University, Tuebingen,
Germany
ª Prof Claus Garbe
ª Prof Thomas Iftner
ª Prof Olaf Riess
General Practitioners
ª Dr Owen Humphreys
ª Dr Jack Maguire
ª Dr Helen Rosengren
Queensland Institute of Medical Research,
Brisbane
ª Prof Adele Green
ª Emeritus Prof Robert MacLennan
ª Dr Rachel Neale
University of British Columbia, Canada
ª A/Prof Jason Rivers
University of California, USA
ª Dr Juergen Bauer
James Cook University, School of
Medicine
ª Dr Kym Daniell
ª Prof Yik-Hong Ho
ª Prof Alfred Lam
ª A/Prof Beverly Raasch
ª Torres Woolley
University of Tasmania, Hobart
ª Dr David Woodward
CARDIOLOGY
Roche Diagnostics, Mannheim, Germany
ª Dr Eberhard Spanuth
University Hospital Mainz, Germany
ª Dr Karl Lackner
Rudolf-Virchow Clinic, University of
Berlin, Germany
ª Priv Doz Dr Martin Moeckel
ª Dr Joern Vollert
University of Ulm, Germany and
Karl Olga University Clinic Stuttgart
ª Dr Eckhard Froehlich
ª Prof Dr Thomas Stoerk
EXERCISE AND PUBLIC HEALTH
Central Queensland University, School of
Health and Human Movement,
Rockhampton
ª Prof Kerry Mummery
Department of Human Services, Victoria
ª Megan Counahan
James Cook University, School of
Medicine
ª Prof Yik-Hong Ho
ª
Prof Craig Veitch
Queensland Health
ª Kathryn Sloots RN BSc (Hons)
ª Tropical Public Health Unit, Townsville
(Riverway Project)
Thuringowa City Council (Riverway Project)
Townsville Sexual Health Services
ª
Dr Arun Menon
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 63
HIV/AIDS
PNG National Department of Health
ª Dr E Daoni
ª Dr Gilbert Hiawalyer
Divine Word University, Madang PNG
ª Mexi Kakoza
ª Dr John Sairere
ª Dr Billy Selve
Lutheran School of Nursing, Madang PNG
ª Sr Gagum Thavung
Modilon General Hospital, Madang PNG
ª Dr Jethro Usurup
PNG National AIDS Council
ª Dr Ninkama Moiya
ª Dr Joachim Pantumari
PNG National HIV/AIDS Support
Programme
ª Dr Berit Gustafsson
ª Dr Greg Law
ª Dr John Millan
ª Dr Paulo Proto
ª Dr Barbara Smith
INDIGENOUS HEALTH
Centre for Aboriginal Economic Policy
Research (CAEPR), Australian National
University
ª Dr Maggie Brady
Centre for Health in Society, University of
Melbourne, Melbourne
ª Dr Ian Anderson
Centre for Remote Health
ª
Ms Anne Mosey
Menzies School of Health
Darwin
ª Dr Richard Chenhall
ª Alan Clough
ª Dr Christine Connors
ª Dr Paul Kelly
Research,
National Drug Research Institute, Curtin
University of Technology
ª Dr Dennis Gray
Queensland Health, Cairns
ª Dr Ashim Sinha
ª Dr Ross Spark
Queensland Health, Gold Coast
ª Paul Dodd
Queensland Health, Torres Strait
ª Phillip Mills
University of Queensland, Brisbane
ª A/Prof Paul Scuffham
ª Prof Andrew Wilson
University of South Australia. Adelaide
ª
Prof Robyn McDermott
Monash University, Melbourne
ª Dr Leonie Segal
University of Western Australia, Perth
ª Dr Judith Finn
National Drug and Alcohol Research
Centre
ª
Dr Catherine Spooner
INJURY
Columbia University, New York, USA
ª Prof John Allegrante
ª Ray Marks
Queensland Health, Health Promotion Unit
ª Paul Vardon
Queensland Health, Mackay Health
Service District
ª Dr Bert Sadleir
Queensland Health, Tropical Public Health
Unit
ª Kelly Hart
ª
ª
ª
Jacqui Lloyd
Kathryn McFarlane
Dr Anne Swinbourne
Queensland Injury Surveillance Unit
(QISU)
ª Richard Hockey
ª A/Prof Robert Pitt
ª Debbie Scott
Surf Life Saving, Australia
ª Dr Peter Fenner
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 64
OCCUPATIONAL HEALTH
Civil Aerospace Medical Institute, USA
ª Ms Connie Peterman
ª Dr Steve JH Véronnea
National Institute of Industrial Health,
Japan
ª Dr Derek Smith
Civil Aviation Authority, Canberra
ª Dr John Putland
PARASITOLOGY
ECTOPARASITES
Department of Health, New South Wales
ª Glennis Lloyd
Department of Health, Federated States of
Micronesia
ª Dr JP Chaine
Department of Human Services, Victoria
ª Megan Counahan
Murdoch University, School of Veterinary
and Biomedical Sciences, Perth
ª A Thompson
Nitpickers, Yungaburra
ª Sheryl Thomas
ª Helen Weld
University of Queensland, Department of
Microbiology, Brisbane
ª Dr Steve Barker
Universidade Federal do Ceará, Faculdade
de Medicina, Fortaleza, Brazil
ª
Prof Jorg Heukelbach
HELMINTHS
LaTrobe University, Melbourne
ª Fiona Williams
Townsville Hospital
ª Dr John Croese
Miwatj Health, East Arnhem Land
ª Dr Wendy Page
Woorabinda Multi-purpose Community
Health Team
ª June Barkworth
Queensland Institute of Medical Research,
Brisbane
ª Dr James McCarthy
TRAVEL MEDICINE
Royal North Shore Hospital
ª A/Prof Bernie Hudson
Worldwise Travel Clinics of New Zealand
ª Dr Marc Shaw
University of Queensland, Ipswich
ª Professor Jeff Wilks
TUBERCULOSIS
PNG Institute of Medical Research
ª Dr Suparat Phaunukoonnon
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 65
VECTOR-BORNE DISEASES
LYMPHATIC FILARIASIS
Mekong Plus Region
ª Prof CP Ramachandran
Centers for Disease Prevention and
Control, USA
ª Dr Tom Burkott
ª Dr Patrick Lammie
ª Prof Eric Ottesen
Ministry of Health, Fiji
ª Dr Joe Koroivueta
Department of Health, Federated States of
Micronesia
ª Dr JP Chaine
Department of Health, PNG
ª Dr Gilbert Hiawalyer
ª Mr Leo Makita
Ministry of Health, Niue
ª Manila Nosa
Ministry of Health, Tuvalu
ª Dr Tekaai Nelesone
PacELF, Fiji
ª Dr Kazuyo Ichimori
Divine Word University, PNG
ª Dr Billy Selve
Dodowa Health Research Centre, Ghana
ª Dr Margaret Gyapong
Emory University, USA
ª Prof Eric Ottesen
Porgera Joint Venture, PNG
ª Dr Peter Bale
ª Dr Kathy Reto
University of Papua New Guinea, PNG
ª Dr Peter Sapak
University of Queensland, Brisbane
ª Dr James McCarthy
Girvan Institute of Medical Research
ª Dr Kieran Scott
University Sains, Malaysia
ª Dr Rahmah Noordin
GlaxoSmithKline
ª Dr Mark Bradley
WHO East Timor
ª Dr Alex Andjaparidze and Staff
James Cook University, School of
Biomedical Sciences
ª Dr Natkunam Ketheesan
ª Dr Jeffrey Warner
WHO-WPRO, Philippines
ª Dr Kevin Palmer
Liverpool School of Hygiene and Tropical
Medicine, UK
ª Ms Joan Fahy
ª Prof David Molyneux
WHO Papua New Guinea
ª
Dr Luo Dapeng
ª
Mr Ishmael John
MALARIA
Australian
Army
Malaria
Brisbane
ª Major Steve Francis
ª LTCOL Peter Nasveld
ª Major Michael Nissen
Centers for Disease
Control, USA
ª Dr Holly A Williams
Institute,
Prevention
Management Sciences for Health, USA
ª Dr Rima Shretta
Pan American Health Organization
ª Dr Isabella Ribiero
Robert Koch Insitut Berlin, Germany
ª Prof Dr Klaus Stark
University of Cape Town, South Africa
ª Prof Karen Barnes
ª Ushma Mehta
and
University of the Witwatersrand, South
Africa
ª Dr Lucille Blumberg
ª Prof Maureen Coetzee
WHO Afro, Zimbabwe
ª Dr John Govere
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 66
DENGUE, RRV AND JAPANESE ENCEPHALITIS
ª
ª
Australian Defence Force
ª Dr Bob Cooper
AQIS
ª
Dr Brian Kay
Dr Peter Ryan
Secretariat of the Pacific Community
(SPC)
ª Dr Tom Kiedrzynski
ª Dr Narendra Singh
Dr James Walker
Biosecurity Australia
ª Dr David Banks
University of Hawaii, USA
ª Dr Duane Gubler
CSIRO Entomology
ª Dr Ulrich Bernier
ª Dr Dan Kline
ª Dr Bob Sutherst
University of Queensland, Department of
Chemical Engineering, Brisbane
ª Dr Peter Halley
ª Dr Rowan Truss
Curtin University, Perth
ª Dr John Mackenzie
Federal University of Minas Gerias, Belo
Horizonte, Brazil
ª Dr Alvaro Eiras
Fiji School of Medicine, Fiji
ª Dr Kamal Kishore
ª Dr Jan Pryor
University of Queensland, Department of
Microbiology and Parasitology, Brisbane
ª Dr Roy Hall
ª Dr John Mackenzie
ª Dr Andrew van den Hurk
Mahidol University, Thailand
ª Dr Piyarat Butraporn
ª Dr Pattamaporn Kittayapong
University of Queensland, Department of
Zoology, Brisbane
ª Mr Peter Cook
ª Mr Peter Moore
ª Dr Scott O’Neill
Northern Territory Health Services
ª Mr Peter Whelan
University of Regensburg, Germany
ª Martin Geier
Plantic Technologies Pty Ltd
ª Mark Fink
ª Rulande Henderson
ª Nick McCaffrey
University of Sydney, Sydney
ª Dr Nigel Beebe
ª Dr Richard Russell
ª Dr Cameron Webb
Queensland Health Scientific Services
ª Alyssa Pyke
ª Dr Greg Smith
Western Australia Health Department
ª Dr Mike Lindsay
Queensland Institute of Medical Research,
Brisbane
ª Dr Leon Hugo
WHO-WPRO, Manila
ª Dr Carol Beaver
ª Dr Kevin Palmer
VECTOR CONTROL
Australian Institute of Marine Science,
Townsville
ª Dr Lyndon Llewellyn
James Cook University, School of
Veterinary and Biomedical Sciences
ª A/Prof Bruce Bowden
Department
of
Primary
Brisbane
ª Dr Michael Kennedy
South Valley University, Aswan, Egypt
ª Dr Essam Shaalan
Industries,
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 67
VETERINARY PUBLIC HEALTH
Consortium for Conservation Medicine,
Wildlife Trust, USA
ª Peter Daszak
CSIRO Australian Animal Health
Laboratory, Geelong
ª Dr Alex Hyatt
Queensland Parks and Wildlife Service,
Environmental Protection Agency
ª Keith McDonald
ª Harry Hines
University of Potschrefstroom, School of
Environmental Sciences and
Development, South Africa
ª
ª
A/Prof Louis Du Preez
Che Weldon
University of Queensland, Department of
Entomology and Zoology, Brisbane
ª Hamish McCullum
University of Hawaii, Department of
Zoology, USA
ª Leonard Freed
Awards/CERTIFICATES
CERTIFICATE OF RECOGNITION,
THE AUSTRALIAN COLLEGE OF EDUCATORS
Recipients:
ª Dr Wayne Melrose
ª Prof Rick Speare
ª A/Prof Peter Leggat
Awarded for dedicated service in tertiary
education and excellence in teaching to
postgraduate students in public health and
tropical medicine at the Anton Breinl Centre,
James Cook University; Awarded annually on
the occasion of World Teachers’ Day.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 68
EDUCATIONAL AWARD,
THE AUSTRALASIAN COLLEGE OF TROPICAL MEDICINE 2005
Recipients:
ª A/Prof Peter Leggat
ª LTCOL Jon Hodge
ª Dr Peter Aitken
Awarded annually by the Australasian
College of Tropical Medicine for Excellence in
tropical medical education – specifically for
the disaster health management course.
VITAE LAMPADA MEDAL, QUEENSLAND HEALTH
Recipient:
ª A/Prof Peter Leggat
Awarded Annually by Queensland Health for
Excellence in Medical and Health Education.
The award recognises A/Prof Leggat’s
contributions to helping to make JCU’s
postgraduate public health programmes one
of the largest in Australasia and one of the
leading public health and tropical medicine
programmes globally.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 69
SIDNEY SAX ORATION
Recipient:
ª None awarded 2005
The Sidney Sax Oration was established in
2001 to honour Dr Sidney Sax, who amongst
other important roles was chair of the Anton
Breinl Centre Advisory Committee for many
years. The Oration and Medal are endorsed
by the Sax family and also by the Public
Health Association of Australia, Queensland
Branch.
PREVIOUS SIDNEY SAX ORATORS
2001 Professor Ian Ring, Queensland Health
2003 Major General Professor John H Pearn
2002 Mary Rose, University of
Witwatersrand
2004 None awarded
ANTON BREINL MEMORIAL LECTURE,
THE AUSTRALASIAN COLLEGE OF TROPICAL MEDICINE
Recipient:
ª A/Prof Peter Leggat
An invited lecture by those who have made
an outstanding contribution to tropical
medicine, including recipients of ACTM
Medals/Surgeon General’s Medal.
CHAIR OF CONVOCATION XVII,
THE AUSTRALASIAN COLLEGE OF TROPICAL MEDICINE
Recipient:
ª A/Prof Peter Leggat
Invited Honorary Chairpersonship of College
Convocation in recognition of contributions to
the Australasian College of Tropical
Medicine.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 70
IGNOBEL PRIZE IN BIOLOGY
Recipient:
ª Dr Craig Williams
Awarded each year at Harvard University, the
IgNobel honours published research that
makes people laugh, then makes them think.
Awarded to Dr Williams for his ground
breaking study “A survey of frog odorous
secretions, their possible functions & their
phylogenetic signigicance”.
PROFESSOR PROMOTIONS
ª
Professor Rick Speare
Promoted to Professor – Chair
Rick Speare is a Professor with the School of
Public Health, Tropical Medicine and
Rehabilitation Sciences, with an interest in
infectious diseases and their control. His
special expertise is in human parasitology.
BEST PRESENTATION AT
INTERNATIONAL SYMPOSIUM ON LABORATORY MARKERS
Recipient:
ª A/Prof Reinhold Müller
Awarded
for
Best
Presentation
at
International Symposium on Laboratory
Markers, Berlin, Germany, May 2005.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 71
INDUCTIONS
A/Prof Peter Leggat
ª Formally inducted as a Member,
College of Fellows, Safety Institute of
Australia by the Governor-General of
the Commonwealth of Australia at
Government House in Canberra, 2005.
HONORARY MEMBERS
ª
Anton Breinl Centre
Made an Honorary Member of the
Australasian College of Tropical
Medicine in 2005
ª
Professor Rick Speare
Made Honorary Fellow
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 72
Peer-Reviewed Publications
Barnett FI, Dürrheim DN, Speare R, Müller
R. Management of Irukandji syndrome in
northern Australia. Rural and Remote Health
5 (online), 2005: 369. Available from:
http://rrh.deakin.edu.au
Barry C, Naidu A, Lim Y, Cortisaans A,
Müller R, Rane A. Does the MONARC
transobturator suburethral sling cause postoperative voiding dysfunction? A prospective
study. International Urogynecology Journal
and Pelvic Floor Dysfunction 2006;17(1):3034. Epub 2005 Aug 11.
Bauer J, Büttner PG, Sander Wiecker T,
Luther H, Garbe C. An interventional study in
1232 young German children to prevent the
development of melanocytic nevi failed to
change sun exposure and sun protective
behavior. International Journal of Cancer
2005;116:755-761.
Bauer J, Büttner PG, Sander Wiecker T,
Luther H, Garbe C. Effect of sunscreen and
clothing on the number of melanocytic nevi in
1812 German children attending day-care.
American
Journal
of
Epidemology
2005;161:620-627.
Bauer J, Büttner PG, Sander Wiecker T,
Luther H, Garbe C. Risk Factors of Incident
Melanocytic Nevi. A Longitudinal Study in a
Cohort of 1232 Young German Children.
International Journal of Cancer 2005;115:
121-126.
Berger L, Hyatt AD, Speare R, Longcore JE.
Life cycle stages of Batrachochytrium
dendrobatidis Longcore et al. 1999, the
amphibian chytrid. Diseases of Aquatic
Organisms. 2005;68:51-63.
Berger L, Marantelli G, Skerratt LF, Speare
R. Virulence of the amphibian chytrid fungus,
Batrachochytrium dendrobatidis, varies with
the strain. Diseases of Aquatic Organisms.
2005;68:47-50.
Berger L, Speare R, Skerratt L. Distribution
of Batrachochytrium dendrobatidis and
pathology in the skin of green tree frogs
(Litoria
caerulea)
with
severe
chytridiomycosis. Diseases of Aquatic
Organisms. 2005;68:65-70
2000. An analysis of the Central Malignant
Melanoma
Registry
of
the
German
Dermatological
Society.
Cancer
2005;103(3):616-24.
Carter A, Müller R, Thompson A. The rate of
decompression sickness in scientific diving at
the Australian Institute of Marine Sciences
(Townsville) 1996 to 2001. South Pacific
Underwater Medicine Society (SPUMS)
Journal 2005:35(3);125-130.
Clough A, d'Abbs P, Cairney S, Gray D,
Maruff P, Parker P, O'Reilly B. Adverse
mental health effects of cannabis use in two
indigenous communities in Arnhem Land,
Northern Territory, Australia: exploratory
study. Austalian and New Zealand Journal of
Psychiatry 2005;39(7):612-620.
Counahan M, Andrews R, Speare R.
Reliability of written parental reports of head
lice in their children. Medical Journal of
Australia 2005;182(3):137-138.
Croese J, O’Neil J, Masson J, Cooke S,
Melrose W, Pritchard D, Speare R. A proof
of concept study establishing Necator
americanus in Crohn’s patients and reservoir
donors. Gut. 2006;55:136-137.
Dale PER, Knight J, Ritchie SA, Kay BH.. A
practical tool to identify water bodies with
potential for mosquito habitat under
mangrove canopy: large-scale airborne
scanning in the thermal band 8-13 um.
Ecology and Management 2005;13:389-394.
Dürrheim DN, Müller R, Saunders V,
Speare R, Lowe J. Australian Public and
smallpox. Emerging Infectious Diseases
2005;11(11):1748-1750.
Hanson D, Hanson J, Vardon P, McFarlane
K, Lloyd J, Müller R, Dürrheim DN., The
injury iceberg: An ecological approach to
planning sustainable community safety
interventions. Health Promotion Journal of
Australia 2005;16 (1):5-15.
Harley D, Sleigh A, Ritchie S. Risks for Ross
River virus disease in tropical Australia.
International
Journal
of
Epidemiology
2005;34:548-555 (delayed issue).
Büttner PG, Leiter U, Eigentler TK, Garbe C.
Time trends of prognostic factors of
cutaneous melanoma between 1976 and
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 73
Hauquitz AC. Looking Down the Barrel of a
Cannon: The Potential Economic Costs of
HIV/AIDS in Papua New Guinea. Papua New
Guinea Medical Journal 2003;46(4).
Leggat PA. Editorial: Travel insurance:
Lessons from recent disasters. Annals of the
Australasian College of Tropical Medicine.
Kurume Medical. 2005;6:36.
Harrison SL, Büttner PG, MacLennan R.
The north Queensland “sun-safe clothing”
study: design and baseline results of a
randomized
trial
to
determine
the
effectiveness of sun-protective clothing in
preventing
melanocytic
nevi.
2005;161(6):536-545.
Leggat PA. Editorial: Travel Medicine-The
sharp end of tropical medicine in Australasia?
Annals of the Australasian College of Tropical
Medicine 2005;6:3-4.
Harrison SL, Nowak M, Büttner PG.
Maternal
beliefs
about
the
reputed
therapeutic uses of sun exposure during
infancy and the post-partum period.
Australian Journal of Midwifery 2005;18(2):
22-8.
Ho YK, Müller R, Veitch C, Rane A,
Dürrheim DN. Faecal incontinence: an
unrecognized epidemic in rural North
Queensland? Results of a hospital-based
outpatient study, Australian Journal of Rural
Health 2005;13:28-34.
Ivers RG, Castro A, Parfitt D, Bailie R,
Richmond R, d’Abbs P. Television and
delivery of health promotion programmes to
remote Aboriginal communities. Health
Promotion Journal of Australia 2005;16(2):
155-158.
Johnson ML, Speare R. Possible modes of
dissemination of the amphibian chytrid,
Batrachochytrium dendrobatidis, in the
environment. Diseases of Aquatic Organisms
2005;65:181-186.
Johnston FH, Morris PS, Speare R,
McCarthy J, Currie B, Ewald D, Page W,
Dempsey K. Strongyloidiasis: A review of the
evidence
for
Australian
practitioners.
Australian
Journal
of
Rural
Health
2005;13:247-254.
Leggat PA. Conference Report: A Festschrift
for Major General John Pearn, AM, RFD.
Annals of the ACTM. 2005;6:6.
Leggat PA. Editorial: Ensuring the health and
safety of humanitarian aid workers. Travel
Medicine and Infectious Disease 2005;3:
119-122.
Leggat PA. Editorial: The South Asian
Tsunami and Rural and Tropical Public
Health. Journal of Rural and Tropical Public
Health 2005;4: 1.
Leggat PA. Environmental Health. Journal of
Occupational Health and Safety – Australia
and New Zealand. 2005;21:163-164.
Leggat PA. Internet Guide to Travel Health.
1st Ed. By Connor E. Journal of Travel
Medicine. 2005;12:358-359.
Leggat PA. SARS…the story so far: Public
health and safety implications.
/World Safety Journal/. 2005; 15(2): 26-28.
Leggat PA. Travel medicine: An Australian
perspective. Travel Medicine and Infectious
Disease 2005;3:67-75.
Leggat PA. Travel Medicine. Check Unit 387.
Short B. Royal Australian College of General
Practitioners. Travel Medicine and Infectious
Disease. 2005;3:57-58.
Leggat PA. Travelling Well-The must have
guide to a safe and healthy journey. 11th Ed.
By Mills D. Journal of Travel Medicine. 2005;
12:115-116.
Leggat
PA.
Trends
in
antimalarial
prescription in Australia 1998-2002. Journal
of Travel Medicine 2005;12:338-342.
Leggat PA. Tropical Medicine: A re-emerging
specialty. ADF Health 2005; 6:76-80.
Leggat PA, Griffiths R, Leggat FW.
Emergency assistance provided abroad to
insured travellers from Australia. Travel
Medicine and Infectious Disease 2005;3:917.
Leggat PA, Harrison SL , Fenner PJ,
Dürrheim DN, Swinbourne AL. Health advice
obtained by tourists travelling to Magnetic
Island: a risk area for “Irukandji” jellyfish in
North Queensland, Australia. Travel Medicine
and Infectious Disease 2005;3:27-31.
Leggat PA, Hodge JV, Aitken P. Editorial:
Disaster Response and Preparedness.
Annals of the Australasian College of Tropical
Medicine 2005: 6: 17-18.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 74
Leggat PA, Peterman C, Véronneau SJH.
Dermatitis reported in medical examinations
of US commercial pilots. Journal of the
Australasian Society of Aerospace Medicine
2005;2:16-18.
surveillance in a remote Pacific Island
Country by adapting a successful African
outbreak
surveillance
model.
Tropical
Medicine
and
International
Health.
2006;11(1):17-21.
Leggat PA, Winkel KN. Professional
Organisation Profile: The Australasian
College of Tropical Medicine. Travel Medicine
and Infectious Disease 2005;3:39-41.
Nisbet DJ, Lee KL, van den Hurk AF,
Johansen CA, Kuno G, Chang GJ,
Mackenzie JS, Ritchie SA, Hall RA.
Identification of new flaviviruses in the
Kokobera virus complex. The Journal of
General Virology 2005;86:121-124.
Lim YK, Müller R, Corstiaans A, Dietz H,
Barry C, Rane A. Suburethral slingplasty
evaluation study in North Queensland,
Australia: The SUSPEND trial. Australian and
New Zealand Journal of Obstetrics and
Gynaecology 2005;45:52-59.
Lim YN, Rane A, Müller R. An ambispective
observational study in the safety and efficacy
pf posterior colporraphy with composite
Vicryl-Prolene
mesh.
International
Urogynecology Journal and Pelvic Floor
Dysfunction 2005;16:126-131.
McDonald KR, Méndez D, Müller R,
Freeman AB, Speare R. Decline in the
prevalence of chytridiomycosis in upland frog
populations in North Queensland, Australia.
Pacific Conservation Biology 2005;11(2):114120.
Melrose WD, Leggat PA. Lymphatic
Filariasis: Disease outbreaks in military
deployments from world war 2. Military
Medicine 2005; 170: 585-589.
Mockel M, Müller R, Vollert J, Muller C, Carl
A, Peetz D, Post F, Kohse JK, Lackner KJ
Role of N-terminal pro-B-type natriuretic
peptide in risk stratification on patients
presenting in the emergency room. Clinical
Chemistry 2005;51(9):1624-1631.
Nowak M, Büttner PG, Raasch B, Daniell K,
McCutcham C, Harrison SL. Lifestyle
changes as a treatment of GastroOesophageal-Reflux Disease – A survey of
General Practitioners in North Queensland.
Therapeutics and Clinical Risk Management
2005;1(3):219-24.
Panaretto KS, Lee HM, Mitchell MR, Larkins
SL, Manessis V, Büttner PG, Watson D.
Impact of a collaborative shared antenatal
care programme for urban indigenous
women: prospective cohort study. Medical
Journal of Australia 2005;182(10):514-519.
Raghavan K, Thomas E, Patole S, Müller R.
Is phototherapy a risk factor for ileus in highrisk neonates? Journal of Maternal-Fetal and
Neonatal Medicine 2005;18(2):129-31.
Ritchie SA. Evolution of dengue control
strategies in north Queensland, Australia.
Arbovirus Research in Australia 2005;9:324330.
Russell RC, Williams CR Sutherst RW,
Ritchie SA. Aedes (Stegomyia) albopictus a dengue threat for southern Australia?
Communicable Disease Intelligence 2005;
29;296-298.
Montgomery BL, Ritchie SA, Hart AJ, Long
SA, Walsh ID. Dengue intervention on
Thursday Island (Torres Strait) 2004: a
blueprint for the future? Arbovirus Research
in Australia 2005;9:268-273.
Shaalan E, Canyon DV, Wagdi Faried M,
Abdel-Wahab H, Mansour A. A review of
botanical phytochemicals with mosquitocidal
potential.
Environment
International
2005;31:1149-1166.
Müller R, Giles LGF. Long-term follow-up of
a randomized clinical trial assessing the
efficacy of medication, acupuncture and
spinal manipulation for chronic mechanical
spinal
pain
syndromes.
Journal
of
Manipulative and Physiological Therpeutics
2005;28(1):3-11.
Shaw M, Leggat PA. Deep venous
thrombosis after air travel. Continuing
Medical Education 2005;23:130-132.
Skiba
L,
Leggat
PA.
Professional
Organisation Profile: The New Zealand
Society of Travel Medicine. Travel Medicine
and Infectious Disease 2005;3:43-44.
Nelesone T, Dürrheim DN, Speare R,
Kiedrzynski T, Melrose WD. Strengthening
sub-national
communicable
disease
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 75
Smith DR, Devine S, Leggat PA, Ishitake T.
Alcohol and tobacco consumption among
police officers. Kurume Medical Journal 2005;
52(1-2):63-65.
Smith DR, Leggat PA. Needlestick and
sharps injuries among Australian medical
students. Journal of the University of
Occupational and Environmental Health
2005;27:237-242.
Smith DR, Leggat PA. Needlestick and sharps
injuries among nursing students. Journal of
Advanced Nursing 2005;51:449-455.
Smith DR, Leggat PA. Occupational hand
dermatitis among health care workers.
Journal of Environmental Dermatology 2005;
12(1):29-39.
Smith DR, Leggat PA. Pioneering Figures in
Public Health: Albert Bruce Sabin - Inventor
of the Sabin Oral Polio Vaccine. Kurume
Medical Journal. 2005;52:111-116.
Smith DR, Leggat PA. The historical
development of occupational health in
Australia: Part 2. 1970-2000. Journal of the
University of Occupational and Environmental
Health 2005;27:137-150.
Smith DR, Leggat PA. The prevalence of
skin disease among the elderly in different
clinical environments. Australasian Journal
on Aging 2005;24:71-76.
Smith DR, Leggat PA. Tobacco smoking
prevalence among a cross-section of dentists
in Queensland, Australia. /Kurume// Medical
Journal. /2005; 52: 147-151.
Smith DR, Leggat PA. Whole body vibration:
Health effects, measurement and minimization.
Professional Safety 2005;50(7):35-40.
Smith DR, Leggat PA, Takahashi K.
Percutaneous exposure incidents among
Australian hospital staff. International Journal
of Occupational Safety and Ergonomics.
2005;11:323-330.
Smith DR, Porter J, Leggat PA, Wang R-S.
Hepatitis
B
sero-conversion
following
immunisation among a cohort of rural
Australian health care workers. Journal of
Occupational
Safety
and
Health
2005;2(2):19-21.
Smith DR, Smyth W, Leggat PA, Wang R-S.
Prevalence of hand dermatitis among
hospital nurses working in a tropical
environment. Australian Journal of Advanced
Nursing 2005;22(3):29-33.
Smith DR, Wei N, Leggat PA, Wang R-S.
HIV/AIDS prevention in China: A challenge
for the new Millennium. Environmental Health
and Preventive Medicine 2005;10:125-129.
Speare R, Canyon DV, Melrose W.
Quantification of blood intake of the head
louse,
Pediculus
humanus
capitis.
International
Journal
of
Dermatology
(10.1111/j.1365-4632.2005.02520.x.) 2005.
Usher K, Lindsay D, Miller M, Miller A. The
challenges faced by Indigenous nursing
students and the strategies they identify as
helpful to their success: a descriptive study.
Contemporary Nurse 2005;19(1-2):17-31.
Webb R, Berger L, Mendez D, Speare R.
MS-222 (tricaine methane sulfonate) does
not kill the amphibian chytrid fungus
Batrachochytrium dendrobatidis. Diseases of
Aquatic Organisms 2005;68:89-90.
Williams CR. The timing of host-seeking
behaviour of the mosquitoes Anopheles
annulipes
sensu
lato
Walker
and
Coquillettidia linealis (Skuse) (Diptera:
Culicidae) in the Murray River Valley, South
Australia. Australian Journal of Entomology
2005;44;110-112.
Williams CR, Kokkinn MJ. Daily patterns of
locomotor and sugar-feeding activity of the
mosquito
Culex
annulirostris
from
geographically
isolated
populations.
Physiological Entomology 2005;30:309-316..
Williams CR, Ritchie SA, Russell RC,
Zborowski P. Development and application of
‘lure and kill’ strategies for the dengue vector
Aedes aegypti in Australia. Arbovirus
Research in Australia 2005;9;397-402.
Wong M, Haswell-Elkins M, Tamwoy E,
McDermott R, d'Abbs P. Perspectives on
clinic attendance, medication and foot-care
among people with diabetes in the Torres
Strait Islands and Northern Peninsula Area.
Australian
Journal
of
Rural
Health
2005;13(3):172-177.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 76
Publications In Press
Allegrante JP, Marks R, Hanson DW.
Ecological models for the prevention and
control of unintentional injury, in Gielen A,
Sleet DA, DiClemente R, eds. Handbook of
Injury
Prevention:
Behavior
Change
Theories, Methods, and Applications, JosseyBass. NJ.
Beebe NW, Whelan PI, van den Hurk A,
Ritchie SA, Cooper RD. 2005. Genetic
diversity of the dengue vector Aedes aegypti
in Australia and implications for future
surveillance
and
mainland
incursion
monitoring.
Communicable
Diseases
Intelligence.
Budden LM, Pierce PF, Hayes BA, Büttner
PG. Australian women’s prediagnostic values
and influencing socio-demographic variables
relating to treatment choices for early breast
cancer treatment. Oncology Nursing Forum
Canyon DV, Speare R. Do head lice spread
in swimming pools? International Journal of
Dermatology.
Carter A, Müller R, Roberts S. The hydration
status and needs of workers at a North
Queensland open-cut mining and fertiliser
production plant. Journal of Occupational
Health and Safety.
d’Abbs P. Indigenous petrol sniffing: lessons
from a coronial inquest Drug and Alcohol
Review.
Dürrheim DN, Müller R, Saunders V,
Speare R, Lowe J. Anthrax bioterrorism, the
Australian population and General Practice.
Australian Family Practitioner.
Glazebrook R, Harrison SL. Obstacles to
maintenance of advanced procedural skills
for rural and remote medical practitioners in
Australia. Rural and Remote Health.
Harrison SL. Rate of development of
incident melanocytic naevi in early childhood.
In: Progress in Skin Cancer Research. Nova.
Harrison SL. Rate of development of
incident melanocytic naevi in early childhood.
In: Progress in Skin Cancer Research. Nova
Science Publishers: New York (preliminary
acceptance received 7 October 2005).
Harrison SL, Saunders V, Nowak M.
Baseline
Survey
of
Sun-Protection
Knowledge, Practices and Policy in Early
Childhood Settings in Queensland, Australia.
Health Education Research: Theory and
Practice.
Hauquitz AC. Poverty, Crime and HIV/AIDS
in Luker V, Dinner S, Patience A (eds) Law,
Order and HIV/AIDS in PNG. ANU Press.
Ivers R, Bailie R, d'Abbs P, Richmond R.
Talking about tobacco: practice in promoting
cessation in Indigenous primary health care
settings. Drug and Alcohol Review.
Leggat PA. Evidence-based management of
acute musculoskeletal pain. Journal of
Occupational Health-Australia and New
Zealand.
Leggat PA. Fast Facts: Travel Medicine. 1st
Ed. By Pollard AJ, Murdoch DR. Journal of
Travel Medicine.
Leggat PA. Handbook for Pediatric Health
Problems at Home and on the Road. 1st Ed.
By Ryder CS. Journal of Travel Medicine.
Leggat PA. Manual of Travel Medicine. 2nd
Ed. By Yung A, Ruff T, Torresi J, Leder K,
O’Brien D. Travel Medicine and Infectious
Disease.
Leggat PA. Oxford Handbook of Tropical
Medicine. 2nd Ed. By Eddleston M, Davidson
R, Wilkinson R, Pierini S. Travel Medicine
and Infectious Disease.
Leggat PA. SARS…the story so far: Public
health and safety implications. World Safety
Journal.
Leggat PA. The Traveler’s Medical Guide. 3rd
Ed. By Fujimoto GR, Robin MR, and Dessery
BL. Journal of Travel Medicine.
Leggat PA. The Sports Diving Medical: A
Guide to Medical Conditions relevant to
SCUBA Diving. 2nd Ed. By Parker J. Travel
Medicine and Infectious Disease.
Leggat PA, Shaw MT. Travelling to the
Commonwealth
Games,
Melbourne,
Australia. Travel Medicine and Infectious
Disease.
Leggat PA, Smith DR. Dermatitis and
aircrew. Contact Dermatitis.
Leggat PA, Smith DR. Prevalence of hand
dermatoses amongst dentists in Queensland,
Australia. International Dental Journal.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 77
Leggat PA, Smith DR. Prevalence of
percutaneous exposure incidents amongst
dentists in Queensland, Australia. Australian
Dental Journal.
MacLean S, d'Abbs P.
Will modifying
inhalants reduce volatile substance misuse?
A review Drugs: Education, Prevention and
Policy.
Nowak M, Büttner PG, Daniell K, Harrison
SL, Raasch B, Speare R. Effectiveness of
Lifestyle Measures in the Treatment of
Gastro-oesophageal Reflux Disease - a Case
Series. Therapeutics and Clinical Risk
Management.
Nowak M, Büttner PG, Woodward D,
Hawkes A. Food and weight related
behaviours: do beliefs matter more than
nutrition knowledge? In: Focus on Nutrition.
Nova Science Publishers.
Nowak M, Harrison SL, Hutton L. Nutritionrelated knowledge, beliefs and practices of
Australian nursing staff. Nutrition and
Dietetics.
Panaretto KS, Lee H, Mitchell M, Larkins S,
Manessis V, Büttner PG, Watson D.
Prevalence of sexually transmitted infections
in urban pregnant Aboriginal and Torres
Strait Islander women in Queensland.
Australian and New Zealand Journal of Public
Health.
Podger DN, Canyon DV. A tree in a page
loaded browse: the sequel. ClarionMag.
Ritchie SA, Williams CR, Montgomery BL.
Field
evaluation
of
New
Mountain
Sandalwood Mosquito Sticks and New
Mountain Sandalwood Botanical Repellent
against mosquitoes in North Queensland,
Australia. Journal of the American Mosquito
Control Association.
Russell RC, Webb CE, Williams CR,
Ritchie SA. Mark-release-recapture to study
dispersal of Aedes aegypti (L.), in Cairns,
Queensland,
Australia.
Medical
and
Veterinary Entomology.
Shaalan EA, Canyon DV, Wagdi Faried M,
Abdel-Wahab H, Mansour A. Effects of sub
lethal concentrations of synthetic insecticides
and Callitris glaucophylla extracts on the
development of Aedes aegypti. Journal of
Vector Ecology.
Shaalan EA, Canyon DV, Wagdi Faried M,
Abdel-Wahab H, Mansour A. Synergistic
efficacy of botanical blends with and without
synthetic insecticides against Aedes aegypti
and Culex annulirostris mosquitoes. Journal
of Vector Ecology.
Shaw MT, Leggat PA. A case of exposure to
Bancroftian filariasis in a traveller to Thailand.
Travel Medicine and Infectious Disease.
Shaw M, Leggat PA, Williams M. Intradermal
pre-exposure rabies immunisation in New
Zealand. Travel Medicine and Infectious
Disease.
Si D, Bailie R, Togni S, d'Abbs P, Robinson
G. Aboriginal Health Workers and diabetes
care in remote community health centres: A
mixed method analysis. Medical Journal of
Australia.
Smith DR, Leggat PA. Tobacco smoking
prevalence among a cross-section of dentists
in Queensland, Australia. Kurume Medical
Journal.
Williams CR, Ritchie SA, Whelan PI.
Potential distribution of the Asian disease
vector Culex gelidus Theobald (Diptera:
Culicidae) in Australia and New Zealand: a
prediction based on climate suitability.
Australian Journal of Entomology.
CDS, BOOKS, MONOGRAPHS & OTHER
PROFESSIONAL PUBLICATIONS
Canyon DV, Speare R. DeLOUSE: Canyon
and Speare's interactive website for the
diagnosis and treatment of pediculosis,
www.delouse.envirointel.com, 2005.
Davis R, Müller R, Tablet taking in Aboriginal
Health At: Quality Use of Medicines Map
website www.qummap.health.gov.au, 2005.
Dürrheim DN, Leggat PA, Shanks GD. Ch. 3.
Malaria prevention. In. Leggat PA, Goldsmid
JM. (Eds). Primer of Travel Medicine.
Ed.
Brisbane:
ACTM
Revised
3rd
Publications, 2005:38-54.
Gordon G, Leggat PA. Ch. 17. Extreme
travellers: high altitude, climate and diving. In.
Leggat PA, Goldsmid JM. (Eds). Primer of
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 78
Travel Medicine. Revised 3rd Ed. Brisbane:
ACTM Publications, 2005:200-211.
Graham H, Putland J, Leggat PA. Ch. 8. Air
travel for people with special needs. In.
Leggat PA, Goldsmid JM. (Eds). Primer of
Travel Medicine. Revised 3rd Ed. Brisbane:
ACTM Publications, 2005:100-112.
Hayes B, Müller R, Prenatal depression: a
randomised controlled trial in emotional
Health of primiparous women In: Depression
Research in Nursing – Global Perspectives,
pp 41-58 Editors Wiliams A, Hagerty B and
Ketefian S; Springer Publication 2005 ISBN
0-8261-5765-3
Kedjarune U, Leggat PA. Ch. 4. Dental
health and travellers. In. Leggat PA,
Goldsmid JM. (Eds).Primer of Travel
Medicine. Revised 3rd Ed. Brisbane: ACTM
Publications, 2005:55-60.
Kelly, P., Miller, A., Chenhall, R., Genat, B.,
Finn, J., & Anderson, I. Indigenous Health –
Building on recently established foundations
and linkages Chapter 4 Building Capacity to
Improve Public Health in Australia, Case
Studies of Academic Achievement, pp: 51-69,
January 2005, ANAPHI.
Leggat PA. Introduction to Travel Medicine.
Super Course Lecture 19341.
URL:
http://www.pitt.edu/~super1/lecture/lec19341/i
ndex.htm (Last updated March 2005)
Leggat PA. Post-Travel Health Consultation.
Super Course Lecture 19351. URL:
http://www.pitt.edu/~super1/lecture/lec19351/i
ndex.htm (Last updated March 2005)
Leggat PA. Preparing to work in a crisis.
SuperCourse
Lecture
20631.
URL:
http://www.pitt.edu/~super1/lecture/lec20631/i
ndex.htm (Last updated September 2005)
Leggat PA. Pre-Travel Health Consultation.
Super Course Lecture 19321. URL:
http://www.pitt.edu/~super1/lecture/lec19321/i
ndex.htm (Last updated March 2005)
Leggat PA. Risk Assessment in Travel
Medicine. Super Course Lecture 19271. URL:
http://www.pitt.edu/~super1/lecture/lec19271/i
ndex.htm (Last updated March 2005)
Leggat PA. SuperCourse Travel Medicine
Course.
URL:
http://www.pitt.edu/~super1/travel/travel.htm
(Last updated March 2005)
Leggat PA. The role of NGOs in disasters.
SuperCourse
Lecture
20621.
URL:
http://www.pitt.edu/~super1/lecture/lec20621/i
ndex.htm (Last updated September 2005)
Leggat PA. Travel health for special groups:
Older travelers. SuperCourse Lecture 19371.
URL:
http://www.pitt.edu/~super1/lecture/lec19371/i
ndex.htm (Last updated March 2005)
Leggat PA Travel medicine and pregnancy.
SuperCourse
Lecture
21011.
URL :
http://www.pitt.edu/~super1/lecture/lec21011/i
ndex.htm (Last updated September 2005)
Leggat PA, Goldsmid JM. (Eds) Primer of
Travel Medicine. Revised 3rd Ed. Brisbane:
ACTM Publications, 2005.
Leggat PA, Goldsmid JM. Ch. 2.
Vaccinations for travel. In.Leggat PA,
Goldsmid JM. (Eds). Primer of Travel
Medicine. Revised 3rd Ed. Brisbane: ACTM
Publications, 2005:22-37.
Leggat PA, Goldsmid JM. Ch. 13. Personal
safety and environmental health. In. Leggat
PA, Goldsmid JM. (Eds). Primer of Travel
Medicine. Revised 3rd Ed. Brisbane: ACTM
Publications, 2005:152-162.
Leggat PA, Goldsmid JM. Ch. 15. Travellers’
diarrhoea. In. Leggat PA, Goldsmid JM.
(Eds). Primer of Travel Medicine. Revised 3rd
Ed. Brisbane: ACTM Publications, 2005:175187.
Leggat PA, Goldsmid JM. Ch. 20. Advocacy
and research. In. Leggat PA, Goldsmid JM.
(Eds). Primer of Travel Medicine. Revised 3rd
Ed. Brisbane: ACTM Publications, 2005:235238.
Leggat PA, Heydon JL. Ch. 11. Working
overseas and medical kits. In. Leggat PA,
Goldsmid JM. (Eds). Primer of Travel
Medicine. Revised 3rd Ed. Brisbane: ACTM
Publications, 2005:128-140.
Leggat PA, Kedjarune U. Ch. 5. Travel
insurance and emergency assistance. In.
Leggat PA, Goldsmid JM. (Eds). Primer of
Travel Medicine. Revised 3rd Ed. Brisbane:
ACTM Publications, 2005:61-70.
Leggat PA, Putland J, Gruhn, J. Ch. 6. Jetlag
and surviving air travel. In. Leggat PA,
Goldsmid JM. (Eds). Primer of Travel
Medicine. Revised 3rd Ed. Brisbane: ACTM
Publications, 2005:73-82.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 79
Leggat P, Ross M. Scope of travel medicine.
In: A Guide to the Practice of Travel
Medicine. 1st ed. SASTM Publications,
Durban. 2005:4-5
Leggat PA, Ross MH, Goldsmid JM. Ch. 1.
Introduction to travel medicine. In. Leggat PA,
Goldsmid JM. (Eds). Primer of Travel
Medicine. Revised 3rd Ed. Brisbane: ACTM
Publications, 2005:3-21.
Leggat PA, Speare R, Silva D, Williams W,
Kedjarune U. Ch. 9. Travelling with children.
In. Leggat PA, Goldsmid JM. (Eds). Primer of
Travel Medicine. Revised 3rd Ed. Brisbane:
ACTM Publications, 2005:113-119.
Miller A, Kelly P, Chenhall R, Genat B, Finn
J, Anderson I. Indigenous Health – Building
on recently established foundations and
linkages Chapter 4 Building Capacity to
Improve Public Health in Australia, Case
Studies of Academic Achievement, January
2005, ANAPHI.
Nowak M, Leggat PA, Putland J. Ch. 7.
Dietary advice for travellers. In. Leggat PA,
Goldsmid JM. (Eds). Primer of Travel
Medicine. Revised 3rd Ed. Brisbane: ACTM
Publications, 2005:83-99.
Ross M, Leggat P (2005). Research and
travel medicine. In: A Guide to the Practice of
Travel
Medicine.
1st
ed.
SASTM
Publications, Durban ISBN 0-620-35300-7
P45-46.
Speare R, Goldsmid JM. Leggat PA. Ch. 19.
Post-travel check-up. In. Leggat PA,
Goldsmid JM. (Eds). Primer of Travel
Medicine. Revised 3rd Ed. Brisbane: ACTM
Publications, 2005:223-232.
Speare R, Melrose W. Human Parasitology.
Postgraduate Student Reference CD. James
Cook University, Townsville, 2005.
Speare R, Miller A. Theory and Practice in
Public
Health.
Postgraduate
Student
Reference CD. James Cook University,
Townsville, 2005.
Stewart L, Leggat PA. Ch. 12. Culture shock.
In. Leggat PA, Goldsmid JM. (Eds). Primer of
Travel Medicine. Revised 3rd Ed. Brisbane:
ACTM Publications, 2005:143-151.
Reports
Carter A, Müller R. Annual employee health
survey 2004. WMC Fertilizers Pty Ltd, March
2005.
Devine, S. Townsville 10,000 Steps: Report
on the Baseline Survey of Physical Activity in
Townsville”. July, 2005.
Carter A, Müller R. The hydration status and
needs of employees at The Monument
Camp. WMC Fertilizers Pty Ltd, May 2005.
Devine S, Carter T, Müller R.
Perceptions of Occupational Health
Safety Concerns at the Phosphate Hill
Report to WMC Fertilizers Pty
September, 2005.
Carter A, Müller R. Study of occupational
fatigue in Production staff at the WMC
Phosphate Hill site. WMC Fertilizers Pty Ltd,
May 2005.
Devine, S. “Get Active Thuringowa: Report
on the Get Active Thuringowa Physical
Activity Survey”. July, 2005.
Devine, S. “Get Active Thuringowa: Report
on the Physical Activity Observation Study of
the Riverway Area”. July, 2005.
Devine, S. “Physical Activity Programmes in
the Workplace – Employee Perceptions.
Report on a qualitative study examining
Thuringowa
City
Council
employee’s
perception of how to promote physical activity
in the workplace”. July, 2005.
Staff
and
Site.
Ltd,
MacLean S, d'Abbs P. Impact of the
Modification of Volatile Substance Products
on the Behaviour of Inhalant Users. Report
for the National Inhalant Task Force.
Melbourne,
Youth
Research
Centre,
University of Melbourne, 2005.
Reeve D. Evaluation of the BrugiarapidTM
cassette. WHO Technical Report, 2005.
Speare R. (consultant) Threat Abatement
Plan for infection of amphibians with chytrid
fungus resulting in chytridiomycosis.
Department of Environment and Heritage.
2005.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 80
Conference Presentations
Aitken
P,
Leggat
PA,
Hodge
J.
“Development of a Postgraduate Qualification
in Disaster Health.” Regional Scientific
Meeting of the Australasian College of
Tropical Medicine, Hobart, Tasmania,
November 2005.
Croese J, Speare R, O’Neil J, Masson J,
Cooke S, Melrose W, Pritchard D. “Necator
americanus in the treatment of Crohn’s
disease.” ACTM Scientific Meeting, 12 June
2005, Rydges Capricornia Resort, Yeppoon
2005.
d’Abbs P. “Alcohol Policy for Post Industrial
Society: Meeting New Challenges” .Invited
Presentation at Australian Drug Foundation
International Conference: Thinking Drinking –
Achieving Cultural Change by 2020,
Melbourne, 21-23 February 2005.
d’Abbs P. “Recent Developments in
Addressing Volatile Substance Misuse”.
Keynote presentation at Australian Winter
School Conference “Drugs, Lifestyle and
Culture: Innovation and Evidence”, Brisbane
4-7 July 2005.
Hanson D. “Sustainability: Did you really think
you could get something for nothing?”
Queensland Safe Communities Conference,
Brisbane, 24–25 October 2005.
Hanson D, Müller R, Dürrheim DN.
“Assessing the Growth and Structure of A
Community-Based
Safety
Promotion
Network.” SUNBELT XXV International
Sunbelt
Social
Network
Conference,
Redondo Beach, California, USA, 16–20
February
2005.
http://www.socsci.uni.edu/%7Essnconf/conf/p
rogramme.html
Hanson D, Müller R, Dürrheim DN,
“Documenting the Development of Social
Capital in a Community Safety Promotion
Coalition Using Social Network Analysis.”
International Conference on Engaging
Communities,
Brisbane,
Australia,14-17
August
2005.
http://www.engaging
communities2005.org/ab-theme-6.html
Harrison SL, Bartlett L, Taylor C, Rolfe T,
Moise A, Reeve C and other members of the
North Queensland Skin Cancer Network.
“Sun Safe Initiative Award for Local
Government
Authorities
in
North
Queensland.” NQCCR Research Day, School
of Medicine, James Cook University, 17
November 2005.
Harrison SL, Büttner PG, MacLennan R,
Rivers J, Kelly J. “How good are parents at
assessing melanocytic naevi (moles) on their
children?” NQCCR Research Day, School of
Medicine, James Cook University, 17
November 2005.
Harrison SL, Büttner PG, MacLennan R.
“The North Queensland “Sun-Safe Clothing
Study”: design and baseline results of a
randomised
trial
to
determine
the
effectiveness of sun-protective clothing in
preventing melanocytic naevi.” School of
Public Health, Tropical Medicine and
Rehabilitation Sciences Research Showcase
Day (Poster), James Cook University. 3
August 2005.
Harrison SL, Devine S, Saunders V,
Büttner PG, Nowak M, Woosnam J,
Morrison M. “Risky Beliefs About the
Therapeutic Uses of Sun Exposure.” NQCCR
Research Day, School of Medicine, James
Cook University, 17 November 2005.
Harrison SL, MacLennan R, Büttner PG.
“Unique design features of a randomized
controlled intervention trial to determine
whether the development of melanocytic
naevi (moles) in early childhood can be
prevented or delayed.” NQCCR Research
Day, School of Medicine, James Cook
University, 17 November 2005.
Harrison SL, MacLennan R, Büttner PG,
MacKie R. “Collective evidence for a
relationship between exposure to sunlight
and
melanocytic
naevus
(mole)
development.” NQCCR Research Day,
School of Medicine, James Cook University,
17 November 2005.
Harrison SL, Saunders V, Nowak M.
“Baseline Survey of Sun Protection
Knowledge, Policy and Practices In
Queensland Early Childhood Services.”
NQCCR Research Day, School of Medicine,
James Cook University, 17 November 2005.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 81
Jog SM, Patole S, Müller R. “Is the severity
and outcome of respiratory illness of preterm
neonates
with
generalised,
minimal
subcutaneous edema different?” ESPR
[European Society for Ped Res] Conference,
Siena, Italy, August 2005.
Leggat PA. Conference Report: A Festschrift
for Major General John Pearn, AM, RFD.
Annals of the ACTM. 2005;6:16.
Leggat PA. “Anton Breinl Memorial Lecture:
Trends in antimalarial prescriptions in
Australia 1998-2002.” Proceedings of "2005To Infinity and Beyond"-Capricornia Medical
Science Association Conference-Annual
Scientific Meeting of the Australasian College
of Tropical Medicine and the Capricornia
Medical Science Association, Yeppoon, 1013 June, 2005: 33.
Leggat PA. “Destination Thailand and
Vietnam.” Proceedings of the 9th Conference
of the International Society of Travel
Medicine, Lisbon, Portugal, May 2005.
Leggat PA. “Emerging issues in travel
medicine.” Medical Directors of University
Health Services Scientific Meeting, Brisbane,
Australia, November 2005
Leggat PA. Keynote address: “The Fulbright
Scholarship Programme.” Golden Key
International Honour Society, James Cook
University Chapter, Induction Ceremony, 22
May 2005.
Leggat PA. “Pregnancy and travel.”
Proceedings of the International Congress for
Tropical Medicine and Malaria, Marseilles,
France, September 2005. PS15.
Leggat PA. “Sun, Sand and Serpentssurviving travel”. Vitae Lampada: a
Festschrift for Professor John Pearn.
Brisbane, June, 2005.
Leggat PA. Travel Health Summit, GSK,
Perth, May 2005.
Leggat PA. Travel Health Summit, GSK,
Cairns, May 2005.
Leggat PA. “Travel Medicine: An Australian
Perspective.” Regional Scientific Meeting of
the Australasian College of Tropical
Medicine, Hobart, Tasmania, November 2005
PO03:22.
Science Association Conference-Annual
Scientific Meeting of the Australasian College
of Tropical Medicine and the Capricornia
Medical Science Association, Yeppoon, 1013 June, 2005: 49.
Leggat PA. “Trends in malaria and
antimalarial use in Australia 1998-2002.”
Regional
Scientific
Meeting
of
the
Australasian College of Tropical Medicine,
Hobart,
Tasmania,
November
2005,
SY02:16.
Leggat PA, Peterman C, Véronneau SJH.
"Dermatitis reported in medical examinations
of
US
Commercial
Airline
Pilots.”
Proceedings of the 9th Conference of the
International Society of Travel Medicine,
Lisbon, Portugal, May 2005.
Leggat PA, Selve B, Carron J, Hiawalyer G,
Melrose W, Wynd S, Dürrheim DN.
“Household survey of coverage and adverse
events of mass drug administration for
lymphatic filariasis control in the Samarai
Murua District of Milne Bay Province, Papua
New
Guinea.”
Proceedings
of
the
International Congress for Tropical Medicine
and Malaria, Marseilles, France, September
2005. P717.
Leggat PA, Selve B, Carron J, Hiawalyer G,
Melrose W, Wynd S, Dürrheim DN.
“Knowledge of household representatives
concerning lymphatic filariasis and its control
in the Samarai Murua District of Milne Bay
Province, Papua New Guinea.” Proceedings
of the International Congress for Tropical
Medicine and Malaria, Marseilles, France,
September 2005. P716.
Leggat PA. Smith DR, “Prevalence and
distribution of musculoskeletal disorders
amongst medical students in Queensland.”
5th Annual Health and Medical Research
Conference of Queensland, Brisbane,
November 2005: P16: 258.
Melrose W. “Does Lymphatic Filariasisinduced Immuno-suppression facilitate fungal
skill infections.” American Society of Tropical
Medicine and Hygiene meeting, Washington,
DC, December 2005.
Leggat PA. “Travel Medicine-The Australian
Perspective.” Proceedings of "2005-To
Infinity and Beyond"-Capricornia Medical
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 82
Moeckel M, Mueller R, Vollert J, Mueller C,
Danne O, Stoerk T. "Lipoprotein-Associated
Phospholipase A2 Additionally to NT-proBNP
and Troponin I is, Useful for Early Risk
Stratification in Patients With Acute Coronary
Syndrome:
A
Multimarker
Approach.”
American
Heart
Association,
13-15
November, 2005.
Moeckel M, Vollert J, Muller Chr, Müller R,
Stoerk T, Gareis R, "Lipoprotein-assoziierte
Phospholipase hat einen ergaenzenden
progrnostischen Nutzen bei Patienten mit
akutem Koronarsyndrom, die mittels Troponin
I und NT-proBNP stratifiziert wurden.“ 71
Jahrestagung der Deutschen Gesellschaft
fuer Kardiologie, Mannheim, 31 March-2 April
2005, Germany.
Reimers P, Raasch B, Harrison SL, Glasby
M. “When, how and why patients present with
lesions they believe to be skin cancers.”
NQCCR Research Day, School of Medicine,
James Cook University, 17 November 2005.
Reeve D. “Evaluation of the BrugiarapidTM
cassette.” Australian Society for Microbiology.
Mission Beach, Australia, August 2005.
Ritchie SA, Russell RC, Williams C. “The
terror of dengue in north Queensland,
Australia - a greener path to dengue control.”
International Congress of the Society for
Vector Ecology, October 2005.
Ritchie SA, et al. “Can mosquito traps be
used for Japanese encephalitis surveillance?”
Annual Workshop of the Australian
Biosecurity CRC, Perth, November 2005.
Ross MH, de Frey A, Leggat PA, Kielkowski
D. “An academic path to travel medicine in
South Africa.” Proceedings of the 9th
Conference of the International Society of
Travel Medicine, Lisbon, Portugal, May 2005.
Saunders V, Harrison SL, Nowak M,
Sallway R, Woosnam J, Clee D, Darr J.
“Baseline
survey
of
sun
protection
knowledge, practices & policy in early
childhood settings throughout Queensland.”
School of Public Health, Tropical Medicine
and Rehabilitation Sciences Research
Showcase Day (Poster), James Cook
University, 3 August 2005.
Shaw MT, Leggat PA. “A case of Bancroftian
filariasis in a traveller.” Proceedings of "2005To Infinity and Beyond"-Capricornia Medical
Science Association Conference-Annual
Scientific Meeting of the Australasian College
of Tropical Medicine and the Capricornia
Medical Science Association, Yeppoon, 1013 June, 2005: 48.
Shaw MT, Leggat PA. “Illness and injury to
travellers on a premium expedition to
Iceland.” Regional Scientific Meeting of the
Australasian College of Tropical Medicine,
Hobart,
Tasmania,
November
2005,
PO01:21.
Shaw M, Leggat PA, Williams M.
“Intradermal
pre-exposure
rabies
immunisation in New Zealand.” Proceedings
of the 9th Conference of the International
Society of Travel Medicine, Lisbon, Portugal,
May 2005; Abstract PO02.19: 114.
Sloots K, Vuleta S, Bartlett LM “Icebergs in
North Queensland.” Townsville Health
Service District 1 day Symposium in Faecal
Incontinence, Townsville, Australia, May
2005
Smith DR, Leggat PA. “Needlestick and
sharps injuries amongst Australian medical
students.” Proceedings of "2005-To Infinity
and Beyond"-Capricornia Medical Science
Association Conference-Annual Scientific
Meeting of the Australasian College of
Tropical Medicine and the Capricornia
Medical Science Association, Yeppoon, 1013 June, 2005: 50.
Smith DR, Leggat PA. “The historical
development and future challenges for
occupational health services in Australia.”
13th International Congress on Occupational
Health
Services,
Utsunomiya,
Japan,
December 2005.
Speare R. “Elements of a strongyloides
control
programme.”
Third
National
Workshop on Strongyloidiasis. Rydges
Capricornia
Resort,
Yeppoon,
10-11
June,2005.
Speare R. “Hookworms: Foe or Friend?”
Scientific Meeting. Thirtieth Year Reunion.
Royal Brisbane Hospital, Herston, Brisbane.
22 October 2005.
Speare R. Papers from theses and
dissertations. School of Public Health,
Tropical
Medicine
and
Rehabilitation
Sciences Research Showcase Day, James
Cook University, 3 August 2005.
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 83
Speare R. “Solving the puzzle of amphibian
declines: the importance of the Queensland
wet tropics.” Wet Tropics Management
Authority, Management Group, 16 August
2005.
amphibian chytrid fungus.” International
Union of Microbiological Societies, XI
International Congress of Mycology, San
Francisco, California, USA 23-28 July 2005.
124-M p. 27.
Speare
R.
“Strongyloidiasis
and
strongyloides: an overview.” Third National
Workshop on Strongyloidiasis. Rydges
Capricornia Resort, Yeppoon, 10-11 June,
2005.
Williams CR. “The scent of a frog:
investigating frog odour and the reasons for
it.” Departmental Seminar, Department of
Biology, Utah State University, Logan UT,
USA, 10 October, 2005.
Speare R, Berger L, Skerratt L, Mendez D.
“Chytridiomycosis and amphibian declines.”
International Wildlife Disease Association
Conference, 26 June to 1 July 2005, Cairns,
Australia.
Williams CR. “Why do frogs smell?” Public
Lecture,
Massachusetts
Institute
of
Technology (MIT), Cambridge MA, USA, 8
October, 2005
Speare R, Weldon C. “Out of Africa: origin of
Batrachochytrium
dendrobatidis,
the
Editorial Board Membership &
Manuscript Review
ADF Health
ª P Leggat - Reviewer
Amphibian and Reptile Conservation
ª R Speare - Reviewer
Annals of The Australasian College of
Tropical Medicine
ª P Leggat - Editorial Board
Cancer
Epidemiology,
Prevention
ª SL Harrison - Reviewer
Biology
and
Contemporary Drug Problems
ª P d’Abbs - Reviewer
Drug and Alcohol Review
ª P d’Abbs - Reviewer
Australian Journal of Entomology
ª C Williams – Reviewer
Eco Health
ª R Speare - Reviewer
Australian Journal of Medical Science
ª P Leggat - Reviewer
Education for Health: Change in Training
and Practice
ª P Leggat - Reviewer
Australian Journal of Zoology
ª R Speare - Reviewer
Australian Military Medicine
ª P Leggat – Reviewer
Australian Sociological Association
ª
Peter d’Abbs - Member
BMC Infectious Diseases
ª R Speare – Reviewer
BMC Public Health
ª
Peter Leggat - Reviewer
Bulletin of the World Health Organization
ª R Speare - Reviewer
Canadian Journal of Zoology
ª C Williams - Reviewer
Emerging Infectious Diseases
ª R Speare - Reviewer
European Journal of Cancer
ª SL Harrison - Reviewer
Health Professional Education
ª P Leggat - Reviewer
Health Education Research
ª D Hanson - Reviewer
Herpetological Review
ª R Speare - Reviewer
International Dental Journal
ª P Leggat - Reviewer
Journal
of the
American
Association
ª P Leggat - Reviewer
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Medical
Page 84
Journal of the American Mosquito Control
Association
ª S Ritchie - Reviewer
Journal of Clinical Epidemiology
ª SL Harrison - Reviewer
Journal of Dental Research (International
Association for Dental Research)
ª P Leggat - Reviewer
Journal of Investigative Dermatology
ª
SL Harrison - Reviewer
Journal of the European Academy of
Dermatology and Venereology
ª R Speare - Reviewer
Journal of Medical Entomology
ª D Canyon - Reviewer
ª S Ritchie - Reviewer
Journal of Occupational Health and
Safety-Australia and New Zealand
ª P Leggat - Editorial Advisory Committee
Journal of Rural & Remote Health
ª
Wayne Melrose - Reviewer
Journal of Rural and Tropical Public
Health
ª D Canyon - Editor-in-Chief
ª P d’Abbs - Editor
ª S Devine - Editor
ª P Leggat - Editor
ª A Miller - Editor
ª R Speare - Editor
Journal of Travel Medicine
ª D Hanson - Reviewer
ª P Leggat - Book Review Editor & Reviewer
Lancet
ª R Speare - Reviewer
Medical and Veterinary Entomology
ª D Canyon - Reviewer
Medical Journal of Australia
ª R McDermott - Reviewer
ª R Müller - Reviewer
ª R Speare - Reviewer
ª M Wenitong - Reviewer
Medicine Today
ª P Leggat - Reviewer
Military Medicine
ª P Leggat - Reviewer
Nutrition and Dietetics
ª M Nowak - Reviewer
Rural and Remote Health
ª R Speare - Reviewer
Statistics in Medicine
ª R Müller – Reviewer
Travel Medicine and Infectious Disease
ª P Leggat - Reviewer, Editorial Board &
Editorial Advisor
Trends in Parasitology
ª
Wayne Melrose - Reviewer
World Safety Journal
ª P Leggat - Reviewer
Nutrition and Dietetics
ª M Nowak – Reviewer
Vaccine
ª P Leggat - Reviewer
Journal of Vector Ecology
ª D Canyon - Reviewer
Refereeing Grant Applications
Alcohol Education and Rehabilitation
Foundation
ª P d’Abbs
Cooperative Research Centre for
Aboriginal Health
ª P d’Abbs
National Health and Medical Research
Council
ª P Büttner
ª
ª
ª
ª
ª
SL Harrison
P Leggat
R McDermott
M Nowak
S Ritchie
JCU Programme Grants Panel
ª D Canyon
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 85
Leadership in Professional
Organisations
Advanced Paediatric Life Support
Australasia
ª Dale Hanson - Faculty
ª
Peter Leggat – Qld Chair
Australian Safe Communities Foundation
ª Dale Hanson - Management Committee
Alcohol Education and Rehabilitation
Foundation
ª Peter d’Abbs – Board of Directors
International Society of Travel Medicine
ª Peter Leggat - Executive Board, 2003-2005
Australian College of Tropical Medicine
ª Peter Leggat - Immediate Past President,
Queensland Health Early Childhood
Implementation Group
ª Simone Harrison – Founding Member
2004-2005; President-Elect, 2005-Present
Australian Indigenous Doctors
Association
ª Mark Wenitong - President
Queensland Health Research and
Evaluation Implementation Group
ª Simone Harrison – Founding Member
Australian Injury Prevention Network
ª Dale Hanson - Australian Executive Qld Rep
World Safety Organization
ª Peter Leggat - Board of Directors, 2003Present
Australian Fulbright Association
Financial Report
INCOME AND EXPENDITURE STATEMENT 2005
Income
JCU Operating Funds
Commonwealth PHERP Funds
Total Income
$1,696,023
$487,828
$2,183,851
Expenditure
Salaries
Travel
Operations and Equipment
$1,633,197
$81,578
$445,604
Total Expenditure
$2,160,379
Grants and Consultancies
$2,914,991
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 86
ACKNOWLEDGEMENTS
Photographs used in this publication with permission and courtesy
Page
Photograph
Courtesy
Front Cover
Anton Breinl Centre
Peter Leggat
2
Bob Douglas
Bob Douglas
2
Bernard Moulden
James Cook University
3
Rick Speare
Rick Speare
5
Anton Breinl Centre
Peter Leggat
6
Hookworm
Rick Speare
7
Portable Altitude Chamber
Peter Leggat
7
Research Showcase
SPHTMRS
9
Library, Divine Word University, Madang
Petra Buttner
10
Rick Speare
Rick Speare
18
TM5501 Class
Peter Leggat
20
Dr Sanjay Patole
Dr Sanjay Patole
20
Dr Scott Kitchener
Dr Scott Kitchener
20
A/Prof Peter Leggat
Peter Leggat
23
Lab
Deon Canyon
26
Researchers from Mahidol University
Peter d’Abbs
27
Head Louse
Deon Canyon
28
Delouse Website
Deon Canyon
34
Blood Test
Dallas Young
37
Tobacco Logo
Dallas Young
39
Skin Cancer
Simone Harrison
46
Script Tree
Deon Canyon
48
Injury Iceberg
Health Promotion Journal
59
Hookworm – Pill Camera
Rick Speare
59
Mouth of Hookworm
Rick Speare
69
Photo Certificate Recognition
Anton Breinl Centre
69
Certificate – Educational Award
Anton Breinl Centre
70
Vitae Lampada Medal
Peter Leggat
70
Sidney Sax Medal
Anton Breinl Centre
71
Certificate - Ignobel Prize
Craig Williams
72
Induction
Peter Leggat
72
Honorary Member
Anton Breinl Centre
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 87
Abbreviations
AHMAC – Australian Health Ministers Advisory
NHMRC - National Health and Medical Research
Council
Council
ANAPHI - Australian Network of Academic Public
Health Institutions
PHERP - Public Health Education and Research
ARPANSA - Australian Radiation Protection &
QCF - Queensland Cancer Fund
Programme
Nuclear Safety Agency
QIMR - Queensland Institute of Medical
MICRRH - Mt Isa Centre for Rural and Remote
Research
Health
WHO - World Health Organization
NACCHO - National Aboriginal Community
Controlled Health Organisation
WMC - Western Mining Company
NATSIHC – National Aboriginal and Torres Strait
Islander Health Council
NCEPH - National Centre for Epidemiology and
Population Health
Anton Breinl Centre for Public Health & Tropical Medicine - ANNUAL REPORT 2005
Page 88