TABLE OF CONTENTS
Transcription
TABLE OF CONTENTS
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