Australian Immunisation Overview
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Questions and Answers

What is the main purpose of active immunisation?

  • To stimulate the immune system to produce its own antibodies. (correct)
  • To monitor immune responses over time.
  • To test vaccine safety on a small number of participants.
  • To directly provide antibodies to non-immune individuals.

    • What phase of clinical trials involves thousands of participants to assess a vaccine's safety and efficacy?

  • Phase III clinical trials (correct)
  • Phase II clinical trials
  • Phase I clinical trials
  • Pre-clinical assessment

    • Which regulatory body is responsible for assessing vaccine safety and effectiveness before licensure?

  • Therapeutic Goods Administration (correct)
  • Food and Drug Administration
  • World Health Organization
  • Centers for Disease Control and Prevention

    • What is the purpose of Phase IV clinical trials in vaccine development?

    <p>To monitor the ongoing safety of vaccines after they are licensed.</p> Signup and view all the answers

    Passive immunisation typically involves which of the following?

    <p>Transferring antibodies directly for short-term protection.</p> Signup and view all the answers

    What is an important factor in addressing vaccine hesitancy?

    <p>Building trust with healthcare providers</p> Signup and view all the answers

    Which of the following is a recommended approach for discussions surrounding vaccinations?

    <p>Focusing on protecting the individual and the community</p> Signup and view all the answers

    Why is honesty about side effects important in vaccination discussions?

    <p>To build trust and reassure the hesitant</p> Signup and view all the answers

    What aspect of vaccine management is crucial for maintaining efficacy?

    <p>Cold chain management</p> Signup and view all the answers

    What is the primary purpose of maintaining a cold chain for vaccines?

    <p>To ensure vaccines are effective and safe for use</p> Signup and view all the answers

    What temperature range should vaccines be kept in during transport and storage?

    <p>+2 to +8 degrees Celsius</p> Signup and view all the answers

    Which of the following are reasons for a cold chain breach?

    <p>All of the above</p> Signup and view all the answers

    What should healthcare providers do if a cold chain breach affects state funded vaccines?

    <p>Notify local public health units and isolate the affected vaccines</p> Signup and view all the answers

    What is the main goal of catch-up vaccinations?

    <p>To ensure complete immunisation in a quick timeframe</p> Signup and view all the answers

    Which vaccine can have upper age limits that prevent catch-up vaccination?

    <p>Rotavirus vaccine</p> Signup and view all the answers

    What is a common mild adverse effect after vaccination?

    <p>Local pain and swelling</p> Signup and view all the answers

    How soon can anaphylaxis occur after vaccination?

    <p>Within 5 minutes</p> Signup and view all the answers

    Where can healthcare professionals find guidelines for vaccine usage?

    <p>Australian Immunisation Handbook</p> Signup and view all the answers

    What vaccination is scheduled for introduction in Australia in 2024?

    <p>Meningococcal B vaccine</p> Signup and view all the answers

    What is a crucial element that should be considered when assessing a screening program's effectiveness?

    <p>Accessibility of the program to all demographics</p> Signup and view all the answers

    Which factor may lead to an over-estimation of a screening program's benefits?

    <p>Lead time bias</p> Signup and view all the answers

    What should be a key focus when determining the target population for a screening program?

    <p>Individuals with a higher risk of developing the disease</p> Signup and view all the answers

    What is one of the psychological harms associated with screening programs?

    <p>Increased feelings of anxiety for individuals</p> Signup and view all the answers

    Which of the following describes length time bias in screening?

    <p>Slow-growing diseases are more likely to be diagnosed earlier</p> Signup and view all the answers

    Which aspect is essential for ensuring a successful screening program?

    <p>Establishing a rigorous follow-up process for those with abnormalities</p> Signup and view all the answers

    What is a potential consequence of false positive results in screening?

    <p>Increased healthcare costs due to unnecessary procedures</p> Signup and view all the answers

    What foundational requirement helps ensure a screening program is controllable and assessable?

    <p>Clearly defined processes and structure</p> Signup and view all the answers

    What is the primary aim of secondary screening programs like breast cancer screening?

    <p>To interrupt the progression of early-stage disease through early detection.</p> Signup and view all the answers

    Which of the following is an example of opportunistic screening?

    <p>Screening performed during a medical checkup for unrelated health issues.</p> Signup and view all the answers

    What is one of the identified biases associated with screening programs?

    <p>Over-detection of non-threatening diseases.</p> Signup and view all the answers

    How does bowel cancer screening primarily aim to reduce mortality?

    <p>Through early detection and treatment of polyps.</p> Signup and view all the answers

    Which screening type specifically targets high-risk individuals?

    <p>Targeted screening.</p> Signup and view all the answers

    Which of the following is NOT considered a screening method?

    <p>A test performed to confirm or exclude diagnoses.</p> Signup and view all the answers

    What essential requirement contributes to a successful screening program?

    <p>Clear communication of benefits and risks to participants.</p> Signup and view all the answers

    Why might certain diseases have screening programs while others do not?

    <p>Availability of effective early treatment options and disease prevalence.</p> Signup and view all the answers

    Which of the following is NOT a criterion for determining whether a disease warrants screening?

    <p>Cost-effectiveness of large-scale testing</p> Signup and view all the answers

    What does HIGH SENSITIVITY in a screening test indicate?

    <p>Most people with the disease are detected</p> Signup and view all the answers

    Which option accurately describes POSITIVE PREDICTIVE VALUE (PPV)?

    <p>The likelihood of having the disease given a positive result</p> Signup and view all the answers

    Which characteristic is NOT important for a screening test?

    <p>High complexity to ensure accuracy</p> Signup and view all the answers

    What is the main focus of a bowel cancer screening program?

    <p>Detection of colorectal cancer at a pre-symptomatic stage</p> Signup and view all the answers

    Which of these options is a critical question that needs to be considered when evaluating a screening program?

    <p>How common is the disease in the population?</p> Signup and view all the answers

    What could be a potential consequence of a test with a high false negative rate in cancer screening?

    <p>Missed early detection of cancer in patients</p> Signup and view all the answers

    Which of the following best describes the importance of understanding the natural history of a disease in the context of screening?

    <p>To assess when and how the disease presents over time</p> Signup and view all the answers

    What is the primary type of screening aimed at detecting health issues in individuals before symptoms occur?

    <p>Preventive screening</p> Signup and view all the answers

    Which type of screening is specifically designed for individuals at high risk for a particular disease?

    <p>Targeted screening</p> Signup and view all the answers

    What is the primary goal of opportunistic screening programs?

    <p>To provide screening at the time of healthcare visits</p> Signup and view all the answers

    Which statement best describes universal screening?

    <p>Screening is performed on an entire population regardless of risk</p> Signup and view all the answers

    Which type of screening is often conducted when certain symptoms are present but a definitive diagnosis has not yet been established?

    <p>Diagnostic screening</p> Signup and view all the answers

    Which principle is most important for successful population-based screening programs?

    <p>Tests used should have a high sensitivity and specificity</p> Signup and view all the answers

    What is a potential drawback of opportunistic screening compared to systematic population-based screening?

    <p>Higher chance of missing high-risk individuals</p> Signup and view all the answers

    What is the main focus of surveillance screening programs?

    <p>To monitor the disease in individuals who have previously been treated</p> Signup and view all the answers

    What type of information is essential to obtain during a health assessment for refugees?

    <p>Full medical history including allergies and previous surgeries</p> Signup and view all the answers

    Which group is characterized by limited access to healthcare services after arrival?

    <p>Asylum seekers without paperwork</p> Signup and view all the answers

    What should be considered when discussing immunizations with a refugee population?

    <p>Cultural beliefs and past experiences related to healthcare</p> Signup and view all the answers

    Which aspect is critical in a consultation regarding a refugee's health?

    <p>Asking about diet, sleep, and mental health</p> Signup and view all the answers

    What is a significant concern regarding the mental health of refugees?

    <p>Acculturation and trauma from their journey</p> Signup and view all the answers

    When referring a refugee for further medical evaluation, what should be prioritized?

    <p>Patient's immediate health concerns and cultural needs</p> Signup and view all the answers

    Which medical testing is often included in health assessments for refuges?

    <p>Testing for sexually transmitted diseases</p> Signup and view all the answers

    What significant public health issue should be addressed in refugees?

    <p>Nutritional deficiencies due to accessibility</p> Signup and view all the answers

    What is important about the management of a refugee's ongoing health?

    <p>Establishing connection with a general practitioner for continuous care</p> Signup and view all the answers

    Which factor should be taken into account regarding social health in refugees?

    <p>Temporary and often mobile housing situations</p> Signup and view all the answers

    What is the primary focus of primary prevention in the context of disease prevention?

    <p>To manage risk factors to prevent disease onset</p> Signup and view all the answers

    Which level of prevention specifically targets early disease diagnosis and management?

    <p>Secondary prevention</p> Signup and view all the answers

    What is the key aim of tertiary prevention in health management?

    <p>Optimizing disease management and reducing complications</p> Signup and view all the answers

    Which type of prevention involves efforts to minimize factors contributing to disease, primarily through social determinant interventions?

    <p>Primordial prevention</p> Signup and view all the answers

    What is the main objective of secondary prevention methods like screening?

    <p>To detect diseases early and treat them promptly</p> Signup and view all the answers

    What is the primary goal of primary prevention in relation to ARF/RHD?

    <p>To prevent disease from developing in the first place</p> Signup and view all the answers

    Which approach aims to address broad risk factors across the population?

    <p>Population approach</p> Signup and view all the answers

    What is a key aspect of tertiary prevention for ARF/RHD?

    <p>Early recognition and management of the disease</p> Signup and view all the answers

    What is a primary strategy in secondary prevention for ARF/RHD?

    <p>Long-term antibiotic treatment to prevent heart damage</p> Signup and view all the answers

    What best defines the concept of prevention paradox?

    <p>A small number of high-risk individuals leads to fewer cases than a large population at low risk</p> Signup and view all the answers

    In the context of economic benefits of prevention, what is a significant cost of diseases like obesity?

    <p>High direct healthcare costs including hospitalizations</p> Signup and view all the answers

    Which strategy focuses on personalizing health interventions for individuals?

    <p>High-risk individual approach</p> Signup and view all the answers

    Which of the following describes the aim of primordial prevention?

    <p>To improve health literacy and social conditions</p> Signup and view all the answers

    What characterizes the approach of individual prevention?

    <p>It is typically resource-intensive and personalized</p> Signup and view all the answers

    What is the main difference between mitigation and adaptation in the context of climate change?

    <p>Mitigation aims to stop climate change from getting worse, while adaptation seeks to live with its impacts.</p> Signup and view all the answers

    Which of the following is a key aspect of interdisciplinary collaboration for addressing climate-sensitive health risks?

    <p>Building partnerships between various disciplines can lead to more effective solutions.</p> Signup and view all the answers

    What is considered a climate-related health risk due to changing weather patterns?

    <p>Heightened risk of vector-borne diseases due to changing habitats.</p> Signup and view all the answers

    Which strategy is essential for public health systems to effectively adapt to climate-related challenges?

    <p>Implementing flexible policies that can respond to evolving climate conditions.</p> Signup and view all the answers

    What role do human activities play in climate-related health risks?

    <p>Human activities, such as carbon emissions, exacerbate climate change and related health risks.</p> Signup and view all the answers

    What is a significant mental health impact of climate change on youth?

    <p>Feelings of powerlessness and betrayal</p> Signup and view all the answers

    Which of the following factors contributes to infectious diseases being affected by climate change?

    <p>Forest fires exposing populations to pathogens</p> Signup and view all the answers

    How many teenagers globally are reported to have mental disorders?

    <p>1 in 7</p> Signup and view all the answers

    What is a potential psychological impact of climate-related trauma?

    <p>Community breakdown and conflict</p> Signup and view all the answers

    What percentage of young people surveyed felt climate change affects their daily life?

    <p>45%</p> Signup and view all the answers

    Which statement accurately reflects the impact of climate change on cardiovascular health?

    <p>It can contribute to increased presentations for cardiovascular disease.</p> Signup and view all the answers

    Which aspect of climate change significantly affects the host status of infectious diseases?

    <p>Increase in host vulnerability due to heat and environmental stressors</p> Signup and view all the answers

    What percentage of surveyed young people expressed high worry about climate change?

    <p>60%</p> Signup and view all the answers

    How does climate change disproportionately affect different socioeconomic groups?

    <p>Those with the lowest carbon footprints are often the most affected.</p> Signup and view all the answers

    What mental health issues may arise as a result of climate-related disasters?

    <p>Development of trauma and fear due to loss of life and livelihood.</p> Signup and view all the answers

    Which health consequence is associated with exposure to smoke from bushfires?

    <p>Increased hospital admissions for cardiovascular and respiratory conditions.</p> Signup and view all the answers

    In terms of climate change, which factor is a significant contributor to public health crises?

    <p>Altered distribution of allergens.</p> Signup and view all the answers

    What was the reported economic cost of the 2019-2020 bushfires in Australia?

    <p>$100 billion.</p> Signup and view all the answers

    What effect does climate change have on water quality?

    <p>May negatively affect water quality.</p> Signup and view all the answers

    Which of the following describes the impact of heatwaves on public health?

    <p>They can exacerbate existing health conditions and cause stress.</p> Signup and view all the answers

    What was one of the immediate health effects seen during the bushfire period in Australia?

    <p>A rise in asthma-related emergency department presentations.</p> Signup and view all the answers

    What is a critical factor for improving public health services globally?

    <p>Collaboration among citizens of different nations</p> Signup and view all the answers

    Which organization is primarily responsible for providing global health leadership and coordination?

    <p>World Health Organization (WHO)</p> Signup and view all the answers

    Which of the following is NOT a role of the World Health Organization (WHO)?

    <p>Setting up military health programs</p> Signup and view all the answers

    Which global health factor impacts access to quality healthcare services?

    <p>Income and social inequality</p> Signup and view all the answers

    What is necessary for effective change in global health systems?

    <p>Partnerships that facilitate joint action across nations</p> Signup and view all the answers

    How does environmental pollution influence global health?

    <p>It leads to an increase in infectious diseases</p> Signup and view all the answers

    Which approach is considered vital for building sustainable health systems globally?

    <p>Providing technical support and capacity building</p> Signup and view all the answers

    Which factor hinders the effectiveness of global health initiatives?

    <p>Political and economic instability</p> Signup and view all the answers

    What is the primary aim of the Planetary Health Alliance?

    <p>To understand and address global environmental change and its health impacts</p> Signup and view all the answers

    Which of the following best describes the field of Global Health?

    <p>An interdisciplinary approach addressing global health issues that transcend borders</p> Signup and view all the answers

    What significant updates are being pursued by Australia in response to global health challenges?

    <p>Revising the International Health Regulations and forming a pandemic response agreement</p> Signup and view all the answers

    What is a key characteristic of the concept of Planetary Health?

    <p>It is a solutions-oriented, transdisciplinary field addressing the effects of human disruptions</p> Signup and view all the answers

    Which of the following statements about strengthening global health systems is true?

    <p>It can benefit from collaboration with various entities, including NGOs</p> Signup and view all the answers

    Why is a transdisciplinary approach critical in addressing global health issues?

    <p>It integrates diverse fields to tackle complex health challenges</p> Signup and view all the answers

    What role does collaborative leadership play in global health initiatives?

    <p>It fosters engagement and shared decision-making among stakeholders</p> Signup and view all the answers

    What is a key focus of global health collaborations?

    <p>Strengthening healthcare systems and institutions</p> Signup and view all the answers

    Which aspect is crucial for effective international pandemic response agreements?

    <p>Updating and adapting regulations to current global health challenges</p> Signup and view all the answers

    Why is promoting collaborative leadership important in global health?

    <p>It ensures sustainable and effective health initiatives</p> Signup and view all the answers

    Which approach is recommended for enhancing involvement in global health efforts?

    <p>Recognizing the need for coordinated multi-player involvement</p> Signup and view all the answers

    What should be prioritized for long-term success in global health collaborations?

    <p>Strengthening of health systems and institutions overall</p> Signup and view all the answers

    How can global health initiatives maintain effectiveness?

    <p>Through promoting strong collaborations among funders and authorities</p> Signup and view all the answers

    What is a significant challenge in global health that effective leadership should address?

    <p>The increasing number of players in health initiatives</p> Signup and view all the answers

    In global health strategies, which of the following is NOT essential for long-term success?

    <p>Isolating health responses from other sectors</p> Signup and view all the answers

    What aspect of collaborative health leadership is emphasized for future health initiatives?

    <p>Community-driven approaches to health delivery</p> Signup and view all the answers

    What is the primary role of the United Nations Environment Programme (UNEP)?

    <p>To advocate for global environmental sustainability.</p> Signup and view all the answers

    Which agenda outlines a specific goal related to climate change?

    <p>The 2030 Agenda for Sustainable Development.</p> Signup and view all the answers

    How does international environmental law contribute to environmental justice?

    <p>By promoting the fair distribution of environmental benefits and burdens.</p> Signup and view all the answers

    What is a key consideration in advocating for climate change legislation?

    <p>Educating the public about environmental issues.</p> Signup and view all the answers

    Which international forum is considered primary for negotiating climate change responses?

    <p>United Nations Framework Convention on Climate Change (UNFCCC)</p> Signup and view all the answers

    What is a significant shortcoming of the national environmental law related to climate change?

    <p>It does not require the Environment Minister to consider climate change.</p> Signup and view all the answers

    Which statement best reflects the role of climate litigation as outlined in recent trends?

    <p>Climate litigation serves as a key tool for achieving climate justice.</p> Signup and view all the answers

    In what context did the United Nations Human Rights Council recognize the human right to a clean and sustainable environment?

    <p>Through the establishment of an environmental Justice Strategy.</p> Signup and view all the answers

    What was a significant legal finding regarding Australia's climate policy?

    <p>It has violated international human rights law concerning climate inaction.</p> Signup and view all the answers

    Which was a notable case highlighting the role of youth in climate litigation?

    <p>A 7-year-old girl from Pakistan initiating a climate lawsuit.</p> Signup and view all the answers

    What was the outcome of the case brought to Brazil’s Supreme Court regarding the Paris Agreement?

    <p>The agreement was recognized as a human rights treaty.</p> Signup and view all the answers

    What challenge do many climate litigation cases address regarding government actions?

    <p>Conforming to the promises made in climate treaties like the Paris Agreement.</p> Signup and view all the answers

    Which demographic has been increasingly involved in climate legal actions, often referenced in recent reports?

    <p>Children and youth under 25 years old.</p> Signup and view all the answers

    What is a key ethical consideration for addressing climate change impacts on future generations?

    <p>Recognizing the negative impact of environmental degradation</p> Signup and view all the answers

    Which ethical approach emphasizes actions that maximize overall happiness and well-being?

    <p>Utilitarian approach</p> Signup and view all the answers

    What does the doctrine of ecological justice assert regarding environmental resources?

    <p>All organisms have a claim to environmental resources</p> Signup and view all the answers

    According to ethical obligations, what should individuals participate in to support public health?

    <p>Activities that enhance community health and legislation</p> Signup and view all the answers

    Which ethical theory focuses on duties and rules regarding human actions toward the environment?

    <p>Deontology</p> Signup and view all the answers

    What consequence might arise from ignoring the health implications of environmental degradation?

    <p>Increased burdens on future generations</p> Signup and view all the answers

    Which aspect of environmental ethics acknowledges that human health relies on other living beings?

    <p>The doctrine of ecological justice</p> Signup and view all the answers

    Which statement about current environmental obligations reflects a proactive approach from adults?

    <p>Adults ought to engage in activities for community and public health.</p> Signup and view all the answers

    Which of the following disasters would be categorized as a rapid onset disaster?

    <p>Earthquake</p> Signup and view all the answers

    What type of disaster is primarily caused by human actions rather than natural events?

    <p>Industrial accidents</p> Signup and view all the answers

    In disaster management, which of the following actions should hospitals prioritize for effective preparedness?

    <p>Conducting regular disaster drills</p> Signup and view all the answers

    What kind of environmental hazard would a volcanic eruption be classified as?

    <p>Tectonic hazard</p> Signup and view all the answers

    What is primarily considered a slow onset disaster?

    <p>Desertification</p> Signup and view all the answers

    What is the primary focus of the response phase in disaster management?

    <p>Save lives</p> Signup and view all the answers

    Which of the following is NOT typically part of the emergency operation response activities?

    <p>Recovery planning</p> Signup and view all the answers

    Which key health-related issue focuses on the living conditions of the affected population?

    <p>Living conditions</p> Signup and view all the answers

    What is the main goal of a rapid assessment following a disaster?

    <p>Identify requirements and local capabilities</p> Signup and view all the answers

    What is a key focus of the recovery phase in disaster management?

    <p>Return to near normal conditions</p> Signup and view all the answers

    Which option best describes mitigation in disaster management cycles?

    <p>Implementing activities to reduce disaster impacts</p> Signup and view all the answers

    Which aspect is essential for effective case management during a disaster?

    <p>Access to healthcare services</p> Signup and view all the answers

    During which emergency operation activity is the community's safety prioritized?

    <p>Search &amp; Rescue</p> Signup and view all the answers

    What is a major aspect of economic recovery after a disaster?

    <p>Growth of the micro and macro economy</p> Signup and view all the answers

    Which of the following is a focus area when addressing human and social recovery needs post-disaster?

    <p>Physical health and emotional well-being</p> Signup and view all the answers

    In disaster management, what typically takes time to accomplish after a major event?

    <p>Economic and environmental recovery</p> Signup and view all the answers

    Which of the following is NOT typically a function of recovery after a disaster?

    <p>Providing immediate food aid</p> Signup and view all the answers

    What does environmental recovery include after a disaster?

    <p>Regeneration of biodiversity and ecosystems</p> Signup and view all the answers

    What is a critical need to address for victims during the recovery phase of disaster management?

    <p>Assessment of different psychosocial needs</p> Signup and view all the answers

    Which area is considered part of the public safety aspect during recovery from natural disasters?

    <p>Rebuilding trust and emotional well-being among community members</p> Signup and view all the answers

    What type of planning is essential for ensuring effective evacuation during a disaster?

    <p>Developing comprehensive evacuation routes and plans</p> Signup and view all the answers

    Study Notes

    Vaccine Protection

    • Protection from disease can take between 7-14 days after vaccination
    • Immunity naturally wanes over time after vaccination, and booster shots are necessary for many diseases.
    • Vaccines do not always cover all strains or types of a disease.

    Cold Chain

    • Vaccines should be stored and transported at a temperature between +2 and +8 degrees Celsius.
    • Cold chains can be disrupted, with most vaccines being destroyed by freezing and some sensitive to heat.
    • Health providers should notify their local public health units or immunisation branches if the cold chain is breached.

    Australian Immunisation Program

    • Provides free vaccines for children.
    • The national immunisation schedule is available online on the health.gov.au website.

    Queensland Immunisation Schedule

    • Includes information on childhood vaccinations.
    • Accessible online at health.qld.gov.au

    Australian Immunisation Handbook

    • A resource for healthcare professionals seeking clinical guidance on the safe and effective use of vaccines.
    • Informs on vaccine use by disease and vaccine type.
    • Provides information on vaccine eligibility.

    Australian Immunisation Register

    • A national register that records all vaccines given to people in Australia.
    • Automatic registration with Medicare.
    • Records vaccines administered through the national program, school program, privately, and for travel.

    Catch-up Vaccinations

    • Intended to complete a person's recommended national immunisation schedule as quickly and effectively as possible to provide optimal disease protection.
    • Requires an assessment of the person’s immunisation status often involving serology testing.
    • Catch-up calculators are available online via the Australian Immunisation Handbook.
    • Certain vaccines, like rotavirus, cannot be used to catch up, as there are age limits.

    Vaccine Safety

    • Common side effects such as mild local pain, swelling, redness, headache, and fatigue are usually short-lived.
    • Anaphylaxis is a medical emergency that can occur within 15 minutes of vaccination.
    • Vasovagal reactions are more common in adults and older children, while anaphylaxis is more frequent in infants and younger children.
    • Misinformation has been known to significantly decrease vaccination rates (e.g., 2019 Samoa measles outbreak).
    Effect of Wakefield's MMR claims
    • Published in 1998, the claims linking the MMR vaccine to autism have had a significant impact on vaccine uptake in the UK.

    Addressing Vaccine Hesitancy

    • Vaccine-hesitant individuals outnumber outright vaccine refusers.
    • Reasons for hesitancy can be complex and should be explored with an open mind.
    • Building trust with individuals is crucial.
    • Discussions should focus on protecting the individual and the community.
    • Address concerns and reassure individuals about safety.
    • Honest communication on side effects is important.
    • General health education plays a key role in addressing vaccine hesitancy.

    Resources

    • Ausvax Summary Report 2022
    • National Immunisation Program Schedule (health.gov.au)
    • Australian Immunisation Handbook (health.gov.au)
    • NCIRS vaccine component fact sheet

    Vaccination and Vaccines

    • Vaccination is the process of getting a vaccine to stimulate the immune system.
    • A vaccine is a biological preparation that stimulates the immune system to produce antibodies against disease.

    Active vs. Passive Immunisation

    • Active immunisation uses a vaccine to stimulate the body's immune system to produce antibodies.
    • Passive immunisation involves the direct transfer of antibodies to a non-immune person for temporary protection.
    Example passive immunisation
    • Human rabies immunoglobulin is used for animal bites and varicella zoster immunoglobulin is used for susceptible people who have been exposed to varicella.

    Vaccine Development and Safety

    • Vaccines undergo several phases of clinical trials before licensure.
    • Pre-clinical assessment involves safety and efficacy testing in lab and animal models.
    • Phase I clinical trials involve a small number of healthy participants to determine vaccine dosage and safety.
    • Phase II clinical trials involve hundreds of participants to assess immunogenicity and safety.
    • Phase III clinical trials involve thousands of participants to test safety and efficacy (disease prevention).
    • The Therapeutic Goods Administration (TGA) assesses safety and effectiveness before a vaccine is licensed.
    • Phase IV involves ongoing monitoring of vaccine safety following licensure.

    Screening Definition

    • Screening identifies unrecognised diseases or defects using tests, examinations, or procedures, applied rapidly to a specific target population without symptoms.

    Types of Screening Programs

    • Population-based screening programs are designed to screen an entire population.
    • Opportunistic screening (case-finding) involves screening individuals who are presenting for other reasons, like a routine checkup.
    • Targeted screening (high-risk) specifically focuses on individuals with known risk factors, like genetic predispositions.

    Screening vs. Diagnostic Testing

    • Screening is the initial step to detect potential health issues or risk factors, while diagnostic testing confirms or excludes a diagnosis in individuals with symptoms.

    Aims of Screening Programs

    • Reduce mortality: Early detection and treatment can lead to more effective management of diseases.
    • Reduce incidence: Identifying and treating precursors can prevent the development of the disease itself.
    • Reduce severity: Early intervention can reduce the impact of the disease on individuals.
    • Increase patient choices: Early detection provides individuals with more options and better control over their health.

    Factors Determining Selection of Diseases for Screening

    • Disease burden: The impact of the disease in terms of morbidity and mortality.
    • Identifiable early stage: The disease needs to have a recognizable pre-symptomatic phase.
    • Natural history of disease: Understanding disease progression helps determine the effectiveness of early intervention.
    • Available treatment: Effective treatments that make a difference in outcomes must exist.

    The Screening Test

    • Acceptance: The test must be acceptable to the population.
    • Safety: The test should be safe and not cause harm to participants.
    • Simplicity: Easy to perform and understand.
    • Affordability: The cost should be manageable for large-scale implementation.
    • Sensitivity: Minimizes false negatives (correctly identifying people with the disease).
    • Specificity: Minimizes false positives (correctly identifying people without the disease).
    • Validation: The test must be scientifically proven to be reliable.
    • Clear criteria: Defined standards for positive and negative test results.

    Benefits and Harms of Screening Programs

    Benefits:

    • Reduced disease burden
    • Reduced mortality
    • Improved disease outcomes

    Harms:

    • False positives: Unnecessary anxiety and follow-up testing.
    • False negatives: Missed diagnoses leading to delayed treatment.
    • Over-diagnosis: Detection of asymptomatic or insignificant conditions.
    • Psychological and physical harms: Stress, discomfort, and potential complications from invasive procedures.
    • Opportunity cost: Resources dedicated to screening may divert from other healthcare needs.

    Biases in Screening Programs

    • Lead time bias: The illusion of longer survival due to earlier detection, not necessarily improved outcomes.
    • Length time bias: Slow-growing diseases are more likely to be detected in screening, leading to artificially positive outcomes compared to rapidly progressing diseases.

    Australian Population-based Screening Framework

    • The Australian framework evaluates the suitability for screening by considering:
      • The disease
      • The test
      • The treatment
      • The program

    Permanent Resident

    • Permanent residents are entitled to the same rights as Australian citizens
    • Permanent residents have a green Medicare card
    • Permanent residents are eligible for HCC (Healthcare Card)
    • Permanent residents receive social security benefits, which include child immunisations
    • Permanent residents have access to English lessons
    • Permanent residents are offered assistance with housing
    • Permanent residents are encouraged to connect with a general practitioner (GP)
    • Permanent residents can be assigned a case manager

    Asylum Seeker

    • Asylum seekers without paperwork are entitled to Blue Medicare Care
    • Asylum seekers without paperwork do not have a healthcare card
    • Asylum seekers without paperwork may have limited access to social security benefits
    • Asylum seekers without paperwork may have work rights
    • Asylum seekers without paperwork have minimal support

    Health Assessment

    • Refugees are not formally assessed upon arrival in Queensland
    • Many refugees arriving in Queensland have never had a health assessment
    • Health assessments include:
      • Health undertaking
      • Health alert
      • Health manifest

    Medical Issues

    • Common health issues to consider:
      • Nutritional problems
      • Infectious diseases
      • Genetic predisposition, such as thalassaemia
      • Cultural beliefs, such as female genital mutilation (FGM)
      • Dental health issues
      • Mental health issues

    Health Assessment

    • Health assessments go beyond blood tests
    • Consider:
      • Taking a full medical history
      • Asking about allergies, past medical history, past surgical history, past obstetric history
      • Listening to the patient's story and journey
      • Understanding their presenting complaint or expectation

    Social Issues

    • Focus on "whole-person care"
    • Be aware of housing issues, including temporary accommodation and mobility
    • Consider education needs
    • Understand the role of social security and vaccination proof for receiving payments
    • Be aware of shopping and children's vaccination requirements

    Consultation

    • Take comprehensive patient history
    • Include details on medication, genogram, and systematic review
    • Conduct a thorough physical examination, including all body systems, nutrition, ears, eyes, teeth, pregnancy, developmental issues, and sexually transmitted diseases

    Consultation

    • Tailor assessments to the patient's needs:
      • Conduct appropriate tests
      • Provide immunisations
      • Ensure follow-up care
      • Refer to specialists, allied health professionals, or both
      • Provide medication based on established priorities

    Mental Health

    • Consider acculturation
    • Understand the impact of trauma and its influence on mental and physical health
    • Use a trauma-informed approach in care
    • Provide support with language and cultural difficulties

    Pathology Tests

    • Pathology tests include:
      • Full blood examination (FBE)
      • Urea and electrolytes (U&E), liver function test (LFT)
      • Hepatitis B surface antigen (sAg) and surface antibody (sAb) (both are needed)
      • Syphilis antibody (Ab)
      • HIV antibody (Ab)
      • Varicella immunoglobulin G (IgG) (if older than 14 years)

    Before Arrival

    • Refugees undergo a departure health check:
      • Physical examination, including legs
      • Chest X-ray (CXR) for pre-existing conditions or potential treatment
      • Malaria test (RDT) and treatment if needed
      • Vaccinations, including MMR, diphtheria-tetanus-acellular pertussis (DTaP), and polio
      • Albenidazole 400mg treatment for children over one year old

    Prevention Definition

    • Prevention is aimed at reducing the likelihood of a disease or disorder impacting an individual, interrupting or slowing its progress, or reducing disability.
    • Prevention is considered better than cure.

    Levels of Prevention

    • Primordial prevention focuses on preventing the development of risk factors by addressing social determinants of health, such as social, environmental, and economic conditions.
    • Primary prevention aims to prevent the occurrence of disease by managing risk factors.
    • Secondary prevention involves early detection and management of an existing disease to improve outcomes.
    • Tertiary prevention optimizes disease management to reduce disability, limit or delay complications or death.

    Rheumatic Heart Disease (RHD) Example

    • RHD is a preventable disease associated with disadvantage and health inequality. It is a significant cause of morbidity and mortality in certain populations.
    • RHD is an abnormal autoimmune response to group A streptococcus (GAS) throat or skin infection, leading to acute rheumatic fever (ARF).
    • ARF features fever, arthritis, carditis, skin changes, and elevated inflammatory markers.
    • Repeated episodes of ARF can cause permanent heart valve damage resulting in RHD.
    • Overcrowded living conditions and poor hygiene infrastructure contribute to the spread of GAS.

    Prevention Strategies for RHD

    • Primordial Prevention: Addressing social determinants such as housing conditions, overcrowding, access to WASH facilities, health literacy, and education.
    • Primary Prevention: Early recognition and treatment of GAS infections in high-risk individuals to prevent ARF/RHD development. This includes community and clinician education.
    • Secondary Prevention: Early recognition of ARF and long-term monthly antibiotic injections (bicillin) to prevent subsequent episodes and permanent heart damage.
    • Tertiary Prevention: Early RHD identification, optimal medical and surgical management.

    Prevention Approaches

    • Individual (high-risk) approach focuses on personalized risk factors to prevent disease.
    • Population approach addresses broad risk factors applicable to the entire population.

    Prevention Paradox

    • A large number of individuals exposed to a small risk can create more cases than a small number exposed to a high risk.

    Population Approach Strengths

    • Addresses widespread risk factors.
    • Useful when there is a dose-response relationship.
    • Offers broad reach but may have minimal impact on individual benefits.

    Population Approach Limitations

    • Individual benefits may be perceived as low.

    Individual Approach Strengths

    • Personalized approach.
    • Socially preferred.
    • Easier for healthcare professionals.

    Individual Approach Limitations

    • Doesn't address the underlying drivers of disease.
    • Overall impact is relatively low.
    • May be more resource-intensive.
    • Doesn't address broader issues.

    Economic Benefits of Prevention

    • Diseases incur significant costs to the healthcare system, including hospitalization.
    • Prevention can lower direct healthcare costs, individual costs, and indirect costs to the economy through reduced premature deaths and years spent in ill health.
    • For example, obesity is estimated to cost 11.8billioninAustralia,with11.8 billion in Australia, with 11.8billioninAustralia,with1 invested in prevention yielding a return of up to $6.

    Global Health Key International Organisations

    • Multilateral organisations:
      • United Nations Organizations:
        • World Health Organization (WHO)
        • UNICEF
        • UNHCR
        • UNDP
    • Global Fund to Fight AIDS, TB and Malaria (GFFTAM)
    • UNAIDS
    • World Bank Group
    • Bilateral organisations:
      • Government aid agencies
        • DFAT
        • USAID
        • EU
    • Schools of Public Health:
      • Research
      • Training new professionals
      • Projects

    Non-Government Organizations

    • Foundations:
      • Ford
      • Bill & Melinda Gates
    • International:
      • FHI360
      • Oxfam
      • CARE
      • Save the Children
    • Faith-based Organizations:
      • Catholic Relief Services
      • Christian Aid
      • World Vision
    • Contracting Agencies:
      • For-profit companies bid on government contracts
      • Management Sciences for Health (MSH)
    • Private Corporations:
      • Pharmaceutical Corporations

    Ensuring Long-Term Success

    • Prioritizing Health Systems and Institutions:
      • Strengthening healthcare systems and institutions
      • Focusing on holistic health delivery
    • Promoting Collaborative Leadership:
      • Strong collaboration and leadership between funders and government authorities
      • Ensuring sustainability and effectiveness of global health initiatives
    • Coordinated Multi-Player Involvement:
      • Enhanced coordination and consultation
      • Recognition of the growing number of players and collaborators in global health efforts

    Planetary Health

    • A solutions-oriented, transdisciplinary field and social movement
    • Focus on analyzing and addressing the impacts of human disruptions to Earth's natural systems on human health and all life on Earth.
    • Planetary Health Alliance:
      • A consortium of more than 450 universities, non-governmental organizations, research institutes, and government entities from more than 75 countries.
      • Committed to understanding and addressing global environmental change and its health impacts.
    • Griffith University is a member of the Planetary Health Alliance.

    The Role of WHO in Global Health

    • Providing leadership on matters critical to health
    • Engaging in partnerships where joint action is needed
    • Shaping the research agenda
    • Setting norms and standards
    • Promoting and monitoring implementation
    • Articulating ethical and evidence-based policy options
    • Providing technical support
    • Building sustainable institutional capacity
    • Monitoring the health situation and assessing health trends
    • Support and collaborate:
      • WHO plays a crucial role in supporting global health initiatives and collaborating with various stakeholders.

    Global Health Challenge

    • Strengthening global health and international pandemic response
    • Australia works closely with the global community
      • Including the World Health Organization
      • To reform and strengthen global health systems
    • The most obvious global health concerns deal with communicable diseases, but global health factors include:
      • Economic and political instability
      • Income and social inequality
      • Lack of education and employment
      • Insufficient food and medicine
      • Climate change and natural disasters
      • Environmental pollution
      • Limited access to quality clean water
      • Poor health system

    Global Health Collaboration

    • Citizens need to collaborate to improve public health services in all nations
    • Stop disease outbreaks at their source

    Global Health Collaboration - World Health Organization (WHO)

    • The directing and coordinating authority for health within the United Nations system
    • Responsible for providing leadership on global health matters, including shaping the health research agenda.

    Fossil Fuel Projects and Climate Change

    • 21 fossil fuel projects are awaiting approval
    • Australia's environmental law does not directly address climate change or its impacts
    • The Environment Minister is not required to consider the impacts of these projects on climate change
    • New fossil fuel developments continue to be approved despite the potential environmental damage

    Human Rights and the Environment

    • The United Nations Human Rights Council recognized the human right to a clean, healthy, and sustainable environment in 2021
    • This recognition aims to protect the most vulnerable and those at risk from environmental degradation

    Climate Litigation

    • Cases related to climate change litigation have more than doubled in five years
    • Climate litigation is becoming a crucial tool for achieving climate justice
    • The majority of cases are in the USA, with 17% in developing countries
    • Cases are being brought by and on behalf of young people, including children
    • Cases are challenging government decisions that are inconsistent with the goals of the Paris Agreement

    Key Climate Litigation Examples

    • The UN Human Rights Committee ruled that Australia violated international human rights law through its climate policies
    • Brazil's Supreme Court declared the Paris Agreement a human rights treaty with supranational status
    • A Dutch court ordered Shell to reduce its carbon dioxide emissions by 45% from 2019 levels by 2030

    International Environmental Law

    • The UN Environment Programme (UNEP) advocates for global environmental protection
    • UNEP assists governments in implementing sustainable development goals
    • UNEP promotes the development and implementation of international environmental law

    Ethical Considerations

    • Environmental degradation caused by climate change is morally wrong due to its negative impact on human health and future generations
    • Maximizing human happiness includes safeguarding the environment
    • The doctrine of ecological justice emphasizes the right of all organisms to a share of environmental resources

    AMA Code of Ethics

    • Doctors are encouraged to participate in activities that contribute to community and public health, including environmental protection, public health, and health-related legislation

    Key health issues post-disaster

    • Endemic and epidemic diseases in affected areas
    • Living conditions of those affected, including population size, location, and density of settlements
    • Availability of safe water and sanitation
    • Underlying nutritional status and immunization coverage
    • Degree of access to healthcare for effective case management

    Disaster Management Cycles

    • There are many models of disaster management.
    • Four main elements or stages include: response, recovery, mitigation, and preparedness.

    Response Stage

    • Focus on saving lives
    • Activities during response include emergency operations such as:
      • Search and rescue
      • First aid
      • Evacuation
      • Relief Services
      • Assessment, planning, and implementation
      • Development of foundations for rehabilitation and recovery
    • Rapid assessment is crucial for identifying requirements, local capabilities, and avoiding unnecessary and harmful assistance.

    Changing Needs/Priorities

    • Needs and priorities change over time.
    • For example, after an earthquake, initial needs focus on mass casualty and then shift to mental health and other long-term needs.

    Recovery Phase

    • Support community rebuilding
    • May take months or years
    • Aspects include:
      • Economic recovery, including renewal and growth of the microeconomy within the affected area, and the macro economy.
      • Environmental recovery, including restoration and regeneration of biodiversity, ecosystems, natural resources, and environmental infrastructure.
      • Human and social recovery involving physical health and emotional, psychological, spiritual, cultural, and social well-being.
      • Reconstruction of roads and transport systems.
      • Repair and restoration in the building industry supply chain.

    Disaster Types by Origin

    • Natural:
      • Tectonic/Geological: Earthquakes, volcanos, tsunamis
      • Mass-movement: Debris movement, rockfalls, debris flows/mudslides, avalanches, and land subsidence
      • Hydrologic: Floods, desertification, landslides
      • Meteorological: Cyclones, tornados, ice storms, hail rain, extreme temperatures, sandstorms, El Niño, and La Niña
      • Climatological: Drought, wildfires, glacial lake outburst
      • Biological: Human epidemics, animal/plant epidemics
      • Other: Meteorites, soil salination, animal attacks
    • Man-made:
      • Technological/Unintentional: Transportation accidents, industrial accidents, infrastructure failures, food shortages, structural fires and failures
      • Intentional: War, terrorism, stampede

    Disaster Types by Time

    • Rapid onset: Storms, earthquakes, fires, industrial accidents, explosions, toxic exposures
    • Slow onset: Drought, desertification, sea level rise, coastal erosion, loss of ecosystems, some toxic exposures

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    Description

    Explore key aspects of the Australian immunisation program, including vaccine efficacy timelines, cold chain logistics, and schedules for childhood vaccinations. Gain insights into the handling and storage requirements essential for vaccine preservation and the resources available for healthcare professionals.

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