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In remote and very remote Australia, young people engage youth workers in sexual health discussions, often out of necessity due to low access to health services. Youth workers' and youth service managers' perspectives on these interactions and the sexual health training they receive are poorly understood. In this study, youth workers and youth service managers working in the Pilbara, a remote region in Western Australia, participated in semi-structured online video interviews. Participants (n = 10) were asked about their experiences and the impact of sexual health training on their work. Data were thematically analysed. Four themes were developed: Pilbara youth workers and youth service managers need sexual health training; locally delivered sexual health training is preferable; online sexual health training may augment knowledge; and strategies to optimise sexual health training are needed. The results of this study suggest current training is not meeting the needs of youth workers and youth service managers in the Pilbara, and they feel under equipped to address sexual health topics with young people. Suggestions are made to improve youth workers' and youth service managers' access to effective sexual health training.

The use of alprazolam in pregnancy can adversely affect maternal and neonatal health. This study examined neonatal outcomes following exposure to alprazolam in pregnancy. Women prescribed alprazolam during pregnancy (n = 48) between 2014 and 2018 were identified from routinely-collected state administrative prescribing records and perinatal data. Two comparison groups of women; 1) prescribed alprazolam outside of pregnancy (n = 96) and 2) women never prescribed alprazolam (n = 96) were also identified. The health of women and their children was examined using administrative hospital, mortality and perinatal data and compared to the comparison groups using generalized linear models. Prenatal alprazolam exposure was not associated with a reduction in average birth weight or gestational age. However, neonates prenatally exposed to alprazolam were more likely be classified as having low birth weight for gestational age compared with alprazolam comparison group (OR: 4.46, 95% CI: 1.54–12.95) and the non-alprazolam comparison group (OR: 3.27, 95% CI: 1.22–8.79). There were no cases of perinatal mortality or floppy baby syndrome in alprazolam-exposed neonates. While the use of alprazolam during pregnancy was not associated with an increased risk of severe adverse neonatal outcomes (e.g. perinatal mortality), it was associated with neonates being born with a low birth weight for gestational age. [ABSTRACT FROM AUTHOR]

Aims This study aimed to investigate acamprosate and naltrexone dispensing patterns in Australia. Methods A 10% representative sample of medications subsidized by the Australian Pharmaceutical Benefits Scheme (PBS) was used to identify individuals who were dispensed naltrexone or acamprosate between January 2006 and December 2023. Data were used to examine concurrent dispensing, medication switching and treatment episode length, as well as changes in prevalence and incidence over time. Results During the study, we identified 22 745 individuals with a total of 117 548 dispensed prescriptions (45.3% naltrexone, 43.0% acamprosate, and 11.7% concurrent dispensing). Alcohol pharmacotherapy dispensing occurred in 1354 per 100 000 individuals. It is estimated that 2.9% of individuals with an alcohol use disorder in Australia are receiving a PBS-listed pharmacological treatment. For both pharmacotherapies, individuals were most likely to be male (60.0%) and 35–54 years of age (56.0%). Individuals were more likely to switch from acamprosate to naltrexone rather than the reverse. From 2006 and 2023, the number of prevalent individuals treated with an alcohol pharmacotherapy significantly increased, driven mainly the use of naltrexone, which more than doubled over the study period. Incident naltrexone-treated individuals were more likely to remain on treatment for the recommended minimum 3-month period compared to acamprosate treated individuals, although overall dispensing for at least 3 months was low (5.1%). Conclusions In Australia between 2006 and 2023, rates of naltrexone dispensing have substantially increased, while acamprosate dispensing showed minimal changes. However, the use of alcohol pharmacotherapies remains low compared with the likely prevalence of alcohol use disorders. [ABSTRACT FROM AUTHOR]

Background Existing research has acknowledged a correlation between stress in pregnancy and poorer respiratory health in offspring. However, research focusing on stress caused by family and domestic violence in the prenatal period is missing. Methods A retrospective cohort study included children born 1987–2010 who were identified as being exposed to FDV in the prenatal period (n  = 1477) from two sources: WA Police Information Management System and WA Hospital Morbidity Data Collection (HMDC) and a non-exposed comparison group (n  = 41 996). Hospitalization for bronchiolitis was identified in HMDC. Cox regression was used to estimate the adjusted and unadjusted hazard ratio and 95% confidence interval for bronchiolitis hospitalizations contact. Results Children exposed to FDV had a 70% (HR 1.70, 95% CI: 1.49–1.94) increased risk of hospitalization for bronchiolitis than non-exposed counterparts by age two. Children exposed to FDV had a longer average hospital stay for bronchiolitis than non-exposed children (4.0 days vs. 3.8 days, P  < 0.001). Conclusions Prenatal exposure to FDV is associated with bronchiolitis hospitalization in children <2 years. Along with other risk factors, clinicians should give consideration to maternal stress factors, including experiencing FDV as a potential contributor to bronchiolitis. [ABSTRACT FROM AUTHOR]

Copyright of Equine Veterinary Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Evidence from previous observational studies suggest that infection by herpes simplex virus (HSV) and varicella zoster virus (VZV) increase the risk of dementia. Objective: To investigate if older adults exposed to HSV treatment have lower risk of dementia than the rest of the population. Methods: We used the 10% Australian Pharmaceutical Benefits Scheme (PBS) database from 2013 to 2022 to ascertain the cross-sectional, time-series and longitudinal association between exposure to HSV treatment and the dispensing of antidementia medicines. Participants were men and women aged 60 years or older. We used Anatomical Therapeutic Chemical (ATC) codes to identify medicines dispensed for the treatment of HSV and dementia. Results: During the year 2022 6,868 (1.2%) of 559,561 of participants aged 60 years or over were dispensed antidementia agent. The odds ratio (OR) of being dispensed an antidementia agent among individuals dispensed treatment for HSV was 0.73 (99% CI = 0.56–0.95). Multilevel logistic regression for the 2013–2022 period for those dispensed HSV treatment was 0.87 (99% CI = 0.75–1.00). Split-time span series from 2013 was associated with hazard ratio of 0.98 (99% CI = 0.89–1.07) for individuals dispensed relative to those not dispensed HSV treatment. All analyses were adjusted for age, sex, and the dispensing of medicines for the treatment of diabetes, hyperlipidemia, hypertension, and ischemic heart disease. Conclusions: The dispensing of antiviral medicines for the treatment of HSV and VZV is consistently, but not conclusively, associated with decreased dispensing of antidementia medicines. This suggests that treatment of HSV and VZV infections may contribute to reduce the risk of dementia. [ABSTRACT FROM AUTHOR]

Substance use during pregnancy is associated with poor neonatal outcomes. Women incarcerated during pregnancy may have a history of substance use, and their babies may be at risk of neonatal abstinence syndrome (NAS). This study examines the incidence of NAS and other outcomes in infants born to currently or formerly incarcerated women. Infants born between 1985 and 2011 in Western Australia were divided into three mutually exclusive groups: born to women incarcerated during pregnancy (n = 708); born within 9–24 months of the mother's release from prison (n = 651); and born to women who were never incarcerated (n = 17,712). The impact of the timing of incarceration during pregnancy was also examined. Neonatal outcomes (NAS, preterm birth, low birthweight, infant mortality and admission to special care nursery) were compared using logistic regression. Infants born to currently or recently incarcerated women had higher odds of all adverse outcomes than infants in the nonexposed group. Infants born to women incarcerated during the second or third trimester (but not the month of birth) had poorer outcomes than infants born to women incarcerated during the month of birth. The findings show that babies born to currently or formerly incarcerated women are equally likely to experience adverse neonatal outcomes. Enhanced maternal healthcare must be provided during incarceration and after release. [ABSTRACT FROM AUTHOR]

Purpose: Medications are commonly used during pregnancy to manage pre‐existing conditions and conditions that arise during pregnancy. However, not all medications are safe to use in pregnancy. This study utilized privacy‐preserving record linkage (PPRL) to examine medications dispensed under the national Pharmaceutical Benefits Scheme (PBS) to pregnant women in Western Australia (WA) overall and by medication safety category. Methods: In this retrospective, cross‐sectional, population‐based study, state perinatal records (Midwives Notification Scheme) were linked with national PBS dispensing data using PPRL. Live and stillborn neonates born between 2012 and 2019 in WA were included. The proportion of pregnancies during which the mother was dispensed a PBS medication was calculated, overall and by medication safety category. Factors associated with PBS medication dispensing were examined using logistic regression. Results: PPRL linkage identified matching records for 97.4% of women with perinatal records. A total of 271 739 pregnancies were identified, with 158 585 (58.4%) pregnancies involving the dispensing of at least one PBS medication. Category A medications (those considered safe in pregnancy) were the most commonly dispensed (n = 119 126, 43.8%) followed by B3 (n = 51 135, 18.8%) and B1 (n = 42 388, 15.6%) medication (those with unknown safety). Over the study period, the dispensing of PBS medications in pregnancy increased (OR: 1.06, 95%CI: 1.06, 1.07). The strongest predictor of medication dispensing in pregnancy was pre‐pregnancy dispensing (OR: 3.61, 95%CI: 3.54, 3.68). Other factors associated with medication use in pregnancy were smoking, older maternal age, obesity, and prior pregnancies. Conclusion: Privacy preserving record linkage provides a way to link cross‐jurisdictional data while preserving patient confidentiality and data security. The dispensing of PBS medication in pregnancy was common and increased over time, with approximately 60% of women dispensed at least one medication during pregnancy. [ABSTRACT FROM AUTHOR]

Summary: Background: Preliminary evidence indicates that ertugliflozin benefits horses and ponies (hereafter collectively referred to as horses) with hyperinsulinaemia and hyperinsulinaemia‐associated laminitis. The effects of ertugliflozin on the results of the oral sugar test used widely in the assessment of insulin dysregulation (ID), have not been reported. Objectives: To report the effects of ertugliflozin on responses to the oral sugar test (OST) in horses with ID. Study design: Retrospective case series. Methods: Clinical records were reviewed to identify horses with ID that had an OST (0.45 mL/kg Karo‐Light PO) performed before and after 4 days of treatment with 0.05 mg/kg ertugliflozin PO s.i.d. Pre‐ and post‐treatment insulin concentrations were compared using Wilcoxon sign‐ranked tests. Results: Ten horses with ID met the inclusion criteria. Significant reductions in plasma insulin concentration were identified at all time points after 4 days of treatment with ertugliflozin relative to pre‐treatment values. At T0 (prior to oral sugar), median insulin concentration reduced from 22.4 μu/mL (IQR: 6.5, 39) pre‐treatment to 4.8 μu/mL (IQR: 3.7, 9.2) at day 4 (p = 0.004). At T60 (60 min after oral sugar), median insulin concentration was 165 μu/mL (IQR: 61.2, 222) pre‐treatment and 78.1 μu/mL (IQR: 30.5, 137) at day 4 (p = 0.004). At T90 (90 min after oral sugar), median insulin concentration was 170 μu/mL (IQR: 88.6, 269) pre‐treatment and 84.7 μu/mL (IQR: 28.7, 122) at day 4 (p = 0.002). Serum triglyceride concentration increased from a median of 0.4 mmol/L (IQR: 0.2, 0.8) pre‐treatment to 0.9 mmol/L (IQR: 0.6, 2) at day 4 of ertugliflozin treatment (p = 0.006). Main limitations: A small heterogenous group of horses and ponies, some with PPID, were used in the absence of a control group. Conclusions: Four daily doses of ertugliflozin at 0.05 mg/kg was associated with lowering of insulin concentrations at baseline and in response to an OST in horses with ID; however, insulin levels did not return to normal in all horses. Increases in triglyceride concentrations were also observed. [ABSTRACT FROM AUTHOR]

Summary Background Objective Study design Methods Results Main limitation Conclusion Sodium‐glucose cotransporter 2 inhibitors (SGLT2i) are being used increasingly in equine practice. While there is emerging clinical evidence of the safety and efficacy of these drugs, there are currently no reports to document owner experiences with treatment.The objective of the study was to report owner experiences and observations following treatment with SGLT2i in horses.A cross‐sectional online survey.Horse owners were recruited via social media, online forums and their veterinarians to participate in an anonymous online survey to document their experiences and observations when treating their horses with SGLT2i.Three hundred forty‐two responses met the inclusion criteria. Ertugliflozin was the most commonly prescribed SGLT2i (79.8%), and the most common reasons for treatment were high insulin concentrations (84.2%) and active laminitis (59.7%). 85.3% of owners reported their horses had an improved quality of life after commencing treatment, while 9.4% reported no change and 5.3% reported a worsening of clinical signs. Of owners who had considered euthanasia prior to treatment (n = 77), 80.5% reported their horse's level of pain to be either mild or absent after 30 days of treatment and 94.8% reported their horse's quality of life to be improved. Most owners (n = 220, 64.7%) reported they were either extremely satisfied or somewhat satisfied (n = 72, 21.2%) with treatment. Treatment concerns included safety/side effects, medication cost, availability and long‐term efficacy. 114 owners (33.3%) reported one or more initial adverse effects upon induction onto the medication, particularly excessive urination (n = 70, 20.5%), excessive drinking (n = 38, 11.1%), excessive weight loss (n = 34, 9.9%) and dullness (n = 26, 7.6%).Sampling bias through social media and veterinary practices and reliance on subjective owner reports.The use of SGLT2i in horses was associated with excellent rates of owner satisfaction and owner‐reported improved quality of life for the horse; however, some adverse effects were observed. [ABSTRACT FROM AUTHOR]

Copyright of Equine Veterinary Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To compare the health of neonates born to women who experienced family and domestic violence (FDV) 12 months prior to birth, with the health of neonates born to women with an earlier history of FDV and women with no history of FDV. Methods: A retrospective cohort of women who experienced FDV within 12 months of birth (antenatal FDV [AFDV]) (n = 1230) was identified using data from the Western Australia (WA) Police Force Incident Management System and WA Hospital Morbidity Data Collection. Two comparison cohorts were used, the first including women with a history of FDV (HFDV) 12–60 months prior to birth (n = 1549) and the second with no history of FDV (NFDV) recorded (n = 3690). Hospital, birth, mortality, and congenital anomaly data were used in generalized linear models to examine and compare neonatal health outcomes. Results: Women in the AFDV group had higher proportions of factors associated with poor neonatal outcomes including smoking (42.4%), substance use (23.0%), and mental health disorders (34.8%). Neonates born to AFDV mothers had significantly higher odds of congenital anomalies (OR: 1.51, 95% CI: 1.18–1.94), low birth weight (1.74, 1.45–2.10), and preterm birth (1.48, 1.22–1.79) compared with neonates born to NFDV mother. Neonatal health outcomes in those born to AFDV women were not significantly different from those born to HFDV women. Conclusions: Antenatal and historical FDV were associated with poor neonatal health outcomes. Additional pregnancy and social support should be offered to women who have experienced FDV during or prior to pregnancy. [ABSTRACT FROM AUTHOR]