Pilot study with randomised control of dual site theta burst transcranial magnetic stimulation (TMS) for methamphetamine use disorder: a protocol for the TARTAN study.

BACKGROUND: Transcranial magnetic stimulation (TMS) (including the theta burst stimulation (TBS) form of TMS used in this study) is a non-invasive means to stimulate nerve cells in superficial areas of the brain. In recent years, there has been a growth in the application of TMS to investigate the modulation of neural networks involved in substance use disorders. This study examines the feasibility of novel TMS protocols for the treatment of methamphetamine (MA) use disorder in an ambulatory drug and alcohol treatment setting. METHODS: Thirty participants meeting the criteria for moderate to severe MA use disorder will be recruited in community drug and alcohol treatment settings and randomised to receive active TMS or sham (control) intervention. The treatment is intermittent TBS (iTBS) applied to the left dorsolateral prefrontal cortex (DLPFC), then continuous TBS (cTBS) to the left orbitofrontal cortex (OFC). Twelve sessions are administered over 4 weeks with opt-in weekly standardized cognitive behaviour therapy (CBT) counselling and a neuroimaging sub-study offered to participants. Primary outcomes are feasibility measures including recruitment, retention and acceptability of the intervention. Secondary outcomes include monitoring of safety and preliminary efficacy data including changes in substance use, cravings (cue reactivity) and cognition (response inhibition). DISCUSSION: This study examines shorter TBS protocols of TMS for MA use disorder in real-world drug and alcohol outpatient settings where withdrawal and abstinence from MA, or other substances, are not eligibility requirements. TMS is a relatively affordable treatment and staff of ambulatory health settings can be trained to administer TMS. It is a potentially scalable and translatable treatment for existing drug and alcohol clinical settings. TMS has the potential to provide a much-needed adjuvant treatment to existing psychosocial interventions for MA use disorder. A limitation of this protocol is that the feasibility of follow-up is only examined at the end of treatment (4 weeks). TRIAL REGISTRATION: Australia New Zealand Clinical Trial Registry ACTRN12622000762752. Registered on May 27, 2022, and retrospectively registered (first participant enrolled) on May 23, 2022, with protocol version 7 on February 24, 2023.

New Insights Into the Relationship Between Drought and Mental Health Emerging From the Australian Rural Mental Health Study.

While it is recognized that drought affects mental health, few population-based longitudinal studies quantify this relationship. In this study, we investigate the effects of drought on mental health in a rural population, and how these effects change with continued exposure to drought conditions. Using a panel dataset consisting of 6,519 observations from the Australian Rural Mental Health Study, we found a non-linear (inverted U-shape) relationship between drought exposure and mental health. Specifically, people experienced an increase of psychological distress for the first 2.5-3 years of drought, after which time this distress dissipates. These effects were maintained after controlling for demographic, social, and environmental factors. We also found that while psychological distress decreases in the later stages of drought, this does not necessarily mean people have good mental health because, for example, factors such as life satisfaction decreased as drought persisted. This is important as it highlights the need for sustained support to mitigate the long-term effects of drought on mental health that persist after the drought has apparently finished.

Early Detection Methods for Silicosis in Australia and Internationally: A Review of the Literature.

Pneumoconiosis, or occupational lung disease, is one of the world's most prevalent work-related diseases. Silicosis, a type of pneumoconiosis, is caused by inhaling respirable crystalline silica (RCS) dust. Although silicosis can be fatal, it is completely preventable. Hundreds of thousands of workers globally are at risk of being exposed to RCS at the workplace from various activities in many industries. Currently, in Australia and internationally, there are a range of methods used for the respiratory surveillance of workers exposed to RCS. These methods include health and exposure questionnaires, spirometry, chest X-rays, and HRCT. However, these methods predominantly do not detect the disease until it has significantly progressed. For this reason, there is a growing body of research investigating early detection methods for silicosis, particularly biomarkers. This literature review summarises the research to date on early detection methods for silicosis and makes recommendations for future work in this area. Findings from this review conclude that there is a critical need for an early detection method for silicosis, however, further laboratory- and field-based research is required.

Health and wellness in the Australian coal mining industry: A cross sectional analysis of baseline findings from the RESHAPE workplace wellness program.

Overweight and obesity has reach pandemic levels, with two-thirds (67%) of adult Australians classified as overweight or obese. As two of the most significant behavioral risk factors for obesity are modifiable (diet and exercise), there exists an opportunity for treatment through workplace health promotion initiatives. As one of Australia's largest industries with its own unique workplace factors, the mining industry has previously reported higher than population levels of overweight and obesity. This represented an opportune setting to test the RESHAPE workplace wellness program. RESHAPE is an eight-step framework (based on the WHO 'Health Workplace Framework and Model') which aims to provide a sustained approach to wellness in the workplace. This paper presents baseline findings from a pilot study that aimed to implement RESHAPE at three mine sites in NSW, Australia, and investigates the issue of overweight and obesity in the coal mining industry. Across three mine sites, 949 coal miners were examined cross-sectionally on a range of workplace, wellness, health, diet, and exercise factors using a paper-based survey. This was a predominantly male sample (90.4%) with the majority (59.2%) of participants aged 25-44 years. Self-reported height and weight measures indicated that less than 20 percent (18.9%) of participants were in a healthy BMI range, while there were effectively equal numbers of overweight (40.9%) and obese (39.1%) participants. Only 3.5% of participants met the daily recommendation for vegetables (5 serves) and shift-workers had greater association with elevated BMI compared to non-shift workers (B = 1.21, 95% CI: 0.23, 2.20, p = 0.016). Poor nutrition is likely to be a key component in elevated levels of overweight and obesity within this industry, with workplace factors compounding challenges workers face in implementing health behavior change. Future studies would benefit from assessing diet and physical activity knowledge in relation to recommendations and serving sizes.

Drought, Wellbeing and Adaptive Capacity: Why Do Some People Stay Well?

Drought is a threat to public health. Individual and community adaptive capacity is crucial when responding to the impacts of drought. Gaps remain in the understandings of the relationship between wellbeing and adaptive capacity, and whether increased wellbeing can lead to improved adaptive capacity (or vice versa). This paper explores the relationship between drought, wellbeing and adaptive capacity to provide insights that will inform actions to enhance adaptive capacity, and hence increase opportunities for effective drought adaptation. The theory of salutogenesis and the associated sense of coherence (SOC) are used to measure adaptive capacity and to explain why some individuals remain well and adapt to adversity while others do not. An online survey of rural residents (n = 163) in drought-affected New South Wales (NSW), Australia, was conducted from November 2018 to January 2019. Linear regression was used to model the relationships between SOC, sociodemographic factors, drought and wellbeing. Findings demonstrate that SOC is strongly correlated with wellbeing. Drought condition did not influence adaptive capacity, although adaptive capacity and drought-related stress were only weakly correlated. Increased wellbeing was found to be associated with stronger adaptive capacity and therefore, an individuals' capacity to cope with adversity, such as drought.

Drought-related stress among farmers: findings from the Australian Rural Mental Health Study.

OBJECTIVES: To investigate general and drought-related stress experienced by farmers at both the personal and community levels, and whether socio-demographic and community factors influence this stress. DESIGN: Multivariate analysis of data from the Australian Rural Mental Health Study (ARMHS), a longitudinal cohort study (2007-2013). SETTING: Non-metropolitan New South Wales. PARTICIPANTS: Subset of 664 ARMHS participants (at baseline) who identified as living or working on a farm. MAIN OUTCOME MEASURES: Personal drought-related stress (PDS), community drought-related stress (CDS), and general psychological distress (K10 score). RESULTS: Farmers who were under 35, both lived and worked on a farm, experienced greater financial hardship, and were in outer regional, remote or very remote NSW reported PDS particularly frequently. Of these factors, only being under 35 and increased remoteness were associated with higher incidence of CDS. Mild wet weather during the prior 12 months reduced PDS and CDS but increased general distress. Moderate or extreme wet weather did not affect PDS or general distress, but moderate wet weather was associated with increased CDS. Drought-related stress and general psychological distress were influenced by different socio-demographic and community factors. CONCLUSIONS: Farmers in NSW experience significant stress about the effects of drought on themselves, their families, and their communities. Farmers who are younger, live and work on a farm, experience financial hardship, or are isolated are at particular risk of drought-related stress. Medical practitioners who provide assistance to farmers and farming communities can contribute to initiatives that relieve stress about drought.