Questions

Question 1
You are a public health physician working in a state health department. The prevalence of tobacco smoking in the non-Indigenous population is 15%, but in the Indigenous population is over 70%. Your director has asked you to develop a smoking cessation program targeting the Indigenous population in the state.

Outline the steps in developing this program.

Question 2
You are a public health physician working in the federal Department of Health. The recently released report from the Intergovernmental Panel on Climate Change (IPCC) on land management notes that the world must turn towards healthy plant-based diets to curb climate change. You have been asked to develop a health promotion program encouraging people to eat less meat and more vegetables.

Outline how you would develop your program.

Questions

Question 1 - Gastroenteritis Outbreak in a Hospital Ward
You are the on-duty public health physician in a primarily urban Public Health Unit. You have been rung by the infection control practitioner (ICP) from the nearby general hospital to say they appear to have an outbreak of vomiting and diarrhoea in one of their general medical wards with, to date, six inpatients and two staff unwell with symptoms, all with onset in the last 48 hours.

Outline the steps in developing this program.

Question 2 - Introduction of RSV Vaccine to National Immunisation Program
The Commonwealth government has just announced funding under the National Immunisation Program for a childhood RSV (respiratory syncytial virus) vaccine to be introduced in 12 months’ time. You have been asked by the Director of the Communicable Disease Control Branch to plan for the introduction of this new vaccine.

Outline how you would develop your program.

Questions

Question 1

You are the Director of Public Health at a regional public health unit. The local fire and rescue services requests that you join a multiagency group coordinating the response to and recovery from a large, high energy fire involving peanuts at a bird food factory. The group involves the fire and rescue service, the EPA, the local government authority and the police. A specific concern about this fire is that laboratory studies indicate that peanut allergen is not deactivated by high temperatures. The factory is on an industrial estate with a residential area approximately 200m south, in the direction of the initial plume. Police have issued a shelter-in-place message, although the plume is buoyant and dispersing effectively. The fire was brought under control in 48hrs, but it was then decided that a “controlled burn” technique would be used to extinguish the fire, meaning it was likely to continue for another 2 or 3 weeks. During this time, fire water containing peanut oil and other contaminants would be recycled through a local pond. 

Describe how you and your team will contribute to the multiagency response and recovery to this incident? 

Question 2

You are public health physician at a state health department. The state experiencing a severe mouse plague in rural areas. A Director of Public Health from an affected region contacts you for advice. They have received separate notifications from two different local hospital about individuals presenting unwell following domestic use of a rodenticide containing zinc phosphide. Zinc phosphide is licensed for agricultural use only and releases phosphine when exposed to moisture. The Director of Public Health reports that, anecdotally, people are resorting to off-label use of zinc phosphide because of a shortage of rodenticides approved for domestic use. 

What advice would you give and how would you assist?

Questions

Question 1

Residents surrounding an industrial and hazardous waste landfill disposal depot have long complained of increased numbers of birth defects and cancers. The landfill is in a peri-urban region of a large city. This issue has been the subject of a number of investigations by the environment protection agency. A recent study concluded that there was an increase in brain cancers in residents living around the waste depot (see table). Residents want the waste depot to be shut down immediately. The Health Minister has asked for advice on the strength of the evidence. The results are presented below.

1. What is a standardized incidence ratio (SIR) and how is it calculated?
2. How would you interpret the results?
3. What further information could be useful to support any advice to the Minister?

Question 2

A prospective study investigated the risk factors for hepatitis C seroconversion in intravenous drug users and reported hazard ratios for a range of modifiable and non-modifiable risk factors for hepatitis C sero-conversion. This study also calculated population attributable risks (PAR) for each of five modifiable risk factors as well for a combination of the modifiable risk factors (see table). Overall, five potentially modifiable risk factors (sharing needles/syringes, sharing other injecting equipment, assisted injecting, frequency of injection and not being in drug treatment) accounted for approximately 50% of HCV cases observed. A new program is being developed to reduce the incidence of hepatitis C in intravenous drug users.

1. Can you explain what is meant by PAR?
2. How would use the PARs to help you decide the modifiable risk factors to target?
3. What other information would be useful in deciding the modifiable risk factors to target?

 

Questions

Question 1

You are working as a public health physician in a regional ACCHO, and the CEO lets you know the Board would like their ACCHO to start a local kidney dialysis service, so community members don’t need to travel. What steps do you take in response to this request? 

Question 2

You are working as a public health physician in an urban ACCHO, and the Board has requested you take a more proactive approach to the prevention of chronic health conditions. They are particularly keen to see a strong preventive approach to child and adolescent health and ask you to develop a strategy. What is your approach?

Questions

Question 1

Your State’s new Drug and Alcohol Court aims to reduce recidivism through better managing substance dependence. Offenders can be issued with a Drug and Alcohol Treatment Order which requires compliance to monitoring, e.g. urine tests two to three times per week, and treatment options including, in some cases, residential rehabilitation. The Government has announced plans to build a new Government-run residential rehabilitation facility to supplement existing NGO-run facilities.

A local Aboriginal leader has expressed reservations about what the new facility will mean for Aboriginal people and has called for a culturally appropriate residential rehabilitation facility to be built.

You are a public health physician in your State Health Department’s Alcohol and Other Drug Branch. You have been asked to consider this issue and lead the development of a plan for the new facility.

1. Describe the process you will undertake to develop the plan, including the consultation process (70%)
2. What are the key matters to be included in the plan? (30%)

Question 2

An innovative sexual health program was established at the local university two years ago. It generated some controversy at the time. It consists broadly of the following:

• Promoting safe sex practices via awareness raising and education strategies and increasing condom availability
• Encouraging students to present for regular sexual health checks to the student health centre whether they have STI symptoms or not

The student population is quite diverse, comprising both Australian resident and overseas students and including a broad range of ethnic groups. The program steering committee, consisting of University management, senior academics and student representatives, has brought you in as a consultant and asked you to evaluate the program.

Outline the key elements of the plan for your proposed evaluation.

Questions

Aboriginal and Torres Strait Islander question 1
You are the line manager for a team comprising mostly public health nurses and health promotion officers in a regional public health unit where the population demographics include three isolated Aboriginal nation clans each with estimated populations of about 1500. In the middle of an annual immunisation campaign that requires your staff to give immunisations directly to these Aboriginal communities, an elder from one of the nation clans calls you in a very agitated state telling you that one of your nurses has immunised an entire family for the second time in this campaign. This elder tells you that this nurse made very racist comments, did not believe the parents of the family that all the children had been immunised already that season, and had very rudely said that even if this was the case having a second flu shot would be okay because of the family’s 'living conditions'.

How do you respond immediately during the elder’s call?

What next steps will you prioritise in your investigations as the line manager and how would you resolve this complaint?

Health promotion question 1
You are a public health physician working in a state health department. The prevalence of tobacco smoking in the non-Indigenous population is 15%, but in the Indigenous population is over 70%. Your director has asked you to develop a smoking cessation program targeting the Indigenous population in the state.

Questions

Question 1: Cryptosporidium outbreak
You are a public health physician working in your state/territory health department. You have been asked to take over the management of an outbreak of Cryptosporidium gastroenteritis thought to be linked to public swimming pools. The graph below describes Cryptosporidium notifications to date in your jurisdiction (first 10 weeks of 2020) and notifications for the equivalent periods in 2018 and 2019, by week of onset. It is now the start of week 11 in 2020.

Detail your approach, including the steps you will take in managing this outbreak?

Question 2: Two Hepatitis B cases
Your Public Health Unit has just identified two incident cases of hepatitis B in persons who have received renal dialysis. Initial enquiries confirm that both cases received dialysis at the same renal dialysis unit on a number of occasions in the last six months.

You have been asked to lead the investigation of this incident.

Describe the steps you would follow in investigating this incident and what outcome(s) you would be seeking to achieve.

Questions

Question 1
You are working in a metropolitan public health unit. Several large bushfires are burning around your district and have begun to encroach on residential areas. High winds in the direction of the metropolitan centre are predicted and you’ve just been notified that several thousand people are about to be advised to evacuate within the next 4 hours. A list of community centres and halls in safe areas will be provided to them. Outline what you would do over the next hours and days.

1. What are the three main areas of public health response in this situation?
2. Explain how you would investigate this issue

Question 2
You are a public health physician working in the Environmental Health Branch (EHB) of the State Health Department. The Government has just confirmed a plan to remediate a legacy contaminated site and use the land for a large new residential development. Existing residents adjacent to the site have commenced campaigning for the project to be abandoned and the land left untouched. They have cited overseas evidence of the risks of remediation and have concerns that both the remediation and new residents will increase traffic congestion.

The Health Minister has made a commitment to the local community that a “Health Study” will be undertaken. The Chief Health Officer (CHO) and the Director of EHB have asked you to rapidly prepare a brief to allow the Minister to make a decision about the form of the Health Study. The brief needs to include reference to the Framework for Human Health Risk Assessment and some study options.

1. What key information will you include in your brief? (70%)
2. What study options are available? (30%)

Questions

Question 1
You are working as a public health adviser in the Maternal and Child Health Unit of a State Health department. There has been a public campaign, initiated by a parents’ group, to include genetic susceptibility testing for Type 1 diabetes as part of the State’s Newborn Screening Program. You have been asked to prepare a paper that details the advantages and disadvantages of such a program. Your manager has asked you to focus on the following questions:

• What are the merits of screening for susceptibility to Type 1 diabetes? (30%)
• What issues need to be considered in the development, design and implementation of such a screening program? (70%)

Question 2
You are part of team that is investigating adverse health effects in miners of rare earths*. There is increasing demand for these elements for the manufacture of batteries and electronic components. However, there are concerns about the health effects on miners of these minerals. You have been asked to develop a research question (and a supporting paper) to investigate the possibility of an increased incidence of lung cancer in these miners.

• What do you think would be an appropriate study design? What are the advantages and disadvantages of this kind of study? (50%)
• What would be the exposure of interest, and how would you define and measure it? (15%)
• What would be the outcome of interest, and how would you define and measure it? (15%)
• What other issues would you need to consider? (20%)

^* The rare earths are a group of 17 elements:

• the lanthanides (cerium, dysprosium, erbium, europium, gadolinium, holmium, lanthanum, lutetium, neodymium, praseodymium, promethium, samarium, terbium, thulium, and ytterbium)
• scandium and yttrium

These minerals are often found together with thorium and uranium

Questions

Question 1
In November 2020, your Chief Health Officer assigned you overall planning responsibility for the roll-out of the national COVID-19 vaccination program in your State. Phase 1a of the program (priority front-line health staff, quarantine and border workers, residents and staff of Aged Care facilities – 700,000 persons Australia-wide) commenced successfully this week, with Phase 1b (other HCWs, other critical emergency service workers, elderly adults >70 years, Aboriginal and Torres Strait islander people >55 years, younger adults with an underlying medical condition or disability – 6.1 million persons Australia-wide) to begin in 6-8 weeks’ time.

• Describe the process you used to develop the Phase 1 roll-out plan, and the key elements of the plan (60%)
• What additional complexities will you need to address in Phase 1b (20%)
• How will you monitor and evaluate the entire program? (20%)

Question 2
You have recently been appointed the Environmental Sustainability Lead for a large metropolitan health service. You are required to develop an Environmental Sustainability Plan for the health service.

• How would you go about developing the Plan? (40%)
• What are the key action areas that need to be included in the Plan? (40%)
• How will you evaluate the plan (20%)