This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.
Aboriginal Midwifery Access Program provides high-quality antenatal care in a trusted environment. The high rate of smoking in pregnancy needs to be addressed.
Australia must improve AFP surveillance to confirm absence of wild poliovirus. Paediatricians can help Australia meet its certification requirements and contribute to the global eradication effort by reporting and investigating all cases of AFP.
ObjectiveTo describe the results of vaccinating children with a history of serious adverse reactions after vaccination or of egg allergy at a special clinic established for that purpose.
DesignRetrospective case series.
PatientsChildren who attended the clinic between 1 August 1994 and 31 July 1996 after being referred by vaccine providers.
SettingA clinic conducted in the Emergency Department of The Canberra Hospital, Australian Capital Territory.
Main outcome measuresReasons for referral; vaccinations given; and subsequent adverse vaccination events.
Results91 children received 155 vaccinations at the clinic, and only one serious event ‐ a hypotonic/hyporesponsive episode (HHE) after diphtheria‐tetanus‐whole cell pertussis (DTPw), oral polio and Haemophilus influenzae type b vaccination ‐ was subsequently reported; this child recovered spontaneously. Fifty‐three children referred because of a previous serious adverse vaccination event were revaccinated at the clinic with whole‐cell pertussis vaccine (47), combined diphtheria and tetanus vaccine (4), tetanus toxoid (1), and typhoid vaccine (1). Three children (referred because of previous meningitis, subdural haemorrhage or parental suspicion of allergy to DTPw) received their first dose of pertussis vaccine at the clinic. The remaining 35 children had a history of egg allergy and were given measles‐mumps‐rubella vaccine.
ConclusionsWe successfully vaccinated children with histories of serious reactions to vaccination, including HHEs, convulsions, apnoea, high temperatures and persistent screaming, as well as those with egg allergy. We believe special clinics can improve vaccination coverage.
The objectives of this study were to describe outcomes of low birthweight (LBW; < 2500 g) babies born in the Australian Capital Territory (ACT) and to identify risk factors associated with LBW in the ACT. A cohort study was conducted involving all births recorded in the ACT Maternal and Perinatal Data Collection sets for 1989-90. Status at discharge is presented for 9373 births each weighing more than 499 g born in 1989 and 1990, classified by birthweight. Other outcomes are given for live births (n = 9309) only. Adjusted odds ratios for significant risk factors for LBW are given for 9084 singleton births whose computer records contained all relevant information. Perinatal mortality rates for LBW babies are consistent with other States, apart from 500-999 and 1500-1999 g babies which have higher rates. Eighteen per cent of LBW babies are transferred to other hospitals. Low birthweight babies are more likely than normal birthweight babies to have 1 and 5 min Apgar scores less than 7, to need resuscitation and to take more than 5 min to establish respiration. Risk of LBW is associated with maternal primiparity, age 35 years or more in primiparous women, history of one or more spontaneous abortions, induced abortions or perinatal deaths, chronic illness, public health insurance and single marital status, and with fetal female sex and congenital anomalies. Babies born weighing less than 2500 g in the ACT have more adverse outcomes and are much more likely to be transferred than normal birthweight babies.(ABSTRACT TRUNCATED AT 250 WORDS)
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