Enhancing sexual healthcare within general practice

Poster abstract presented at IUSTI World Congress, 15-17 October 2012, Melbourne, Australi

Rapid Assessment of Nonindigenous Marine Species on Coral Reefs in the Main Hawaiian Islands

v. ill. 23 cm.QuarterlyCoral reefs at Kaua‘i, O‘ahu, Moloka‘i, Maui, and Hawai‘i were surveyed using a rapid assessment method for marine nonindigenous and cryptogenic species commonly found in Hawaiian harbors and embayments with restricted circulation. In 41 sites surveyed by rapid assessment 26 nonindigenous and cryptogenic species (three algae, 19 invertebrates, and four fishes) were recorded from a total of 486 total taxa identified, and 17 of the nonindigenous and cryptogenic species occurred at only one or two sites. No more than six nonindigenous and cryptogenic species were recorded at any one site, and 21 of the 41 sites had fewer than three. By comparison, laboratory identification of samples collected from seven of the sites closest to harbors found 6–23 nonindigenous and cryptogenic species per site. Values for nonindigenous and cryptogenic species from rapid assessment were compared with factors potentially influencing spread and proliferation of introduced marine species. These factors included distances from harbors, boat-launching ramps, stream mouths, and shorelines; degree of shoreline urbanization; quantity of artificial surfaces in the water; reef condition and isolation from the open ocean; and native species richness. A best subsets regression model explained over 65% of the variance in nonindigenous and cryptogenic species from two predictor variables and their interaction: isolation from the open ocean and number of native taxa, with most of the variance explained by a highly significant relationship of nonindigenous and cryptogenic species with isolation from open-ocean conditions

The Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy Pilot Study protocol: a feasibility step-wedge cluster randomised trial to improve health providers' management of smoking during pregnancy.

INTRODUCTION: Indigenous women have the highest smoking prevalence during pregnancy (47%) in Australia. Health professionals report lack of knowledge, skills and confidence to effectively manage smoking among pregnant women in general. We developed a behaviour change intervention aimed to improve health professionals' management of smoking in Indigenous pregnant women-the Indigenous Counselling And Nicotine (ICAN) QUIT in Pregnancy. This intervention includes webinar training for health professionals, an educational resources package for health professionals and pregnant women, free oral nicotine replacement therapy (NRT) for pregnant women, and audit and feedback on health professionals' performance.The aim of this study is to test the feasibility and acceptability of the ICAN QUIT in Pregnancy intervention to improve health professionals' provision of evidence-based culturally responsive smoking cessation care to Australian Indigenous pregnant smokers. METHODS AND ANALYSIS: This protocol describes the design of a step-wedge cluster randomised pilot study. Six Aboriginal Medical Services (AMSs) are randomised into three clusters. Clusters receive the intervention staggered by 1 month. Health professionals report on their knowledge and skills pretraining and post-training and at the end of the study. Pregnant women are recruited and followed up for 3 months. The primary outcome is the recruitment rate of pregnant women. Secondary outcomes include feasibility of recruitment and follow-up of participating women, and webinar training of health professionals, measured using a designated log; and measures of effectiveness outcomes, including quit rates and NRT prescription rates. ETHICS AND DISSEMINATION: In accordance with the Aboriginal Health and Medical Research Council guidelines, this study has been developed in collaboration with a Stakeholder and Consumer Aboriginal Advisory Panel (SCAAP). The SCAAP provides cultural consultation, advice and direction to ensure that implementation is acceptable and respectful to the Aboriginal communities involved. Results will be disseminated to AMSs, Aboriginal communities and national Aboriginal bodies

Improving smoking cessation care in pregnancy at Aboriginal Medical Services: 'ICAN QUIT in Pregnancy' step-wedge cluster randomised study

Objectives This study aimed to examine the impact of the ‘ICAN QUIT in Pregnancy’ intervention on individual health providers (HPs) smoking cessation care (SCC) knowledge, attitudes and practices in general, and specifically regarding nicotine replacement therapy (NRT) prescription. Design Step-wedge clustered randomised controlled study. HPs answered a preintervention and 1–6 months postintervention survey. Setting Six Aboriginal Medical Services (AMSs) in three states of Australia. Participants All HPs were invited to participate. Of 93 eligible, 50 consented (54%), 45 completed the presurvey (90%) and 20 the post (40%). Intervention Included three 1-hour webinar sessions, educational resource package and free oral NRT. Outcomes HPs knowledge was measured using two composite scores—one from all 24 true/false statements, and one from 12 NRT-specific statements. Self-assessment of 22 attitudes to providing SCC were measured using a five-point Likert scale (Strongly disagree to Strongly agree). Two composite mean scores were calculated—one for 15 general SCC attitudes, and one for 7 NRT-specific attitudes. Self-reported provision of SCC components was measured on a five-point Likert scale (Never to Always). Feasibility outcomes, and data collected on the service and patient level are reported elsewhere. Results Mean knowledge composite scores improved from pre to post (78% vs 84% correct, difference 5.95, 95%CI 1.57 to 10.32). Mean NRT-specific knowledge composite score also improved (68% vs 79% correct, difference 9.9, 95%CI 3.66 to 16.14). Mean attitude composite score improved (3.65 (SD 0.4) to 3.87 (SD 0.4), difference 0.23, 95%CI 0.05 to 0.41). Mean NRT-specific attitudes composite score also improved (3.37 (SD 0.6) to 3.64 (SD 0.7), difference 0.36, 95%CI 0.13 to 0.6). Selfreported practices were unchanged, including prescribing NRT. Conclusions A multicomponent culturally sensitive intervention in AMSs was feasible, and might improve HPs provision of SCC to pregnant Aboriginal women. Changes in NRT prescription rates may require additional intensive measures

New insights into the magmatic-hydrothermal system and volatile budget of Lastarria volcano, Chile: Integrated results from the 2014 IAVCEI CCVG 12th Volcanic Gas Workshop.

Recent geophysical evidence for large-scale regional crustal inflation and localized crustal magma intrusion has made Lastarria volcano (northern Chile) the target of numerous geological, geophysical, and geochemical studies. The chemical composition of volcanic gases sampled during discrete campaigns from Lastarria volcano indicated a well-developed hydrothermal system from direct fumarole samples in A.D. 2006, 2008, and 2009, and shallow magma degassing using measurements from in situ plume sampling techniques in 2012. It is unclear if the differences in measured gas compositions and resulting interpretations were due to artifacts of the different sampling methods employed, short-term excursions from baseline due to localized changes in stress, or a systematic change in Lastarria's magmatic-hydrothermal system between 2009 and 2012. Integrated results from a two-day volcanic gas sampling and measurement campaign during the 2014 International Association of Volcanology and Chemistry of the Earth's Interior (IAVCEI) Commission on the Chemistry of Volcanic Gases (CCVG) 12th Gas Workshop are used here to compare and evaluate current gas sampling and measurement techniques, refine the existing subsurface models for Lastarria volcano, and provide new constraints on its magmatic-hydrothermal system and total degassing budget. While compositional differences among sampling methods are present, distinct compositional changes are observed, which if representative of longterm trends, indicate a change in Lastarria's overall magmatic-hydrothermal system. The composition of volcanic gases measured in 2014 contained high proportions of relatively magma- and water-soluble gases consistent with degassing of shallow magma, and in agreement with the 2012 gas composition. When compared with gas compositions measured in 2006-2009, higher relative H2O/CO2 ratios combined with lower relative CO2/St and H2O/St and stable HCl/St ratios (where St is total S [SO2 + H2S]) are observed in 2012 and 2014. These compositional changes suggest variations in the magmatic-hydrothermal system between 2009 and 2012, with possible scenarios to explain these trends including: (1) decompression-induced degassing due to magma ascent within the shallow crust; (2) crystallization-induced degassing of a stalled magma body; (3) depletion of the hydrothermal system due to heating, changes in local stress, and/or minimal precipitation; and/or (4) acidification of the hydrothermal system. These scenarios are evaluated and compared against the geophysical observations of continuous shallow inflation at ~8 km depth between 1997 and 2016, and near-surface ( < 1 km) inflation between 2000 and 2008, to further refine the existing subsurface models. Higher relative H2O/CO2 observed in 2012 and 2014 is not consistent with the depletion or acidification of a hydrothermal system, while all other observations are consistent with the four proposed models. Based on these observations, we find that scenarios 1 or 2 are the most likely to explain the geochemical and geophysical observations, and propose that targeted shallow interferometric synthetic-aperture radar (InSAR) studies could help discriminate between these two scenarios. Lastly, we use an average SO2 flux of 604 \ub1 296 t/d measured on 22 November 2014, along with the average gas composition and diffuse soil CO2 flux measurements, to estimate a total volatile flux from Lastarria volcano in 2014 of ~12,400 t/d, which is similar to previous estimates from 2012

Sociodemographic gradients in breast and cervical cancer screening in Korea: the Korean National Cancer Screening Survey (KNCSS) 2005-2009

<p>Abstract</p> <p>Background</p> <p>Cancer screening rates in Korea for five cancer types have increased steadily since 2002. With regard to the life-time cancer screening rates in 2009 according to cancer sites, the second highest was breast cancer (78.1%) and the third highest was cervical cancer (76.1%). Despite overall increases in the screening rate, disparities in breast and cervical cancer screening, based on sociodemographic characteristics, still exist.</p> <p>Methods</p> <p>Data from 4,139 women aged 40 to74 years from the 2005 to 2009 Korea National Cancer Screening Survey were used to analyze the relationship between sociodemographic characteristics and receiving mammograms and Pap smears. The main outcome measures were ever having had a mammogram and ever having had a Pap smear. Using these items of information, we classified women into those who had had both types of screening, only one screening type, and neither screening type. We used logistic regression to investigate relationships between screening history and sociodemographic characteristics of the women.</p> <p>Results</p> <p>Being married, having a higher education, a rural residence, and private health insurance were significantly associated with higher rates of breast and cervical cancer screening after adjusting for age and sociodemographic factors. Household income was not significantly associated with mammograms or Pap smears after adjusting for age and sociodemographic factors.</p> <p>Conclusions</p> <p>Disparities in breast and cervical cancer screening associated with low sociodemographic status persist in Korea.</p

Improving smoking cessation care in pregnancy at Aboriginal Medical Services: 'ICAN QUIT in Pregnancy' step-wedge cluster randomised study

Planning is critical to mitigating the sudden and potentially catastrophic impact of an infectious disease pandemic on society. National pandemic policy documents cover a wide variety of control options, often with nonspecific recommendations for action. Despite advances in analytical methods for gaining early situational awareness (i.e., of a disease’s transmissibility and severity) and for predicting the likely effectiveness of interventions, a major gap exists globally in terms of integrating these outputs with the advice contained in policy documents. Decision models (and decision science as a field, more broadly) provide an approach to defining and evaluating alternative policy options under complex and changing conditions. A decision model for infectious disease pandemics is an appropriate method for integrating evidence from situational and intervention analysis tools, along with the information in policy documents, to provide robust advice on possible response options (including uncertainty). A decision model for pandemic response cannot capture all of the social, political, and ethical considerations that impact decision-making. Such a model should therefore be embedded in a decision support system that emphasizes this broader context.Freya M. Shearer, Robert Moss, Jodie McVernon, Joshua V. Ross, James M. McCa

What do antenatal care providers understand and do about oral health care during pregnancy: a cross-sectional survey in New South Wales, Australia

BACKGROUND: There is mounting evidence to support the lack of awareness among pregnant women about health consequences and long term risks associated with poor oral hygiene during pregnancy. A recognised and important point of influence is their interaction with health professionals, particularly when receiving Antenatal Care. However, there is limited evidence about the perceptions of ANC providers in Australia toward the provision of perinatal oral healthcare. This study was undertaken to explore the knowledge, attitudes and practices of Antenatal Care (ANC) providers in New South Wales (NSW), Australia providing perinatal oral healthcare and to identify barriers to and predictors of their practices in this area. METHODS: A cross sectional survey was undertaken of ANC providers (general practitioners, obstetricians/gynaecologists and midwives) practising in NSW, Australia. Participants were recruited through their professional organisations via email, postal mail, and networking at conferences. The survey addressed the domains of knowledge, attitude, barriers and practices towards oral healthcare, along with demographics. Data was entered into SPSS software and analysed using descriptive and inferential statistics. RESULTS: A total of 393 surveys (17.6% response rate) were completed comprising 124 general practitioners, 74 obstetricians/gynaecologists and 195 midwives. The results showed limited knowledge among ANC providers regarding the impact of poor maternal oral health on pregnancy/infant outcomes. Most (99%) participants agreed that maternal oral health was important yet few were discussing the importance of oral health or advising women to visit a dentist (16.4–21.5%). Further, less than a third felt they had the skills to provide oral health advice during pregnancy. ANC providers who were more knowledgeable about maternal oral health, had training and information in this area and greater experience, were more likely to engage in practices addressing the oral health of pregnant women. CONCLUSION: The findings suggest that ANC providers in NSW are not focussing on oral health with pregnant women. ANC providers seem willing to discuss oral health if they have appropriate education/training and information in this area. Further research at a national level is required to confirm whether these findings are similar in all Australian states

Thermal, deformation, and degassing remote sensing time‐series (A.D. 2000‐2017) at the 47 most active volcanoes in Latin America: Implications for volcanic systems

Volcanoes are hazardous to local and global populations, but only a fraction are continuously monitored by ground‐based sensors. For example, in Latin America, more than 60% of Holocene volcanoes are unmonitored, meaning long‐term multi‐parameter datasets of volcanic activity are rare and sparse. We use satellite observations of degassing, thermal anomalies, and surface deformation spanning 17 years at 47 of the most active volcanoes in Latin America, and compare these datasets to ground‐based observations archived by the Global Volcanism Program (GVP). This first comparison of multi‐satellite time‐series on a regional scale provides information regarding volcanic behavior during, non‐, pre‐, syn‐ and post‐eruptive periods. For example, at Copahue volcano, deviations from background activity in all three types of satellite measurements were manifested months to years in advance of renewed eruptive activity in 2012. By quantifying the amount of degassing, thermal output, and deformation measured at each of these volcanoes, we test the classification of these volcanoes as open or closed volcanic systems. We find that ~28% of the volcanoes do not fall into either classification and the rest show elements of both, demonstrating a dynamic range of behavior that can change over time. Finally, we recommend how volcano monitoring could be improved through better coordination of available satellite‐based capabilities and new instruments