Student-centered interventions the key to student health care worker influenza vaccination

Objectives: To investigate influenza vaccination uptake rates, attitudes and motivations towards influenza vaccination among student health care workers (HCWs). Methods: Self-reported influenza vaccination uptake among student HCWs at The University of Notre Dame Australia, Fremantle, Western Australia (UNDAF) was surveyed before and after implementation of a peer-led, student-centered campaign to raise awareness of, and improve access to, influenza vaccination. Data were weighted and analysed using logistic regression. Results: Pre-campaign influenza vaccination uptake was 36.3% (95% CI=31.8%-40.8%), with students identifying lack of awareness of both the Australian Government’s recommendations and university policy, cost, and inconvenience of vaccine access as key barriers. Post-campaign vaccination coverage increased significantly to 55.9% (95% CI=52.2%-59.6%). Multivariate logistic regression, controlled for statistically insignificant confounders of age and gender, showed that being a student HCW in 2014 (campaign year) was significantly and independently associated with influenza vaccination (OR 2.2, 95% CI=1.7-2.9, P\u3c0.001). Other significant factors were eligibility for National Immunisation Programme (NIP) funded vaccine (OR 12.3, 95% CI=6.3 – 24.0, P\u3c0.001), employment as HCWs (OR 1.9, 95% CI=1.5-2.6, P\u3c0.001), recalled campaign materials (OR 1.8, 95% CI=1.2 – 2.7, P=0.002) and enrolled in medicine (OR 1.6, 95% CI=1.1-2.4, P=0.016). Conclusions: Student HCWs’ influenza vaccination uptake improved significantly following a low-cost, peer-led promotional campaign. This approach can be adapted to other settings

Clinical audit project in undergraduate medical education curriculum: An assessment validation study

Objectives: To evaluate the merit of the Clinical Audit Project (CAP) in an assessment program for undergraduate medical education using a systematic assessment validation framework. Methods: A cross-sectional assessment validation study at one medical school in Western Australia, with retrospective qualitative analysis of the design, development, implementation and outcomes of the CAP, and quantitative analysis of assessment data from four cohorts of medical students (2011-2014). Results: The CAP is fit for purpose with clear external and internal alignment to expected medical graduate outcomes. Substantive validity in students’ and examiners’ response processes is ensured through relevant methodological and cognitive processes. Multiple validity features are built-in to the design, planning and implementation process of the CAP. There is evidence of high internal consistency reliability of CAP scores (Cronbach’s alpha \u3e 0.8) and inter-examiner consistency reliability (intra-class correlation\u3e0.7). Aggregation of CAP scores is psychometrically sound, with high internal consistency indicating one common underlying construct. Significant but moderate correlations between CAP scores and scores from other assessment modalities indicate validity of extrapolation and alignment between the CAP and the overall target outcomes of medical graduates. Standard setting, score equating and fair decision rules justify consequential validity of CAP scores interpretation and use. Conclusions: This study provides evidence demonstrating that the CAP is a meaningful and valid component in the assessment program. This systematic framework of validation can be adopted for all levels of assessment in medical education, from individual assessment modality, to the validation of an assessment program as a whole

Adverse events following influenza immunization reported by healthcare personnel using active surveillance based on text messages

Studies have demonstrated that healthcare personnel (HCP) have concerns about the potential side effects of trivalent inactivate influenza vaccine (IIV3).1-3 A recent metaanalysis of reasons HCP refuse IIV3 indicates the strongest predictors of vaccine acceptance are belief that the vaccine is safe and belief the vaccine does not cause the disease it is meant to prevent.

What can 14 CO measurements tell us about OH?

The possible use of 14CO measurements to constrain hydroxyl radical (OH) concentrations in the atmosphere is investigated. 14CO is mainly produced in the upper atmosphere from cosmic radiation. Measurements of 14CO at the surface show lower concentrations compared to the upper atmospheric source region, which is the result of oxidation by OH. In this paper, the sensitivity of 14CO mixing ratio surface measurements to the 3-D OH distribution is assessed with the TM5 model. Simulated 14CO mixing ratios agree within a few molecules 14CO cm¿3 (STP) with existing measurements at five locations worldwide. The simulated cosmogenic 14CO distribution appears mainly sensitive to the assumed upper atmospheric 14C source function, and to a lesser extend to model resolution. As a next step, the sensitivity of 14CO measurements to OH is calculated with the adjoint TM5 model. The results indicate that 14CO measurements taken in the tropics are sensitive to OH in a spatially confined region that varies strongly over time due to meteorological variability. Given measurements with an accuracy of 0.5 molecules 14CO cm¿3 STP, a good characterization of the cosmogenic 14CO fraction, and assuming perfect transport modeling, a single 14CO measurement may constrain OH to 0.2¿0.3×106 molecules OH cm¿3 on time scales of 6 months and spatial scales of 70×70 degrees (latitude×longitude) between the surface and 500 hPa. The sensitivity of 14CO measurements to high latitude OH is about a factor of five higher. This is in contrast with methyl chloroform (MCF) measurements, which show the highest sensitivity to tropical OH, mainly due to the temperature dependent rate constant of the MCF¿OH reaction. A logical next step will be the analysis of existing 14CO measurements in an inverse modeling framework. This paper presents the required mathematical framework for such an analysis

Why HITnet kiosks didn\u27t hit the mark for sexual health education of Western Australian Aboriginal youth

Objective: To assess the use, appropriateness of, and staff feedback on specific sexual health modules, which were installed on Heuristic Interactive Technology (HITnet) kiosks at Aboriginal Community Controlled Health Services (ACCHS). The HITnet kiosks were aimed at Aboriginal youth visiting these sites. Methods: Modules on the HITnet kiosks were assessed for (1) cultural appropriateness using Yunkaporta’s Aboriginal pedagogy framework and (2) compliance with the World Health Organization’s (WHO) advice on key elements for comprehensive sexual health education for young people. Data measuring kiosk use were obtained through HITnet kiosk activity reports. An online survey of ACCHS staff was used to qualitatively assess use of, and staff perceptions of, HITnet kiosks. Results: Kiosk modules were consistent with seven of the eight elements of Yunkaporta’s framework and all of the WHO recommendations. The most popular module generated 3,066 purposeful sessions and the least popular module generated 724 purposeful sessions across nine sites in 2012. While teenagers were the most frequent of the kiosk user groups (39.5% in 2012), the majority of users (56%) were not in the target group (i.e. elders 4%, adults 25%, children 27%). Key issues reported by ACCHS staff (n=11) included: lack of clarity regarding staff responsibility for overseeing kiosk functionality; kiosks attracting “inappropriate ages”; and “lack of privacy” based on kiosk location, screen visibility, and absence of headphones preventing discreet access. Conclusions: The modules were tailored to a young Aboriginal audience through technology thought to be appealing to this group. However, barriers to use of the kiosk included kiosk design features, location, and lack of clarity around responsibility for kiosk operation. Implications: Aboriginal youth need easy access to sexual health messages in a ‘safe’, non-judgmental space. Information and communication that is accessible via personal and mobile devices may be a better vehicle than public kiosks