Priscilla Robinson

Health effects of exposure to cyanobacteria (blue–green algae) during recreational water–related activities

Abstract: The aim of this study was to investigate effects on health of exposure to cyanobacteria as a result of recreational water activities. Participants, who were aged six years and over, were interviewed at water recreation sites in South Australia, New South Wales and Victoria on selected Sundays during January and February 1995. Telephone follow–up was conducted two and seven days later to record any subsequent diarrhoea, vomiting, flu–like symptoms, skin rashes, mouth ulcers, fevers and eye or ear irritations. On the Sundays of interview, water samples from the sites were collected for cyanobac–terial cell counts and toxin analysis. There were 852 participants, of whom 75 did not have water contact on the day of interview and were considered unexposed. The 777 who had water contact were considered exposed. No significant differences in overall symptoms were found between the unexposed and exposed after two days. At seven days, there was a significant trend to increasing symptom occurrence with duration of exposure (P = 0.03). There was a significant trend to increasing symptom occurrence with increase in cell count (P = 0.04). Participants exposed to more than 5000 cells per mL for more than one hour had a significantly higher symptom occurrence rate than the unexposed. Symptoms were not correlated with the presence of hepatotoxins. These results suggest symptom occurrence was associated with duration of contact with water containing cyanobacteria, and with cyanobacterial cell density. The findings suggest that the current safety threshold for exposure of 20 000 cells per mL may be too high. (Aust N Z J Public Health 1997; 21: 562–6)

Hallux valgus and hallux rigidus: a comparison of impact on health-related quality of life in patients presenting to foot surgeons in Australia

BackgroundHallux valgus and hallux rigidus are common foot conditions that lead to a deterioration in health status. Patients with significant pain or deformity from these conditions frequently resort to surgery. In this project, the foot health status of patients with hallux valgus and hallux rigidus presenting to foot surgeons in Australia was compared.MethodsFoot health status was measured in 120 participants using the Foot Health Status Questionnaire (FHSQ), a validated 0 – 100 point health status instrument. All participants had presented for surgical advice regarding hallux valgus/rigidus. The mean age of participants was 48.0 years (SD ± 14.3, range 19 – 79).ResultsIn the sample, 68% of participants were diagnosed with hallux valgus and 32% with hallux rigidus. Participants with hallux rigidus had greater levels of pain and functional limitation compared with hallux valgus. The mean difference for pain was 13.8 points (95% CI 4.6 to 22.9) and the mean difference for function was 15.0 points (95% CI 5.3 to 24.7). Both conditions result in similarly negative levels of impact on shoe fit and overall foot health.ConclusionThis study found measurable differences in foot health status between hallux valgus and hallux rigidus in participants presenting for surgical consultation. While both appear to have a negative impact on health status, hallux rigidus has a more significant impact.

A comparison of general practitioner response rates to electronic and postal surveys in the setting of the National STI Prevention Program.

Objective: To compare the response rates achieved for an online survey with a postal survey of general practitioners (GPs) as a method to evaluate the National STI Prevention Program.

Communicate to vaccinate : the development of a taxonomy of communication interventions to improve routine childhood vaccination

BackgroundVaccination is a cost-effective public health measure and is central to the Millennium Development Goal of reducing child mortality. However, childhood vaccination coverage remains sub-optimal in many settings. While communication is a key feature of vaccination programmes, we are not aware of any comprehensive approach to organising the broad range of communication interventions that can be delivered to parents and communities to improve vaccination coverage. Developing a classification system (taxonomy) organised into conceptually similar categories will aid in: understanding the relationships between different types of communication interventions; facilitating conceptual mapping of these interventions; clarifying the key purposes and features of interventions to aid implementation and evaluation; and identifying areas where evidence is strong and where there are gaps. This paper reports on the development of the ‘Communicate to vaccinate’ taxonomy.MethodsThe taxonomy was developed in two stages. Stage 1 included: 1) forming an advisory group; 2) searching for descriptions of interventions in trials (CENTRAL database) and general health literature (Medline); 3) developing a sampling strategy; 4) screening the search results; 5) developing a data extraction form; and 6) extracting intervention data. Stage 2 included: 1) grouping the interventions according to purpose; 2) holding deliberative forums in English and French with key vaccination stakeholders to gather feedback; 3) conducting a targeted search of grey literature to supplement the taxonomy; 4) finalising the taxonomy based on the input provided.ResultsThe taxonomy includes seven main categories of communication interventions: inform or educate, remind or recall, teach skills, provide support, facilitate decision making, enable communication and enhance community ownership. These categories are broken down into 43 intervention types across three target groups: parents or soon-to-be-parents; communities, community members or volunteers; and health care providers.ConclusionsOur taxonomy illuminates and organises this field and identifies the range of available communication interventions to increase routine childhood vaccination uptake. We have utilised a variety of data sources, capturing information from rigorous evaluations such as randomised trials as well as experiences and knowledge of practitioners and vaccination stakeholders. The taxonomy reflects current public health practice and can guide the future development of vaccination programmes.

'Communicate to vaccinate' (COMMVAC). building evidence for improving communication about childhood vaccinations in low- and middle-income countries: protocol for a programme of research

BackgroundEffective provider-parent communication can improve childhood vaccination uptake and strengthen immunisation services in low- and middle-income countries (LMICs). Building capacity to improve communication strategies has been neglected. Rigorous research exists but is not readily found or applicable to LMICs, making it difficult for policy makers to use it to inform vaccination policies and practice.The aim of this project is to build research knowledge and capacity to use evidence-based strategies for improving communication about childhood vaccinations with parents and communities in LMICs.Methods and designThis project is a mixed methods study with six sub-studies. In sub-study one, we will develop a systematic map of provider-parent communication interventions for childhood vaccinations by screening and extracting data from relevant literature. This map will inform sub-study two, in which we will develop a taxonomy of interventions to improve provider-parent communication around childhood vaccination. In sub-study three, the taxonomy will be populated with trial citations to create an evidence map, which will also identify how evidence is linked to communication barriers regarding vaccination.In the projects fourth sub-study, we will present the interventions map, taxonomy, and evidence map to international stakeholders to identify high-priority topics for systematic reviews of interventions to improve parent-provider communication for childhood vaccination. We will produce systematic reviews of the effects of high-priority interventions in the fifth sub-study. In the sixth and final sub-study of the project, evidence from the systematic reviews will be translated into accessible formats and messages for dissemination to LMICs.DiscussionThis project combines evidence mapping, conceptual and taxonomy development, priority setting, systematic reviews, and knowledge transfer. It will build and share concepts, terms, evidence, and resources to aid the development of communication strategies for effective vaccination programmes in LMICs.

Online Resources for New Mothers: Opportunities and Challenges for Perinatal Health Professionals

Studies have shown increasing Internet use for health information and service facilities. After consulting a convenience sample of new mothers, this study applied select terms and phrases to a widely accepted search engine and investigated its potential for providing resources for new mothers. Results of this quantitative content analysis showed that only four of the 13 phrases used in the search generated 50% or more websites containing content relevant to new mothers. Findings indicate that informational support by way of electronic fact sheets is available using the Google search engine. However, functional support (e.g., social networks, consultation phone details, and mother–infant activities) configured limited data resources using the Google search engine. In addition, because websites can be difficult to navigate, users’ technical proficiency needs to be taken into consideration as well as the sites’ up-to-date information. With Internet technology rapidly expanding, perinatal educators and other perinatal health-care professionals need to be informed about current online resources to help direct consumers to useful online resources and mitigate the often overwhelming and confusing information.

Enhancing Aspects of the Higher Education Student Experience.

Enhancing the student experience is now recognised by tertiary institutions as a valuable undertaking. Universities are committed to providing the broadest possible range of student services and activities, to continue to attract and retain a capable, diverse student cohort and to build on the Universitys commitment to equity, access and participation. In late 2007, the student population at a large Australian university was consulted by means of an electronic questionnaire to gauge their views about student services and a proposal to establish a student ‘one stop shop’. Facilitating engagement and collaboration of services and their provision can enable equity across all student populations, ultimately increasing retention and satisfaction of students in higher education. In this paper we report here of focus group discussion which examined and explored the ways in which services could be centralised for students through a one-stop ‘student hub’.

Health Belief Model: Evaluating Marketing Promotion in a Public Vaccination Program

National health objectives are driven to increase participation rates. Individual health decisions are determined by attitudes, behavior, lifestyles, and government policies. This research, therefore, examined not just the development and delivery of a message targeting individual voluntary behavior change, but the intention of changes in social structures that will facilitate individuals reaching their potential; thus the purpose of this article is to shed light on the uptake of the human papillomavirus (HPV) immunization using the health belief model (HBM). Research was conducted with the use of focus groups by drawing on the framework of the HBM. This research approach is conceptual by nature, based on the virtue of marketing promotion and on HBM literature. Though offering the vaccine free to the general public provides additional evidence to certain groups on the intention to act or uptake of the vaccine, awareness levels were found to be poor despite increased efforts by the government trying to promote this vaccine. There was evidence that social capital and trust can produce effective communication message strategies that reinforce social bonds. This article provides an interesting basis for further investigation; however, as implausible as it seems the article also contributes to the concept of perceived benefits and of self-efficacy.

How the causes, consequences and solutions for problem gambling are reported in Australian newspapers: a qualitative content analysis

Objective: To inform public health approaches to problem gambling by examining how the news media covers problem gambling, with a particular focus on the causes, consequences and solutions to problem gambling, and the ‘actors’ and sources who influence media coverage.

Hepatitis B virus exposure and vaccination in a cohort of people who inject drugs: What has been the impact of targeted free vaccination?

Forty percent of new hepatitis B virus (HBV) infections in Australia occur in people who inject drugs (PWID); long‐term infection carries the risk of serious liver disease. HBV incidence among Australian PWID has not been measured since the advent of targeted (2001) and adolescent school‐based “catch‐up” (1998) vaccination programs. We measured HBV incidence and prevalence in a cohort of PWID in Melbourne, Australia and examined demographic and behavioral correlates of exposure and vaccination.