1.  Title: Promoting health and equity: Evidence, policy and action: Cases from the Western Pacific Region. Author: World Health Organization [WHO]. Regional Office for the Western Pacific Source: Manila, Philippines, WHO, Regional Office for the Western Pacific, 2009 Mar. [173] p. Abstract: Recent years have seen a growth in the evidence base on policies and actions to promote health equity. Despite efforts, however, the evidence shows that inequalities are increasing rather than decreasing in many countries. This may partly be due to faulty policy decisions. There is clearly need for a better evidence-based approach on health policies to achieve equity. At the same time, understanding is inadequate on how policy-makers can best make use of the growing evidence base on promoting equity in health. There is a need for stronger links between evidence and health policy-making and implementation. To respond in part to this need, the WHO Western Pacific Regional Office convened the High Level Meeting on Promoting Health Equity: Evidence, Policy and Action from 16-18 October 2007 in Phnom Penh, hosted by the Royal Government of Cambodia, to provide an opportunity to exchange experiences and identify ways to promote the more systematic use of equity research in health policy and action. Health ministers and other stake holders engaged in the evidence-to-policy process were invited to submit case studies that illustrate the process. This book compiles the nine cases presented at the meeting. An introductory chapter comprises a synthesis of the cases and the lessons learned from them. Language: English Keywords: CAMBODIA | CHINA | VIETNAM | NEW ZEALAND | MALAYSIA | MONGOLIA | SUMMARY REPORT | CASE STUDIES | DELIVERY OF HEALTH CARE | PRIMARY HEALTH CARE | TREATMENT | HEALTH POLICY | HEALTH SERVICES | TUBERCULOSIS | CAPACITY BUILDING | PREVENTION AND CONTROL | PROGRAM ACCESSIBILITY | Developing Countries | Asia, Southeastern | Asia | Asia, Eastern | Oceania | Developed Countries | Asia, Northern | Studies | Research Methodology | Health | Medical Procedures | Medicine | Policy | Political Factors | Sociocultural Factors | Infections | Diseases | Program Sustainability | Programs | Organization and Administration | Program Evaluation Document Number: 331453 |
| 2. Title: Catching up on contraception. Author: Allen K Source: Australian Family Physician. 2009 Jun;38(6):380-2. Abstract: BACKGROUND: Providing contraceptive advice is a core activity in general practice. There have been numerous changes to the contraceptive options available in Australia over the past 10 years. It is important that general practitioners are aware of these changes so that they can advise patients appropriately. OBJECTIVE: This article examines the changes that have occurred in contraception over the past decade and discusses the implications of these changes to clinical practice. DISCUSSION: Up-to-date knowledge about how the combined oral contraceptive pill works is reflected in changes to packaging and formulations, with varying success. Other changes include the over-the-counter availability of emergency contraceptive pills and the new combined hormonal vaginal ring. There has been a resurgence in intrauterine device use and their insertion has Level 1 (nonprocedural) indemnity status in most medical defence organisations. Bleeding with long acting progestogen only contraception remains a problem and management options include antiprostaglandins, tranexamic acid, doxycycline, the combined oral contraceptive pill and removal of the device. Sterilisation remains an option for older men and women and newer methods are available. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | KNOWLEDGE | ORAL CONTRACEPTIVES, COMBINED | EMERGENCY CONTRACEPTION | SATISFACTION | VAGINAL RING | STERILIZATION, SEXUAL | INFORMED CHOICE | Oceania | Developed Countries | Sociocultural Factors | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Psychological Factors | Behavior | Contraceptive Usage Document Number: 341574 |
3.  Peer Reviewed Title: Evidence behind the WHO guidelines: hospital care for children: what is the evidence that BCG vaccination should not be used in HIV-infected children? Author: Bannister C; Bennett L; Carville A; Azzopardi P Source: Journal of Tropical Pediatrics. 2009 Apr;55(2):78-82. Abstract: The World Health Organization has produced guidelines for the management of common illnesses in hospitals with limited resources. This series reviews the scientific evidence behind WHO's recommendations. The WHO guidelines, and more reviews are available at: http://www.ichrc.org. This review addresses the question: What is the evidence that BCG vaccination should not be used in HIV-infected children? The limited evidence currently available has been the basis of the WHO recommendation that BCG vaccination should not be used in HIV-positive children, as severe complications appear more commonly in HIV-infected individuals [8]. This decision is supported by the findings from the Fallo [13] and Hesseling [18, 20] studies. Although the WHO have suggested that HIV-infected infants should not be vaccinated this is obviously difficult in countries where BCG vaccination is administered before HIV status can be detected. Many high HIV-burden countries do not have viral-specific testing (such as PCR) routinely available to adequately assess the infection status of every new born infant. More research needs to be undertaken in this area to clarify the situation, and treating clinicians need to be made aware of this issue with all its complexity. The WHO recommendation highlights the need for viral-specific testing to be widely available in developing countries. This will ensure HIV-infected infants are not exposed to BCG which may be potentially dangerous and HIV-exposed but uninfected infants are not denied this important vaccine. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | WHO | STANDARDS | CHILDREN | HOSPITALS | DELIVERY OF HEALTH CARE | VACCINES | HIV INFECTIONS | Oceania | Developed Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health Facilities | Health | Medical Procedures | Medicine | Health Services | Viral Diseases | Diseases Document Number: 341013 |
| 4. Title: Emergency contraception - knowledge and attitudes in a group of Australian university students. Author: Calabretto H Source: Australian and New Zealand Journal of Public Health. 2009 Jun;33(3):234-9. Abstract: OBJECTIVE: To explore first year Australian university students' knowledge and attitudes about emergency contraception and their understanding of the risk for pregnancy. METHOD: A self-report questionnaire was completed by a convenience sample of 627 first year on-campus students from both health and non-health disciplines. RESULTS: Knowledge about emergency contraception (EC) was generally poor including misunderstanding that it can only be used the 'morning after', as well as where it may be accessed. Its potential use was, however, more highly accepted as a preventative measure after unprotected sexual intercourse than abortion in the event of unplanned pregnancy. Women had better knowledge than men, and on a number of measures there were significant differences between these groups. CONCLUSIONS: Poor knowledge about the timing, accessibility, action and side effects of EC may act as a barrier to its use in the event of unprotected sexual intercourse. Although EC has been available in Australia as a Schedule 3 medication since 2004, its availability from pharmacies is not well known, nor is access from other primary health care providers. Implications: The lack of knowledge about EC may lead to its underutilisation and underlines the need for future educational strategies about EC as well as the need for health professionals who provide contraceptive services to discuss EC with clients. Health promotion campaigns which are both general as well as gender-specific may improve overall community knowledge about this method of contraception. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | SAMPLING STUDIES | STUDENTS | UNIVERSITIES | EMERGENCY CONTRACEPTION | KNOWLEDGE | ATTITUDES | ABORTION | QUESTIONNAIRES | CONTRACEPTIVE METHOD ACCEPTABILITY | Oceania | Developed Countries | Studies | Research Methodology | Education | Schools | Contraception | Family Planning | Sociocultural Factors | Psychological Factors | Behavior | Fertility Control, Postconception | Contraceptive Usage Document Number: 342310 Notification |
| 5. Title: Factors influencing the duration of pregnancy termination with vaginal misoprostol for fetal abnormality. Author: Dickinson JE; Doherty DA Source: Prenatal Diagnosis. 2009 May;29(5):520-4. Abstract: OBJECTIVE: Evaluation of factors influencing the duration of second-trimester pregnancy interruption with vaginal misoprostol for fetal abnormality. METHODS: All medical terminations >or=13 weeks of gestation 1/1997 to 12/2007 were prospectively identified. Cases receiving vaginal misoprostol 400 microg 6-hourly were extracted from the database and outcomes reviewed. RESULTS: This consecutive case series comprised 1066 women. Median maternal age was 31 years [interquartile range (IQR) 26, 36] and 15.4% had at least one prior cesarean delivery. Principal indications for termination were aneuploidy (37.6%), neural tube defects (15.9%) and cardiac anomalies (9.4%). Median gestation at termination was 19.5 weeks (IQR 17.9, 21). Median abortion interval was 16.1 h (IQR 12, 23.5). Lower maternal age (median duration 17.6 vs 15.2 vs 13.6 h, age < 30 vs 30-39 vs > 40 years, p < 0.001), nulliparity (median duration 19 vs 14.3 h, nulliparous vs parous, p < 0.001) and increasing gestation (median duration 13 vs 17.8 h, <16 vs >20 weeks, p < 0.001) were associated with abortion prolongation. Controlling for gestation, age and parity, apart from musculoskeletal abnormalities (associated with abortion prolongation, p = 0.03), the specific fetal anomaly did not influence duration. CONCLUSIONS: Three factors: nulliparity, younger maternal age and increasing gestation, were associated with abortion prolongation. Apart from musculoskeletal abnormalities, the fetal anomaly had no impact on abortion duration. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | CONGENITAL ABNORMALITIES | ABORTION | MISOPROSTOL | TIME FACTORS | AGE FACTORS | NULLIPARITY | Oceania | Developed Countries | Neonatal Diseases and Abnormalities | Diseases | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Population Characteristics | Parity | Fertility Measurements | Fertility Document Number: 342614 Notification |
| 6. Peer Reviewed Title: The Relationship Between Rejection Sensitivity and Compliant Condom Use. Author: Edwards GL; Barber BL Source: Archives of Sexual Behavior. 2009 Sep 4; Abstract: Those who are rejection sensitive anxiously expect and readily perceive rejection. Rejection sensitivity is hypothesized to predict behavior; however, this link may be more evident in some contexts than others. The current study examined the link between rejection sensitivity and condom use. Australian young adults in romantic (n = 649, 70% female) and casual (n = 144, 76.2% female) relationship contexts completed measures on rejection sensitivity, condom use preferences, and condom use. Regression analysis showed that rejection sensitivity predicted condom use when participants' condom use preferences were at odds with those they thought their partner held. Specifically, highly rejection-sensitive individuals who preferred more frequent condom use reported using condoms less often, if that was what they thought their partners wanted. The results lend support to the model of rejection sensitivity in that individuals comply more with their perceived partner's preferences if they are more rejection-sensitive. The results also highlight the need to take the situational context into consideration when examining links between personality dispositions and behavior. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | STATISTICAL REGRESSION | YOUTH | CONDOM USE | SEX BEHAVIOR | DECISION MAKING | INTERPERSONAL RELATIONS | PERCEPTION | QUESTIONNAIRES | Oceania | Developed Countries | Data Analysis | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Behavior | Psychological Factors Document Number: 342840 |
| 7. Title: Previous abortion and risk of pre-term birth: a population study. Author: Freak-Poli R; Chan A; Tucker G; Street J Source: Journal of Maternal-Fetal and Neonatal Medicine. 2009 Jan;22(1):1-7. Abstract: OBJECTIVE: This population study was undertaken to determine whether previous abortion is an independent risk factor for pre-term birth and to calculate population-attributable risks for risk factors. METHODS: All South Australian first singleton births in 1998-2003 (n = 42 269) were included in a multivariable logistic regression analysis, comparing pre-term births with term births. RESULTS: Risk factors for pre-term birth were found to be: being indigenous, single, a smoker [adjusted odds ratio (AOR) 1.28, 95% confidence interval 1.17-1.41], age 40 years or older, reproductive technology assistance, threatened miscarriage, antepartum haemorrhage, urinary tract infection, pregnancy hypertension and suspected intra-uterine growth restriction. A previous spontaneous abortion was of borderline statistical significance, whereas a previous induced abortion (AOR 1.25, 1.13-1.40) was an independent risk factor. A dose-response relationship was found with increasing number of previous spontaneous or induced abortions. Population-attributable risks were highest for pregnancy hypertension (12.4%) and antepartum haemorrhage (9.2%). Smoking and previous induced abortion had risks of 4.7% and 2.7%, respectively. Among indigenous women, 51% of whom smoked, 16.4% of pre-term birth could be attributed to smoking. CONCLUSIONS: A previous induced abortion and smoking during pregnancy (particularly among indigenous women) are preventable risk factors for pre-term birth. Their population-attributable risks are likely to be under-estimates from under-reporting. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PREGNANT WOMEN | INDIGENOUS POPULATION | PREVALENCE | ABORTION | RISK ASSESSMENT | PREMATURE BIRTH | RISK FACTORS | REPRODUCTIVE TECHNOLOGIES | ABORTION, SPONTANEOUS | MATERNAL AGE | PREECLAMPSIA | Oceania | Developed Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Measurement | Fertility Control, Postconception | Family Planning | Evaluation | Pregnancy Outcomes | Pregnancy | Reproduction | Health | Pregnancy Complications | Diseases | Parental Age | Age Factors Document Number: 330718 Notification |
| 8. Title: Barriers to best outcomes in breastfeeding for Maori: mothers' perceptions, whanau perceptions, and services. Author: Glover M; Waldon J; Manaena-Biddle H; Holdaway M; Cunningham C Source: Journal of Human Lactation. 2009 Aug;25(3):307-16. Abstract: This research explores the perceptions of New Zealand Maori women and their whanau (customary Maori extended family) toward barriers to achieving best outcomes in infant feeding: exclusively breastfed infants at 6 months. Interviews are undertaken with 59 Maori women who have given birth in the previous 3 years and 27 whanau members. Although mothers and whanau members feel positively toward breastfeeding and generally expect to breastfeed exclusively, these expectations are unmet in many cases because of lack of support when establishing breastfeeding; lack of support when life circumstances change; lack of timely, culturally relevant, and comprehensible information; confusion about smoking while breastfeeding; uncertainty about the safety of bed-sharing, and perceived lack of acceptability of breastfeeding in public. The relatively high rates of tobacco use by Maori create a tension for breastfeeding mothers, cited by some as a reason for ending breastfeeding prematurely. Language: English Keywords: NEW ZEALAND | RESEARCH REPORT | MOTHERS | INFANT | BREASTFEEDING | TOBACCO USE | SAFETY | Oceania | Developed Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Behavior | Public Health Document Number: 342916 |
| 9. Title: Choosing medical or surgical terminations of pregnancy in the first trimester: what is the difference? Author: Goodyear-Smith F; Knowles A Source: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2009 Apr;49(2):211-5. Abstract: BACKGROUND: Women seeking termination of pregnancy in Auckland, New Zealand can chose between medical and surgical options up to eight weeks gestation. AIMS: To assess demographic differences or changes over time between proportions of women choosing medical or surgical abortions at a single centre and determine whether changing the mifepristone-misoprostol interval from two to one day impacted on outcomes. METHODS: Retrospective audit of two consecutive years (December 2005-November 2006 and December 2006-November 2007) of first-trimester surgical and medical terminations where the mifepristone-misoprostol interval was reduced from two to one day between years. Analysis using descriptive statistics and assessment of probability of observed differences between groups. RESULTS: A total of 1495 terminations were performed in 2005-2006 and 1588 in 2006-2007. No significant difference (P = 0.4) of eligible women choosing medical (21% and 23%) or surgical abortion between years. Ethnicity, age and residency status did not influence choice. Medical termination of pregnancy was more likely in women who were without previous children (P = 0.009), pregnancies (P = 0.02) or terminations (P = 0.04). Medical termination was similarly effective within six hours with either two- or one-day intervals. CONCLUSIONS: Both medical and surgical first-trimester abortions are safe and effective. It is optimal to be able to offer women choice. Reducing the medical interval to one day does not increase adverse outcomes. Language: English Keywords: NEW ZEALAND | RESEARCH REPORT | RETROSPECTIVE STUDIES | ABORTION | PREGNANCY, FIRST TRIMESTER | MISOPROSTOL | RU-486 | ADMINISTRATION AND DOSAGE | ANALGESIA | Oceania | Developed Countries | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Hormone Antagonists | Hormones | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342383 Notification |
| 10. Title: The effects of hormonal contraceptives on bone turnover markers and bone health. Author: Herrmann M; Seibel MJ Source: Clinical Endocrinology. 2009 Sep 9; Abstract: Abstract Sex hormones are important regulators of bone metabolism. As hormonal contraceptives contain either estrogens or progestins, or a combination thereof, it is conceivable that these widely used agents have an effect on bone metabolism and bone health. The main users of hormonal contraceptives, adolescent girls and young women, are still building bone and accruing bone mass and may therefore be particularly susceptible to the effects of hormonal contraceptives on bone. Despite these concerns, the effects of hormonal contraceptives on bone health are still poorly understood. As biochemical markers of bone turnover have been proven useful tools in the assessment and monitoring of bone metabolism, we reviewed the effects of combined and gestagen-only hormonal contraceptives on bone turnover markers and related effects on bone mineral density and fracture risk in premenopausal women, as documented in the literature until January 2009. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | ADOLESCENTS, FEMALE | SKELETAL EFFECTS | ORAL CONTRACEPTIVES | ORAL CONTRACEPTIVES, COMBINED | Oceania | Developed Countries | Demographic Factors | Population | Adolescents | Youth | Age Factors | Population Characteristics | Physiology | Biology | Contraceptive Methods | Contraception | Family Planning Document Number: 342760 |
| 11. Title: Breast cancer in young women and its impact on reproductive function. Author: Hickey M; Peate M; Saunders CM; Friedlander M Source: Human Reproduction Update. 2009 May-Jun;15(3):323-39. Abstract: BACKGROUND: Breast cancer is the most common cancer in women in developed countries, and 12% of breast cancer occurs in women 20-34 years. Survival from breast cancer has significantly improved, and the potential late effects of treatment and the impact on quality of life have become increasingly important. Young women constitute a minority of breast cancer patients, but commonly have distinct concerns and issues compared with older women, including queries regarding fertility, contraception and pregnancy. Further, they are more likely than older women to have questions regarding potential side effects of therapy and risk of relapse or a new primary. In addition, many will have symptoms associated with treatment and they present a management challenge. Reproductive medicine specialists and gynaecologists commonly see these women either shortly after initial diagnosis or following adjuvant therapy and should be aware of current management of breast cancer, the options for women at increased genetic risk, the prognosis of patients with early stage breast cancer and how adjuvant systemic treatments may impact reproductive function. METHODS: No systematic literature search was done. The review focuses on the current management of breast cancer in young women and the impact of treatment on reproductive function and subsequent management. With reference to key studies and meta-analyses, we highlight controversies and current unanswered questions regarding patient management. RESULTS: Chemotherapy for breast cancer is likely to negatively impact on reproductive function. A number of interventions are available which may increase the likelihood of future successful pregnancy, but the relative safety of these interventions is not well established. For those who do conceive following breast cancer, there is no good evidence that pregnancy is detrimental to survival. We review current treatment; effects on reproductive function; preservation of fertility; contraception; pregnancy; breastfeeding and management of menopausal symptoms following breast cancer. CONCLUSION: This paper provides an update on the management of breast cancer in young women and is targeted at reproductive medicine specialists and gynaecologists. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | BREAST CANCER | SURGERY | DRUGS | GENETICS | FERTILITY | CONTRACEPTION | PREGNANCY | BREASTFEEDING | MENOPAUSE | AGE FACTORS | TAMOXIFEN | Oceania | Developed Countries | Cancer | Neoplasms | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology | Population Dynamics | Demographic Factors | Population | Family Planning | Reproduction | Infant Nutrition | Nutrition | Population Characteristics | Fertility Agents | Reproductive Control Agents Document Number: 341960 |
| 12. Peer Reviewed Title: The emergency contraceptive pill rescheduled: a focus group study of women's knowledge, attitudes and experiences. Author: Hobbs M; Taft AJ; Amir LH Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):87-91. Abstract: BACKGROUND AND METHODOLOGY: The levonorgestrel-containing emergency contraceptive pill (ECP), amongst other strategies, has the potential to assist in reducing unintended pregnancy and abortion rates. Since the rescheduling of the ECP in January 2004 to over-the-counter (OTC) status from pharmacies in Australia, there is little information about Australian women's ECP knowledge, attitudes or practice. The aim of the study was to explore Australian women's knowledge of, attitudes towards and experiences of using the ECP, particularly since it has been available OTC. This paper reports a qualitative study using six focus groups, which were conducted between February and June 2007 in four Australian states with 29 women aged 16-29 years. RESULTS: Participants had a lack of specific knowledge about the ECP. Most were positive about the ECP being available OTC, however some expressed concerns about younger women misusing it. Women's experiences obtaining the ECP from the pharmacy were both positive and negative. Most women said they would use the ECP again if required and would recommend it to a friend. Pharmacists were seen as important suppliers of the ECP but women felt it was not their role to provide advice about contraception or sexually transmitted infections. DISCUSSION AND CONCLUSIONS: The findings from this study confirm views from other studies, which suggest that although women have some concerns in relation to OTC supply of the ECP, they believe that the deregulation of the ECP is a positive step. The data also suggest that women need to be provided with more information and education about the ECP. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | FOCUS GROUPS | WOMEN | EMERGENCY CONTRACEPTION | KNOWLEDGE | ATTITUDES | LEVONORGESTREL | CONTRACEPTIVE USAGE | CONTRACEPTIVE AVAILABILITY | AGE FACTORS | Oceania | Developed Countries | Data Collection | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Sociocultural Factors | Psychological Factors | Behavior | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Population Characteristics Document Number: 330948 |
| 13. Title: The spermostatic and microbicidal actions of quinones and maleimides: towards a dual purpose contraceptive agent. Author: Hughes LM; Griffith R; Carey A; Butler T; Donne SW; Beagley KW; Aitken RJ Source: Molecular Pharmacology. 2009 Mar 31; Abstract: There is an urgent need to develop safe, effective dual-purpose contraceptive agents that combine the prevention of pregnancy with protection against sexually transmitted disease. Here we report the identification of a group of compounds that on contact with human spermatozoa induce a state of 'spermostasis', characterized by the extremely rapid inhibition of sperm movement without compromising cell viability. These spermostatic agents were more active and significantly less toxic than the reagent in current clinical use, nonoxynol 9, giving therapeutic indices (ratio of spermostatic to cytotoxic activity) that were orders of magnitude greater than this traditional spermicide. Although certain compounds could trigger reactive oxygen species generation by spermatozoa, this activity was not correlated with spermostasis. Rather, the latter was associated with alkylation of two major sperm tail proteins that were identified as A Kinase Anchoring Proteins (AKAP3 and AKAP4) by mass spectrometry. As a consequence of disrupted AKAP function, the abilities of cAMP to drive PKA-dependent activities in the sperm tail such as the activation of SRC and the consequent stimulation of tyrosine phosphorylation, were suppressed. Furthermore, analysis of microbicidal activity using Chlamydia, revealed powerful inhibitory effects at the same low micromolar doses that suppressed sperm movement. In this case, the microbicidal action was associated with alkylation of MOMP, a major Chlamydial membrane protein. Taken together, these results have identified for the first time a novel set of cellular targets and chemical principles capable of providing simultaneous defense against both fertility and the spread of sexually transmitted disease. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | MICROBICIDES | SPERM IMMOBILIZING AGENTS | CONTRACEPTIVE AGENTS, FEMALE | SEXUALLY TRANSMITTED DISEASE PREVENTION | NONOXYNOL-9 | SPERMICIDAL CONTRACEPTIVE AGENTS | Oceania | Developed Countries | Research Methodology | Demographic Factors | Population | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases Document Number: 330928 |
| 14. Title: Innovative pediatric palliative care programs in four countries. Author: Knapp C; Madden V; Marston J; Midson R; Murphy A; Shenkman E Source: Journal of Palliative Care. 2009 Summer;25(2):132-6. Abstract: Over the past three decades, pediatric palliative care programs have been developed and refined throughout the world. The purpose of this study was to provide information on experiences from four of those programs, yet we acknowledge that there are many other innovative programs that deserve recognition for the services they provide to children and families. This study is limited in that it is unable to compare outcomes from the four programs, such as patient-reported quality of life, that might help to better understand the impact of pediatric palliative care. Nonetheless, information sharing can inspire and educate others with the overarching goal of globally advancing pediatric palliative care. Language: English Keywords: AUSTRALIA | SOUTH AFRICA | UNITED KINGDOM | UNITED STATES OF AMERICA | SUMMARY REPORT | CHILD HEALTH SERVICES | CARE AND SUPPORT | DELIVERY OF HEALTH CARE | IMPLEMENTATION | PROGRAM DESIGN | OBSTACLES | COUNSELING | REFERRAL AND CONSULTATION | FUNDS | Oceania | Developed Countries | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Europe, Western | Europe | North America | Americas | Maternal-Child Health Services | Primary Health Care | Health Services | Health | Programs | Organization and Administration | Clinic Activities | Program Activities | Financial Activities | Economic Factors Document Number: 342874 |
| 15. Peer Reviewed Title: Reasons for termination of pregnancy in women aged 35 and over [letter] Author: Lee W; Mazza D Source: Medical Journal of Australia. 2009 Aug 3;191(3):188-9. Abstract: This letter speaks about the reasons women aged 35 and over are terminating pregnancy in Melbourne, Australia. In addition to reasons for termination, it also includes the contraceptive methods used by the women prior to the pregnancy and determines that further qualitative research is needed to explore the women's understanding of fertility and pregnancy risk. Language: English Keywords: AUSTRALIA | CRITIQUE | RETROSPECTIVE STUDIES | ABORTION | AGE FACTORS | MOTIVATION | CONTRACEPTIVE METHODS CHOSEN | Oceania | Developed Countries | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Population Characteristics | Demographic Factors | Population | Psychological Factors | Behavior | Contraceptive Usage | Contraception Document Number: 342939 Notification |
| 16. Title: A text messaging trial in family planning clinics. Author: Mackenzie H Source: Studies In Health Technology and Informatics. 2009;146:154-9. Abstract: The New Zealand Family Planning Association (Family Planning) is a national not-for-profit organization providing sexual and reproductive primary care health services as well as health promotion, professional training and advocacy on issues of sexual and reproductive health. By 2006 Family Planning had become acutely aware of the increasing amount of staff time being used to make phone calls to clients, particularly about appointment reminders and laboratory results, and the associated escalation in telephone costs. Much of the increased cost related to the trend for the clients, who are predominantly under 25 year of age, to have only a mobile phone as their phone contact. This paper describes a project to identify and implement an alternative means of communication with these clients, with the outcome being the introduction of a text messaging program (txt2remind) integrated with the Practice Management System (Medtech 32) into clinics by June 2008. Language: English Keywords: NEW ZEALAND | RESEARCH REPORT | PRIMARY HEALTH CARE | FAMILY PLANNING | TELECOMMUNICATIONS | CONTACTING CLIENTS | Oceania | Developed Countries | Health Services | Delivery of Health Care | Health | Broadcast Media | Mass Media | Communication | Clients | Program Activities | Programs | Organization and Administration Document Number: 342050 |
| 17. Title: Sonographic appearances of the endometrium after termination of pregnancy in asymptomatic versus symptomatic women. Author: McEwing RL; Anderson NG; Meates JB; Allen RB; Phillipson GT; Wells JE Source: Journal of Ultrasound In Medicine. 2009 May;28(5):579-86. Abstract: OBJECTIVE: The purpose of this study was to describe normal sonographic appearances of the endometrium in asymptomatic women after elective termination of pregnancy (TOP) and to determine whether sonographic findings are discriminatory in symptomatic women after TOP. METHODS: Sonographic parameters were compared in prospectively recruited women after elective TOP. The first 38 were asymptomatic. In a later group, 105 had symptoms suggestive of retained products of conception (RPOC). Endometrial thickness, cavity irregularity, echogenicity of cavity contents, color Doppler flow, and resistive indices (RIs) were assessed. In the symptomatic group, sonographic findings were correlated with symptoms and histologic results. RESULTS: There was a marked overlap in sonographic appearances between the groups. The endometrial cavity is commonly irregular and thickened and may show prominent color Doppler flow in women with an uneventful course as well as in women with histologically proven RPOC. Differences between asymptomatic and symptomatic women were only seen for: endometrial thickness (10.8 mm [range, 1-29 mm] versus 15.3 mm [range, 1.8-34 mm]; P = .0005), and cavity irregularity was greater in symptomatic women (P = .001). Color Doppler flow mean RIs were similar. Symptoms were similar in women proceeding to curettage versus no curettage; no significant relationship was found between individual symptoms and sonographic parameters. Chorionic villi were seen in 47 of 56 women (84%) with positive histologic results. CONCLUSIONS: Sonographic appearances and symptoms correlate poorly with each other and with histologic results. Sonography has limited benefits in triaging women with suspected RPOC after TOP in the first trimester. Our findings support a more conservative approach to suspected RPOC after TOP. Language: English Keywords: NEW ZEALAND | RESEARCH REPORT | COMPARATIVE STUDIES | CLIENTS | PREGNANCY, FIRST TRIMESTER | ABORTION | CURETTAGE | PRODUCTS OF CONCEPTION, RETENTION | SIGNS AND SYMPTOMS | ENDOMETRIAL EFFECTS | ULTRASONICS | HISTOLOGY | Oceania | Developed Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy Complications | Diseases | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 341998 Notification |
| 18. Title: Outcomes for subsequent pregnancy in women who have undergone misoprostol mid-trimester termination of pregnancy. Author: Mirmilstein V; Rowlands S; King JF Source: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2009 Apr;49(2):195-7. Abstract: In Australia, the most common method of mid-trimester termination of pregnancy (TOP) is by medical induction with the prostaglandin E 1 analog misoprostol. This study was undertaken to compare the pregnancy outcomes of women who had undergone a misoprostol mid-trimester TOP in their last pregnancy with those of a similar cohort of women without a history of misoprostol TOP. This study suggests a possibility that medical mid-trimester TOP with misoprostol increases the risk of preterm or very preterm delivery in a subsequent pregnancy but larger studies are needed to confirm or dismiss this. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | CONTROL GROUPS | WOMEN | PREGNANCY OUTCOMES | ABORTION | MISOPROSTOL | PREMATURE BIRTH | RISK FACTORS | Oceania | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Health Document Number: 342384 Notification |
| 19. Title: Knowledge of emergency contraception amongst tertiary students in far North Queensland. Author: Mohoric-Stare D; DE Costa C Source: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2009 Jun;49(3):307-11. Abstract: BACKGROUND: Emergency contraception (EC) has been available in Australia without prescription since 2003. However, there has been little research into the extent of knowledge of the actions, effectiveness and availability of EC among the general population. AIMS: To determine the extent of knowledge of EC among tertiary students in Far North Queensland, and their ability to access EC in the region. METHODS: A questionnaire was distributed to tertiary students in Cairns asking about their knowledge of EC, its effectiveness and its availability over-the-counter in pharmacies, as well as their willingness to access EC themselves if indicated, in settings in which they may be known, and in those where they would be unknown. RESULTS: Of 500 questionnaires 460 were returned; 29% of participants had used EC in the past. Only 20% understood the correct timeframe in which EC can be used; 40% were not aware of its availability over-the-counter in pharmacies, and more than 20% felt unable to purchase EC in a pharmacy where they could be recognised. Only 44% of participants were aware of the cost of EC. CONCLUSION: A significant lack of information regarding the availability, methods of action and limitations of EC was noted in this well-educated population. There was also a high proportion of participants who felt unable to access EC in a pharmacy where they might be known, a factor limiting accessibility of the method in small town and community settings. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | STUDENTS | EMERGENCY CONTRACEPTION | KNOWLEDGE | QUESTIONNAIRES | CONTRACEPTIVE AVAILABILITY | CONTRACEPTIVE EFFECTIVENESS | AWARENESS | Oceania | Developed Countries | Education | Contraception | Family Planning | Sociocultural Factors Document Number: 341798 |
| 20. Title: Fear and fertility in inflammatory bowel disease: a mismatch of perception and reality affects family planning decisions. Author: Mountifield R; Bampton P; Prosser R; Muller K; Andrews JM Source: Inflammatory Bowel Diseases. 2009 May;15(5):720-5. Abstract: BACKGROUND: Smaller family size and voluntary childlessness has been reported in IBD; however, the disease-related reasons for this from a patient viewpoint are not described. The aims were to 1) determine whether IBD patients' perceptions of the issues surrounding IBD, pregnancy, and childbearing influence their reproductive behavior, and 2) describe these specific perceptions and concerns related to fertility and pregnancy. METHODS: All contactable subjects between 18-50 years of age from a hospital-based IBD database were surveyed by postal questionnaire. Data were obtained regarding age, gender, IBD diagnosis and treatment, body image and sexual relationships, as well as both objective and subjective data regarding fertility and pregnancy. Comparisons were made to community norms where data were available. Contingency tables with Fisher's exact test were used. RESULTS: Of 365 subjects, 255 responded (70%). The mean age was 35.5 years overall, 34.7 years for women. In all, 34% of participants were male, 127 had Crohn's disease (CD), 85 ulcerative colitis (UC), and 5 indeterminate colitis (IC). The average fertility rate was no different between women with CD and UC (1.0 and 1.2 births/woman, respectively; P = 0.553), compared with 1.81 for all Australian women. Although 42.7% of IBD patients reported a fear of infertility, patients only sought medical fertility advice at the same rate as the general population. Fear of infertility was most evident in women, those with CD, and those reporting previous surgery. Specific patient concerns, which appear to have decreased patients' family size, included IBD heritability, the risk of congenital abnormalities, and medication teratogenicity. CONCLUSIONS: The unusually high response rate indicates the centrality of reproductive issues to IBD patients. "Voluntary" childlessness in this group appears to result from concerns about adverse reproductive outcomes that may not be justified. Patients require accurate counseling addressing fertility and pregnancy outcomes in IBD to assist in their decision making. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | SURVEYS | CLIENTS | GASTROINTESTINAL EFFECTS | PERCEPTION | FEAR | PREGNANCY | FERTILITY | CONGENITAL ABNORMALITIES | VOLUNTARY CHILDLESSNESS | Oceania | Developed Countries | Sampling Studies | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Physiology | Biology | Psychological Factors | Behavior | Emotions | Reproduction | Population Dynamics | Demographic Factors | Population | Neonatal Diseases and Abnormalities | Diseases | Reproductive Behavior Document Number: 342482 |
| 21. Peer Reviewed Title: Does readily available emergency contraception increase women's awareness and use? Author: Novikova N; Weisberg E; Fraser IS Source: European Journal of Contraception and Reproductive Health Care. 2009 Feb;14(1):39-45. Abstract: BACKGROUND: In Australia just over half of all women of reproductive age have experienced an unplanned pregnancy, many of which could have been avoided by use of emergency contraception. A dedicated emergency contraceptive pill (ECP) pack became available on prescription in Australia in 2002, and over the counter in 2004. OBJECTIVES: To determine if availability of a dedicated over the counter ECP pack in Australia increased knowledge and use of emergency contraception (EC). MATERIAL AND METHODS: Women attending three free-standing abortion clinics in Sydney answered an anonymous questionnaire on their knowledge and use of the ECP. Group 1 (208 women) was recruited prior to a dedicated ECP pack being available, group 2 (308) after it was available on prescription, and group 3 (202) after it became available over the counter. RESULTS: Women who had heard about EC were significantly younger (p < 0.005). The mean age of women who had never heard about EC was 29.8 years compared to 26.3 for women who had heard about EC. More women expressed awareness of the ECP after it became available over the counter. Women in group 2 attained a higher educational level than women in the other groups (p < 0.005). There was a significant trend to increased use of the ECP in women of higher educational level (p < 0.005). The use of EC did not increase significantly with improved availability and access. CONCLUSIONS: Among women seeking termination of pregnancy wider availability of the ECP has increased women's awareness of EC but not use. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | KAP SURVEYS | WOMEN | CONTRACEPTIVE USAGE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | PHARMACY DISTRIBUTION | CONTRACEPTIVE DISTRIBUTION | KNOWLEDGE | CONTRACEPTIVE PREVALENCE | AGE FACTORS | EDUCATIONAL STATUS | Developed Countries | Oceania | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Sociocultural Factors | Population Characteristics | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 330346 |
| 22. Title: Internal or infernal devices: experiences of contraception among Australian women living with hepatitis C. Author: Olsen A; Banwell C; Dance P Source: Health Care For Women International. 2009 Jun;30(6):456-74. Abstract: In this article we seek to delineate the experiences of contraceptive use by Australian women living with hepatitis C. Using semi-structured, in-depth interviews, 109 women with hepatitis C from two cities in Australia, Melbourne (Victoria) and Canberra (the Australian Capital Territory), were interviewed about their alcohol and other drug use, their contraceptive history, and their experiences of hepatitis C. We aimed to understand why such a high proportion of women living with hepatitis C (66%) had previously reported that they were not currently using contraception. Many women had used contraception at some stage of their lives but were no longer using it because they had experienced contraceptive failure or uncomfortable side effects. Others were concerned about the impact of contraception on their fertility, were planning to get pregnant or considered themselves to be celibate. Hepatitis C appeared to have little impact on their contraceptive practices, but some women's illicit drug use had an important influence. Illicit drug use was, for some, an encouragement to seek long-term forms of contraception that reduced their chances of pregnancy while for others drug taking hampered their contraceptive use. In compliance with health promotion campaigns of the last two decades, women were generally more concerned about preventing sexually transmissible infections than pregnancies, particularly with new or casual partners. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | INTERVIEWS | WOMEN | HEPATITIS | CONTRACEPTION FAILURE | CONTRACEPTIVE USAGE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | PREGNANCY | SEXUALLY TRANSMITTED DISEASE PREVENTION | PREVENTION AND CONTROL | Oceania | Developed Countries | Data Collection | Research Methodology | Demographic Factors | Population | Viral Diseases | Diseases | Contraception | Family Planning | Contraceptive Agents | Reproduction | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections Document Number: 341019 |
| 23. Peer Reviewed Title: A nationwide cohort study of the use of the levonorgestrel intrauterine device in New Zealand adolescents. Author: Paterson H; Ashton J; Harrison-Woolrych M Source: Contraception. 2009 Jun;79(6):433-8. Abstract: BACKGROUND: While the use of the levonorgestrel intrauterine device (LNG-IUD) is well established in the adult population, there have been no research studies specifically on the use of the LNG-IUD in adolescents. STUDY DESIGN: A nationwide cohort study of 179 adolescents in New Zealand using the LNG-IUD, by means of a follow-up questionnaire to their practitioner, was conducted to determine the indications for insertion of the LNG-IUD and to establish patterns of use, including duration of use and reasons for removal. RESULTS: The study, with a 94% response rate, demonstrated that the most common indication for use was menorrhagia (17%); 29% of adolescents had an "off-label" primary indication. There was a 1-year continuation rate of 85%. The cumulative incidence of expulsion was 8%. CONCLUSION: The results of this study should be reassuring for practitioners and adolescents considering use of the LNG-IUD. However, further research is required into the safety and efficacy of the LNG-IUD in adolescents especially in the management of off-label indications. Language: English Keywords: NEW ZEALAND | RESEARCH REPORT | COHORT ANALYSIS | ADOLESCENTS | IUD | INSERTION | MENORRHAGIA | SIGNS AND SYMPTOMS | Oceania | Developed Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Menstruation Disorders | Diseases Document Number: 342600 |
| 24. Title: A survey of New Zealand RANZCOG Fellows on their use of the levonorgestrel intrauterine device in adolescents. Author: Paterson H; Miller D; Devenish C Source: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2009 Apr;49(2):220-5. Abstract: BACKGROUND: The levonorgestrel intrauterine device (LNG-IUD) is an established treatment for adult women. Although it is being used in adolescents, there is little published research in this age group to date. Recent reviews and editorials have challenged the long-held views that intrauterine devices should not be used in young women. AIMS: This study aimed to identify the patterns of use, including indications and contraindications of the LNG-IUD in adolescents by RANZCOG Fellows practising in New Zealand. METHODS: A postal survey of New Zealand RANZCOG Fellows on their use of the LNG-IUD in females aged 10-19 years. RESULTS: There was a 72% response rate. Half of the respondents had inserted the LNG-IUD in adolescents. Non-inserters identified a significantly greater number of contraindications than inserters (chi2, P < 0.0001). Over half of those respondents who had inserted a device in an adolescent did so fewer than three times per year. Intellectual disability and endometriosis, both unlicensed indications, were the two most commonly identified circumstances for insertion by respondents. CONCLUSIONS: Patterns of insertion of the LNG-IUD in adolescents by RANZCOG Fellows in New Zealand differ and there was equipoise over its use. Further research is required to establish the efficacy, safety and acceptability of the LNG-IUD in adolescents. Language: English Keywords: NEW ZEALAND | RESEARCH REPORT | SURVEYS | PHYSICIANS | ADOLESCENTS, FEMALE | IUD, HORMONE RELEASING | LEVONORGESTREL | CONTRAINDICATIONS | INSERTION | ENDOMETRIOSIS | MENTAL RETARDATION | QUESTIONNAIRES | Oceania | Developed Countries | Sampling Studies | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Treatment | Medical Procedures | Medicine | Health Services | Diseases | Intelligence | Personality | Psychological Factors | Behavior Document Number: 342382 |
| 25. Peer Reviewed Title: Longitudinal study of self-reported sexually transmitted infection incidence by gender and age up to age thirty-two years. Author: Paul C; van Roode T; Herbison P; Dickson N Source: Sexually Transmitted Diseases. 2009 Feb;36(2):63-9. Abstract: OBJECTIVES: To examine how incidence of self-reported sexually transmitted infections (STIs) varies by gender and age, and the factors that influence this. METHODS: A longitudinal study of a cohort born in Dunedin, New Zealand in 1972/1973. They were questioned about STIs and sexual behavior at age 21, 26, and 32 years (1993-2005). Incidence rates were calculated over 3 age periods and compared using Poisson regression. RESULTS: Of the 1037 members of the original cohort, 92% or more of survivors completed the computer questionnaire at each age. Incidence rates of STIs from first coitus to age 21, age 21 to 26, and age 26 to 32, were 2.0, 3.2, and 2.0 per 100 person-years, respectively for men and 4.4, 3.0, and 1.4 per 100 person-years, respectively for women. After adjustment for sexual behavior, rates for men were elevated from age 21 to 26 compared with first coitus to 21 years of age [incidence rate ratio (IRR) = 1.9, 95% confidence interval (CI) 1.3 to 2.8), but not from age 26 to 32 (IRR = 1.1, 95% CI 0.70-1.9). For women, adjusted rates decreased with age; from 21 to 26 compared with first coitus to 21 (IRR = 0.79, 95% CI 0.56-1.1) and further from 26 to 32 (IRR = 0.39, 95% CI 0.27-0.57). CONCLUSIONS: These unique data, comprising repeated assessment of reported behaviors and STIs in the same population, show that the period before age 21 is a time of special risk for STIs for women and of lower risk for men. The low risk among women aged 26 to 32 years after adjustment for sexual behavior warrants further investigation. Language: English Keywords: NEW ZEALAND | RESEARCH REPORT | KAP SURVEYS | EPIDEMIOLOGIC METHODS | COHORT ANALYSIS | LONGITUDINAL STUDIES | ADULTS | SEXUALLY TRANSMITTED DISEASES | SEX FACTORS | AGE FACTORS | SEX BEHAVIOR | RISK BEHAVIOR | PREVALENCE | Developed Countries | Oceania | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Behavior | Measurement Document Number: 330400 |
| 26. Title: Contraception and pregnancy then and now: examining the experiences of a cohort of mid-age Australian women. Author: Read C; Bateson D; Weisberg E; Estoesta J Source: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2009 Aug;49(4):429-33. Abstract: BACKGROUND: More than 50% of women who have an unplanned pregnancy report using a contraceptive method. Since the launch of the pill 50 years ago, a number of cross-sectional surveys have examined contraceptive use in the Australian context. There is, however, little data on contraceptive use and efficacy over a woman's reproductive years. AIM: To determine the pattern of contraceptive use of Australian women over their reproductive lifespan, with particular emphasis on the relationship between contraceptive use and pregnancy. METHOD: One thousand women from the mid-age cohort of the Australian Women's Longitudinal Study were invited to participate in the Family Planning survey by completing a questionnaire about their reproductive histories. RESULTS: Completed questionnaires were received for 812 women. The contraceptive pill was the most commonly ever used contraceptive method at 94% and also the most commonly used method prior to all pregnancies. Contraceptive failure increased with increasing gravidity; 11.4% with the first pregnancy to 23.0% with the fourth pregnancy, while 28.8% of the respondents reported an 'accidental' pregnancy due to stopping contraception for reasons such as concern about long-term effects and media stories. CONCLUSIONS: While surveys indicate that 66-70% of Australian women use a contraceptive method, more than half of unplanned pregnancies apparently occur in women using contraception. The modern Australian woman, in common with her predecessors, still faces significant challenges in her fertility management. This survey provides a longitudinal perspective on contraceptive use in relation to pregnancy and highlights the issue of efficacy of contraceptives in real-life situations. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | COHORT ANALYSIS | WOMEN | PREGNANCY, UNPLANNED | PREGNANCY | CONTRACEPTION | AGE FACTORS | Oceania | Developed Countries | Research Methodology | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Reproduction | Family Planning | Population Characteristics Document Number: 342556 |
| 27. Title: Effect of oral contraceptive cycle phase on performance in team sport players. Author: Rechichi C; Dawson B Source: Journal of Science and Medicine In Sport / Sports Medicine Australia. 2009 Jan;12(1):190-5. Abstract: The purpose of this study was to examine whether common team sport performance variables (anaerobic power, reactive strength and repeat sprint ability) are affected by acute hormonal fluctuation within a monophasic oral contraceptive (OC) cycle. Ten female team sport athletes completed performance tests at three time points of a single OC cycle, during the consumption phase (CONS), early (WITH1) and late in the withdrawal phase (WITH2). Tests included drop jumps (30cm and 45cm heights), a counter movement jump, a 10s cycle sprint test and a 5x 6s repeated sprint cycle test. Resting endogenous serum oestradiol and progesterone concentrations were also measured. No significant differences were observed between phases for the counter movement jump and cycle tests (total work and peak power). Reactive strength measured from the 30cm drop height was significantly lower during WITH2 (162+/-38cms(-1)) compared to both CONS (177+/-44cms(-1)) and WITH1 (178+/-40cms(-1)) (p<0.05). Reactive strength measuredfrom the 45cm drop height was significantly higher in CONS (178+/-48cms(-1)) compared to both WITH1 and WITH2 (161+/-39cms(-1) and 158+/-29cms(-1), respectively) (p<0.05). Serum oestradiol levels were greater during WITH2 compared to both WITH1 and CONS (p<0.05) but there was no difference in serum progesterone levels. The results demonstrate that for female team sport athletes, only reactive strength varied significantly throughout an OC cycle, possibly due to the action of hormones on neuromuscular timing and the stretch-shortening cycle. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | ATHLETES | SPORTS | LOW-DOSE PROGESTINS | ORAL CONTRACEPTIVES | MUSCULAR EFFECTS | Oceania | Developed Countries | Population Characteristics | Demographic Factors | Population | Social Behavior | Behavior | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Methods | Physiology | Biology Document Number: 341744 |
| 28. Peer Reviewed Title: The 'problem' of Asian women's sexuality: public discourses in Aotearoa/New Zealand. Author: Simon-Kumar R Source: Culture, Health and Sexuality. 2009 Jan;11(1):1-16. Abstract: Public health research in New Zealand views Asian health - particularly, Asian women's sexual health issues - as a priority problem. In recent years, high rates of abortion and the growing incidence of unsafe sex among younger age Asian migrants have been publicized as a health concern. Public health research implicates migrant experiences and cultural factors as responsible for these trends. Loneliness and isolation among international students, inability to communicate effectively in English and lack of knowledge of available services are highlighted as reasons for the growing sexual ill-health in the Asian population in New Zealand. Extending from these, public health measures aim at improving culture-sensitive services, including targeted education. The present paper offers a critical commentary on these accepted public health perceptions that inform policy in New Zealand. It takes a Third World feminist approach to critique dominant public health discourses on Asian women's sexuality and questions the construction of knowledges about what are 'normal' and 'pathological' sexual practices. The paper revisits the data used to describe the 'problem' of Asian sexuality and argues that in order to understand sexual practices, it is important to query the cultural lenses that are used to describe and define them. Language: English Keywords: NEW ZEALAND | CRITIQUE | EVALUATION | ASIANS | WOMEN | IMMIGRANTS | ETHNIC GROUPS | SEXUALITY | SEX BEHAVIOR | RISK BEHAVIOR | ABORTION RATE | CULTURE | PSYCHOSOCIAL FACTORS | PUBLIC OPINION | FEMINISM | Oceania | Developed Countries | Cultural Background | Population Characteristics | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Personality | Psychological Factors | Behavior | Fertility Control, Postconception | Family Planning | Sociocultural Factors | Attitudes Document Number: 341121 |
| 29. Title: Pregnancy and protection: perceptions, attitudes and experiences of Australian female adolescents. Author: Skinner SR; Smith J; Fenwick J; Hendriks J; Fyfe S; Kendall G Source: Women and Birth. 2009 Jun;22(2):50-6. Abstract: BACKGROUND AND PURPOSE: Despite decades of research, development and evaluation of educational and promotional strategies to prevent teenage pregnancy, we have only a limited understanding of the strategies that are effective and why. This study sought to explore female teenagers' attitudes, perceptions and experiences of contraceptive use, and describe the influence of this on pregnancy risk. METHODS: A qualitative approach was used to explore the contraceptive behaviour in a purposive sample of sexually active Australian females aged 14-19 years. Teenagers were drawn from three sub-groups: antenatal and postnatal services (pregnant-continuing); termination services (pregnant-terminating); and sexual health clinics (never-pregnant). Sixty-eight individual, semi-structured interviews were conducted. Thematic analysis was employed to analyse the data and generate a rich, description of contraceptive behaviour. RESULTS: Whilst participants were familiar with contraception, many used it inconsistently. Commitment to pregnancy prevention was firmly located within participants' attitudes toward teenage pregnancy and parenthood, perceptions of pregnancy risk and perceptions of the costs and benefits of using contraception. Further, motivation to use contraception fluctuated in different contexts, such as romantic relationships. CONCLUSIONS: Our research highlights the importance of attitudes toward contraception, pregnancy and parenthood in shaping teenagers' motivation to use contraception. Educational and prevention programs must address the spectrum of attitudes underlying teenagers' contraceptive and reproductive decisions in order to alter pathways to teenage pregnancy and early parenting. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | QUALITATIVE RESEARCH | ADOLESCENTS, FEMALE | CONTRACEPTIVE USAGE | CONDOM USE | ADOLESCENT PREGNANCY | ATTITUDES | PERCEPTION | INTERVIEWS | ALCOHOL USE AND ABUSE | CONTRACEPTIVE USAGE DETERMINANTS | MOTIVATION | Oceania | Developed Countries | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Risk Reduction Behavior | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Psychological Factors | Data Collection Document Number: 342480 |
| 30. Peer Reviewed Title: Validation of an Integrated Management of Childhood Illness algorithm for managing common skin conditions in Fiji. Author: Steer AC; Tikoduadua LV; Manalac EM; Colquhoun S; Carapetis JR; Maclennan C Source: Bulletin of the World Health Organization. 2009 Mar;87(3):173-9. Abstract: OBJECTIVE: To assess the sensitivity of an Integrated Management of Childhood Illness (IMCI) algorithm to detect common skin conditions in children in Fiji. METHODS: We collected data from the assessments of children aged between 2 months and 5 years who presented to one of two health clinics. Every child was assessed by a nurse trained in the use of the IMCI algorithm and also an expert paediatrician. We used a kappa statistic to measure agreement between the nurse/algorithm assessment method and the paediatrician's diagnosis. FINDINGS: High sensitivity for identifying skin problems (sensitivity: 98.7%; 95% confidence interval, CI: 95.5-99.9) was found for the algorithm applied by IMCI-trained nurses, who were able to identify the one child with a severe skin infection and all three children with periorbital cellulitis. Sensitivity was high for the classification of abscess/cellulitis (sensitivity: 95%; 95% CI: 75.1-99.9) and infected scabies (sensitivity: 89.1%; 95% CI: 77.8-95.9), but lower for identification of impetigo, fungal infection and, in particular, non-infected scabies. CONCLUSION: The IMCI skin algorithm is a robust tool that should be incorporated into the IMCI after some modifications relating to scabies and impetigo. Its use by primary health-care workers will reduce the burden of skin diseases in children in Fiji through improved case identification and management. The algorithm should be considered in other countries where skin diseases in children are a priority, particularly in the Pacific region. Language: English Keywords: FIJI | EVALUATION REPORT | NURSES AND NURSING | PHYSICIANS | DERMATOLOGICAL EFFECTS | CHILD HEALTH SERVICES | INTEGRATED PROGRAMS | SIGNS AND SYMPTOMS | PHYSICAL EXAMINATIONS AND DIAGNOSES | TREATMENT | TRAINING ACTIVITIES | Developing Countries | Oceania | Evaluation | Health Personnel | Delivery of Health Care | Health | Physiology | Biology | Maternal-Child Health Services | Primary Health Care | Health Services | Programs | Organization and Administration | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Training Programs | Education Document Number: 342353 |
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