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Abstract Background Hepatitis B infection is a major public health concern in Vanuatu, with approximately 9% of the general population estimated to be living with chronic hepatitis B. Most new infections are due to mother-to-child transmission (MTCT). Hepatitis B vaccination is available in Vanuatu, but coverage rates for first dose within 24 h of birth and third dose are suboptimal. While treatment of chronic hepatitis B infection with tenofovir disoproxil fumarate (TDF) is available in country, there is no capacity to test hepatitis B e antigen and limited capacity to test hepatitis B virus (HBV) DNA viral load, which is a current eligibility requirement for women in pregnancy to access hepatitis B prophylaxis for MTCT per National guidelines. Recently, the World Health Organization guidelines have been updated to recommend universal peripartum antiviral prophylaxis (PAP) of pregnant women living with hepatitis B to prevent MTCT of HBV, without assessment of viral load in places without access to testing. However, these recommendations are conditional based on low-certainty evidence. The aim of this trial is to evaluate the effectiveness and safety of universal PAP and provide evidence for the global guidelines. Methods A single arm field trial compared to real world control sites will be conducted in Vanuatu involving pregnant women attending antenatal care services with positive HBsAg rapid tests. Participants at the control sites will undergo routine care. Participants at the intervention sites will all receive oral TDF prophylaxis from second trimester to completion of infant primary hepatitis B vaccination schedule. Primary data analysis will be by intention-to-treat. Initial analyses will be unadjusted comparisons of the intervention sites and control sites. Adjusted analyses will be performed, as needed, and presented in addition to unadjusted comparisons. Discussion This study will provide evidence of acceptability, effectiveness and cost-effectiveness of prophylaxis for all women with hepatitis B during pregnancy, as per the updated WHO guidelines, compared with current practice. The outcome of this trial will provide critical information to inform national and global guidelines around universal peripartum antiviral prophylaxis for hepatitis B during pregnancy. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN: ACTRN12623001202651p. Registered 21 November 2023.

Abstract Background Community health workers (CHWs) had important roles mitigating the impact of the COVID-19 pandemic in vulnerable communities. We described how CHWs supported the dissemination of COVID-19 information and services during the early pandemic response. Methods Online article searches were conducted across five scientific databases, with review article reference lists hand searched to identify grey/unpublished literature. Articles were included if they reported on a program that engaged CHWs and aimed to prevent/control COVID-19. Results Nineteen relevant programs were identified from 18 included articles. CHWs were widely engaged in the pandemic response, especially in low- and middle-income countries and in vulnerable communities. CHWs’ ability to effectively disseminate COVID-19 information/services was enabled by community trust and understanding community needs. CHWs were often underfunded and required to work in difficult conditions. Pre-existing services incorporating CHWs rapidly adapted to the new challenges brought by the pandemic. Conclusions We recommend establishing programs that employ CHWs to disseminate health information and services in communities at-risk of misinformation and poor health outcomes during non-pandemic times. CHWs are well-placed to deliver interventions should an infectious disease outbreak arise. Having pre-existing trusted relationships between CHWs and community members may help protect vulnerable groups, including when outbreaks occur.

Summary: Background: The Northern Territory (NT) has the highest prevalence of chronic hepatitis B (CHB) in Australia. The Hep B PAST program aims to improve health outcomes for people living with CHB. Methods: This mixed methods study involves First Nations peoples living in the NT. We used participatory action research principles across three steps: 1. Foundation step: establishing hepatitis B virus (HBV) status and linkage to care; 2. Capacity building: training the health workforce; 3. Supported transition to primary healthcare: implementation of the “Hub and Spoke” model and in-language resources. Analysis occurred at three time points: 1. Pre-Hep B PAST (2018); 2. Foundation step (2020); and 3. Completion of Hep B PAST (2023). Evaluation focuses on four key indicators, the number of people: 1) with documented HBV status; 2) diagnosed with CHB; 3) receiving care; and 4) receiving treatment. Findings: Hep B PAST (2018–23) reached 40,555 people. HBV status was documented in 11% (1192/10,853), 79.2% (26,075/32,915) and 90.8% (28,675/31,588) of people at pre-Hep B PAST, foundation step, and completion respectively. An estimated 99.9% (821/822) of people were diagnosed, 86.3% (709/822) engaged in care, and 24.1% (198/822) on antiviral treatment at completion. CHB prevalence in the study population is 2.6%, decreasing from 6.1% to 0.4% in the pre- and post-vaccination cohorts. Interpretation: Hep B PAST is an effective model of care. Partner health services are exceeding elimination targets. This model could enable other countries to enhance the cascade of care and work towards eliminating HBV. Funding: National Health and Medical Research Council.

Abstract Background The cohealth Health Concierge program operated in Melbourne, Australia from July 2020 to 30 June 2022. It provided peer-to-peer support to culturally and linguistically diverse residents of high-rise public housing. During this time, the COVID-19 public health response changed frequently and included movement restriction, testing and vaccination. We conducted a mixed-methods evaluation to determine the Health Concierge program’s impact on residents’ engagement with health services and public health activities. Methods The evaluation, informed by a Project Reference Group, used the RE-AIM framework. We analysed data from 20,901 routinely collected forms describing interactions between Concierges and residents from August 2021 to May 2022. Additional evaluation-specific data were collected between March and May 2022 in four housing estates; we surveyed 301 residents and conducted 32 interviews with residents, Concierges and program stakeholders. Results Concierges promoted COVID-safe behaviours; linked residents with support, testing and vaccination services; and disseminated up-to-date information. Of the 20,901 recorded interactions, 8,872 (42%) included Concierges providing support around COVID-19 vaccination. Most surveyed residents (191/301, 63%) reported speaking with a Concierge in the previous six months. The self-reported two-dose COVID-19 vaccine uptake was 94% (283/301). Some residents described having meaningful, appreciated conversations with Concierges, and some described superficial interactions. While residents initially welcomed the program, many felt it failed to evolve. Poorly defined management and hiring criteria led to variable program implementation. A need for bicultural workers to continue linking residents with services was discussed. Conclusions Concierges’ impact on residents may have contributed to high community uptake of COVID-19 testing and vaccination, and had benefits beyond the COVID-19 remit. We recommend the program be revised and continued to inform further preparedness planning and support service access generally. Program models such as this have potential to inform and reassure high-risk communities during a pandemic. In addition, such programs can help overcome vaccine hesitancy and promote protective health behaviours, regardless of whether a pandemic is currently occurring. Ensuring these programs remain responsive to the changing needs of end-users needs over time is imperative.

Abstract Background Hepatitis B is a chronic viral infection, a leading cause of primary liver cancer and identified as a major public health priority by the World Health Organization. Despite a high proportion of people in Australia who have been diagnosed with hepatitis B, significant gaps remain in health care access and in accurate knowledge about hepatitis B. Most people with hepatitis B in Australia were born in China, where the infection has an intergenerational impact with significant social implications resulting from the infection. Understanding how people of Chinese ethnicity with hepatitis B understand and respond to hepatitis B is imperative for reducing morbidity, mortality, and the personal and social impact of the infection. Methods Qualitative semi-structured interviews with people with hepatitis B of Chinese ethnicity recruited through a specialist service identified the advice people with hepatitis B thought was important enough to inform the experience of people newly diagnosed with hepatitis B. A thematic analysis of the data privileged the lived experience of participants and their personal, rather than clinical, explanations of the virus. Results Hepatitis B infection had psychological and physical consequences that were informed by cultural norms, and to which people had responded to with significant behavioural change. Despite this cohort being engaged with specialist clinical services with access to the most recent, comprehensive, and expert information, much of the advice people with hepatitis B identified as important for living with hepatitis B was not based on biomedical understandings. Key suggestions from people with hepatitis B were to form sustainable clinical relationships, develop emotional resilience, make dietary changes, regulate energy, and issues related to disclosure. Conclusions The study highlights conflicts between biomedical and public health explanations and the lived experience of hepatitis B among people of Chinese ethnicity in Australia. Beliefs about hepatitis B are embedded within cultural understandings of health that can conflict with bio-medical explanations of the infection. Acknowledging these perspectives provides for insightful communication between health services and their clients, and the development of nuanced models of care informed by the experience of people with hepatitis B.

Abstract Objective: To measure progress towards Australia's National Hepatitis B Strategy 2014–17 targets, and assess geographic variation in disease burden and access to care for those living with chronic hepatitis B (CHB). Methods: Data were generated from routinely collected sources, including risk‐group prevalence and population data, infectious diseases notifications, Medicare records, and immunisation registry data, and assessed nationally and according to geographic area for 2013–15. Results: CHB prevalence in 2015 was 239,167 (1.0%), with 62% of those affected having been diagnosed (target 80%). Treatment uptake was 6.1% (target 15%), and only 15.3% of people with CHB received guideline‐based care. CHB prevalence ranged within Australia's 31 Primary Health Networks (PHNs) from 1.77% (NT) to 0.56% (Grampians & Barwon South West VIC). No PHN reached the 15% treatment target, with uptake highest in South Western Sydney (13.7%). Immunisation coverage reached the 95% target in three PHNs. Conclusions: The CHB burden in Australia is significant and highly geographically focused, with notable disparities in access to care across Australia. Implications for public health: Efforts to improve progress toward National Strategy targets should focus on priority areas where the prevalence of CHB is substantial but access to treatment and care remains low.

The study assessed whether a nursing intervention based on selfregulation theory, the Attentional Focus and Symptom Management Intervention (AFSMI), could help women who underwent day surgery for breast cancer to achieve better pain management and decreased emotional distress. The sample consisted of 117 patients with breast cancer who were outpatients and undergoing surgery as part of the initial treatment for their cancer. All subjects were interviewed at three different occasions. The subjects were randomized into the experimental group (n=61) or the usual care group (control, n=56). The subjects in the experimental group received the intervention in two sessions, 3-4 days and 10-11 days after surgery. The outcomes were the subjects’ pain and emotional distress. Results showed significant differences between the experimental and control group at post-test on home management, total mood disturbance, confusion and tension scores implying that the intervention was effective in achieving these outcomes. Clinical significance has illustrated that a nursing intervention applied during immediate recovery of breast cancer surgery is quite clinically relevant to reduce emotional distress. Self-regulation theory could effectively be used as a guide in developing nursing intervention programs in practice for patients with cancer undergoing day surgery as a primary treatment.

L’objectif de cette étude était d’évaluer la capacité d’une intervention infirmière basée sur la théorie de l’auto-régulation, nommément l’Intervention sur le focus attentionnel, l’évaluation et la gestion des symptômes (FAEGS), d’aider les femmes atteintes d’un cancer du sein et ayant subi une chirurgie d’un jour à mieux gérer leur douleur et à réduire leur détresse émotionnelle. L’échantillon comprenait 117 patientes atteintes d’un cancer du sein et subissant une intervention chirurgicale en clinique externe à titre de premier traitement anticancéreux. Toutes les participantes ont été interviewées à trois reprises. Elles ont été randomisées dans un groupe expérimental (n = 61) ou dans un groupe contrôle (n = 56) qui recevait les soins habituels. Les membres du groupe expérimental recevaient les interventions en deux séances, soit 3-4 jours et 10-11 jours après la chirurgie. La douleur et la détresse émotionnelle des participantes constituaient les résultats à mesurer. Les résultats après l’intervention FAEGS présentaient d’importantes différences entre les deux groupes, en post-test, dans les domaines suivants : gestion du domicile, perturbation totale de l’humeur, confusion et tension. Ces différences indiquaient que l’intervention avait réussi à atteindre certains des résultats escomptés. Des études ont montré que les interventions infirmières qui sont effectuées au tout début de la période de rétablissement d’une opération liée au cancer du sein jouent un rôle clinique important dans la réduction de la détresse émotionnelle. La théorie de l’auto-régulation pourrait très bien servir de guide dans la création de programmes d’interventions infirmières à l’intention de patients atteints d’un cancer et subissant une chirurgie d’un jour à titre de traitement primaire.

Abstract Objective: The number of Australians living with chronic hepatitis B (CHB) is thought to be increasing, as are adverse outcomes including cirrhosis and liver cancer, however, robust, up‐to‐date estimates of this burden are limited. Contemporary estimates of the prevalence of CHB in Australia are essential to guide appropriate public health and clinical responses. Methods: This study used census‐based methodology attributing risk of CHB by country of birth and Aboriginal and Torres Strait Islander status, augmented with priority risk‐group based estimates. Deterministic mathematical modelling was used for comparison and for validation of census‐derived estimates. Results: An estimated 218,000 Australians (plausible range 192,000–284,000) are living with CHB, a significant increase over previous estimates. The prevalence derived using mathematical modelling was similar, at 204,000. Notable differences were observed by geographic area in both prevalence and the populations predominantly affected. It is estimated that only 56% of people living with CHB in Australia have been diagnosed and notified. Conclusions: The prevalence of CHB in Australia is increasing, with 1% of the population now estimated to be affected. The majority of the burden is experienced by people born overseas in endemic areas, with more than 95% of new cases of CHB entering the population through migration. Implications: It is imperative that more attention and greater resources are devoted to addressing CHB in Australia; to increase the proportion of Australians affected who have been diagnosed and who are on treatment, in accordance with the First National Hepatitis B Strategy.

Recently, there has been a growing concern in clinical settings regarding the use of evidence-based best practices. We have noted the appearance of various training activities and resources that can be used by oncology nurses. Using a time series design, this study highlights that the actual utilization of evidence in practice remains unchanged after an intervention of a formal PowerPoint presentation of evidence on symptom management in oncology, and the distribution of reference folders with research results to nurses. It emerges that very few nurses are interested and that the nurses who use evidence are those who do it as part of their functions (staff manager, clinicians). Recommendations for practice, education and research are suggested.

La récente préoccupation des milieux cliniques à utiliser des pratiques exemplaires issues de données probantes est grandissante. Nous voyons apparaître différentes formations et ressources pouvant être utilisées par les infirmières en oncologie. Cette étude met en relief, à l’aide d’un devis à séries temporelles, qu’après une intervention sous forme d’une présentation formelle PowerPoint et de cartables distribués aux infirmières sur les données probantes, l’utilisation véritable des données probantes dans la pratique est inchangée. Il en ressort que très peu d’infirmières s’y intéressent et que celles qui les utilisent sont celles qui le font dans le cadre de leurs fonctions (cadre conseil, cliniciennes). Des recommandations pour la pratique, la formation et la recherche sont suggérées.

L’objectif de cette étude était d’évaluer la capacité d’une intervention infirmière basée sur la théorie de l’auto-régulation, nommément l’Intervention sur le focus attentionnel, l’évaluation et la gestion des symptômes (FAEGS), d’aider les femmes atteintes d’un cancer du sein et ayant subi une chirurgie d’un jour à mieux gérer leur douleur et à réduire leur détresse émotionnelle. L’échantillon comprenait 117 patientes atteintes d’un cancer du sein et subissant une intervention chirurgicale en clinique externe à titre de premier traitement anticancéreux. Toutes les participantes ont été interviewées à trois reprises. Elles ont été randomisées dans un groupe expérimental (n = 61) ou dans un groupe contrôle (n = 56) qui recevait les soins habituels. Les membres du groupe expérimental recevaient les interventions en deux séances, soit 3-4 jours et 10-11 jours après la chirurgie. La douleur et la détresse émotionnelle des participantes constituaient les résultats à mesurer. Les résultats après l’intervention FAEGS présentaient d’importantes différences entre les deux groupes, en post-test, dans les domaines suivants : gestion du domicile, perturbation totale de l’humeur, confusion et tension. Ces différences indiquaient que l’intervention avait réussi à atteindre certains des résultats escomptés. Des études ont montré que les interventions infirmières qui sont effectuées au tout début de la période de rétablissement d’une opération liée au cancer du sein jouent un rôle clinique important dans la réduction de la détresse émotionnelle. La théorie de l’auto-régulation pourrait très bien servir de guide dans la création de programmes d’interventions infirmières à l’intention de patients atteints d’un cancer et subissant une chirurgie d’un jour à titre de traitement primaire.

The study assessed whether a nursing intervention based on selfregulation theory, the Attentional Focus and Symptom Management Intervention (AFSMI), could help women who underwent day surgery for breast cancer to achieve better pain management and decreased emotional distress. The sample consisted of 117 patients with breast cancer who were outpatients and undergoing surgery as part of the initial treatment for their cancer. All subjects were interviewed at three different occasions. The subjects were randomized into the experimental group (n=61) or the usual care group (control, n=56). The subjects in the experimental group received the intervention in two sessions, 3-4 days and 10-11 days after surgery. The outcomes were the subjects’ pain and emotional distress. Results showed significant differences between the experimental and control group at post-test on home management, total mood disturbance, confusion and tension scores implying that the intervention was effective in achieving these outcomes. Clinical significance has illustrated that a nursing intervention applied during immediate recovery of breast cancer surgery is quite clinically relevant to reduce emotional distress. Self-regulation theory could effectively be used as a guide in developing nursing intervention programs in practice for patients with cancer undergoing day surgery as a primary treatment.

Almost 500 extrasolar planets have been found since the discovery of 51 Peg b by Mayor and Queloz in 1995. The traditional field of planetology has thus expanded its frontiers to include planetary environments not represented in our Solar System. We expect that in the next five years space missions (Corot, Kepler and GAIA) or ground-based detection techniques will both increase exponentially the number of new planets discovered and lower the present limit of a ∼1.9 Earth-mass object [e.g.Mayor et al., Astron. Astrophys., 2009, 507, 487]. While the search for an Earth-twin orbiting a Sun-twin has been one of the major goals pursued by the exoplanet community in the past years, the possibility of sounding the atmospheric composition and structure of an increasing sample of exoplanets with current telescopes has opened new opportunities, unthinkable just a few years ago. As a result, it is possible now not only to determine the orbital characteristics of the new bodies, but moreover to study the exotic environments that lie tens of parsecs away from us. The analysis of the starlight not intercepted by the thin atmospheric limb of its planetary companion (transit spectroscopy), or of the light emitted/reflected by the exoplanet itself, will guide our understanding of the atmospheres and the surfaces of these extrasolar worlds in the next few years. Preliminary results obtained by interpreting current atmospheric observations of transiting gas giants and Neptunes are presented. While the full characterisation of an Earth-twin might requires a technological leap, our understanding of large terrestrial planets (so called super-Earths) orbiting bright, later-type stars is within reach by current space and ground telescopes. [ABSTRACT FROM AUTHOR]