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Early intervention (EI) for children with physical disabilities is advocated as a means of enhancing child outcomes and family functioning. The issues confronted by service providers in delivering this support have received relatively little attention. The purpose of this study was to gain an understanding of the experiences of frontline EI staff delivering services to children with physical disabilities and their families. Researchers sought views about the ways in which EI programs provide services, how programs build and maintain relationships with families and team members, the prevalence of changing and unmet family needs, the presence of barriers to optimal service delivery, and recommendations for service improvement. Qualitative interviews with 10 staff members highlighted both positive aspects of service quality and issues encountered in the provision of services. Staff commented favorably on family-centered practice; aspects of service structure/delivery, including offering a wide range of supports, flexible service provision, and the focus on intervening early; and provider-related aspects including teamwork and interagency coordination and appropriate personal qualities and skills. Despite the strong endorsement of EI, participants also identified several challenges: meeting the high demand for services, under and unmet needs, and inadequate funding and staffing.

This case report describes Boerhaave syndrome in an otherwise healthy male after Kambo use in Australia. Kambo is produced from the sections of the Phyllomedusa bicolor (Boddaert, 1772) tree frog. Also known as the giant leaf frog, two-coloured leaf frog, waxy-monkey tree frog and kambô, is native to South America. Its use is part of a traditional cleansing ceremony but has been adopted by the alternative health movement. [ABSTRACT FROM AUTHOR]

Background: Australia commenced human papillomavirus (HPV) vaccination in 2007, with a two-year catch-up to the age of 26; catch-up cohorts are thus now entering their thirties. Plans for monitoring vaccine impact involve pre- and post-vaccination assessment of cervical HPV DNA in the general population and in high grade abnormalities. Although HPV serology is less sensitive than DNA genotyping, it assesses lifetime exposure and may be easier to measure in the general population. However, benchmark pre-vaccination seroprevalence of vaccine-included types in unvaccinated women with high grade abnormalities has not previously been reported. Methods: We assessed seroprevalence for HPV16/18 from a population-based sample of 3,729 women with normal cytology and 971 women with confirmed high grade abnormalities (CIN2/3), aged 30-64 years, unvaccinated, and recruited in New South Wales in 2006-2010. We examined the variation in HPV16/18 seropositivity by age and in relation to a range of reproductive and behavioural characteristics in the subgroup of normal cytology women with no recent history of high grade cervical disease. Results: The HPV 16, 18 and combined seroprevalence was 19%, 7% and 24% among women with normal cytology, and 39%, 13% and 44% among women with CIN2/3, respectively. For both groups, HPV16/18 seroprevalence was highest at age 30-39 years and decreased with age. In multivariable analysis for women with normal cytology, HPV16 and HPV18 seropositivity were each associated with the number of lifetime sexual partners (p-trend <0.001 and 0.052, respectively) and for HPV16 this was also associated with age (p-trend <0.001) and prior diagnosis of Chlamydia (adjusted OR 1.89, 95%C 1.27-2.80). Conclusions: The findings of this study inform pre-vaccination estimates of HPV seropositivity in women with normal cytology and women with high grade abnormalities. Almost a quarter of unvaccinated women aged over 30 years with normal cytology, and more than 40% of those with CIN2/3, had seroconverted to HPV 16 or 18. These findings provide a potential additional benchmark for assessing the effects of HPV vaccination. [ABSTRACT FROM AUTHOR]

More than 200,000 displaced Karen from Burma have been "warehoused" in displaced persons' camps on the Thai-Burma border for more than 20 years. Recently, the United Nations High Commissioner on Refugees (UNH CR) has embarked on the durable solution of resettlement to third countries for these people. In this paper, the experiences and perceptions of resettlement of Christian Karen are explored through the findings from two focus groups with recently arrived refugees, augmented by contextual discussions with Christian Karen community leaders in Australia. Focus group participants displayed a strong and overt sense of identity, both as individual Karen and as part of the Christian Karen community, locally and trans-nationally, indicating that Christian Karen identity remains intact during displacement and strongly influences the resettlement experience for this group. [ABSTRACT FROM AUTHOR]

Aim: Determine measles seropositivity and vaccine coverage in children aged 1 to 4 years inclusive. Compare data in those who produced immunisation records and those who relied on parental recall. Establish variables associated with seropositivity. Methods: Design: Population- and area-based, cluster sample of 1- to 4-year-olds; households surveyed by trained interviewer. Setting: Australia-wide, excluding New South Wales. Questionnaires completed between February and April 1995. Subjects: 2117 completed questionnaires were returned for children aged 1 to 4 years, 923 of whom provided a sufficient blood sample for analysis. Results: Overall seropositivity was 86% for the 923 children tested and was strongly associated with previous immunisation ( P < 0.001) and age ( P < 0.001), but not with parental report of a previous measles diagnosis ( P = 0.581). Eight hundred and forty-three (91%) reported previous measles immunisation, with 760 (90%) of these testing seropositive. Four hundred and ninety-one (55%) parents/guardians produced immunisation records, while 400 (45%) relied on recall. Immunised children whose parents relied on recall were equally likely to be seropositive as children whose parents produced records. The 923 children tested were representative of the 2117 who completed questionnaires in all factors except age, where children below 2 years old were under represented ( P < 0.001). Conclusions: These data support the current second routine measles immunisation prior to school entry, and reinforce the need to promote the first routine dose to achieve measles elimination. [ABSTRACT FROM AUTHOR]

Previous research points to the importance of both kin and non-kin ties within social networks as sources of social support. This study examines the kin and non-kin providers of specific types of support to dual-parent low-income Australian families caring for young children. The study highlights the importance of family and friends as support providers. Study participants tended to rely on family, including parents, siblings and other family members, and friends for emotional and information support. Parents also tended to provide material and practical support. While neighbors and community agencies offered some emotional and information support, overall, these sources were minimal.© 2002 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objective: Surgery for paediatric cancer presents many stresses on patients and families. The authors aimed to understand the long‐term impact of childhood cancer surgery on survivors and parents. Methods: The study recruited participants from 11 Australia/New Zealand hospitals for telephone interviews. The authors used descriptive statistics to analyse participants' quantitative distress ratings and conducted thematic analysis of shared surgical experiences and needs. Results: Of 32 participants (n = 17 survivors, n = 15 parents), survivors' mean age at surgery was 6.9 (SD = 5.17) and parents' children were 2.1 years old (SD = 1.41) at time of surgery. Survivors had surgery on average 15.2 years ago (SD = 6.72) and parents' children 11.5 years ago (SD = 3.94). Parents and survivors rated surgery as highly distressing. Pre‐operatively, survivors recalled experiencing fear and pain mainly associated with pre‐operative procedures. Post‐operatively, survivors reported immobility and some lasting behavioural disturbances. Parents described pre‐ and intra‐operative anxiety and stress and some lasting post‐operative psychological disturbances. Experiences appeared to improve with clear/consistent communication from hospital staff, proximity to hospital, and with support for parents and children post‐operatively. Conclusions: Surgical treatment for childhood cancer can have a lasting impact for survivors and parents. Better information provision may improve families' surgical experience whilst reducing anxiety, distress and physical discomfort. [ABSTRACT FROM AUTHOR]

Background Australia commenced a publically-funded, National Human Papillomavirus (HPV) Vaccination Program in 2007 with a two year catch-up phase for females aged 12–26 years. Objective To identify the factors associated with the uptake of the HPV vaccine (which has a recommended 3-dose schedule in Australia) by young adult women vaccinated by general practitioners and community-based programs within the catch-up phase. Methods 1139 women who were eligible to receive the free HPV vaccine during the catch-up period were recruited in 2008–2009 (age 20–29 years at recruitment), in New South Wales, after having a normal (negative) cervical smear result recorded on the NSW Pap Test Register. Participants completed a self-administered questionnaire providing information on vaccination status, and sociodemographic and other factors. Results Overall, 880 (77%) women reported receiving ≥1 dose of the vaccine and 777 women (68%) reported receiving ≥2 doses. In multivariable analysis (adjusting for the period for which each woman was eligible for free HPV vaccination), uptake of ≥1 dose of the vaccine was significantly associated with being born in Australia ( p < 0.01), being single ( p = 0.02), being nulliparous ( p < 0.01), living in a higher socioeconomic status area ( p -trend = 0.03), living in more remote areas ( p = 0.03), drinking alcohol ( p < 0.01) and using hormonal contraceptives ( p < 0.01). Although vaccinated women were more likely to have fewer sexual partners than unvaccinated women ( p -trend = 0.02), they were also more likely to report a prior sexually transmitted infection (STI) ( p = 0.03). Similar factors were associated with receiving ≥2 doses. Conclusions In this group, women living in higher socioeconomic status areas were more likely to be vaccinated against HPV in the catch-up phase of the national program. Although vaccinated women tended to have fewer sexual partners, they also reported prior STIs, which may be a marker of increased risk of prior exposure to HPV. The findings of this study reinforce the continuing need to prioritise equitable delivery of vaccination to various population subgroups. [ABSTRACT FROM AUTHOR]