Box Hill South, Australia
Box Hill South, Australia

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Pugh J.D.,Edith Cowan University | Twigg D.E.,Edith Cowan University | Martin T.L.,Perth Business Center | Rai T.,Edith Cowan University
Midwifery | Year: 2013

Objective: the ongoing attrition of the midwifery workforce frustrates future workforce planning and the provision of maternity services in Western Australia. This project determined factors contributing to the intention of the midwives to move jobs and/or leave the profession. Design: a cross-sectional survey approach was taken for this descriptive research utilising a self-administered questionnaire developed by the Nursing and Midwifery Office, Department of Health, Western Australia. Setting: public and private health sectors in Western Australia, April-May 2010. Participants: 1,600 midwives employed in the public and private health sectors throughout Western Australia were invited to participate: 712 responded (44.5%), one-fifth of the state's registered midwives. Findings: most midwives worked part-time in a clinical role in public hospitals. Almost half intended moving jobs within 5 years and/or leaving midwifery. Excluding midwives of retirement age, the most common reasons for intending to move jobs were family commitments, working conditions and role dissatisfaction. Those intending to leave midwifery cited work-life balance, career change and family commitments. Midwives thought addressing the following issues would improve midwifery retention: flexible work arrangements, remuneration, staffing and caseload, workplace culture, professional development and models of care. Key conclusions: retaining the midwifery workforce requires attention to workforce practices particularly flexible work arrangements and workloads; models of care to strengthen midwives' relationships with clients and colleagues; and accessible professional development. Implications for practice: a review of workplace practices at unit and institution levels is urgently required in Western Australia so that midwives can achieve work-life balance and practice to the full extent of their professional role. These changes are necessary to forestall premature retirement of skilled and experienced midwives from the profession and workforce churn. © 2012.


Minas B.,Perth Business Center | Laing S.,Perth Business Center | Jordan H.,University of Melbourne | Mak D.B.,Perth Business Center
BMC Public Health | Year: 2012

Background: In May 2005, the Western Australian Department of Health (WA Health) developed a communication strategy to improve the awareness and appropriate use of non-occupational post-exposure prophylaxis (nPEP) in WA. The communication strategy included the development of an nPEP information pamphlet, the establishment of a 24 hour nPEP phone line and the distribution of the WA Health nPEP guidelines to health professionals. The communication strategy was aimed at gay men, people in sero-discordant relationships, people living with HIV, injecting drug users and health care providers with patients from these populations. This evaluation aimed to assess the awareness and appropriate use of nPEP in WA before and after the commencement of the nPEP communication strategy. Methods. A program logic method was used to identify the immediate (short-term) and ultimate (long-term) outcomes of the communication strategy. The achievement of these outcomes was evaluated using data from website statistics, a survey of sexuality sensitive doctors, statistics published in Perth Gay Community Periodic Surveys (PGCPS) and data from the WA nPEP database. A 2 test for trend was conducted to identify any significant changes in the ultimate outcome indicators pre- and post-strategy. Results: nPEP awareness among gay men in the PGCPS initially increased from 17.2% in 2002 to 54.9% in 2008, then decreased to 39.9% in 2010. After the commencement of the communication strategy, the proportion of nPEP prescriptions meeting the eligibility criteria for nPEP significantly increased (61.2% in 2002-2005 to 90.0% in 2008-2010 (p<.001)). The proportion of nPEP recipients who completed the prescribed course of nPEP (46.6% in 2002-2005 to 66.9% in 2008-2010 (p=.003)) and the proportion who received a post-nPEP HIV test three to four months after the first visit for nPEP (38.8% in 2002-2005 to 51.9% in 2008-2010 (p=.023)) also increased. Conclusions: Since the introduction of the nPEP communication strategy, the delivery and appropriate use of nPEP have significantly improved in WA. In the 2008-2010 period, an improvement in HIV testing of nPEP recipients at three month follow-up was reported for the first time in WA. However, there is a need for ongoing activities to raise nPEP awareness among gay men. © 2012 Minas et al.; licensee BioMed Central Ltd.


Spickett J.,Collaborating Center for Environmental Health Impact Assessment | Spickett J.,Curtin University Australia | Katscherian D.,Collaborating Center for Environmental Health Impact Assessment | Katscherian D.,Perth Business Center | And 2 more authors.
Environmental Impact Assessment Review | Year: 2012

Health Impact Assessment (HIA) is a developing component of the overall impact assessment process and as such needs access to procedures that can enable more consistent approaches to the stepwise process that is now generally accepted in both EIA and HIA. The guidelines developed during this project provide a structured process, based on risk assessment procedures which use consequences and likelihood, as a way of ranking risks to adverse health outcomes from activities subjected to HIA or HIA as part of EIA.The aim is to assess the potential for both acute and chronic health outcomes. The consequences component also identifies a series of consequences for the health care system, depicted as expressions of financial expenditure and the capacity of the health system.These more specific health risk assessment characteristics should provide for a broader consideration of health consequences and a more consistent estimation of the adverse health risks of a proposed development at both the scoping and risk assessment stages of the HIA process. © 2011 Elsevier Inc.


Kwan K.S.H.,Perth Business Center | Giele C.M.,Perth Business Center | Greville H.S.,Curtin University Australia | Reeve C.A.,Kimberley Population Health Unit | And 2 more authors.
Sexual Health | Year: 2012

Objectives To describe the epidemiology of congenital and infectious syphilis during 19912009, examine the impact of public health interventions and discuss the feasibility of syphilis elimination among Aboriginal people in Western Australia (WA). Methods: WA congenital and infectious syphilis notification data in 19912009 and national infectious syphilis notification data in 20052009 were analysed by Aboriginality, region of residence, and demographic and behavioural characteristics. Syphilis public health interventions in WA from 19912009 were also reviewed. Results: During 19912009, there were six notifications of congenital syphilis (50% Aboriginal) and 1441 infectious syphilis notifications (61% Aboriginal). During 19912005, 88% of notifications were Aboriginal, with several outbreaks identified in remote WA. During 20062009, 62% of notifications were non-Aboriginal, with an outbreak in metropolitan men who have sex with men. The Aboriginal:non-Aboriginal rate ratio decreased from 173:1 (19912005) to 15:1 (20062009). Conclusions: These data demonstrate that although the epidemiology of syphilis in WA has changed over time, the infection has remained endemic among Aboriginal people in non-metropolitan areas. Given the continued public health interventions targeted at this population, the limited success in eliminating syphilis in the United States and the unique geographical and socioeconomic features of WA, the elimination of syphilis seems unlikely in this state.


Vally H.,Australian National University | Vally H.,La Trobe University | Peel M.,South Metropolitan Area Health Service | Cameron S.,Australian National University | And 4 more authors.
Australian and New Zealand Journal of Public Health | Year: 2012

Objective: To investigate the relationship between risk of Ross River virus (RRV) infection and proximity to mosquito-breeding habitat surrounding a tidal wetland ecosystem in south-west Australia. Methods: Geographic information systems (GIS) were used to spatially map cases of RRV disease in the Leschenault region between July 1995 and June 1996. Half kilometre buffer zones were constructed around the Leschenault Estuary and associated waterways; RRV disease case counts were calculated for each zone. Results: Different relationships between RRV disease incidence and proximity to saltmarsh mosquito habitat were observed east of the Leschenault Estuary compared with an urban region to the south. Disease incidence showed a decreasing trend away from eastern margins of the Estuary, particularly for the first 2 km. In the urban region, RRV disease risk was low close to the Estuary, but increased further out and remained steady across the remainder of that region. Conclusions: The findings support an increased risk of contracting RRV disease for people residing close to eastern margins of the Leschenault Estuary. Implications: This study highlights how historical data combined with GIS can improve understanding of the epidemiology of RRV disease. This has a valuable role in assessing the risk of mosquito-borne disease for land-use planning. © 2012 Public Health Association of Australia.


Mak D.B.,Perth Business Center | Bulsara M.K.,The University of Notre Dame Australia | Wrate M.J.,The University of Notre Dame Australia | Carcione D.,Perth Business Center | And 2 more authors.
Journal of Paediatrics and Child Health | Year: 2013

Aim Adolescence is the final opportunity for a large-scale immunisation programme before adulthood. The Western Australian (WA) school-based vaccination programme provides Year 7 students with free vaccination against hepatitis B virus (HBV); diphtheria, tetanus and pertussis (dTpa); varicella zoster virus (VZV); and human papilloma virus (HPV). We aimed to identify factors determining consent form return and vaccination uptake. Methods Data were collected via a statewide, web-based database in 2009 and 2010. Proportions of students who returned a vaccine consent form, and completed HBV and HPV multi-dose courses and dTpa and VZV vaccination were determined. Factors associated with these outcomes were identified with multivariate analysis using logistic regression, accounting for clustering by school. Results In 2010, 92.8% of WA Year 7 students returned a vaccination consent form and 85.3%, 74.3%, 66.7.0% and 26.4% completed their adolescent vaccination(s) against dTpa, HPV (females only), HBV and VZV, respectively. Consent form return and dTpa vaccination uptake improved between 2009 and 2010. Independent and consistently negative associations were observed between outcome variables (consent form return and vaccine uptake) and male gender, geographically remote schools, government schools and schools in the most socio-economically disadvantaged areas. Both HBV and HPV course completion were higher in Catholic than government schools, and the same in government and independent schools. Conclusion To effectively maximise vaccination coverage, the WA school-based adolescent vaccination programme must specifically target male students and schools in the most disadvantaged and remote areas. © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).


Mak D.B.,Perth Business Center | Grace J.,Shelby Consulting | Bastian L.,Perth Business Center | Aquilina H.,Shelby Consulting | Sweeting J.,Shelby Consulting
Health Promotion Journal of Australia | Year: 2012

Issue addressed: The Get the Facts website, aimed at Western Australian (WA) youth aged 14-17 years, provides information about sexual health, blood-borne viruses and sexual relationships, and how to access appropriate health services. It was developed as one component of a comprehensive sexually transmitted infection (STI) prevention and control program implemented within Western Australia. Methods: An evaluation was undertaken to assess how the website might be improved and be more effectively marketed to its target audience. Website usage data, on-line survey responses and qualitative data from focus group testing of the website were collected and analysed. Results: Website visitors were from 194 countries, with the majority being Australian (65%) and 27% of Australian visitors being from WA. Website usage patterns indicated that the site was of greater relevance to WA than other visitors. An estimated 5% of 14-17 year old WA residents had visited the site in 2010. Online survey and focus group data indicated that the website provides sexual health and bloodborne virus information that is relevant to young people and in a format that they find acceptable and accessible. Conclusions: The ?Get the Facts? website appeals to its target audience and provides them with relevant information. The challenge is to improve its promotion so it reaches its full potential WA youth audience.


Kwan K.S.H.,Perth Business Center | Giele C.M.,Perth Business Center | Combs B.,Perth Business Center | Mak D.B.,Perth Business Center
Sexual Health | Year: 2012

Objective: Antenatal testing for specified sexually transmissible infections (STIs) and blood-borne viruses (BBVs) is recommended by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). In 2007, the Department of Health, Western Australia (DoHWA) issued an operational directive (OD) recommending universal testing for chlamydia and additional testing for women in the STI endemic regions of Western Australia (WA). To assess adherence to these guidelines, seven WA public hospitals were audited. Design and setting: Demographic details and testing information of the last 200 women who gave birth immediately before 30 June 2007 (baseline audit) and 30 June 2010 (follow-up audit) were obtained from each hospital's antenatal records. Results: Data from 2718 women who delivered at ≥36 weeks' gestation were analysed (baselinen=1353; follow-upn=1365). Testing at the first antenatal visit in accordance with the guidelines improved over time (RANZCOG: 68-74%; χ 2-test = 13.96, d.f.=1, P<0.001; DoHWA OD: 12-40%; χ 2-test = 279.71, d.f.≤1, P0.001). Retesting at 2836 weeks' gestation in the STI endemic regions improved for chlamydia (3-10%; χ 2-test = 17.40, d.f.=1, P<0.001) and gonorrhoea (3-7%; χ 2-test=6.62, d.f.=1, P<0.05), but not for syphilis or HIV. Chlamydia prevalence was 3% and 8% among nonAboriginal and Aboriginal women, respectively. Conclusion: The proportion of women delivering in WA public hospitals who had antenatal STI and BBV tests improved after publication and promotion of the OD. © 2012 CSIRO.


Antenatal testing for specified sexually transmissible infections (STIs) and blood-borne viruses (BBVs) is recommended by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). In 2007, the Department of Health, Western Australia (DoHWA) issued an operational directive (OD) recommending universal testing for chlamydia and additional testing for women in the STI endemic regions of Western Australia (WA). To assess adherence to these guidelines, seven WA public hospitals were audited.Demographic details and testing information of the last 200 women who gave birth immediately before 30 June 2007 (baseline audit) and 30 June 2010 (follow-up audit) were obtained from each hospitals antenatal records.Data from 2718 women who delivered at 36 weeks gestation were analysed (baselinen=1353; follow-upn=1365). Testing at the first antenatal visit in accordance with the guidelines improved over time (RANZCOG: 68-74%; (2)-test = 13.96, d.f.=1, P<0.001; DoHWA OD: 12-40%; (2)-test = 279.71, d.f.=1, P<0.001). Retesting at 28-36 weeks gestation in the STI endemic regions improved for chlamydia (3-10%; (2)-test = 17.40, d.f.=1, P<0.001) and gonorrhoea (3-7%; (2)-test=6.62, d.f.=1, P<0.05), but not for syphilis or HIV. Chlamydia prevalence was 3% and 8% among nonAboriginal and Aboriginal women, respectively.The proportion of women delivering in WA public hospitals who had antenatal STI and BBV tests improved after publication and promotion of the OD.


PubMed | Perth Business Center and M Clinic
Type: Journal Article | Journal: Sexual health | Year: 2016

Background In July 2010, the Western Australian AIDS Council established the M Clinic, a peer-led STI testing service for MSM. This study describes trends in HIV notifications among MSM in WA from 2004 to 2013, particularly the impact of the M Clinic on newly acquired HIV diagnoses.The number and proportion of MSM HIV cases with newly acquired infection were compared for the 2004-2006, 2007-2009 and 2011-2013 time periods. Data from 2010 were excluded as the M Clinic opened in July 2010.Between the 2004-2006 and 2007-2009 periods, the number of MSM with newly acquired HIV increased by 50% (23 to 33 cases) and the number of newly acquired cases as a proportion of all new HIV diagnoses among MSM increased from 27% to 35% (30% increase) (P=0.25). In the 2011-2013 period, the number of newly acquired HIV cases among MSM more than doubled to 70 cases and comprised 53% of all new HIV diagnoses among MSM (P<0.05). Of the 70 newly acquired HIV cases in the 2011-2013 period, 30% (n=21) were diagnosed at the M Clinic.The proportion of MSM HIV notifications that were newly acquired increased between 2004 and 2013 in WA, with the greatest increase seen after the M Clinic commenced operation. A peer-led approach to HIV testing should be considered in order to achieve early diagnosis and treatment of HIV among MSM.

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