ORCID Profile
0000-0003-1970-9792
Current Organisations
University of Sydney
,
Children's Hospital at Westmead
,
NSW Ministry of Health
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Publications
Parental and societal support for adolescent immunization through school based immunization programs
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.VACCINE.2013.04.064
Abstract: Adolescent immunizations such as human papillomavirus vaccine have been implemented through school based immunization programs (SBIPs) in Australia. We assessed community attitudes toward immunization of adolescents though SBIPs. A cross-sectional population survey of rural and metropolitan households in South Australia in 2011. Univariate and multiple regression analyses identified predictors of support for a SBIP. Participation rate was 57.3% with 1926 adults interviewed. Overall, 75.9% regarded school as the best place to offer adolescent immunizations, with 16.4% preferring the family physician. Parents of high school students were most supportive (88.4%) of a SBIP with 87.9% of their adolescents reported as having participated in the program. Adults 18-34 years (79.4%) were more likely to support a SBIP compared to older adults (68.7% of >55 years) [adjusted OR=2.39, p=0.002] and men were more supportive (80.3%) than women (71.7%) [adjusted OR=1.54, p=0.003]. Reasons for participation in the SBIP included convenience (39.9%), public funding for the service (32.4%), and confidence in immunization recommendations (21.0%). Public support for the SBIP was very high particularly amongst parents whose adolescent/s had participated in the program.
Sex, Condoms and Sexually Transmissible Infections: A Qualitative Study of Sexual Health in Young Australian Men
Publisher: Springer Science and Business Media LLC
Date: 10-09-2010
DOI: 10.1007/S10508-010-9664-6
Abstract: Young males have a key role in shaping contraceptive use in a sexual relationship, yet often remain the invisible partner in safe sex promotion. This article describes a conceptual model of STI risk and condom use based on the perceptions and experiences of condom use in a group of young Australian males. An explorative descriptive design was used to conceptualize participants' condom use histories into an organized description of behavior. Forty-two semi-structured interviews were conducted with a purposive s le of males aged 15 to 25 years over an 18 month period. A sequential analytical process of data immersion, coding, and category generation was used to identify personal meanings, motivations, and contextual factors associated with condom use and non-use. Three primary discourses associated with young males' perceptions of STI risk and responding approach to condom use constructed personal commitment to sexual safety as dynamic, context-dependent, and outcome-driven (pregnancy versus STIs as the primary motivator of condom use). A regretful discourse associated with experiences of, or suspected unwanted outcomes, also emerged through changes in risk appraisals and safe sex intentions and behavior. Interventions to increase condom use should go beyond the traditional focus on risky behavior and disease prevention frameworks by addressing the contextual influences on personal risk appraisals and deliver innovative messages to reduce negative social meanings associated with condom use.
Young males’ perspectives on pregnancy, fatherhood and condom use: Where does responsibility for birth control lie?
Publisher: Elsevier BV
Date: 2011
DOI: 10.1016/J.SRHC.2010.10.002
Abstract: To improve our understanding of males' role in contraceptive practices, this paper explores the relationship between young males' perspectives on pregnancy and fatherhood and their attitudes, beliefs and practices in relation to condom use and birth control. Semi-structured interviews were conducted with a s le of 42 males aged 15-25 years. A systematic process of thematic analysis was used to reduce and organise the narrative data around the focus areas of relationships, sex, condom use, STIs and pregnancy/fatherhood. To facilitate the emergence of key patterns in the data, new data was constantly compared with existing ideas to formulate and refine codes and descriptive categories. The analysis revealed a clear discrepancy between young males' desire to prevent pregnancy and the level of control they assumed over this. Despite pregnancy emerging as the overriding concern for participants, this failed to motivate continued use of condoms when STI risk was perceived as low and a partner was using birth control. Reliance on a partner's use of hormonal contraceptives and in several cases, beliefs of low personal responsibility for pregnancy prevention reduced young males' participation in fertility control. Young males' unfavourable attitudes toward immediate pregnancy and fatherhood provide a unique opportunity for safe sex promotion by encouraging greater ownership over sexual and reproductive health outcomes. However, this requires a shift in the meanings associated with condoms, from a disease prevention only orientation to one that promotes condom use as a positive act for self and partner protection.
The effect of exercise on vaccine-related pain, anxiety and fear during HPV vaccinations in adolescents
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.VACCINE.2018.04.069
Abstract: With increased school-based vaccinations for improved coverage rates and practicality, the World Health Organization (WHO) recently endorsed research to identify possible interventions to reduce vaccine-related pain in mass clinical and school-based settings. In particular, the lack of research in adolescents indicate a particular need in this population. Acute exercise has analgesic effects and has been used as a behavioural adjuvant to vaccination. Here, we examine the effect of exercise on vaccine-related pain, anxiety and fear in adolescents, during a school-based program for HPV vaccinations. 116 students (Female: 61, Male: 55) aged 11-13 years were randomly allocated to either an Exercise (n = 60) or Control (n = 56) group. All participants completed demographic and Trait-anxiety questionnaires prior to receiving the vaccine according to usual care. The Exercise group also performed upper body exercise for 15 min prior to receiving the vaccine. Immediately after the vaccine administration, all participants reported on pain, anxiety and fear at the time of receiving the vaccine. Female adolescents in the Exercise group reported significantly less pain (3.64 95% CI, 2.98-4.30) than Controls (4.58 95% CI, 3.96-5.19 p = 0.04). Further, females reported greater pain and anxiety than males in the Control group but not the Exercise group. This study supports the use of exercise prior to vaccine administration, especially in female adolescents who are particularly vulnerable to negative experiences during vaccination procedures. Furthermore, the ease of application, as well as the benefit of exercise, provides support for the use of simple exercise prior to vaccination in mass vaccination settings. Clinical trial registry: ANZCTR, ACTRN12614001185651.
The study design and methodology for the ARCHER study - adolescent rural cohort study of hormones, health, education, environments and relationships
Publisher: Springer Science and Business Media LLC
Date: 05-09-2012
Atheroprotective effect of dietary walnut intake in ApoE-deficient mice: Involvement of lipids and coagulation factors
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.THROMRES.2013.01.003
Abstract: Consumption of n-3 polyunsaturated fatty acids (PUFA) and antioxidant polyphenols is considered to decline the risk of cardiovascular disease. To provide an explanation for this cardioprotective effect, we performed an intervention study with proatherogenic Apoe(-/-) mice which were fed during eight weeks with a high fat diet supplemented with either walnuts (rich in n-3 PUFA and antioxidant compounds), walnut oil (with n-3 PUFA only) or sunflower oil as a control (12 mice per group). Feeding walnuts, but not walnut oil, caused a 55% reduction in atherosclerotic plaque development in the aortic arch in comparison to the control diet. This was associated with reduced staining of plaques for CD36, a scavenger receptor expressed by macrophages. Feeding mice with walnuts also lowered plasma levels of triglycerides, cholesterol and prothrombin with 36%, 23% and 21 %, respectively, compared to control diet. In addition, accumulation of lipids in the liver was decreased, while plasma antioxidant capacity was increased. On the other hand, feeding mice with walnut oil did not provoke significant changes in these parameters in comparison to the control diet. Platelet activation and thrombus formation under flow remained unchanged with either diet. In Apoe(-/-) mice on high fat diet, intake of dietary walnut (but not walnut oil) beneficially influences lipid metabolism and atherosclerotic plaque development, with no more than limited effects on platelet and coagulation function.
Adolescent substance use and educational attainment: An integrative data analysis comparing cannabis and alcohol from three Australasian cohorts
Publisher: Elsevier BV
Date: 11-2015
DOI: 10.1016/J.DRUGALCDEP.2015.08.034
Abstract: The relative contributions of cannabis and alcohol use to educational outcomes are unclear. We examined the extent to which adolescent cannabis or alcohol use predicts educational attainment in emerging adulthood. Participant-level data were integrated from three longitudinal studies from Australia and New Zealand (Australian Temperament Project, Christchurch Health and Development Study, and Victorian Adolescent Health Cohort Study). The number of participants varied by analysis (N=2179-3678) and were assessed on multiple occasions between ages 13 and 25. We described the association between frequency of cannabis or alcohol use prior to age 17 and high school non-completion, university non-enrolment, and degree non-attainment by age 25. Two other measures of alcohol use in adolescence were also examined. After covariate adjustment using a propensity score approach, adolescent cannabis use (weekly+) was associated with 1½ to two-fold increases in the odds of high school non-completion (OR=1.60, 95% CI=1.09-2.35), university non-enrolment (OR=1.51, 95% CI=1.06-2.13), and degree non-attainment (OR=1.96, 95% CI=1.36-2.81). In contrast, adjusted associations for all measures of adolescent alcohol use were inconsistent and weaker. Attributable risk estimates indicated adolescent cannabis use accounted for a greater proportion of the overall rate of non-progression with formal education than adolescent alcohol use. Findings are important to the debate about the relative harms of cannabis and alcohol use. Adolescent cannabis use is a better marker of lower educational attainment than adolescent alcohol use and identifies an important target population for preventive intervention.
Perceptions and Experiences of First Sexual Intercourse in Australian Adolescent Females
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1016/J.JADOHEALTH.2008.04.017
Abstract: To better understand the factors that influence the initiation of first intercourse among adolescent females and to explore the context in which this occurs. A purposive s le of sexually active female teenagers aged between 14 and 19 years were recruited from sexual and reproductive health clinics across the Perth metropolitan area. Sixty-eight in-depth, semistructured interviews were conducted. Thematic analysis was employed to analyze the narrative data. Meanings and interpretations that emerged were constantly verified through subsequent inquiry. The degree of personal control over the factors that led to their first experience of intercourse determined how teenagers reflected upon the experience. Those who were "ready" were more likely to have delayed intercourse until they were comfortable with both when and with whom this occurred. In contrast, conforming to peer norms, coercion from sexual partners and being intoxicated were common reasons for premature and unwanted first experience of sexual intercourse. The explorative approach used in this study deepens current understanding of the factors influencing and associated with intercourse initiation, and how these reflect different aspects of adolescent development. In particular, the role of young peoples' sociocultural environment, including peer interaction and alcohol intoxication, alongside pressure from sexual partners in premature and unwanted sexual activity may assist in informing educational interventions of greater personal relevance and impact.
Ethical Challenges in School-Based Immunization Programs for Adolescents: A Qualitative Study
Publisher: American Public Health Association
Date: 07-2015
Abstract: Objectives. We investigated ethical issues in school-based immunization programs for adolescents and how they are addressed. Methods. We used qualitative methods and an ethnographic approach to observe 9 secondary schools on immunization days in South Australia in 2011 concurrently, we conducted 9 focus groups with female secondary school students, 6 semistructured interviews with parents, and 10 interviews with nurses and teachers. We explored ethical challenges from the perspective of these groups. Results. We identified ethical challenges for the delivery of adolescent immunization in a school-based setting in 3 main areas: informed consent, restrictions on privacy, and harm to students in the form of fear and anxiety. Conclusions. We found areas in which the design and delivery of school-based immunization programs can be improved. Information about immunization should be provided in ways that are appropriate to young people and their parents, and privacy protections should be enhanced when possible. Involving young people in the design and delivery of programs would assist with making these improvements.
Adolescent Pregnancy in Australia
Publisher: Springer US
Date: 2014
The kids are OK: It is discrimination, not same-sex parents, that harms children
Publisher: AMPCo
Date: 23-10-2017
DOI: 10.5694/MJA17.00943
Guiding, sustaining and growing the public involvement of young people in an adolescent health research community of practice
Publisher: Wiley
Date: 27-10-2022
DOI: 10.1111/HEX.13616
Abstract: Public involvement in health research and its translation is well recognized to improve health interventions. However, this approach is insufficiently practised and evidenced in relation to young people. This paper presents an analysis of the process of co‐producing a framework, partnership model and a growing network of young people informing and guiding an adolescent health research community of practice. A Living Lab is a participatory research approach that brings together a broad range of stakeholders in iterative cycles of research, design, development, pilot‐testing, evaluation and delivery to implement effective responses to complex phenomena. The geographical setting for this study was Sydney, NSW, Australia, and involved both youth and adult stakeholders from this region. The study spanned three phases between July 2018 and January 2021, and data collection included a range of workshops, a roundtable discussion and an online survey. The co‐production process resulted in three key outputs: first, an engagement framework to guide youth participation in health research second, a partnership model to sustain youth and adult stakeholder collaboration third, the growth of the public involvement of young people with a range of projects and partners. This study investigated the process of co‐producing knowledge with young people in an adolescent health community of practice. A reflexive process supported youth and adult stakeholders to collaboratively investigate, design and pilot‐test approaches that embed young people's engagement in adolescent health research. Shared values and iterative methods for co‐production can assist in advancing mutual learning, commitment and trust in specific adolescent health research contexts. Young people guiding and informing an adolescent health research community of practice were involved in this study, and one of the participants is a paper co‐author.
Voluntary School-Based Human Papillomavirus Vaccination: An Efficient and Acceptable Model for Achieving High Vaccine Coverage in Adolescents
Publisher: Elsevier BV
Date: 09-2010
A Budget Impact Model for the use of Drug-Eluting Stents in Patients with Symptomatic Lower-Limb Peripheral Arterial Disease: An Australian Perspective
Publisher: Springer Science and Business Media LLC
Date: 21-06-2021
DOI: 10.1007/S00270-021-02848-8
Abstract: Improvement in long-term outcomes through innovative, cost-effective medical technologies is a focus for endovascular procedures aimed at treating symptomatic lower-limb peripheral arterial disease (PAD). The advent of drug-eluting stents (DES) has improved symptomatic PAD treatment via a reduction in high rates of target lesion revascularisation (TLR). The present study aimed to compare the 5-year financial impact of treatment with Eluvia, a new paclitaxel-eluting stent, versus treatment with Zilver PTX, a drug-coated stent, among patients in Australia by developing a budget impact model (BIM). A BIM was developed from an Australian public hospital payer perspective using Australian national cost weights (AUD), published literature, and public hospital audit data. Clinical outcomes, including clinically driven TLRs (CD-TLRs), adverse events, and length of stay, were based on the 2-year results of the IMPERIAL trial, which compared Eluvia DES to Zilver PTX. Assuming EVP eligibility rate of 80% and DES uses rate ranging from 10 to 28% (superficial femoral artery lesions only), the 5-year model forecasted a treatment population between 14,428 and 40,399 patients. The model estimated 1499–4198 fewer CD-TLRs and 16,515–46,243 fewer hospital days with Eluvia DES use. This translated to 5-year potential savings of $4.3–$12.1 million to the Australian public hospital payer attributable to reduced CD-TLRs for Eluvia DES and $33.1–$92.6 million to Australian public hospitals owing to reduced adverse events and hospital bed days. Eluvia DES use as treatment for symptomatic lower-limb PAD could lead to potential savings for the Australian public healthcare system based on improved patient outcomes.
Scale construction utilising the Rasch unidimensional measurement model: A measurement of adolescent attitudes towards abortion
Publisher: OMICS Publishing Group
Date: 06-2012
DOI: 10.4066/AMJ.2012.952
Adolescent hepatitis B immunisation—should it be the law?
Publisher: Elsevier BV
Date: 06-2001
DOI: 10.1111/J.1467-842X.2001.TB00567.X
Abstract: Universal hepatitis B immunisation of young adolescents was included in the Australian Standard Vaccination Schedule in 1998. However, rates of immunisation among adolescents world-wide have often been inadequate. Australia's experience in this area is no exception, particularly in States where school-based delivery is not carried out. Legislation for pre-school immunisation certification currently exists in several States and this legislation is distinctly different from the compulsory or mandatory immunisation that exists in several other developed countries. There have been demonstrable gains in uptake as a result of mandatory immunisation requirements in the United States and there is evidence to suggest that immunisation certification in Australia has also been beneficial. However, it is important to recognise that both certification and mandatory immunisation legislation have inherent difficulties. In this paper, we argue that legislation for high school immunisation certification, as part of a multi-faceted vaccine delivery strategy tailored to adolescents, is required to achieve the uptake that will lead to interruption of transmission of the hepatitis B virus in Australia. Not only will it substantially reduce incident cases of hepatitis B for the next decade, it will also provide a framework for the successful introduction of future adolescent vaccine initiatives in Australia.
Approach to the Patient: Pharmacological Management of Trans and Gender-Diverse Adolescents
Publisher: The Endocrine Society
Date: 03-09-2021
Abstract: Internationally, increasing numbers of children and adolescents with gender dysphoria are presenting for care. In response, gender-affirming therapeutic interventions that seek to align bodily characteristics with an in idual’s gender identity are more commonly being used. Depending on a young person’s circumstances and goals, hormonal interventions may aim to achieve full pubertal suppression, modulation of endogenous pubertal sex hormone effects, and/or development of secondary sex characteristics congruent with their affirmed gender. This is a relatively novel therapeutic area and, although short-term outcomes are encouraging, longer term data from prospective longitudinal adolescent cohorts are still lacking, which may create clinical and ethical decision-making challenges. Here, we review current treatment options, reported outcomes, and clinical challenges in the pharmacological management of trans and gender- erse adolescents.
Adolescents' Use of Dr Google: Help or Hindrance?
Publisher: Wiley
Date: 11-2018
DOI: 10.1111/JPC.14203
You Can Help People: Adolescents' Views on Engaging Young People in Longitudinal Research
Publisher: Wiley
Date: 26-09-2012
Efficacy, safety, and immunogenicity of the human papillomavirus 16/18 AS04-adjuvanted vaccine in women older than 25 years: 4-year interim follow-up of the phase 3, double-blind, randomised controlle
Publisher: Elsevier BV
Date: 12-2014
Letter to the Editor in response to O.M. Bautista, A. Luxembourg. Deconstructing the measure of vaccine efficacy against disease irrespective of HPV in HPV vaccine clinical trials. Contemporary Clinic
Publisher: Elsevier BV
Date: 03-2017
Human papillomavirus prevalence in Canberra high school students: significance for vaccination strategies and adolescent health
Publisher: CSIRO Publishing
Date: 2006
DOI: 10.1071/SH06044
Is sexual content in new media linked to sexual risk behaviour in young people? A systematic review and meta-analysis
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/SH16037
Abstract: Background: Social networking and digital media increasingly have an impact on the lives of young people. We undertook a systematic review and meta-analysis of studies that examined the relationship between exposure to sexually explicit websites (SEWs) and ‘sexting’ (i.e. sending semi-nude or nude photos from a mobile phone) and the sexual attitudes and practices of young people. Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses statement, Medline, EMBASE and PsycINFO were searched for papers that described the statistical association between viewing SEWs or sexting by young people (defined as 10–24 years) and their sexual attitudes and behaviours. Results: Fourteen studies, all cross-sectional in design, met the inclusion criteria. Six studies (10 352 participants) examined young people’s exposure to SEWs and eight (10 429 participants) examined sexting. There was substantial variation across studies in exposure and outcome definitions. Meta-analyses found that SEW exposure was correlated with condomless sexual intercourse (odds ratio (OR) 1.23, 95% confidence interval (CI): 1.08–1.38, two studies) sexting was correlated with ever having had sexual intercourse (OR 5.58, 95% CI: 4.46–6.71, five studies), recent sexual activity (OR 4.79, 95% CI: 3.55–6.04, two studies), alcohol and other drug use before sexual intercourse (OR 2.65, 95% CI: 1.99–3.32, two studies) and multiple recent sexual partners (OR 2.79, 95% CI: 1.95–3.63, two studies). Most studies had limited adjustment for important potential confounders. Conclusions: Cross-sectional studies show a strong association between self-reported exposure to sexual content in new media and sexual behaviours in young people. Longitudinal studies would provide a greater opportunity to adjust for confounding, and better insight into the causal pathways underlying the observed associations.
Social media’s role in support networks among LGBTQ adolescents: a qualitative study
Publisher: CSIRO Publishing
Date: 28-10-2021
DOI: 10.1071/SH21110
Abstract: Background Adolescents use social media more frequently than other age groups. Social media has been described as a safe environment for lesbian, gay, bisexual, transgender and queer and/or questioning (LGBTQ) adolescents. As part of mixed-methods research investigating the association between social networks and sexual agency, we present qualitative findings on how LGBTQ adolescents connect online to form support networks. Methods We recruited 30 adolescents aged 14–17 years who identified as LGBTQ in terms of their gender or attraction in the longitudinal Social Networks and Agency Project. Semi-structured interviews were conducted online or face-to-face across Australia. Thematic analysis was used to explore perceptions and experiences of participants in relation to social media use and relationships. Results Two overarching themes were identified: LGBTQ adolescents use social media for identity, relationships and wellbeing support. Social media is not always free of discrimination for LGBTQ adolescents. Many LGBTQ participants joined Facebook groups to connect with LGBTQ peers. Facebook was considered a vital support for those with mental health concerns including suicidal ideation. Participants gave and received support from group members, which was considered useful for those feeling isolated or victimised. LGBTQ adolescents formed friendships, romantic relationships and gained information on sex, relationships, and sexual health from these groups. Participants described negative experiences including discrimination within Facebook groups, mismanaged groups and exposure to anti-LGBTQ sentiments. Conclusion Social media is an environment where LGBTQ adolescents can connect, educate and support each other, which may have beneficial effects for this marginalised group. There remain issues with social media including discrimination against and within LGBTQ communities.
What predicts postpartum pertussis booster vaccination? A controlled intervention trial
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.VACCINE.2014.10.074
Abstract: 'Cocooning' aims to protect susceptible infants from pertussis via caregiver vaccination. Control trials evaluating educational interventions to promote cocooning are lacking. We evaluated the role of message-framing vs. standard health information in promoting pertussis vaccination. We recruited postpartum women from a maternity hospital in Sydney, Australia (November 2010-July 2012). Participants self-completed a pertussis knowledge and attitudes questionnaire. We then assigned pertussis-susceptible (no pertussis vaccine ≤10 years) participants to receive a gain-framed, loss-framed p hlet or control (Government Pertussis factsheet) using weekly sequential block allocation. Next, participants were offered a pertussis vaccine (dTpa) and completed a post-questionnaire on discharge. A baseline questionnaire was completed for 96.4% (1433/1486) of postpartum women approached. Missing data was excluded (n=29). Next, participants (1404) were screened for vaccine status: 324 (23%) reported prior pertussis booster vaccine receipt, leaving 1080 participants requiring vaccination. Among susceptible mothers, 70% (754/1080) were vaccinated post-intervention. Rates were similar between 'gain', 'loss' or 'control' p hlets (69.1% vs. 71.8% vs. 68.8% p=0.62). Intention to be vaccinated (OR 2.46, p<0.001 95% CI: 1.69-3.58), perceived vaccine benefits (OR: 1.61, p<0.001 95% CI: 1.25-2.15) and having received a vaccine recommendation (OR 1.68 p=0.025 95% CI: 1.07-2.65) were independent predictors of vaccine uptake. At discharge, overall pertussis vaccine coverage had increased from 23% to 77% among women screened (1078/1404). A cocooning strategy for pertussis vaccination can be highly effective when partially implemented within maternity hospitals, with information accompanied by a funded vaccine. Mothers were highly receptive to vaccination in the postnatal ward: facts about pertussis were as effective as message-framing in promoting a high uptake of 70%. Perceived vaccine benefits, intentions and vaccine recommendation were important predictors of uptake. Our intervention trial increased the existing pertussis vaccine coverage of 23-77%.
‘I see it everywhere': young Australians unintended exposure to sexual content online
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/SH17132
Abstract: Background There are wide variations in the reported prevalence of exposure to sexual content online, but the literature tends not to distinguish between intended and unintended exposure. Moreover, there is little research exploring the pathways through which exposure occurs or descriptions of such content. While there is much public concern regarding exposure to sexual content, Australian students receive little or no education on mitigating the effect of sexual content online. Methods: Eleven focus group discussions with high school students aged 14–18 years were conducted to discover young people’s experiences of exposure to sexual content in social media. In this paper, we describe these pathways to sexual content exposure, the nature of the sexual content young people are exposed to and their views about this exposure. Results: Focus groups showed that exposure to sexual content through social media occurred through networks of ‘friends’ or followers, and paid-for advertising. Content ranged from subtle messages or photos to explicit pornographic pictures/videos. Most of the exposure young people described was unintended. Conclusions: Exposure to sexual content, no matter the scope and intensity, was almost unavoidable among young people who use social media. Utilising this information to educate young people on mitigating the effect of sexual content, rather than trying to prevent young people from viewing it, could be a more effective approach.
HPV.edu study protocol: A cluster randomised controlled evaluation of education, decisional support and logistical strategies in school-based human papillomavirus (HPV) vaccination of adolescents
Publisher: Springer Science and Business Media LLC
Date: 15-09-2015
Vaccinating young adults against human papillomavirus: the importance of understanding health decision-making and behaviour
Publisher: CSIRO Publishing
Date: 2007
DOI: 10.1071/SH07005
Abstract: Vaccination of young teenage females against human papillomavirus (HPV) with a newly licenced quadrivalent vaccine designed to prevent cervical cancer and genital warts has recently been recommended by the Australian government and will be implemented through schools from April 2007. In addition, a fully funded ‘catch-up’ vaccination program for young women up to age 26 years has been approved for a 2-year period, from July 2007. As general practitioners (GPs) will be the main immunisation providers for this age group, in order to achieve high vaccination coverage and maximal impact on disease, it will be critical for GPs to be opportunistic in recommending this vaccine. An initial study of young Australians’ attitudes towards HPV vaccination and hypothetical acceptance of the vaccine was published in this journal. We draw on this study and data published elsewhere to discuss issues of HPV vaccine acceptability, and the likely challenges of a mass vaccination initiative in this age group in Australia. We suggest specific strategies to support GPs, and highlight areas for further research in HPV vaccine acceptability.
Adolescent and young adult HPV vaccination in Australia: Achievements and challenges
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.YPMED.2011.08.015
Abstract: Australia commenced an ongoing school based government funded human papillomaviruses (HPV) (cervical cancer prevention) vaccination program in April 2007 for adolescent females aged 12-13 years. In addition, up to December 31, 2009, a catch-up program for young females 13-26 years of age was offered: a school-based vaccination program was used to offer HPV vaccine to girls enrolled in school (14-17 years), and general practitioners or other community health provider offered vaccine to young women aged 18-26 years. To date, only the quadrivalent vaccine (HPV 6/11/16/18) has been utilized in the funded program. Acceptance of the vaccine is high with coverage of 3 doses of the HPV vaccine in the school age cohort around 70%, and just over 30% in the older age cohort. Since the vaccination program was initiated, a reduction in new cases of genital warts of 73% among vaccine eligible age females has been evidenced in STI clinics across Australia. A reduction of 44% of new cases in young males (not a part of the free program) was also documented during this same time period, suggesting significant herd immunity. Similarly, in the state of Victoria, a small but significant decrease in high grade abnormalities in Pap screening findings has been reported in young women<18 years for the period 2007-9, as compared to pre-vaccination. Challenges for the future include how we can sustain and improve HPV vaccination coverage in young Australian women, while maintaining cervical cancer screening participation and reviewing cervical cancer screening methods.
Efficacy, safety, and immunogenicity of the human papillomavirus 16/18 AS04-adjuvanted vaccine in women older than 25 years: 7-year follow-up of the phase 3, double-blind, randomised controlled VIVIAN
Publisher: Elsevier BV
Date: 10-2016
School-based vaccination: A systematic review of process evaluations
Publisher: Elsevier BV
Date: 12-2011
DOI: 10.1016/J.VACCINE.2011.10.033
Abstract: School-based vaccination is becoming a more widely used method of vaccine delivery. However, evaluations of school-based vaccination program implementation have not been systematically reviewed. This paper describes the results of a systematic review of the literature on process (or implementation) evaluations of school-based vaccination delivery. Search terms: "school based vaccination" OR (("schools" OR "school") AND ("immunisation" OR "immunization" OR "vaccination")). Humans English language Age: 6-18 (school-age children and adolescents) No editorials No letters. Databases: PUBMED Embase.com Cochrane Database of Systematic Reviews Cinahl Web of Science PsycINFO. Inclusions: Articles must have originated from an advanced economic 'developed' country, be peer-reviewed, available in English, randomised or non-randomised controlled design, published from 1970 to August 2010 and focused on vaccinations provided in the school setting and during school time which reported one or more outcomes. qualitative or descriptive papers without any evaluation component papers that only reported on impact evaluation (i.e. number of students vaccinated) and those published before 1970. A total of 14 articles were identified as including some element of a process evaluation of a school-based vaccination program. Nurses, parents, teachers, and adolescents were involved in measures of procedural factors related to school-based vaccination implementation. Outcomes included return rates of consent forms knowledge about the specific vaccine offered attitudes toward vaccination and school-based vaccination reasons for non-vaccination resources, support, and procedures related to implementation and environmental factors within the school that may impact vaccination success. Vaccination coverage was also reported in the majority of papers. Many studies reported on the importance of ensuring all stakeholders (school nurses, parents, teachers, and adolescents) receive appropriate information and are involved in the vaccination program and implementation processes. Specific consent form dissemination procedures have demonstrated higher return rates. Further controlled studies are needed to determine the best practice approach to implementing these programs is a variety of contexts.
Pertussis vaccination coverage among Australian women prior to childbirth in the cocooning era: A two-hospital, cross-sectional survey, 2010 to 2013
Publisher: Wiley
Date: 11-01-2016
DOI: 10.1111/AJO.12429
Abstract: Recent pertussis epidemics have triggered implementation of cocooning, involving caregiver vaccination to indirectly protecting susceptible infants. To determine patient, provider and setting factors associated with maternal pertussis booster vaccination (dTpa) within 5-10 years before childbirth. Cross-sectional survey using Health Belief Model constructs among postpartum women in a tertiary referral centre and a private hospital in Sydney, Australia. Pertussis vaccination was current among 33.7% of the 2483 new mothers (0.5% vaccinated during pregnancy). Women were more likely to be vaccinated if they had heard of 'whooping cough' from a health professional (OR: 2.59, P < 0.001, 95% CI: 1.70-3.95), were recommended the vaccine (OR: 2.48, P < 0.00, 95% CI: 1.55-4.00), perceived pertussis as 'severe' for adults (OR: 1.21, p0.009, 95% CI: 1.05-1.39) and 'common' within their community (OR: 1.38, P < 0.001, 95% CI: 1.18-1.61). They more often agreed that it was their parental responsibility to be vaccinated (OR: 1.61, P = 0.002, 95% CI: 1.19-2.18), and this would help prevent their baby from contracting pertussis (OR: 1.22, P = 0.046, 95% CI: 1.00-1.47). Vaccinated women were less likely to report vaccination barriers: time constraints (OR: 0.75, P < 0.001, 95% CI: 0.66-0.85) and having safety concerns (OR: 0.80, P < 0.001, 95% CI: 0.69-0.92). Additionally, their partners reported three times higher uptake (76% vs 49% P < 0.001 95% CI: 2.66-3.85). Current pertussis vaccination in only one in every three postpartum participants may indicate insufficient coverage to protect newborns. Practitioners are instrumental in raising awareness and addressing vaccine concerns. Integrating vaccination into routine obstetric care, whether antenatally or postnatally, may minimise barriers.
'It's a logistical nightmare!' Recommendations for optimising human papillomavirus school-based vaccination experience
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/SH09140
Abstract: Introduction: To date, no published studies examine procedural factors of the school-based human papillomavirus (HPV) vaccination program from the perspective of those involved. This study examines the factors that were perceived to impact optimal vaccination experience. Methods: Schools across Sydney were selected to reflect a range of vaccination coverage at the school level and different school types to ensure a range of experiences. Semi-structured focus groups were conducted with girls and one-on-one interviews were undertaken with parents, teachers and nurses until saturation of data in all emergent themes was reached. Focus groups and interviews explored participants’ experiences in school-based HPV vaccination. Transcripts were analysed, letting themes emerge. Results: Themes related to participants’ experience of the organisational, logistical and procedural aspects of the vaccination program and their perceptions of an optimal process were organised into two categories: (1) preparation for the vaccination program and (2) vaccination day strategies. In (1), themes emerged regarding commitment to the process from those involved, planning time and space for vaccinations, communication within and between agencies, and flexibility. In (2), themes included vaccinating the most anxious girls first, facilitating peer support, use of distraction techniques, minimising waiting time girls, and support staff. Discussion: A range of views exists on what constitutes an optimal school-based program. Several findings were identified that should be considered in the development of guidelines for implementing school-based programs. Future research should evaluate how different approaches to acquiring parental consent, and the use of anxiety and fear reduction strategies impact experience and uptake in the school-based setting.
Safety, tolerability, acceptability and immunogenicity of an influenza vaccine delivered to human skin by a novel high-density microprojection array patch (Nanopatch™)
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.VACCINE.2018.05.053
Abstract: Injection using needle and syringe (N&S) is the most widely used method for vaccination, but requires trained healthcare workers. Fear of needles, risk of needle-stick injury, and the need to reconstitute lyophilised vaccines, are also drawbacks. The Nanopatch (NP) is a microarray skin patch comprised of a high-density array of microprojections dry-coated with vaccine that is being developed to address these shortcomings. Here we report a randomised, partly-blinded, placebo-controlled trial that represents the first use in humans of the NP to deliver a vaccine. Healthy volunteers were vaccinated once with one of the following: (1) NPs coated with split inactivated influenza virus (A/California/07/2009 [H1N1], 15 µg haemagglutinin (HA) per dose), applied to the volar forearm (NP-HA/FA), n = 15 (2) NPs coated with split inactivated influenza virus (A/California/07/2009 [H1N1], 15 µg HA per dose), applied to the upper arm (NP-HA/UA), n = 15 (3) Fluvax® 2016 containing 15 µg of the same H1N1 HA antigen injected intramuscularly (IM) into the deltoid (IM-HA/D), n = 15 (4) NPs coated with excipients only, applied to the volar forearm (NP-placebo/FA), n = 5 (5) NPs coated with excipients only applied to the upper arm (NP-placebo/UA), n = 5 or (6) Saline injected IM into the deltoid (IM-placebo/D), n = 5. Antibody responses at days 0, 7, and 21 were measured by haemagglutination inhibition (HAI) and microneutralisation (MN) assays. NP vaccination was safe and acceptable all adverse events were mild or moderate. Most subjects (55%) receiving patch vaccinations (HA or placebo) preferred the NP compared with their past experience of IM injection with N&S (preferred by 24%). The antigen-vaccinated groups had statistically higher HAI titres at day 7 and 21 compared with baseline (p 0.05), although the group sizes were small. The geometric mean HAI titres at day 21 for the NP-HA/FA, NP-HA/UA and IM-HA/D groups were: 335 (189-593 95% CI), 160 (74-345 95% CI), and 221 (129-380 95% CI) respectively. A similar pattern of responses was seen with the MN assays. Application site reactions were mild or moderate, and more marked with the influenza vaccine NPs than with the placebo or IM injection. Influenza vaccination using the NP appeared to be safe, and acceptable in this first time in humans study, and induced similar immune responses to vaccination by IM injection.
Fall in Human Papillomavirus Prevalence Following a National Vaccination Program
Publisher: Oxford University Press (OUP)
Date: 19-10-2012
Abstract: In April 2007, Australia became the first country to introduce a national government-funded human papillomavirus (HPV) vaccination program. We evaluated the program's impact on genotype-specific HPV infection prevalence through a repeat survey of women attending clinical services. HPV genoprevalence in women aged 18-24 years attending family planning clinics in the prevaccine period (2005-2007) was compared with prevalence among women of the same age group in the postvaccine period (2010-2011). The same recruitment and testing strategies were utilized for both sets of s les, and comparisons were adjusted for potentially confounding variables. The prevalence of vaccine HPV genotypes (6, 11, 16, and 18) was significantly lower in the postvaccine s le than in the prevaccine s le (6.7% vs 28.7% P < .001), with lower prevalence observed in both vaccinated and unvaccinated women compared with the prevaccine population (5.0% [adjusted odds ratio, 0.11 95% confidence interval, 0.06-0.21] and 15.8% [adjusted odds ratio, 0.42 95% confidence interval, 0.19-0.93], respectively). A slightly lower prevalence of nonvaccine oncogenic HPV genotypes was also found in vaccinated women (30.8% vs 37.6% adjusted odds ratio, 0.68 95% confidence interval, 0.46-0.99). Four years after the commencement of the Australian HPV vaccination program, a substantial decrease in vaccine-targeted genotypes is evident and should, in time, translate into reductions in HPV-related lesions.
Social media use and health and wellbeing of LGBTQ youth: A systematic review (Preprint)
Publisher: JMIR Publications Inc.
Date: 02-04-2022
Abstract: GBTQ in iduals are at higher risk of poor mental health and wellbeing. Social media platforms can provide LGBTQ youth a space which counters heteronormative environments and potentially supports mental health and wellbeing. n this systematic review, we sought to assess the relationship between social media use and mental health and wellbeing in LGBTQ youth. earches were conducted in ACM Digital Library, CINAHL, OVID Embase, OVID Medline, and Web of Science. Quality was assessed using the Newcastle-Ottawa Scale for quantitative articles and the Critical Appraisal Skills Programme for qualitative articles. Qualitative synthesis was performed on articles that satisfied eligibility and inclusion criteria. wenty-six articles (15 qualitative, 8 quantitative, and 3 mixed methods) met the inclusion criteria. Social media is a popular tool commonly used by LGBTQ youth to connect with LGBTQ communities. LGBTQ youth also negotiated and explored identity and obtained support from peers on social media. Instagram, Tumblr, and Twitter were commonly used to access LGBTQ content due to ease of anonymity. Identity management was important for LGBTQ youth with social media allowing strategic disclosure. Key strategies for managing identities included being anonymous, censoring locations/content, restricting audiences, and using multiple accounts. Quantitative studies showed that social media was associated with reduced mental health concerns and increased wellbeing for LGBTQ youth. Mental health concerns arising from social media use were attributed to policies that did not accommodate for changed identities. e found that social media may support mental health and wellbeing of LGBTQ youth through peer connection, identity management, and social support but findings were limited by weaknesses in the evidence. More robust studies are needed to determine the relationship between social media use and LGBTQ mental health, particularly among adolescents. This may inform interventions to promote social media health literacy and the mental health and wellbeing of this vulnerable group.
Development of a human papillomavirus vaccination intervention for Australian adolescents
Publisher: SAGE Publications
Date: 28-07-2016
Abstract: Australia has implemented a nation-wide programme providing a human papillomavirus (HPV) vaccine to girls and boys through school-based programmes. Previous research has identified three distinct areas for attention: (1) lack of understanding about HPV and HPV vaccination, (2) young people’s desire for involvement in decision-making about HPV vaccination and (3) fear of HPV vaccination. We aimed to develop an intervention to address young people’s low levels of understanding, to promote their involvement in consent and reduce vaccination-related fear and anxiety. Formative qualitative research was conducted in six public, private and Catholic schools in the Sydney metropolitan area. Girls who were offered the vaccine in a school programme and aged 12–13 years were interviewed in focus groups. Piloting of materials was conducted in three private schools across Sydney with both girls and boys, and changes and additions were made to the materials in accordance with feedback. We developed an educational intervention aimed at addressing gaps in young people’s knowledge and understanding, and offering strategies to improve confidence with vaccination and reduce needle-related anxiety. Components of the final intervention include film chapters, a magazine, a website, an app and teacher support materials. The intervention is designed for teachers and/or nurses to deliver and is linked to the school-based HPV vaccination programme. This is the first educational intervention designed for young people in HPV school-based vaccination, to be developed from empirical data with the involvement of young people themselves.
Prospective mixed methods study of online and offline social networks and the development of sexual agency in adolescence: the Social Networks and Agency Project (SNAP) protocol
Publisher: BMJ
Date: 17-05-2019
DOI: 10.1136/BMJOPEN-2018-024329
Abstract: Social media may play a role in adolescent sexual development. The limited research on social media use and sexual development has found both positive and negative influences. The focus of this study is on sexual agency: a positive sexual outcome. This paper describes the protocol for the Social Networks and Agency Project (SNAP) study which aims to examine the relationship between online and offline social networks and the development of healthy relationships and sexual agency in adolescence. The SNAP study is a mixed methods interdisciplinary longitudinal study. Over an 18-month period, adolescents aged 15–17 years at recruitment complete three questionnaires (including demographics, sexual behaviour, sexual agency and social networks) three in-depth interviews and fortnightly online diaries describing their sexual behaviour and snapshots of their social networks that week. Longitudinal analyses will be used to describe changes in sexual behaviour and experiences over time, sexual agency, social media use, and social network patterns. Social network analysis will be used to capture relational data from which we will be able to construct sociograms from the respondent’s perspective. Interview data will be analysed both in relation to emergent themes (deploying a grounded theory approach), and from a cross-disciplinary perspective. This mixed method analysis will allow for comparisons across quantitative and qualitative data, for consistency and differences, and will enhance the robustness of data interpretation and conclusions drawn, as multiple data sources are triangulated. Ethical approval was granted by the University of Sydney Human Research Ethics Committee and the Family Planning New South Wales Ethics Committee. The study will provide comprehensive, prospective information on the social and sexual development of adolescents in the age of social media and findings will be disseminated through conference presentations and peer-reviewed publications.
Sexually transmitted infections. Initiatives for prevention
Publisher: Walter de Gruyter GmbH
Date: 07-2007
DOI: 10.1515/IJAMH.2007.19.3.285
Abstract: Sexually transmissible infections (STIs) are responsible for a significant burden of disease in both developed and developing countries and young people are disproportionately affected by STIs and their consequences. STI rates in young people are determined by a wide range of well documented influences. These include physiological, cognitive and behavioural factors, as well as environmental factors such as the social, and cultural context in which young people live. Despite the erecognition of these influences, their complex inter-relationships are less well documented and the evidence for interventions to reduce STIs in young people is similarly less clear. This paper explore tht most important factors that impact STI rates in young people in Australia and reviews interventions that have shown success, in Australia and elsewhere. In addition, promising strategies for the promotion of sexual health and reduction of STIs in young Australians, are discussed.
How Australian Female Adolescents Prioritize Pregnancy Protection
Publisher: SAGE Publications
Date: 13-04-2011
Abstract: Grounded theory principles were systematically employed to reveal key differences in pregnancy risk and underlying disparities in contraceptive use in (a) never-pregnant (b) pregnant-terminated and (c) pregnant-continued teenagers. Analysis of 69 semistructured interviews revealed a bicausal model of pregnancy protection that accounted for variation in contraceptive use across the s le. Diverging pregnancy/childbearing desires and risk perceptions were conceptualized into three behavioral patterns that represented higher and lower levels of commitment to prevent pregnancy. The various ways that teenagers made sense of their behavior highlight the importance of acknowledging and respecting ersity in perspectives and experiences and provide a useful framework for educational and practitioner-delivered interventions with greater relevance and impact.
How can data harmonisation benefit mental health research? An example of the Cannabis Cohorts Research Consortium
Publisher: SAGE Publications
Date: 06-03-2015
Evaluation of Type Replacement Following HPV16/18 Vaccination: Pooled Analysis of Two Randomized Trials
Publisher: Oxford University Press (OUP)
Date: 2017
DOI: 10.1093/JNCI/DJW300
Risk-taking behaviours among younger adolescents in rural and regional New South Wales: preventing adverse health outcomes
Publisher: Informa UK Limited
Date: 04-05-2017
Could HPV Testing on Self-collected Samples Be Routinely Used in an Organized Cervical Screening Program? A Modeled Analysis
Publisher: American Association for Cancer Research (AACR)
Date: 02-2021
DOI: 10.1158/1055-9965.EPI-20-0998
Abstract: Cervical screening on self-collected s les has mainly been considered for targeted use in underscreened women. Updated evidence supports equivalent sensitivity of PCR-based human papillomavirus (HPV) testing on self-collected and clinician-collected s les. Using a well-established model, we compared the lifetime impact on cancer diagnoses and deaths resulting from cervical screening using self-collected s les only, with and without the existing restriction in Australia to women aged 30+ years and ≥2 years overdue, compared with the mainstream program of 5-yearly HPV screening on clinician-collected s les starting at 25 years of age. We conservatively assumed sensitivity of HPV testing on self-collected relative to clinician-collected s les was 0.98. Outcomes were estimated either in the context of HPV vaccination (“routinely vaccinated cohorts ” uptake as in Australia) or in the absence of HPV vaccination (“unvaccinated cohorts”). In unvaccinated cohorts, the health benefits of increased participation from self-collection outweighed the worst case (2%) loss of relative test sensitivity even if only 15% of women, who would not otherwise attend, used it (“additional uptake”). In routinely vaccinated cohorts, population-wide self-collection could be marginally (0.2%–1.0%) less effective at 15% additional uptake but 6.2% to 12.4% more effective at 50% additional uptake. Most (56.6%–65.0%) of the loss in effectiveness in the restricted self-collection pathway in Australia results from the requirement to be 2 or more years overdue. Even under pessimistic assumptions, any potential loss in test sensitivity from self-collection is likely outweighed by improved program effectiveness resulting from feasible levels of increased uptake. Consideration could be given to offering self-collection more widely, potentially as an equal choice for women. See related commentary by Lim, p. 245
Pathways to a cancer-free future: A protocol for modelled evaluations to maximize the future impact of interventions on cervical cancer in Australia
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.YGYNO.2018.12.019
Abstract: Australia's HPV vaccination and HPV-based cervical screening programs are changing the landscape in cervical cancer prevention. We aim to identify areas which can make the biggest further impact on cervical cancer burden. This protocol describes the first stage of a program of work called Pathways-Cervix that aims to generate evidence from modelled evaluations of interventions across the cervical cancer spectrum. Based on evidence from literature reviews and guidance from a multi-disciplinary Scientific Advisory Committee (SAC), the most relevant evaluations for prevention, diagnosis and treatment were identified. Priority evaluations agreed by the SAC included: increasing/decreasing and retaining vaccination uptake at the current level vaccinating older women increasing screening participation methods for triaging HPV-positive women improving the diagnosis of cervical intraepithelial neoplasia (CIN) and cancer treating cervical abnormalities and cancer and vaccinating women treated for CIN2/3 to prevent recurrence. Evaluations will be performed using a simulation model, Policy1-Cervix previously used to perform policy evaluations in Australia. Exploratory modelling of interventions using idealised scenarios will initially be conducted in single birth cohorts. If these have a significant impact on findings then evaluations with more realistic assumptions will be conducted. Promising strategies will be investigated further by multi-cohort simulations predicting health outcomes, resource use and cost outcomes. Pathways-Cervix will assess the relative benefits of strategies and treatment options in a systematic and health economic framework, producing a list of 'best buys' for future decision-making in cervical cancer control.
Exposure to Pornography and Adolescent Sexual Behavior: Systematic Review (Preprint)
Publisher: JMIR Publications Inc.
Date: 30-09-2022
Abstract: ormative experiences in adolescence lay the foundation for healthy and pleasurable romantic and sexual relationships. Exposure to pornography may affect these experiences. e aimed to synthesize evidence published in the past decade on the relationship between exposure to pornography and sexual behavior (earlier age of first sex [& years], condomless sex, past-year multiple partners [& ], lifetime multiple partners [& ], group sex, sexual aggression including forced sex, paid sex, teenage pregnancy, and history of sexually transmitted infection) in adolescents aged between 10 and 19 years. e identified 19 eligible studies by searching MEDLINE, PsycINFO, Cochrane, CINAHL, Embase, and Web of Science databases from January 2010 to November 2022. ut of 8 studies that assessed earlier age of first sex, 5 studies, including 1 longitudinal study, found a statistically significant association with exposure to pornography. Given that most studies were cross-sectional or had substantial limitations, causal inference could not be made. Also, exposure to pornography was not measured consistently. The evidence was conflicting or insufficient to draw any conclusions regarding other outcomes. ore quantitative research is needed to elucidate the association between pornography exposure and sexual behavior, and sex education should adopt evidence-based approaches to minimize the potential harms from pornography. ROSPERO International Prospective Register of Systematic Reviews CRD42021227390 www.crd.york.ac.uk rospero/display_record.php?RecordID=227390
Young adult sequelae of adolescent cannabis use: An integrative analysis
Publisher: Elsevier BV
Date: 09-2014
Risk of HPV-16/18 Infections and Associated Cervical Abnormalities in Women Seropositive for Naturally Acquired Antibodies: Pooled Analysis Based on Control Arms of Two Large Clinical Trials
Publisher: Oxford University Press (OUP)
Date: 30-04-2018
Cannabis use and non-clinical dimensions of psychosis in university students presenting to primary care
Publisher: Wiley
Date: 07-12-2010
DOI: 10.1111/J.1600-0447.2010.01546.X
Abstract: To explore the relationship between cannabis use and self-reported dimensions of psychosis in a population of university students presenting for any reason to primary care. One thousand and forty-nine students attending the Student Health Unit, National University of Ireland, Galway, completed self-report questionnaires on alcohol and substance misuse, non-clinical dimensions of psychosis [Community Assessment of Psychic Experiences (CAPE)], anxiety and depression [Hospital Anxiety and Depression Scale (HADS)]. Association of cannabis use with psychiatric symptoms was explored whilst controlling for confounds. More frequent cannabis use was independently associated with greater intensity of positive, negative and depressive psychotic symptoms. The earlier the age of onset of cannabis use, the more positive psychotic symptoms were reported. These findings support the hypotheses that cannabis use increases the risk of developing psychotic symptoms and that this risk is further increased in those in iduals who use cannabis more heavily and commence it at a younger age.
England's Teenage Pregnancy Strategy: a hard-won success
Publisher: Elsevier BV
Date: 08-2016
Eliciting youth and adult recommendations through citizens’ juries to improve school based adolescent immunisation programs
Publisher: Elsevier BV
Date: 05-2014
DOI: 10.1016/J.VACCINE.2014.02.098
Abstract: Completion of adolescent immunisation schedules in Australia is sub-optimal despite a well-established school based delivery program. The aim of this study was to seek adolescent and adult views on how existing adolescent school based immunisation policy and program delivery could be improved to increase adolescent immunisation uptake. Two citizens' juries held separately, one with adolescent participants and one with adult participants deliberated on recommendations for public policy. Jury members were selected using a stratified s ling technique and recruited from a standing panel of community research participants through a market research company in South Australia. Juries were conducted in Metropolitan South Australia over two days and used university facilities with all meals and refreshments provided. Fifteen adults and 16 adolescents participated in the adult and youth juries respectively. Similar recommendations were made by both juries including increased ensuring the accuracy of information provided to adolescents and parents employing a variety of formats for information delivery and greater consideration of students' physical and emotional comfort in order to improve the experience for adolescents. While the youth jury recommended that it should be compulsory for adolescents to receive vaccines through the school based immunisation program, the adult jury recommended an 'opt-out' system of consent. Both juries also recommended the use of incentives to improve immunisation uptake and immunisation course completion. Eliciting adolescent views and including the perspectives of adolescents in discussions and development of strategies to improve engagement in the school based immunisation program provided valuable insight from the group most impacted by these policies and practices. Specifically, incorporation of adolescent and community views using citizens' juries may lead to greater overall support from the community as their values and needs are more accurately reflected.
Childhood Behavior Problems and Age at First Sexual Intercourse: A Prospective Birth Cohort Study
Publisher: American Academy of Pediatrics (AAP)
Date: 02-2015
Abstract: Early first sexual intercourse (FSI) is a risk factor for unplanned teenage pregnancy, sexually transmitted infection, and adverse social, emotional, and physical health outcomes in adolescence and into adulthood. The aim of this study was to examine relationships between internalizing (eg, anxious/depressed, withdrawn) and externalizing (eg, delinquent, aggressive) behavior problems in childhood and age at FSI. We used a large, population-based birth cohort (The Western Australian Pregnancy Cohort [Raine] Study) to address this question. Child behavior was measured by using the Child Behavior Checklist collected from parents at ages 2, 5, 8, 10, and 14 and scores calculated for total, internalizing, and externalizing behavior problems. At age 17, 1200 participants reported sexual behavior. Participants with clinically significant Child Behavior Checklist scores (T ≥60) were at increased risk for earlier first sexual intercourse (FSI) (& years). Adjusted odds ratios revealed that total and externalizing behavior problems from age 5 years onward significantly increased the risk of earlier FSI for boys. In girls, externalizing problems from age 10 years increased the risk for earlier FSI. Internalizing problems at ages 8 and 10 were significantly associated with early FSI for boys but not girls. Externalizing behavior from as early as 5 in boys and 10 in girls is a significant risk factor for earlier age at FSI. Adolescent sexual health promotion should consider early intervention in children with behavior problems, particularly boys.
One giant leap towards Australian adolescents’ understanding of the human papillomavirus vaccine
Publisher: Informa UK Limited
Date: 03-2012
DOI: 10.1586/EOG.12.3
Awareness of human papillomavirus, cervical cancer and its prevention among primigravid antenatal clinic attendees in a tertiary care hospital in Sri Lanka: a cross-sectional study.
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/SH18080
Social Media Use and Health and Well-being of Lesbian, Gay, Bisexual, Transgender, and Queer Youth: Systematic Review
Publisher: JMIR Publications Inc.
Date: 21-09-2022
DOI: 10.2196/38449
Abstract: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) in iduals are at higher risk of poor mental health and well-being. Social media platforms can provide LGBTQ youths with a space that counters heteronormative environments and potentially supports mental health and well-being. Mental health includes an in idual’s state of psychological and emotional well-being and not merely the absence of mental disorders. We sought to identify how LGBTQ youths and adolescents use social media for connection with other LGBTQ peers and groups, identity development, and social support and how these affect mental health and well-being. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) procedures were used to guide this review. Searches were conducted in ACM Digital Library, CINAHL, Ovid Embase, Ovid MEDLINE, and Web of Science in March 2021. This review focused on LGBTQ youths aged 10 to 24 years. Included peer-reviewed studies must comprise social media explore peer connection, identity development, or social support and be published from 2012 onward. In total, 2 researchers extracted data and performed quality assessments independently using the Newcastle-Ottawa Scale for quantitative articles and the Critical Appraisal Skills Programme for qualitative articles. Qualitative synthesis was performed on articles that satisfied the eligibility criteria. A total of 26 studies (n=15, 58% qualitative n=8, 31% quantitative n=3, 12% mixed methods) met the inclusion criteria. Of the 8 quantitative studies, 6 (75%) were cross-sectional, and 2 (25%) were cohort studies. All studies ranged from moderate to high quality. Social media was a popular tool used by LGBTQ youths to connect with LGBTQ communities. In qualitative data, we found that LGBTQ youths negotiated and explored identity and obtained support from peers on social media. Instagram, Tumblr, and Twitter were commonly used to access LGBTQ content owing to ease of anonymity. Identity management was the most studied social media affordance, important to LGBTQ youths for strategic disclosure. Key strategies for managing identities included being anonymous, censoring locations or content, restricting audiences, and using multiple accounts. Quantitative studies (3/8, 38%) showed that social media was associated with reduced mental health concerns and increased well-being among LGBTQ youths. Mental health concerns arising from social media use were attributed to discrimination, victimization, and policies that did not accommodate changed identities. We found that social media may support the mental health and well-being of LGBTQ youths through peer connection, identity management, and social support, but findings were limited by weaknesses in the evidence. More robust and longitudinal studies are needed to determine the relationship between social media use and LGBTQ mental health, particularly among adolescents. The findings may inform interventions to promote social media health literacy and the mental health and well-being of this vulnerable group. PROSPERO CRD42020222535 www.crd.york.ac.uk rospero/display_record.php?RecordID=222535
Usability, acceptability, and feasibility of a High-Density Microarray Patch (HD-MAP) applicator as a delivery method for vaccination in clinical settings
Publisher: Informa UK Limited
Date: 9
Assessing seasonal vaccine‐related cross‐protection from 2009 pandemic H1N1 influenza through teacher absenteeism
Publisher: Elsevier BV
Date: 08-2011
Knowledge, Attitudes, and Perceptions of the Arabic-Speaking Community in Sydney, Australia, toward the Human Papillomavirus (HPV) Vaccination Program: A Qualitative Study
Publisher: MDPI AG
Date: 24-08-2021
Abstract: Background: Little is known about acceptability of the human papillomavirus (HPV) vaccine among parents of adolescents from culturally and linguistically erse backgrounds in Australia. This study aimed to explore the knowledge and attitudes of parents from Arabic backgrounds towards HPV vaccination offered to their children in the national school-based vaccination program. Methods: Qualitative interviews were conducted in Western Sydney, with parents of adolescents from Arabic backgrounds. Recruitment was via informal personal contacts and passive snowballing. Face-to-face semi-structured interviews were conducted in Arabic. These were audio-recorded, transcribed, and translated into English. Thematic analysis was used to identify emerging themes. Results: Commonly identified themes across fifteen interviews included: (1) lack of awareness and knowledge of HPV and its vaccination, (2) awareness and understanding of the government vaccination information sheet, (3) parents’ preferences for information provision, (4) the role of parents’ religious beliefs in forming attitudes about HPV vaccination, and (5) lost opportunities to educate parents about HPV vaccination during general practitioner (GP) visits. Conclusion: The findings point to the need to address cultural, language, and communication barriers to improve awareness and acceptability of HPV vaccination in the Arabic community. Educational strategies should be tailored to this community based on their specific information needs and preferences.
Efficacy of fewer than three doses of an HPV-16/18 AS04-adjuvanted vaccine: combined analysis of data from the Costa Rica Vaccine and PATRICIA trials
Publisher: Elsevier BV
Date: 07-2015
Very Low Prevalence of Vaccine Human Papillomavirus Types Among 18- to 35-Year Old Australian Women 9 Years Following Implementation of Vaccination
Publisher: Oxford University Press (OUP)
Date: 07-02-2018
Abstract: A quadrivalent human papillomavirus vaccination program targeting females aged 12-13 years commenced in Australia in 2007, with catch-up vaccination of 14-26 year olds through 2009. We evaluated the program's impact on HPV prevalence among women aged 18-35 in 2015. HPV prevalence among women aged 18-24 and 25-35 was compared with prevalence in these age groups in 2005-2007. For women aged 18-24, we also compared prevalence with that in a postvaccine study conducted in 2010-2012. For the 2015 s le, Vaccination Register-confirmed 3-dose coverage was 53.3% (65.0% and 40.3% aged 18-24 and 25-35, respectively). Prevalence of vaccine HPV types decreased from 22.7% (2005-2007) and 7.3% (2010-2012), to 1.5% (2015) (P trend < .001) among women aged 18-24, and from 11.8% (2005-2007) to 1.1% (2015) (P = .001) among those aged 25-35. This study, reporting the longest surveillance follow-up to date, shows prevalence of vaccine-targeted HPV types has continued to decline among young women. A substantial fall also occurred in women aged 25-35, despite lower coverage. Strong herd protection and effectiveness of less than 3 vaccine doses likely contributed to these reductions.
Post Hoc Analysis of the PATRICIA Randomized Trial of the Efficacy of Human Papillomavirus Type 16 (HPV-16)/HPV-18 AS04-Adjuvanted Vaccine against Incident and Persistent Infection
Publisher: American Society for Microbiology
Date: 02-2015
DOI: 10.1128/CVI.00457-14
Abstract: The efficacy of the human papillomavirus type 16 (HPV-16)/HPV-18 AS04-adjuvanted vaccine against cervical infections with HPV in the Pa pilloma Tri al against C ancer i n Young A dults (PATRICIA) was evaluated using a combination of the broad-spectrum L1-based SPF 10 PCR-DNA enzyme immunoassay (DEIA)/line probe assay (LiPA 25 ) system with type-specific PCRs for HPV-16 and -18. Broad-spectrum PCR assays may underestimate the presence of HPV genotypes present at relatively low concentrations in multiple infections, due to competition between genotypes. Therefore, s les were retrospectively reanalyzed using a testing algorithm incorporating the SPF 10 PCR-DEIA/LiPA 25 plus a novel E6-based multiplex type-specific PCR and reverse hybridization assay (MPTS12 RHA), which permits detection of a panel of nine oncogenic HPV genotypes (types 16, 18, 31, 33, 35, 45, 52, 58, and 59). For the vaccine against HPV types 16 and 18, there was no major impact on estimates of vaccine efficacy (VE) for incident or 6-month or 12-month persistent infections when the MPTS12 RHA was included in the testing algorithm versus estimates with the protocol-specified algorithm. However, the alternative testing algorithm showed greater sensitivity than the protocol-specified algorithm for detection of some nonvaccine oncogenic HPV types. More cases were gained in the control group than in the vaccine group, leading to higher point estimates of VE for 6-month and 12-month persistent infections for the nonvaccine oncogenic types included in the MPTS12 RHA assay (types 31, 33, 35, 45, 52, 58, and 59). This post hoc analysis indicates that the per-protocol testing algorithm used in PATRICIA underestimated the VE against some nonvaccine oncogenic HPV types and that the choice of the HPV DNA testing methodology is important for the evaluation of VE in clinical trials. (This study has been registered at ClinicalTrials.gov under registration no. NCT00122681.)
The relationship between optic disc parameters and female reproductive factors in young women
Publisher: Asia Pacific Academy of Ophthalmology
Date: 2019
DOI: 10.22608/APO.2018329
What adolescents think of relationship portrayals on social media: a qualitative study
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/SH20056
Abstract: Background Understanding the factors influencing adolescents’ relationship views is important because early romantic relationships often act as precursors for relationships in adulthood. This study sought to examine the types of relationship-focused content adolescents witness on social media and how they perceive its effect on their romantic relationship beliefs. Methods: Sixteen semistructured interviews were conducted with Australian adolescents aged 16–19 years who were purposively s led from a larger longitudinal study. Interview transcripts were analysed qualitatively using constructivist grounded theory. Results: Participants described the types of romantic relationship portrayals they saw on social media, including relationship-focused trends like ‘Relationship Goals’ and ‘Insta-Couples’. Participants explained their ability to identify incomplete and unrealistic relationship portrayals, as well as the pressure to share their relationships online in the same incomplete fashion. Views regarding the influence of social media were varied, but most believed social media relationship portrayals had some level of influence on young people’s relationship views some participants believed this occurred regardless of awareness of the incompleteness of the online portrayal. Conclusions: Although participant interview data revealed the pervasiveness of social media relationship portrayals, it also revealed the sophisticated capabilities of adolescents in critiquing online media portrayals.
Pertussis Booster Vaccination in Pregnancy: Women Who had it Compared to Those Who Waited
Publisher: Elsevier BV
Date: 2015
‘Is it like one of those infectious kind of things?’ The importance of educating young people about HPV and HPV vaccination at school
Publisher: Informa UK Limited
Date: 24-04-2017
Adolescent medicine in paediatric practice
Publisher: BMJ
Date: 11-2005
Human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine for the prevention of cervical cancer and HPV-related diseases
Publisher: Informa UK Limited
Date: 22-02-2016
DOI: 10.1586/14760584.2016.1124763
Abstract: Vaccines are available against human papillomavirus (HPV), the causal agent of cervical and other cancers. Efficacy data from the HPV-16/18 AS04-adjuvanted vaccine clinical trial program were reviewed. Six randomized, controlled phase II/III trials evaluating cervical endpoints enrolled women from erse populations and geographical locations. The program analyzed extensively the cohorts most relevant from a public health perspective: the total vaccinated cohort (TVC), approximating a general population including those with existing or previous HPV infection, and TVC-naïve, approximating a population of young women before sexual debut. Results show that the vaccine reduces HPV-16/18 infection and associated cervical endpoints in women regardless of age, location, or sexual experience. It provides cross-protection against some non-vaccine oncogenic HPV types and types causing genital warts, and may be effective against vulvar, oral, and anal HPV infection. Early epidemiology data following its introduction suggest a decline in the prevalence of vaccine and some non-vaccine HPV types.
Acute exercise does not improve immune response to HPV vaccination series in adolescents
Publisher: Elsevier BV
Date: 12-2019
Decline in prevalence of human papillomavirus infection following vaccination among Australian Indigenous women, a population at higher risk of cervical cancer: The VIP-I study
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.VACCINE.2018.05.104
Abstract: Cervical cancer occurrence and mortality are strongly correlated with socioeconomic disadvantage, largely due to unequal access to screening and treatment. Universal human papillomavirus (HPV) vaccination provides the opportunity to greatly reduce this global health disparity. Australian Indigenous women have substantially higher rates of cervical cancer than non-Indigenous women, primarily due to under-screening. We investigated HPV infection rates in Indigenous women 7 years after implementation of the national HPV vaccination program. We used a repeat cross-sectional design, with the baseline being provided by an HPV prevalence survey among Indigenous women attending clinics for cervical cytology screening, prior to the start of the vaccination program in 2007. We returned to clinics in four locations during 2014-15, and invited women aged 18-26 years attending for screening to provide a cervical specimen for HPV testing, as well as to complete a short questionnaire and consent to allow access of their records in the National HPV Vaccination Program Register. We used well-established laboratory methods to test specimens for specific HPV genotypes. A total of 142 women were recruited at participating sites and compared to 155 who had been recruited at the same locations in the 2007 pre-vaccine survey. The two groups were identical in regard to age, with the more recent group having a higher proportion of hormonal contraception users, and a lower proportion of smokers. The proportion found to have any HPV type fell from 58 to 36% with the decline being entirely due to reductions in vaccine types, which fell by 94% from 24 to 1.4%. Australia's national HPV vaccination program appears to be successfully protecting a very high proportion of Indigenous women against vaccine targeted HPV types, who have in the past been at elevated risk of cervical cancer.
Clinical Outcomes of Ambulatory Endovascular Treatment Using 4-French and 6-French Femoral Access Strategies: The Bio4amb Multicentre Trial (Dec, 10.1007/s00270-020-02738-5, 2020)
Publisher: Springer Science and Business Media LLC
Date: 08-04-2021
DOI: 10.1007/S00270-021-02827-Z
Abstract: The original version of this paper did not contain a list of Bio4amb investigators.
Interventions for young people in Australia to reduce HIV and sexually transmissible infections: a systematic review
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/SH09079
Abstract: Background: Like young people in other developed countries, sexually active young Australians can have an increased risk of acquiring sexually transmissible infections (STIs). This paper reviews intervention programs that aim to reduce the incidence and transmission of HIV and STIs among young people in Australia. Methods: Articles were identified from seven databases. Intervention studies conducted in Australia that included young people aged 12–25 years were reviewed. A two-dimensional matrix consisting of ‘setting’ and ‘intervention type’ was developed to categorise each study. Results: Forty-two studies met the inclusion criteria, and the majority were uncontrolled intervention studies. Of these, 23/42 studies measured participation in chlamydia ± other STI testing and found that the highest participation rates took place in non-clinical and non-general practice health care settings. Four studies facilitated access to testing indirectly, through the internet or other media. Ten studies involved the provision of education and measured its impact on factors such as knowledge, attitudes and/or behaviour. Three studies involved novel immunisation strategies for either hepatitis B or human papillomavirus vaccines. Two studies evaluated the impact of enhanced STI surveillance programs on prevalence rates. Conclusions: Proactive STI testing in non-clinical and some health settings appears feasible and achieves higher testing rates than in general practice however, more evaluation of testing strategies in general practice settings is required. New technologies such as the internet and SMS are useful adjuncts for influencing behaviours such as condom use and STI testing. Media c aigns that promote STI testing can have a positive impact on testing rates.
Fit4YAMs: Structuring a Lifestyle Intervention for Rural Overweight and Obese Young Adult Males Using Participatory Design
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.JADOHEALTH.2017.06.019
Abstract: Young adult males (YAMs) are understudied with respect to lifestyle interventions to address overweight and obesity in this group. This study reports on the participatory design of the structure and delivery of the Fit4YAMs text message-based lifestyle intervention for 18- to 25-year-old rural YAMs in Australia. Two semi-structured focus group discussions were held with six overweight or obese YAMs. Sessions explored their preferences for the structure and delivery of a weight loss intervention. Focus groups were recorded, and the contents transcribed verbatim for thematic analysis. The YAMs were unanimous in their preference for a highly personalized intervention program, complete with personalized goal setting, personalized motivation and engagement strategies, and personalized text message content. A text message frequency of three-four messages per week was deemed optimal for this group. Minimal direct contact by the intervention team was requested, but with clear guidelines and reminders of key contacts whom they could contact should they require help and guidance. The YAMs also agreed that a comprehensive goal setting session and personalization session prior to commencement of the intervention would be best. To engage rural YAMs in lifestyle interventions, a high degree of personalization of the program appears important. Although initially more time and resource intensive than a less personalized approach, it is essential to identify strategies to prevent and reverse weight gain in this hard to engage group. Maximizing their engagement using a more personalized approach could be the key to promoting long-term health outcomes in this group.
Human Papillomavirus and Cervical Cancer in Australasia and Oceania: Risk-factors, Epidemiology and Prevention
Publisher: Elsevier BV
Date: 08-2008
DOI: 10.1016/J.VACCINE.2008.05.041
Abstract: The region encompassing Australasia and Oceania, including Australia, New Zealand, Fiji and Papua New Guinea, is a erse one with respect to ethnicities, cultures and behaviours. It includes countries with comprehensive cervical cytology screening programmes which can be credited with significant reductions in cervical cancer incidence and mortality, and countries with no prevention programmes and significantly higher incidence and mortality. As elsewhere in the world, human papillomavirus (HPV)-16 and 18 are the commonest high-risk types, with the highest rates in women under 25 years of age. These two high-risk HPV types are found most frequently in cervical cancers and high-grade dysplasias, although there are minimal data for many countries in Oceania. In April 2007, Australia became the first country worldwide to commence a government funded universal HPV vaccine programme. The school-based programme targets 12-year old females in an ongoing schedule, with a catch-up programme up to 26 years of age, to be completed in mid-2009. Vaccine introduction has been comprehensively rolled out, with around 75% uptake of the complete vaccine schedule among school-girls in the first year of this initiative. This represents a successful model for other countries. We present data on cervical cancer, risk factors and prevention strategies, including epidemiology of HPV and HPV vaccine strategies.
“I just signed”: Factors influencing decision-making for school-based HPV vaccination of adolescent girls.
Publisher: American Psychological Association (APA)
Date: 2010
DOI: 10.1037/A0021449
Abstract: Australia was one of the first countries to implement a nationwide program providing HPV vaccination to girls at school. To date, there are no published studies describing decision-making processes and behavior postimplementation of HPV vaccination of adolescents participating in a school-based program. A purposive s le of nine schools was selected to reflect a range of vaccination coverage and school types. Semistructured focus groups with girls and interviews with parents, teachers, and immunization nurses (n = 185) were conducted until saturation was reached. Transcripts were analyzed inductively and emergent themes were subject to constant comparison. Explanatory model of decision-making in HPV vaccination. An explanatory model of decision-making and behavior was constructed from the data. Five decision-making states emerged across a continuum of vaccination behavior: active decision-vaccinated, passive decision- vaccinated, passive decision- not vaccinated, active decision- not vaccinated, and antivaccination. A range of factors influenced participants in each decision-behavior state. Adolescents were often part of the decision-making process. Where adolescents were not involved, nonagreement sometimes occurred. We have presented a variety of paths girls and their parents experience regarding decision-making and behavior in HPV vaccination. Attitudes, past experiences, and worldviews contributed to this process.
“Is cancer contagious?”: Australian adolescent girls and their parents: Making the most of limited information about HPV and HPV vaccination
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.1016/J.VACCINE.2010.02.078
Abstract: Australia has implemented a nation-wide program providing HPV vaccination to girls at school. To date, there are no published studies that explore knowledge about HPV and HPV vaccine post-implementation of the national school-based HPV vaccination program. A purposive s le of schools was selected to reflect a range of vaccination coverage (high versus lower uptake), and different school types (Catholic, Independent or Government). Semi-structured focus groups and interviews were conducted with girls and their parents respectively, until saturation was reached. Transcripts were analysed, letting themes emerge from the data. A core theme from both girls and parents was lack of knowledge. Supporting themes were lack of knowledge of HPV, lack of knowledge of vaccine, and realisation of their lack of knowledge. Their lack of knowledge was common in three areas: what HPV is, how HPV is transmitted, and the HPV and cervical cancer connection. The lack of knowledge about HPV vaccination was reflected in what the vaccine protects against, how the vaccine works, HPV vaccination recommendations, the vaccine and Pap smear connection, and myths about HPV vaccination. Both girls and parents wanted more information, had a tendency to defer responsibility, and parents expressed judgment of themselves as parents. Low levels of knowledge and understanding about HPV vaccination among adolescents and parents have implications for adolescents' future health practices, including sexual risk behaviour, condom usage, and cervical screening. Reasons for the low levels of knowledge are explored, as are implications for school-based educational interventions.
Prospective cohort study of childhood behaviour problems and adolescent sexual risk-taking: gender matters
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/SH16240
Abstract: Background Externalising (delinquent, aggressive) and internalising (anxious/depressed, withdrawn) behaviour problems are prevalent in childhood. Few studies have prospectively measured relationships between childhood behaviour problems and adolescent health risk behaviour, a major predictor of morbidity and mortality. This study sought to determine relationships, by gender, between childhood behaviour problems and adolescent risky sexual behaviours and substance use. Methods: In a population-based birth cohort [The Western Australian Pregnancy Cohort (Raine) Study], total, externalising and internalising behaviour problems (domain-specific T ≥ 60) were calculated from parent-reported Child Behavior Checklist at ages 2, 5, 8, 10 and 14 years. At age 17 years, 1200 (49% male) participants reported sexual and substance use activity Results: For both genders, those with earlier externalising behaviour problems were more likely to be sexually active (oral sex or sexual intercourse) by age 17 years. Males with childhood externalising behaviour problems were more likely to have multiple sexual partners by age 17 years than those without such problems [adjusted odds ratio (aOR) 2.96, 95% confidence interval (CI) 1.49–5.86]. Females with childhood externalising behaviour problems were more likely to have had unwanted sex (aOR 1.91, 95% CI 1.04–3.53). Externalising behaviour problems were associated with substance use for both genders. No association was found between internalising behaviour problems and risky behaviour. Conclusions: Externalising behaviour problems from as early as 5 years old in boys and 8 years old in girls predict a range of risky sexual behaviour in adolescence, which has important implications for targeting interventions in adolescence.
Risk of newly detected infections and cervical abnormalities in adult women seropositive or seronegative for naturally acquired HPV‐16/18 antibodies
Publisher: Wiley
Date: 05-07-2019
DOI: 10.1002/CAM4.1879
Abstract: Infections with human papillomavirus (HPV) types 16 and 18 account for ~70% of invasive cervical cancers but the degree of protection from naturally acquired anti‐HPV antibodies is uncertain. We examined the risk of HPV infections as defined by HPV DNA detection and cervical abnormalities among women years in the Human Papilloma VIrus Vaccine Immunogenicity ANd Efficacy trial's (VIVIANE, NCT00294047) control arm. Serum anti‐HPV‐16/18 antibodies were determined at baseline and every 12 months in baseline DNA‐negative women (N = 2687 for HPV‐16 and 2705 for HPV‐18) by enzyme‐linked immunosorbent assay (ELISA) from blood s les. HPV infections were identified by polymerase chain reaction (PCR) every 6‐months, and cervical abnormalities were confirmed by cytology every 12 months. Data were collected over a 7‐year period. The association between the risk of type‐specific infection and cervical abnormalities and serostatus was assessed using Cox proportional hazard models. Risk of newly detected HPV‐16‐associated 6‐month persistent infections (PI) (hazard ratio [HR] = 0.56 [95%CI:0.32 0.99]) and atypical squamous cells of undetermined significance (ASC‐US+) (HR = 0.28 [0.12 0.67]) were significantly lower in baseline seropositive vs baseline seronegative women. HPV‐16‐associated incident infections (HR = 0.81 [0.56 1.16]) and 12‐month PI (HR = 0.53 [0.24 1.16]) showed the same trend. A similar trend of lower risk was observed in HPV‐18‐seropositive vs ‐seronegative women (HR = 0.95 [0.59 1.51] for IIs, HR = 0.43 [0.16 1.13] for 6‐month PIs, HR = 0.31 [0.07 1.36] for 12‐month PIs, and HR = 0.61 [0.23 1.61] for ASC‐US+). Naturally acquired anti‐HPV‐16 antibodies were associated with a decreased risk of subsequent infection and cervical abnormalities in women years. This possible protection was lower than that previously reported in 15‐ to 25‐year‐old women.
Intersectoral collaboration to implement school-based health programmes: Australian perspectives
Publisher: Oxford University Press (OUP)
Date: 27-01-2016
Abstract: Understanding the processes and the factors influencing intersectoral collaboration is vital for the ongoing success of programmes that rely on effective partnerships between sectors, such as the school-based immunization programme, the school dental health programme and health promotion interventions delivered in school settings. We studied school-based health programmes delivered by partnerships between health, education and the local government sectors. We used purposive s ling to identify 19 people working in school-based health programmes and interviewed them about the barriers and enablers of successful collaboration. Data were analysed thematically. We found that collaboration between complex systems was a skilled endeavour which relied on a strong foundation of communication and interpersonal professional relationships. Understanding the core business, operational context and intersectoral point-of-view of collaborative partners was important both for establishing good intersectoral programmes and sustaining them as contexts and personnel changed. Aligning ergent sectoral agendas early in the collaborative process was essential for ensuring that all partners could meet their core business needs while also delivering the programme outcomes.
Endurant stent graft demonstrates promising outcomes in challenging abdominal aortic aneurysm anatomy
Publisher: Elsevier BV
Date: 2021
Wall shear rates in human and mouse arteries: Standardization of hemodynamics for in vitro blood flow assays: Communication from the ISTH SSC subcommittee on biorheology
Publisher: Elsevier BV
Date: 02-2021
DOI: 10.1111/JTH.15174
Development and validation of measures to evaluate adolescents' knowledge about human papillomavirus (HPV), involvement in HPV vaccine decision-making, self-efficacy to receive the vaccine and fear an
Publisher: Elsevier BV
Date: 06-2017
Comparing adolescent and parent reports of externalizing problems: A longitudinal population‐based study
Publisher: Wiley
Date: 05-11-2019
DOI: 10.1111/BJDP.12270
Abstract: Adolescent and parent reports of adolescent mental health problems often correlate poorly, and understanding this discrepancy has clinical importance. Yet contextual factors have only been inconsistently explained. At the 14- and 17-year follow-ups of the Western Australian Pregnancy Cohort (Raine) Study, 1,596 parent-child dyads completed the parent-reported Child Behaviour Checklist (CBCL) and the adolescent-rated Youth Self-Report (YSR). Maternal, family, adolescent, and parent factors were examined as potential predictors of discrepancies. When adolescent YSR scores were in the clinical range but parents' CBCL ratings were not, adolescents were more likely to report alcohol intoxication in the last 6 months, illicit drug use, low school motivation, and depression. When parents reported externalizing behaviour in the clinical range but adolescents did not, the characteristics associated with this were a younger maternal age, receiving social security benefit, stress related to parenting, depression, and poor family functioning. These new results will inform clinical management and research with adolescents who present with behavioural disorders. Statement of contribution What is already known on this subject? We know that adolescent and parent reports of adolescent mental health problems often correlate poorly, but little is known about which contextual factors lead to disagreement. Understanding the factors that influence agreement is clinically relevant for predicting and identifying externalizing behavioural disorders. This is a large-scale study with the ability to assess the impact of numerous psychosocial factors on instrument disagreement. What the present study adds We found that substance use, depression and low school motivation impacted on discrepancy in externalizing behaviour scores for 14-year-old male adolescents and their parents. Parental depression, stress, low family income, and family dysfunction also led to a higher likelihood of discrepancy in scores.
Age at menarche and age at first sexual intercourse: A prospective cohort study
Publisher: American Academy of Pediatrics (AAP)
Date: 12-2013
Abstract: Younger age at menarche (AAM) may put girls at risk for earlier first sexual intercourse (FSI). Young age at FSI has far-reaching negative outcomes. We describe the longitudinal relationship between AAM and FSI in a large prospective birth cohort. AAM was collected from 554 girls from the Western Australia (Raine) Pregnancy Cohort Study, prospectively from age 10 or retrospectively at age 14. Age at FSI was collected at ages 17 and 20. Cox regression models describe likelihood of FSI by age and years since menarche for younger (& years) and older (≥14 years) AAM relative to average AAM (12–13 years). Girls with younger AAM and average AAM were equally likely to have FSI by age 16 (adjusted hazard ratio [aHR]: 0.90 [95% confidence interval (CI): 0.60–1.35]). FSI by age 16 was less likely among girls with older AAM than those with average AAM (aHR: 0.35 [95% CI: 0.17–0.72]). Girls with younger AAM had a longer median interval between menarche and FSI than girls with average AAM (5.0 years [interquartile range: 4.4–8.5 years] vs 3.7 years [interquartile range: 2.4–5.3 years]). Those with younger AAM were less likely to report FSI within 4 years of menarche than those with average AAM (0–2 years aHR: 0.04 [95% CI: 0.01–0.31] 2–4 years aHR: 0.36 [95% CI: 0.23–0.55]). By age 20, 429 girls (77.4%) reported FSI. Younger AAM was not a risk factor for younger age at FSI in this cohort.
Immunogenicity, safety, usability and acceptability of microarray patches for vaccination: a systematic review and meta-analysis
Publisher: BMJ
Date: 10-2023
Prior human papillomavirus‐16/18 AS04‐adjuvanted vaccination prevents recurrent high grade cervical intraepithelial neoplasia after definitive surgical therapy: Post‐hoc analysis from a randomi
Publisher: Wiley
Date: 09-09-2016
DOI: 10.1002/IJC.30391
Perceptions of teen motherhood in Australian adolescent females: Life-line or lifederailment
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.WOMBI.2011.10.007
Abstract: The findings presented in this paper describe the beliefs and attitudes of three different groups of adolescent females about teen motherhood. These were elicited from a larger analysis that explored and theorized contraceptive pathways in a s le of young Australian women. A purposive s le of females aged 14 to 19 years was recruited from three distinct populations in the city of Perth, Western Australia: (1) never-pregnant (2) pregnant-terminated and (3) pregnant-continued. Grounded theory principles were used to analyze data generated from 69 semi-structured interviews conducted over a 21 month period (2006-2008). Two categories that described teenagers' attitudes to pregnancy and motherhood were elicited from the analysis. These explained the level of priority that teenagers placed on using contraception and postponing the transition to parenthood. The category labeled 'life derailment' represented how those who had never had a pregnancy or had terminated a pregnancy constructed teen motherhood as potentially restricting their personal, career and social transition to adulthood. The alternative category, 'life-line', reflected how those who continued with their pregnancy perceived teen motherhood as a positive and transformative experience that fostered personal growth. The findings from this study contribute further insight into the complex nature of adolescent contraceptive use and pregnancy risk. The analysis has strengthened evidence of the critical role of self-perceptions of pregnancy and childbearing on teenagers' fertility outcomes. It has also emphasized the broader life circumstances that shape these attitudes, intentions and related behavior. Strategies directed toward academic support and vocational skill development may broaden teenage girls' perceived future options and achievement capacity, thus influencing key reproductive health outcomes.
Safety, acceptability and tolerability of uncoated and excipient-coated high density silicon micro-projection array patches in human subjects
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.VACCINE.2017.10.021
Abstract: Most vaccinations are performed by intramuscular injection with a needle and syringe. However, this method is not ideal due to limitations, such as the risk of needle-stick injury, the requirement for trained personnel to give injections and the need to reconstitute lyophilized vaccines. Therefore, we tested an alternative delivery technology that overcomes the problems with needle and syringe. The Nanopatch™ is an array of 10,000 silicon micro-projections per cm
Clinical Outcomes of Ambulatory Endovascular Treatment Using 4-French and 6-French Femoral Access Strategies
Publisher: Springer Science and Business Media LLC
Date: 23-12-2021
DOI: 10.1007/S00270-020-02738-5
Abstract: Ambulatory peripheral vascular interventions have been steadily increasing. In ambulatory procedures, 4F devices might be particularly useful having the potential to reduce access-site complications however, further evidence on their safety and efficacy is needed. BIO4AMB is a prospective, non-randomized mulitcentre, non-inferiority trial conducted in 35 centres in Europe and Australia comparing the use of 4F- and 6F-compatible devices. The main exclusion criteria included an American Society of Anaesthesiologists class ≥ 4, coagulation disorders, or social isolation. The primary endpoint was access-site complications within 30 days. The 4F group enrolled 390 patients and the 6F group 404 patients. Baseline characteristics were similar between the groups. Vascular closure devices were used in 7.7% (4F group) and 87.6% (6F group) of patients. Patients with vascular closure device use in the 4F group were subsequently excluded from the primary analysis, resulting in 361 patients in the 4F group. Time to haemostasis was longer for the 4F group, but the total procedure time was shorter (13.2 ± 18.8 vs. 6.4 ± 8.9 min, p 0.0001, and 39.1 ± 25.2 vs. 46.4 ± 27.6 min, p 0.0001). Discharge on the day of the procedure was possible in 95.0% (4F group) and 94.6% (6F group) of patients. Access-site complications were similar between the groups (2.8% and 3.2%) and included predominantly groin haematomas and pseudoaneurysms. Major adverse events through 30 days occurred in 1.7% and 2.0%, respectively. Ambulatory peripheral vascular interventions are feasible and safe. The use of 4F devices resulted in similar outcomes compared to that of 6F devices.
Optimizing intersectoral collaboration between health and education: the Health Bridges study
Publisher: Oxford University Press (OUP)
Date: 29-12-2015
Preconception reflections, postconception intentions: the before and after of birth control in Australian adolescent females
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/SH13020
Abstract: Background The relationship between pregnancy intentions and contraceptive behaviour is difficult to establish. This study explored the contraceptive histories of teenagers with a recent experience of pregnancy to generate qualitative profiles of pregnancy intentions. Subsequent intentions in relation to birth control were also examined. Methods: A purposive s le of female teenagers aged 14–19 years was recruited from various clinical and community-based antenatal and postnatal services and termination services across the Perth metropolitan area. The current analysis was based on a total of 56 semistructured interviews. A two-staged process of thematic analysis was conducted to identify commonalities emerging from the narrative data. Results: Three pregnancy intention profiles were identified: 1) unplanned, unwanted, unlikely 2) planned, wanted, likely and 3) unplanned, ambivalent, likely. Each profile represents variation in pathways to pregnancy based on teenagers’ accounts of pregnancy desires, personal responsibility over contraceptive use, and perceptions of pregnancy risk. Regardless of the way that pregnancy was resolved (i.e. termination or childbirth), similar postconception intentions surrounding birth control emerged through a shared discourse of pregnancy avoidance across the s le. Conclusions: Exploring adolescents’ understandings of the decisions and behaviours that lead to pregnancy will assist in the development of more accurate assessment tools to identify those at risk of unplanned and unwanted pregnancies. Our research also suggests that the provision of contraceptive counselling immediately after conception, followed by ongoing support, may help to maintain strong intentions to delay further pregnancies as identified in our study.
Assessment of herd immunity and cross-protection after a human papillomavirus vaccination programme in Australia: a repeat cross-sectional study
Publisher: Elsevier BV
Date: 10-2014
The effect of exercise on local and systemic adverse reactions after vaccinations – Outcomes of two randomized controlled trials
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.VACCINE.2018.09.067
Abstract: An adverse reaction associated with vaccination is considered to be a key barrier to vaccinate, yet little attention has been given to interventions to reduce their occurrence. Exercise is a behavioural adjuvant which may also influence adverse reactions. Here, two randomized controlled trials are reported, examining the effects of exercise on self-reported adverse reactions following vaccination in adolescents and young adults. Study one 116 adolescents receiving the HPV vaccine were randomly allocated to either Control (n = 56) or Pre-vaccine Exercise (n = 60) group (2015-2016). Exercise consisted of 15-minutes upper body exercise. Study two 78 young adults receiving the influenza vaccine were randomly allocated to either Control (n = 19), or one of 3 exercise groups: Pre-vaccine Arm (n = 19), Pre-vaccine Leg (n = 20) or Post-vaccine Arm (n = 20) (2017). Exercise included 15-minutes of arm or leg exercises prior to or after vaccination. All participants in both studies completed an adverse events diary for seven-days post-vaccination. Study one Reported days of tenderness in female adolescents that exercised were significantly lower than control (p = 0.032), with a similar trend in reported days of pain (p = 0.050). Furthermore, days of feeling ill (p = 0.070) and reduced appetite (p = 0.067) were found to be lower with exercise, although not significant. Overall, female adolescents reported significantly more days of pain (p = 0.003), tenderness (p < 0.001), swelling (p = 0.011), and feeling ill (p = 0.0040). Study two Exercise groups reported reduced days of swelling (p = 0.018), fever (p = 0.013), and lowered appetite (p = 0.011) across both genders. Furthermore, females reported reduced days of medication use with exercise (p = 0.034), and a trend toward reduced days of swelling (p = 0.052). In two separate trials, a short bout of exercise reduced reported adverse reactions after vaccinations for local and systemic adverse reactions. Gender differences in reported local and systemic adverse reactions were more evident among adolescents than young adults. These findings support the need for further work to examine the potential benefit of exercise in improving vaccination procedures.
Progression of HPV infection to detectable cervical lesions or clearance in adult women: Analysis of the control arm of the VIVIANE study
Publisher: Wiley
Date: 08-03-2016
DOI: 10.1002/IJC.29971
Pregnancy and protection: Perceptions, attitudes and experiences of Australian female adolescents
Publisher: Elsevier BV
Date: 06-2009
DOI: 10.1016/J.WOMBI.2008.12.001
Abstract: 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. A qualitative approach was used to explore the contraceptive behaviour in a purposive s le 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 in idual, semi-structured interviews were conducted. Thematic analysis was employed to analyse the data and generate a rich, description of contraceptive behaviour. 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. 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.
Exposure to Pornography and Adolescent Sexual Behavior: Systematic Review
Publisher: JMIR Publications Inc.
Date: 28-02-2023
DOI: 10.2196/43116
Abstract: Formative experiences in adolescence lay the foundation for healthy and pleasurable romantic and sexual relationships. Exposure to pornography may affect these experiences. We aimed to synthesize evidence published in the past decade on the relationship between exposure to pornography and sexual behavior (earlier age of first sex [ years], condomless sex, past-year multiple partners [ ], lifetime multiple partners [ ], group sex, sexual aggression including forced sex, paid sex, teenage pregnancy, and history of sexually transmitted infection) in adolescents aged between 10 and 19 years. We identified 19 eligible studies by searching MEDLINE, PsycINFO, Cochrane, CINAHL, Embase, and Web of Science databases from January 2010 to November 2022. Out of 8 studies that assessed earlier age of first sex, 5 studies, including 1 longitudinal study, found a statistically significant association with exposure to pornography. Given that most studies were cross-sectional or had substantial limitations, causal inference could not be made. Also, exposure to pornography was not measured consistently. The evidence was conflicting or insufficient to draw any conclusions regarding other outcomes. More quantitative research is needed to elucidate the association between pornography exposure and sexual behavior, and sex education should adopt evidence-based approaches to minimize the potential harms from pornography. PROSPERO International Prospective Register of Systematic Reviews CRD42021227390 www.crd.york.ac.uk rospero/display_record.php?RecordID=227390
Randomised controlled trial of an educational strategy to increase school-based adolescent hepatitis B vaccination
Publisher: Elsevier BV
Date: 06-2000
DOI: 10.1111/J.1467-842X.2000.TB01572.X
Abstract: This study aimed to evaluate a specifically designed hepatitis B education romotion curriculum package as part of a successful hepatitis B vaccination delivery system to adolescents. A randomised-controlled trial was used to evaluate the effect of the curriculum package (or intervention) on uptake of vaccine. Schools were randomly selected from the metropolitan region of Melbourne to intervention (66 schools or 7,588 students) or control groups (69 schools or 9,823 students). Class teachers administered the intervention to students over 4 class periods before the vaccination course. The difference in mean school uptake between intervention and control was small at 1-2% per dose. 95% confidence intervals around the differences were -5% to 2% per dose and not significant. Intervention schools taught an average of 7 items out of 12 from the curriculum package. Immunisation rates increased by 4-10% per dose between low and high implementation schools, but this trend was not significant. Impact evaluation demonstrated significantly greater knowledge of hepatitis B and vaccination among students in the intervention than the control group. Hepatitis B vaccination of pre-adolescents was not increased by the implementation of a curriculum package that successfully increased knowledge and awareness of hepatitis B in a school-based vaccination program. Additional strategies directed at the education of parents, the cooperative role of schools and pro-active providers might also be required to maximise vaccine uptake in this age group.
Implanon as a contraceptive choice for teenage mothers: a comparison of contraceptive choices, acceptability and repeat pregnancy
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.CONTRACEPTION.2009.12.006
Abstract: This study was conducted to compare the incidence of repeat teenage pregnancy over a 24-month period postpartum among users of Implanon, the combined oral contraceptive pill (COCP) or depot medroxyprogesterone acetate (DMPA) and barrier methods or nothing (barrier/none). Contraceptive continuation rates 24 months postpartum for Implanon and COCP/DMPA were also compared. A prospective cohort study was conducted. Comparison groups were postpartum teenagers (12-18 years old) who self-selected Implanon (n=73), COCP/DMPA (n=40) and barrier/none (n=24). Questionnaires were used to gather data at recruitment and postpartum at 6 weeks and then 3 monthly intervals for 2 years. At 24 months postpartum, 48 (35%) teenagers had conceived. Implanon users became pregnant later than other contraceptive groups (p=.022), with mean time to first repeat pregnancy of 23.8 months [95% confidence interval (CI), 22.2-25.5], compared to 18.1 months (95% CI, 15.1-20.7) for COCP/DMPA and 17.6 months (95% CI, 14.0-21.3) for barrier/none. Implanon users were more likely to continue their use at 24 months than COCP/DMPA (p<.001) users. The mean duration for Implanon users was 18.7 months (95% CI, 17.0-20.3) compared to 11.9 months (95% CI, 9.5-14.3) for COCP/DMPA. Teenagers who choose Implanon are significantly less likely to become pregnant and were found to continue with this method of contraception 24 months postpartum compared to those who choose COCP or DMPA and barrier methods or nothing.
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