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Biomedical subjects

Roslyn G Poulos

Publications and source records attributed to Roslyn G Poulos.

6 recordsLinked to original sources
PubMed2004

Getting it right--the Australian Childhood Immunisation Register and immunisation rates in south-eastern Sydney.

OBJECTIVES: To assess the completeness of ACIR data for south-eastern Sydney children at 12 to < 15 months of age and to develop strategies to improve rates. METHODS: We surveyed children aged 12 to < 15 months listed as overdue on the ACIR011A report, December 2001, by contacting the last immunisation provider or the parents. RESULTS: From the 470 children listed as overdue, 162 children were systematically selected to form the study group. Seventeen were lost to follow-up and results are available for 145 children. Eighty children were up to date (69, encounter forms incorrect or not sent; 11, vaccinated overseas) and 11 children had moved overseas. Fifty-four children were overdue (30, provider error due to incorrect Haemophilus influenzae type b (Hib) schedule or Hib vaccine omitted; 18 did not complete schedule; 6 conscientious objectors). CONCLUSIONS: Our study indicates that between 6-9% of children on the register were likely to be overdue, whereas the ACIR011A report identified 19%. Failure of immunisation providers to correctly complete, or send encounter forms to the ACIR was the main reason for this discrepancy. Migration and failure to record overseas vaccination were also factors. IMPLICATIONS: Public health units should develop good working relationships with immunisation providers to assist and encourage immunisation and the completion and submission of encounter forms. A quarterly review, using the third dose assumption, of all children aged 12 to < 15 months identified on the ACIR011A report as overdue for immunisation may be an effective way for public health units to increase apparent rates for their area.

Bacterial Capsules↗
PubMed2004

Enhanced surveillance of acute hepatitis B in south-eastern Sydney.

Hepatitis B is a notifiable condition in all Australian states and territories. Medical practitioners and health facilities are required to report episodes of acute disease, while laboratories must notify on positive serological results. In New South Wales laboratories are required to report only the presence of hepatitis B surface antigen (HBsAg). Without clinical information, laboratory reporting of HBsAg fails to distinguish between acute infection and chronic carriage. Since practitioner under reporting is well recognised, surveillance data are likely to underestimate the true incidence of acute clinical infection. Two retrospective reviews of an enhanced surveillance system to improve the identification of acute hepatitis B in south-eastern Sydney are presented. Over a 6-month period, the enhanced surveillance system increased the identification of acute cases by at least threefold. Over a 5-year period, medical practitioners or hospitals reported only 25 per cent of acute disease, the remainder being initially notified by laboratories. Approximately half of the laboratory notifications contained only HBsAg results. The availability of clinical notes, liver enzyme or IgM to core antigen results assisted the public health unit in the identification of possible acute disease. This system of enhanced surveillance has proven to be sustainable, with minimal resources required. We suggest that sentinel enhanced surveillance systems in a sample of New South Wales public health units would be an effective and efficient method to improve the surveillance of acute hepatitis B, and that laboratories be required to report IgM to core antigen, if available, when notifying a positive HBsAg result.

Acute Disease↗
PubMed2003

The performance of instrumental activities of daily living scale in screening for cognitive impairment in elderly community residents.

A retrospective analysis of Short Orientation-Memory-Concentration (OMC) and Lawton's IADL data was performed to assess the association between instrumental activities of daily living (IADL) and a rating of cognitive impairment, and to test whether IADL measures can be used to screen for dementia. The study analyzed data from 1,095 elderly community residents who were regarded as potentially benefiting from care coordination. Three IADL items (telephone use, self-medication, and handling finances) were statistically associated with cognitive impairment (OMC cutoff 10/11), independent of age and sex. An IADL indicator based on these items had only modest power in predicting cognitive impairment, its highest sensitivity being 0.71. Specificity was 0.75 at this point, but increased to 0.97 if higher indicator scores were used to define a positive result. In conclusion, the usefulness of an IADL indicator seems limited to ruling out further cognitive assessment rather than positively identify those with dementia.

Activities of Daily Living↗
PubMed2002

Refining the public health response to primary meningococcal conjunctivitis.

Primary meningococcal conjunctivitis (PMC) is accepted as an uncommon condition. This report describes two recent cases of PMC in newborn infants in a hospital nursery. In both cases the organisms identified were non-groupable strains of N. meningiditis, considered to be of low pathogenic potential. Both infants received systemic therapy and recovered without sequelae. The Guidelines for the early clinical and public health management of meningococcal disease in Australia recommend the notification of PMC to public health authorities and chemoprophylaxis of contacts. However, our 2 cases suggest that the guidelines should allow for an assessment of risk in determining the public health response. This assessment should include the severity of the conjunctivitis and the serogroup of the N. meningitidis isolate.

Anti-Bacterial Agents↗