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Background: The "Watch Me Grow" (WMG) study examines the current developmental surveillance system in South West Sydney. This paper describes the establishment of the study birth cohort, including the recruitment processes, representativeness, follow-up and participants' baseline risk for future developmental risk.Methods: Newborn infants and their parents were recruited from two public hospital postnatal wards and through child health nurses during the years 2011-2013. Data was obtained through a detailed participant questionnaire and linked with the participant's electronic medical record (EMR). Representativeness was determined by Chi-square analyses of the available clinical, psychosocial and sociodemographic EMR data, comparing the WMG participants to eligible non-participants. Reasons for non-participation were also elicited. Participant characteristics were examined in six, 12, and 18-month follow-ups.Results: The number of infants recruited totalled 2,025, with 50 % of those approached agreeing to participate. Reasons for parents not participating included: lack of interest, being too busy, having plans to relocate, language barriers, participation in other research projects, and privacy concerns. The WMG cohort was broadly representative of the culturally diverse and socially disadvantaged local population from which it was sampled. Of the original 2025 participants enrolled at birth, participants with PEDS outcome data available at follow-up were: 792 (39 %) at six months, 649 (32 %) at 12 months, and 565 (28 %) at 18 months. Participants with greater psychosocial risk were less likely to have follow-up outcome data. Almost 40 % of infants in the baseline cohort were exposed to at least two risk factors known to be associated with developmental risk.Conclusions: The WMG study birth cohort is a valuable resource for health services due to the inclusion of participants from vulnerable populations, despite there being challenges in being able to actively follow-up this population. [ABSTRACT FROM AUTHOR]

Background: It is unclear if podiatric foot care for people with rheumatoid arthritis (RA) in New South Wales (NSW) meets current clinical recommendations. The objective of this study was to survey podiatrists' perceptions of the nature of podiatric foot care provision for people who have RA in NSW. Methods: An anonymous, cross-sectional survey with a web-based questionnaire was conducted. The survey questionnaire was developed according to clinical experience and current foot care recommendations. State registered podiatrists practising in the state of NSW were invited to participate. The survey link was distributed initially via email to members of the Australian Podiatry Association (NSW), and distributed further through snowballing techniques using professional networks. Data was analysed to assess significant associations between adherence to clinical practice guidelines, and private/public podiatry practices. Results: 86 podiatrists participated in the survey (78% from private practice, 22% from public practice). Respondents largely did not adhere to formal guidelines to manage their patients (88%). Only one respondent offered a dedicated service for patients with RA. Respondents indicated that the primary mode of accessing podiatry was by self-referral (68%). Significant variation was observed regarding access to disease and foot specific assessments and treatment strategies. Assessment methods such as administration of patient reported outcome measures, vascular and neurological assessments were not conducted by all respondents. Similarly, routine foot care strategies such as prescription of foot orthoses, foot health advice and footwear were not employed by all respondents. Conclusions: The results identified issues in foot care provision which should be explored through further research. Foot care provision in NSW does not appear to meet the current recommended standards for the management of foot problems in people who have RA. Improvements to foot care could be undertaken in terms of providing better access to examination techniques and treatment strategies that are recommended by evidence based treatment paradigms. [ABSTRACT FROM AUTHOR]

Reveals the sexual practices which have led gay men in Sydney, New South Wales, Australia to become infected with HIV. Constraints to preventive practice; Need to consider whether clear messages that condoms are not 100 percent protective; Way in which to communicate the idea of 'body fluids.'

The growth of e–Universities and flexible delivery in higher education may also lead to increased use of electronic course evaluation methods. The effectiveness and methodology of electronic surveys are discussed. In the graduate–entry, problem–based University of Sydney Medical Program extensive use is made of web technologies for curriculum delivery and evaluation. The design and response rates for web–based “End of Year” student evaluation surveys in the medical program are reported for the period 1997–2001. To be used successfully in course evaluation, online surveys should be infrequent, short, simply designed and free from password access, and de–identified results should be displayed to students on their completion of a survey. [ABSTRACT FROM AUTHOR]

Presents results of a study on the evaluation of expert and non-expert problem-based learning (PBL) tutors by medical students at the University of Sydney, New South Wales. Pattern of three weekly PBL tutorials; Recruitment of tutors; Feedback form of tutors; Best method of student evaluation on PBL tutorial teaching.

This paper reports on the use of the Course Experience Questionnaire (CEQ) as an instrument to monitor the medical programme at the University of Sydney and in particular to measure improvements in teaching quality with the introduction of the new graduate-entry problem-based programme. In addition, it raises the more general issue of interpretation of CEQ results in courses designed around problembased learning (PBL). Students' perceptions of teaching quality were sought using a whole class questionnaire survey and small group interviews. Students in the new programme rated their course more highly than did students in the old programme with respect to good teaching, appropriate assessment, generic skills and overall satisfaction. These improvements did not hold with respect to the clarity of goals and standards, nor for perceptions of an appropriate workload. The results are interpreted in context and it is argued that particular items in the CEQ do not reflect the educational philosophy or the instructional processes of PBL programmes. [ABSTRACT FROM AUTHOR]

Increasingly, evaluation is seen primarily as means of achieving quality improvement in higher education. The student-centred, open evaluation system in the medical programme at the University of Sydney has been developed with the fundamental aim of maintaining and improving programme quality. Students' potential concerns about their learning experiences are actively sought through a variety of qualitative and quantitative collection methods. Feedback is divided into three types: individual, group and year. Methods of data collection are described for each type of feedback and issues involved in managing feedback are discussed. Frequencies are reported for categories of individual student feedback in 1998 and 1999, classified according to whether comments were positive or negative. To effectively support improvement in course quality, an evaluation system must be based on a clear educational rationale, use a variety of methods and be managed with a sensitivity to the needs of students and teachers. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study on the number of World Youth Day (WYD) 2008 pilgrims who visited the emergency departments (ED) of Saint Vincent's Hospital and Sydney Hospital in New South Wales from July 9 to 23. There were 87 pilgrims who visited the ED of Saint Vincent's Hospital and 104 at Sydney Hospital. About 154 of 191 ED presentations were during the period of official WYD events with a peak on the papal visit on July 17. WYD pilgrims constitute 7.8% of ED visits for the period.

Background: The Central Coast Integrated Care Program CCICP is one of three integrated care demonstrator projects within NSW Australia funded for three years to challenge existing service fragmentation within and between health and social care sectors. The district-wide complex intervention focused on vulnerable youth, vulnerable older persons and people with chronic and complex conditions. As part of the formative evaluation of the CCICP, the Project Integrate Framework was used to map integrated care progress. This Framework provides an evidence-based understanding of the key dimensions and items of integrated care associated with successful implementation. Methods: Based upon the Project Integrate dimensions, an online survey of key stakeholders was undertaken. The survey results underpinned a workshop to assist CCICP team reflection and assessment of progress. This exercise enabled future program priorities and strategies to be set. Key stakeholder interviews were mapped to the Project Integrate dimensions for additional perspective. Results: The research results indicated where progress had been achieved, where learnings had been embedded in service delivery and aided the determination of priorities for action. Learnings about the suitability of Project Integrate dimensions and their use in online, interview and workshop formats will enable its use in other Australian and international settings. Discussion: The Project Integrate Framework aims to provide a conceptual basis for reflecting on the design and implementation of integrated care programs/projects. Our research found the survey tool alone was inadequate to assess integrated care progress, with many answers reflecting uncertainty Neither Disagree nor Agree. The data was reviewed in a workshop with the CCICP team to contextualise the uncertainty, particularly given the formative assessment stage. This greatly enhanced the understanding of progress in care integration on the Central Coast. This finding is congruent with the recommendation for the use of the Framework outlined in the original research. The Project Integrate Framework was identified by the CCICP team as a key communication tool, enabling a consistent terminology for integrated care. However, certain terminologies were not always understandable or meaningful to everyone. Group discussions were important to generate collective understanding of the meaning and importance of the dimensions. As with international case examples, progress towards system integration was regarded as poor, with substantial structural barriers beyond the control of the CCICP team. The intervention appears to be tracking more favourably in the dimensions of person-centred care, clinical and professional integration which was linked to sustained efforts to build relationships and enable a shared understanding of what the CCICP was seeking to achieve normative integration. Conclusion: Use of the Project Integrate framework supported by appreciative dialogue has enabled the CCICP team to reflect on progress and spread of integrated care within the Central Coast Local Health District and on what should be their next steps for spreading and building sustainability. The research findings are being used to refine the Project Integrate Framework as a means to support on-line assessments of integrated care to enable programs to have meaningful group discussions on design and implementation, and as a means to facilitate comparative research. [ABSTRACT FROM AUTHOR]

Background: The Project Integrate[i] conceptual framework began with a literature review on conceptual frameworks and relevant aspects of integrated care, from which a new conceptual framework, was built iteratively. This framework provides a standard set of dimensions and sub-elements which can be used to describe any integrated care initiative. As part of the formative evaluation of the Central Coast Integrated Care Program (CCICP), we have employed the Project Integrate Framework to map the integration efforts of the program, provide a consistent and common language, to enable supported self-assessment of progress towards integrated care and to allow for international benchmarking. Methods: An online survey of key stakeholders was undertaken mapping the degree of agreement on progress towards the Project Integrate dimensions. The survey results were used as a support tool in a workshop to assist CCICP team reflection and assessment and build a situational analysis of care integration progress within the program. This exercise was used as the basis to support agreement of future priorities and strategies within the program. Results: The survey results indicated where progress towards care integration had been achieved in the Central Coast. It was then used as a support tool in a workshop setting to assist the CCICP team to reflect and self-assess progress towards integrated care. Reflections regarding international comparators were made, stimulating further discussion, this led to the recognition of progress made to date and a realistic review of where progress should be given the maturity of the intervention. Achievements and opportunities were identified, with priority areas mapped out. A key priority was communication, in particular, building a common and consistent language for integrated care. Workforce and upskilling regarding data warehousing and analysis was also identified as an opportunity for future work. Di scussion: The survey tool alone was inadequate since many answers reflected uncertainty regarding progress (Neither Disagree nor Agree), thus the data required review and further consideration by the team to contextualise the uncertainty, particularly given the formative stage of assessment. The power of the survey results was in the group analysis and the contextualized discussion which ensued and added greatly to the understanding of progress in care integration on the Central Coast. The Project Integrate Framework and its nomenclature was identified by the CCICP team as a key communication tool, to build a consistent terminology for integrated care and its use in reporting, communication and stakeholder engagement. As with international case studies, progress towards system integration was regarded as poor, with substantial structural barriers beyond the control of the CCICP team. However, the intervention appears to be tracking more favourably in the dimension of patient-centred care. Conclusion: Use of the Project Integrate framework has enabled the CCICP team to reflect on progress and spread of integrated care within the Central Coast Local Health District and where their next steps should be for spreading and building sustainability. [ABSTRACT FROM AUTHOR]

BACKGROUND: Recent vaccine mandates in Australia, as in other high income settings, have sought to change the behavior of parents, including those who would otherwise access nonmedical exemptions. Since 2014, Australian state governments have introduced and progressively tightened policies restricting the access of unvaccinated children to early education and child care. In 2016, the Federal Government removed financial entitlements and subsidies from nonvaccinating families. We sought to ascertain the impact of these policies on vaccine coverage rates by state, and also to consider their impact on communities with high numbers of registered refusers. METHODS: Interrupted time series models were fitted by using the Autoregressive Integrated Moving Average framework to test for changes in trend in vaccination rates following implementation of government policies. RESULTS: Australian vaccine coverage rates were rising before the vaccine mandates and continued to do so subsequently, with no statistically significant changes to coverage rates associated with the interventions. The exception was New South Wales, where vaccine coverage rates were static before the policy intervention, but were increasing at an annual rate of 1.25% after (P < .001). The impact of the policies was indistinguishable between communities with high, medium and low numbers of registered vaccine refusers. CONCLUSIONS: In our study, we show that childhood vaccine coverage continued on its positive trajectory without any conclusive evidence of impact of mandatory policies. Overseas policymakers looking to increase coverage rates would be well-advised to examine the contribution of pre-existing and parallel nonmandatory interventions employed by Australian governments to the country's enhanced coverage. [ABSTRACT FROM AUTHOR]