The Immunisation Beliefs and Intentions Measure (IBIM): Predicting parents’ intentions to immunise preschool children

In England, uptake of the second dose of MMR (against measles, mumps, rubella), and dTaP/IPV or DTaP/IPV booster (against diphtheria, tetanus, pertussis, polio), is lower than that of the primary course. The Immunisation Beliefs and Intentions Measure (IBIM), based on the theory of planned behaviour (TPB) and qualitative interviews, was used to predict parents’ intentions to take preschoolers for these recommended vaccinations. Parents from 43 child groups in southern England were randomised to receiving questions about either MMR (N = 193) or dTaP/IPV (N = 159). Overall, 255 parents fully completed TPB-based items. Regression analyses revealed that parental attitudes about the protective benefits of immunising and perceived behavioural control were strong, reliable predictors of intention to immunise with MMR. For dTaP/IPV, perceived protective benefits and number of children reliably predicted intention to immunise. Differences between parents with ‘maximum immunisation intentions’ and those with ‘less than maximum intentions’ are described. The IBIM appears to be a useful measure for predicting parents’ intentions to immunise preschoolers. Implications for improving uptake are discussed.     

Australia's notifiable diseases status, 2000. Annual report of the National Notifiable Diseases Surveillance System.

In 2000, there were 89,740 notifications of communicable diseases in Australia collected by the National Notifiable Diseases Surveillance System (NNDSS). The number of notifications in 2000 was an increase of 5.9 per cent over those reported in 1999 (84,743) and the largest reporting year since the NNDSS commenced in 1991. Notifications in 2000 consisted of 28,341 bloodborne infections (32% of total), 24,319 sexually transmitted infections (27%), 21,303 gastrointestinal infections (24%), 6,617 vaccine preventable infections (7%), 6,069 vectorborne infections (7%), 2,121 other bacterial infections (legionellosis, meningococcal infection, leprosy and tuberculosis) (2%), 969 zoonotic infections (1%) and only one case of a quarantinable infection. Steep declines in some childhood vaccine preventable diseases such as Haemophilus influenzae type b, measles, mumps and rubella, continued in 2000. In contrast, notifications of pertussis and legionellosis increased sharply in the year. Notifications of bloodborne viral diseases (particularly hepatitis B and hepatitis C) and some sexually transmitted infections such as chlamydia, continue to increase in Australia. This report also summarises data on communicable diseases from other surveillance systems including the Laboratory Virology and Serology Surveillance Scheme (LabVISE) and sentinel general practitioner schemes. In addition this report comments on other important developments in communicable disease control in Australia in 2000.     

Australian patterns of practice survey in the adjuvant systemic treatment of early breast cancer

Background: The aim was to examine patterns of practice in the adjuvant systemic treatment of early breast cancer in order to determine consistency of practice, areas of controversy and whether practice is evidence based. Methods: A survey was sent to all Medical Oncologists listed with the Medical Oncology Group of Australia (n = 291) in September 2003. Demographics and information on the use of aids to assist clinical decision making were obtained. Seven short case scenarios were provided and oncologists asked what systemic treatment they would recommend (outside a clinical trial), for a woman with no significant comorbidities. Results/Conclusion: There were 106 replies (36%); 81 (28%) treating women with early breast cancer. Demographic data was available for 80/81 respondents and treatment details on all 81. The majority treated more than 20 patients/year; 52/80 (65%). Respondents represented a reasonable cross section of Australian oncologists with approximately 25% responding from most states and higher rates from several smaller states. Forty‐nine (61%) used prognostic tables or aids. The responses received suggest that practice patterns in Australia are consistent with current evidence and in general comply with international guidelines. There was a tendency to treat patients at high risk with anthracyclines and with higher doses and longer courses. Younger patients were treated more aggressively. A greater variety of regimens were recommended for very high risk patients suggesting a lack of consensus. Of concern, a small proportion recommended tamoxifen for estrogen receptor‐negative disease and others did not recommend its use for estrogen receptor‐positive disease.