Objectives: (i) To describe birth size of Aboriginal babies by sex, gestational age, and Aboriginality; (ii) to analyse the results with reference to standards of ponderal index and birthweight for gestational age. Subjects: 570 liveborn singletons routinely delivered at Royal Darwin Hospital between January 1987 and March 1991, and recorded in the Delivery Suite Register as being born to an Aboriginal mother. Main outcome measures: Weight, length and head circumference at birth. Results: The mean birthweight was 3098 g (standard deviation, 601 g), peak gestational age was 39 weeks, 13% were low birthweight and 7% were preterm. Preterm rates did not differ significantly for sex and Aboriginality. Babies without a non-Aboriginal ancestor had a lower mean birthweight and at term, were significantly smaller than babies with a non-Aboriginal ancestor as assessed by mean birthweight, length, head circumference and ponderal index. More than a quarter of babies (27%) without a non-Aboriginal ancestor were below the 10th percentile of birthweight for gestational age, compared with 14.2% of babies with a non-Aboriginal ancestor. Conclusions: On the basis of postnatal clinical estimates of gestational age, Aboriginal babies have a preterm rate of 7% and Aboriginal babies without a non-Aboriginal ancestor are smaller in size at birth than babies with a non-Aboriginal ancestor.

Rapid access chest pain clinics (RACCs) are an innovative outpatient pathway that allows low-intermediate risk patients to avoid hospitalisation. However, the extent of RACCs in Australia is unknown. We aimed to identify Australian RACCs and describe the characteristics and landscape of this model of care in Australia.Australian RACCs were identified through four pathways: 1) Systematic literature search; 2) Google Search; 3) Word of mouth via RACC leaders including through the National Health and Medical Research Council Translation Centres that form the membership of the Australian Health Research Alliance; and 4) through the Cardiac Society of Australia and New Zealand emailing list. All RACCs identified were invited to complete a survey exploring the clinic's characteristics.Twenty-five (25) RACCs were identified, and present in all Australian states and territories. All public (n=16 of 16, response rate=100%) and three private (n=3 of nine, response rate=33%) RACCs completed the survey, with most RACCs located in major cities (n=14, 74%). In the 2022 calendar year, responding RACCs reported assessing 7,718 patients. RACCs had a median waiting time of 8.5 days (interquartile range [IQR] 4-18 days), 10 RACCs assessed >50% of patients within 7 days of referral, and 11 RACCs assessed ≥80% of patients within 14 days. Service variations included: clinic days/week (median=3; IQR 1.25-4 days), patient volume (median=335; IQR 130-600; range, 96-1,674 patients/yr), staffing (all RACCs had at least one consultant), other RACCs involved cardiology advanced trainees (n=13), nursing staff (n=11), basic physician trainees or senior resident medical officers, that is, post-graduate year (PGY) 3+ (n=2), and PGY1/PGY2s (n=3). All clinics accepted emergency department referrals (n=19), with additional referrals from general practitioners in 12 RACCs, and in-hospital/other clinic referrals in nine. Telehealth was used in 13 clinics. The most common initial investigation was stress echocardiography (eight clinics), computed tomography coronary angiogram (six clinics), and exercise stress test (five clinics).Our survey is the first to describe the national implementation of RACC and map the delivery of care in Australia. An additional outcome is the development of a national network of centres to collaboratively develop a "best practice" model of care for RACCs to improve patient outcomes.

Once considered endemic only to tropical and subtropical climates such as Southeast Asia and northern Australia, melioidosis is expanding to non-endemic areas such as the southern US. Climate change is impacting infectious diseases, melioidosis being no exception. Now is the time to inform and prepare: as this Communicable episode’s title indicates, melioidosis is going global. Join hosts Angela Huttner and Josh Davis on their in-depth exploration of melioidosis with invited experts Dr. Ella Meumann and Prof. Bart Currie from Royal Darwin Hospital, Darwin, Australia. Topics range from melioidosis discovery, clinical presentation, diagnostic approaches and host risk factors to the disease’s expanding endemicity. Melioidosis is an infectious disease caused by the sapronotic agent Burkholderia pseudomallei and contracted by both people and animals through direct contact with contaminated soil, air or waters. Current burden estimates of 169’000 cases and 89’000 deaths per year are thought to be grossly underreported due to limited access to laboratory diagnostics and lack of clinical awareness. Experts call for melioidosis to be recognized as a neglected tropical disease in order to give this disease the urgent attention and resources it deserves. This episode was edited by Kathryn Hostettler and peer-reviewed by Dr. Goulia Ohan of Yerevan State Medical University, Armenia.

Researchers acknowledge the need to share study results with the patients and their communities, but this is not done consistently due to a plethora of barriers, including a paucity of data to guide best practice approaches in different populations.This study was nested within a large multi-center randomized controlled trial of antimalaria treatment. Data on dissemination preferences were collected at the third-month follow-up visit using a short questionnaire. Data were analyzed using descriptive statistics and subsequently fed into an iterative process with key stakeholders, to develop suitable strategies for result dissemination.A total of 960 patients were enrolled in the trial, of whom 84.0% participated in the nested survey. A total of 601 (74.6%) participants indicated interest in receiving trial results. There was significant heterogeneity by study country, with 33.3% (58/174) of patients indicating being interested in Cambodia, 100% (334/334) in Ethiopia, 97.7% (209/214) in Pakistan, but none (0/85) in Indonesia. The preferred method of dissemination varied by site, with community meetings, favored in Ethiopia (79.0%, 264/334) and individualized communication such as a letter (27.6%, 16/58) or phone calls (37.9%, 22/58) in Cambodia. Dissemination strategies were designed with key stakeholders and based on patient preferences but required adaptation to accommodate local logistical challenges.The varying preferences observed across different sites underscore that a one-size-fits-all approach is inadequate. Strategies can be tailored to patient preference but require adaptation to accommodate logistical challenges.

PS5 Standard for Pharmacy Based Immunisation Programs

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