New regimens with combined oral contraceptive pills--moving away from traditional 21/7 cycles.

The practice of extending combined oral contraceptive use (COC) and eliminating or reducing the hormone free interval has been in use for many years. More recently a range of products with new dosing options has been developed and marketed. Women and physicians in developed countries are comfortable with and many prefer the use of extended COC regimens which provide an option to eliminate or reduce the frequency of regular withdrawal bleeding. The extension of active pill taking and the reduction or elimination of the hormone-free interval have been shown to be beneficial for women who experience menstrual cycle-related problems such as heavy bleeding or dysmenorrhoea. The hormone-free interval of less than seven days has additional benefits in managing hormone withdrawal symptoms and efficacy may be improved in situations where pills are inadvertently missed or in women who are perceived as 'poor' pill takers. This paper provides a descriptive review highlighting the development of new dosing options that alter the traditional 21/7 COC regimen. The rationale for and the acceptability of COCs developed with alternative dosing regimens is examined.

Marrying research, clinical practice and cervical screening in Australian Aboriginal women in western New South Wales, Australia.

INTRODUCTION: Research shows that Australian Aboriginal women experience a significantly higher rate of mortality from cervical cancer than non-Aboriginal women. We now understand that infection with human papillomavirus (HPV) is a necessary pre-requisite for cervical cancer. This knowledge, together with the development of prophylactic vaccines against the HPV types most commonly associated with cervical cancer (16 and 18), made it vital to gain nationally representative HPV genotyping data for Australian women, including Aboriginal and Torres Strait Islander women. A research project, the 'Women, Human papilloma virus prevalence, Indigenous, Non indigenous, Urban, Rural Study' (WHINURS) was designed to obtain the HPV status of Aboriginal and non-Aboriginal women when they presented for their routine cervical screen. Family Planning NSW (FPNSW), an organisation that had previously worked in community based projects to increase Aboriginal participation in cervical screening, provided an investigator site in western NSW with the intention to recruit 50 Aboriginal women and 100 non-Aboriginal women. METHODS: The method was a consultative approach, including national and local frameworks for Aboriginal and Torres Strait Islander recruitment. The FPNSW Dubbo team devised a series of strategies to maximise recruitment when this did not progress according to plan. Strategies were developed to meet this challenge, including street walks, attendance at community forums, flexible appointments, drop-in times and assistance with travel and babysitting. RESULTS AND CONCLUSION: As a result of the activities listed above, 43 women were recruited to WHINURS, just seven short of the target. Collaborative community-based consultation, as well as the research study itself increased the number of Aboriginal women accessing cervical screening at the family planning clinic. This was sustained a year after the conclusion of the study.

Working with an Aboriginal community liaison worker.

FPA Health (Family Planning NSW) has conducted two integrated clinical and health promotion projects with Aboriginal communities in western NSW, Australia. The first was in Coonamble, a small rural community which had been selected as a pilot site for the Royal Australian College of General Practitioners Women's Aboriginal and Torres Strait Islander Project and was managed by FPA Health with support from the Dubbo/Plains Division of General Practice and Macquarie Area Health Service. The second was in Dubbo, a regional city where FPA Health had an existing centre and which had funding support from the Rio Tinto Aboriginal Foundation. The aim of this article was to share the learning and knowledge gained in managing these projects and to describe the experience of working with Aboriginal Community Liaison Workers who belong to and are supported by, the local Aboriginal community. The article aimed to illustrate the role and value of utilising these workers within a mainstream health service. The beneficial outcomes include improving service provision to Aboriginal women, adding to community knowledge about reproductive and sexual health issues and increasing the cultural knowledge and competency of a mainstream health service organisation.