Introduction：There are large Pacific island communities in western and south-western Sydney, New South Wales, Australia. In 2011 and 2012, measles outbreaks disproportionally affected children and youth within these communities. The objectives of this study were to explore barriers to immunization in a Pacific island community from the perspectives of community members and health professionals and to conduct a pilot programme whereby immunization catch-up clinics were held in a Samoan church in western Sydney.Methods：Interviews were conducted with Pacific island community members (n = 12) and health professionals connected with the Pacific island community (n = 7) in 2013. A partnership with a local Samoan church was established to provide an accessible venue for immunization catch-up clinics.Results：Among the community members there were high levels of belief in the importance of immunization and a positive view regarding the protection offered by immunization. A key barrier reported by community members was being busy and therefore having limited time to get children immunized. The important role of the church within the community was emphasized in the interviews, and as a result, two immunization catch-up clinics were held in a Samoan church in western Sydney. The age range of attendees was 7–33 years. A total of 31 measles, mumps and rubella doses and 19 meningococcal C doses were given during the two clinics.Discussion：The outcomes of the interviews and the subsequent clinics highlighted the potential of churches as a venue for providing public health interventions such as catch-up immunization.

This is a retrospective cohort study comparing blastocyst transfer outcomes following intracytoplasmic sperm injection utilizing epididymal versus testicular sperm for men with obstructive azoospermia. All cases at a single center between 2012 and 2016 were included. Operative approach was selected at the surgeon's discretion and included microepididymal sperm aspiration or testicular sperm extraction. Blastocyst culture was exclusively utilized prior to transfer. The primary outcome was live birth rate. Secondary outcomes included fertilization rate, blastulation rate, euploidy rate, and implantation rate. A mixed effects model was performed. Seventy-six microepididymal sperm aspiration cases and 93 testicular sperm extraction cases were analyzed. The live birth rate was equivalent (48.6% vs 50.5%, P = 0.77). However, on mixed effects model, epididymal sperm resulted in a greater likelihood of fertilization (adjusted OR: 1.37, 95% CI: 1.05-1.81, P = 0.02) and produced a higher blastulation rate (adjusted OR: 1.41, 95% CI: 1.1-1.85, P = 0.01). As a result, the epididymal sperm group had more supernumerary blastocysts available (4.3 vs 3, P < 0.05). The euploidy rate was no different. Pregnancy rates were no different through the first transfer cycle. However, intracytoplasmic sperm injection following microepididymal sperm aspiration resulted in a greater number of usable blastocysts per patient. Thus, the true benefit of epididymal sperm may only be demonstrated via a comparison of cumulative pregnancy rates after multiple transfers from one cohort.
Adult ; Azoospermia ; Embryo Implantation ; Embryo Transfer ; Epididymis/cytology* ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic/methods* ; Sperm Retrieval ; Spermatozoa/cytology* ; Testis/cytology*