Topics
Indigenous health
Utility of exercise electrocardiography testing for the diagnosis of coronary artery disease in a remote Australian setting
Objective: To determine the utility of exercise electrocardiography testing (EET) in evaluating suspected coronary artery disease in a remote Australian setting where a significant proportion of patients are Indigenous Australians.Design: Retrospective cohort study with grouping based on EET results.Patients and setting: 268 patients with suspected coronary artery disease who underwent EET at Alice Springs Hospital — a specialist teaching hospital ...
Patricia N Hurune MB ChB · Justine M O’Shea MB BS · Graeme P Maguire MB BS, PhD, FRACP · Saliya S Hewagama MB BS, FRACP
Birthweight and fasting glucose and insulin levels: results from the Aboriginal Birth Cohort Study
Objective: To examine the relationships between birthweight, current size, and fasting glucose and fasting insulin levels in Aboriginal adolescents.Design, participants and setting: Longitudinal prospective study of a Northern Territory Aboriginal birth cohort of 686 Aboriginal babies born at the Royal Darwin Hospital between January 1987 and March 1990, and followed up between December 2006 and January 2008 in over 40 NT locations.Main outcome measures: ...
Susan M Sayers FAAP, FRACP, PhD · Susan A Mott BSc, RN, MPH · Kay D Mann MMathStat · Mark S Pearce BSc, MSc, PhD · Gurmeet R Singh PhD, MD, FRACP
A time and a place
History tells us that policies fail, and services falter, when they are not developed in consultation with those for whom they are designed.
Ruth Armstrong
Beyond cultural security; towards sanctuary
Using the concept of trauma-informed care to help Aboriginal and Torres Strait Islander children and their families recover from stressful life events.
Helen M Milroy MB BS, FRANZCP, CATCAP
Future initiatives to improve the health and wellbeing of Aboriginal and Torres Strait Islander peoples
There are now signs of substantial improvement in the health of Indigenous people, although there are persisting problems of access and worsening issues in some areas. But there is also a conspicuous lack of health data to show impacts and help plan future activities. The new national plan to guide investment is a step forward, but issues of racism and discrimination need to also be addressed.
Kerry Arabena
Refining the concept of cultural competence: building on decades of progress
Cultural competence strategies aim to make health services more accessible for patients from diverse cultural backgrounds. Recently, such strategies have focused on specific groups, and particularly Indigenous Australians, where services have failed to address large disparities in health outcomes. Limitations of cultural competence largely fall into three categories: lack of clarity around how the concept of culture is used in medicine, inadequate recognition of ...
Rosalie D Thackrah BA, GradDipEd, MA · Sandra C Thompson MPH, PhD, FAFPHM
How will we close the gap in smoking rates for pregnant Indigenous women?
Aboriginal and Torres Strait Islander women are more than three times more likely to smoke during pregnancy than non-Indigenous women, greatly increasing the risk of poor birth outcomes. Our systematic review found that there is currently no evidence for interventions that are effective in supporting pregnant Aboriginal and Torres Strait Islander women to quit smoking, which impedes development and implementation of evidence-informed policy and ...
Megan E Passey BMed(Hons), MPH, MSc · Jamie Bryant PhD, BPsych(Hons) · Alix E Hall BPsych(Hons) · Robert W Sanson-Fisher PhD, ClinMPsych, BPsych(Hons)
Urban Aboriginal and Torres Strait Islander children’s exposure to stressful events: a cross-sectional study
This study attempts to determine the frequency and types of stressful events experienced by urban Aboriginal and Torres Strait Islander children, and to explore the relationship between these experiences and the children’s physical health and parental concerns about their behaviour and learning ability.
Deborah A Askew PhD, MHlthSci, GradDipNutr · Philip J Schluter BSc(Hons), MSc, PhD · Geoffrey K P Spurling MB BS, FRACGP, MPH · Chelsea J R Bond BAppSci(Hons), PhD · Alex D H Brown PhD, FRACP
Impact of swimming on chronic suppurative otitis media in Aboriginal children: a randomised controlled trial
Children in two remote Northern Territory Aboriginal communities were studied to measure the impact of four weeks of daily swimming on rates of ear discharge with a tympanic membrane penetration and on the microbiology of the nasopharynx and middle ear.
Anna T N Stephen MPH · Amanda J Leach BAgSc(Hons), MAgSc, PhD · Peter S Morris MB BS, PhD, FRACP
Traditional healers help close the gap
IN 2009, THE ROYAL Australian and New Zealand College of Psychiatrists awarded the Mark Sheldon Prize for Indigenous mental health to ngangkari (traditional healers) Andy Tjilari and Rupert Langkatjukur Peter. The two were further honoured in 2011 by the World Council for Psychotherapy with the Sigmund Freud Award (bestowed by the City of Vienna, Austria). The awards recognised their distinguished contributions in mental health to the ...
Robert M Parker
Changes in smoking intensity among Aboriginal and Torres Strait Islander people, 1994–2008
To the Editor: The recent study by Thomas1 documents the change in smoking intensity of Australian Indigenous people between 1994 and 2008. A significant overall reduction in heavy smoking was observed with a corresponding increase in the proportion of light smoking. This is an interesting epidemiological observation but it should not be misinterpreted as a public health achievement or as a desirable goal in itself. As Thomas ...
Colin P Mendelsohn · Gillian S Gould
Changes in smoking intensity among Aboriginal and Torres Strait Islander people, 1994–2008
In reply: Nowhere in my article do I promote reducing the number of cigarettes patients smoke, rather than smoking cessation, as a goal for clinicians. Mendelsohn and Gould have created their own straw man with which to argue. I explain in the third paragraph of the Discussion that the population changes in smoking intensity may have been caused by previously heavy smokers cutting down (with only ...
David P Thomas
Characteristics of the community-level diet of Aboriginal people in remote northern Australia
The results of this 12-month assessment provide a compelling rationale that more needs to be done to improve diet and nutrition in remote communities.
Julie K Brimblecombe GradDipNut · Megan M Ferguson BSc, GradDipNut · Selma C Liberato GradDipNut · Kerin O’Dea BSc, PhD
Hookworm in the Northern Territory: down but not out
A retrospective study shows that microbiologically confirmed hookworm infection is now a rare event in the NT, persisting mainly in adults outside the target group of the community children’s deworming program.
Jane Davies* MB BS, MRCP(UK), DTM · Suman S Majumdar* BMed, MPHTM, MRCP(UK) · Robert T M Forbes BM BS, BSc, MSc · Pam Smith BSc · Bart J Currie FRACP, FAFPHM, DTM · Robert W Baird MB BS, FRACP, FRCPA
The brain painting: “the snake eating away the life of your memory”
In a highly commended artwork entry for the 2012 Dr Ross Ingram Memorial Prize, a traditional dot painting style and storytelling is used as the basis for a health promotion poster addressing the risks and signs of dementia in Aboriginal people.
Anna L Dwyer AdvDipAustLanguage
Listening to what Indigenous people in remote communities say about alcohol restrictions and cannabis use: ‘Good thing that the alcohol’s gone, but the gunja has kept going
Incorrect authorship: In “Listening to what Indigenous people in remote communities say about alcohol restrictions and cannabis use: ‘Good thing that the alcohol’s gone, but the gunja has kept going’ ” in the 3 September 2012 issue of the Journal (Med J Aust 2012; 197: 275), it was incorrectly stated that Alan Clough was the sole author of this letter. Due to space constraints in the print version of the Journal and Journal policy concerning the authorship of letters, the members of the Cape York Cannabis Project team who co-authored the letter were not individually named in the original publication as co-authors of the letter. We wish to name these co-authors individually. They are: Susan Jacups, Jan Robertson, Bernadette Rogerson and Veronica Graham.
Alan R Clough MSc
Lip lupus erythematosus
A reminder of the high incidence of both systemic and cutaneous lupus erythematosus in Indigenous Australians.
Johanna M Warren · Peter F Bourke PhD, FRACP · Lachlan J Warren MB BS, FRACGP, FACD
The reliability of single-field fundus photography in screening for diabetic retinopathy: the Central Australian Ocular Health Study
A study comparing single-field fundus photography with expert clinical examination finds the former is a valid tool in detecting diabetic retinopathy in Indigenous people in remote communities of Central Australia.
Janice J-Y Ku MB BS · John Landers PhD, FRANZCO · Tim Henderson MB, ChB, FRANZCO · Jamie E Craig DPhil, FRANZCO
Male reproductive health disorders among Aboriginal and Torres Strait Islander men: a hidden problem?
A study of help-seeking behaviours, reproductive disorders and rates of testing for prostate problems in Aboriginal and Torres Strait Islander men from urban, rural and remote communities in the Northern Territory and Queensland.
Michael J Adams BSW, MA, PhD · Veronica R Collins BSc, MSc(Epidemiol), PhD · Michael P Dunne BA(Hons), PhD · David M de Kretser MB BS, MD, FRACP · Carol A Holden BSc(Hons), PhD, MPH
Sexual health in Indigenous communities
Extreme rates of gonorrhoea in remote areas must be reducedIn this issue of the Journal, there are two important articles highlighting the disadvantages experienced by Indigenous Australians, and offering important practical suggestions for improving health care.1,2 The article by Graham and colleagues analyses the notification rates for chlamydia and gonorrhoea in Australia by Indigenous status.1 Their findings are stunning. Compared with non-Indigenous Australians, Indigenous Australians have ...
Christopher K Fairley FRACP, PhD, FACSHP · Jane S Hocking MPH, MHlthSc, PhD
The roadmap to close the gap for vision
Indigenous Australians have six times more blindness than the national average, but 94% of the vision loss is preventable with eye examinations and timely access to treatment. The Roadmap emphasises regional needs-based planning for service delivery and accountability.
Hugh R Taylor MD, FRANZCO, AC · Andrea I Boudville MIH · Mitchell D Anjou MScOptom
Trends in reports of child maltreatment in the Northern Territory, 1999–2010
An analysis of administrative data shows rapid increases in both notifications and substantiated cases of maltreatment in the NT Aboriginal population, suggesting a need for further expansion of services to address both immediate safety and the wider determinants of maltreatment.
Steven L Guthridge MB BS, MTH, FAFPHM · Philip Ryan MB BS, FAFPHM · John R Condon PhD, FAFPHM · Leah M Bromfield BAppSci(Psych)(Hons), PhD · John R Moss MSocSci, MB BS, FPHAA · John W Lynch PhD, MPH
Epidemiology of chlamydia and gonorrhoea among Indigenous and non-Indigenous Australians, 2000–2009
Objectives: To assess notification trends for chlamydia and gonorrhoea infections in Indigenous Australians compared with non-Indigenous Australians in 2000–2009.Design and setting: We assessed trends in national notification rates using univariate Poisson regression and summary rate ratios.Main outcome measures: Crude notification rates and summary rate ratios, by Indigenous status, sex, age and area of residence.Results: Over the 10-year ...
Simon Graham BIS, MAppEpi · Rebecca J Guy BAppSc, MAppEpi, PhD · Basil Donovan MB BS, MD · Hamish McManus BEcon, BAcTS, MBIOS · Jiunn-Yih Su MB, MPH · Carol El-Hayek BSc, MEpi · Kellie S H Kwan BA(Hons), GradCertAppEpi · Amalie Dyda BHSc(Hons), MAppEpi · Handan C Wand MA, MSc, PhD · James S Ward BA
Changes in smoking intensity among Aboriginal and Torres Strait Islander people, 1994–2008
Together with reports of the decreasing prevalence of smoking among Indigenous people, this first report of a significant reduction in heavy smoking by Indigenous smokers is good news. Reducing smoking intensity and prevalence will lead to fewer deaths and less illness due to smoking. Reducing the number of heavy smokers will also assist smoking cessation among Indigenous people. These changes in smoking intensity occurred before the recent increase in attention to and investment in tobacco control in Indigenous communities, but at a time of significant mainstream anti-tobacco public health activity. Similar trends in smoking intensity have been reported in the total Australian population.
David P Thomas MB BS, PhD, FAFPHM
Genetic research in Indigenous health: significant progress, substantial challenges
To the Editor: Kowal’s article resonates with our experience.1 However, the National Health and Medical Research Council has supported genetic testing in Indigenous Australians for longer than she cites. Through a 1995–1997 project grant, a 1998 PhD scholarship,2,3 a 2006 program grant and an Australia Research Fellowship (2008–), the NHMRC has supported work on kidney and related chronic diseases, in protocols endorsed by two remote communities and approved ...
Wendy E Hoy