Public Health Commons^™

Sustainable Antenatal Care Services In An Urban Indigenous Community: The Townsville Experience, Kathryn S. Panaretto, Melvina R. Mitchell, Lynette Anderson, Sarah L. Larkins, Vivienne Manessis, Petra G. Buettner, David Watson

Aboriginal Policy Research Consortium International (APRCi)

Objective: To evaluate the impact of a sustained, community-based collaborative approach to antenatal care services for Indigenous women.

Design: Prospective quality improvement intervention, the Mums and Babies program, in a cohort of women attending Townsville Aboriginal and Islanders Health Service, 1 January 2000 – 31 December 2005 (MB group), compared with a historical control group (PreMB group), 1 January 1998 – 30 June 1999.

Main outcome measures: Proportion of women having inadequate antenatal care and

screening; perinatal indicators. Results: Thenumberofantenatalvisitsperpregnancyincreasedfromthree

(interquartilerange[IQR],twotosix)inthePreMBgrouptosix(IQR,fourtoten)inthe MB group (P < 0.001). There were significant improvements in care planning, completion of cycle-of-care, and antenatal education activities throughout the study period. About 90% of all women attending for antenatal care were screened for sexually transmitted diseases, 89% had measurement of haemoglobin level, and serological tests for hepatitis B and syphilis (minimum antenatal screening). There was increased attendance for dating and morphology scans. In the MB group compared with the PreMB group, there was a significant reduction in perinatal mortality (14 v 60 per 1000 births; P=0.014). Conclusion: Sustained access to a community-based, integrated, shared antenatal service has improved perinatal outcomes among Indigenous women in Townsville.

Social Determinants Of Health And Disease Working Together, Amresh Srivastava

Psychiatry Presentations

No abstract provided.

Post-Operative Extended Volume External Beam Radiation Therapy Is Safe For High Risk Esophageal Cancer Patients, Edward Yu, Patricia Tai, Jawaid Younus, Richard Malthaner, Larry Stitt, Pauline Truong, George Rodrigues, Robert Ash, Rashid Dar, Anna Tomiak, Mark Vincent, Walter Kocha, Brian Dingle, Richard Inculet

Oncology Presentations

Post-operative radiation therapy (RT) (1) and post-operative chemoradiation (2) have been used for esophageal cancer patients deemed high risk for recurrence after esophagectomy.

Defining opitmal RT target volume after esophagectomy is difficult due to significant changes in patient anatomy and function.

Some radiationon cologists advocated the inclusion of the anastomotic site within the irradiation volume due to concerns for potential increased relapse risk, while others did not subscribe to this practice due to concerns for increased treatment related toxicity.

We have previously reported patient outcome benefit using extended volume RT In management with high risk esophageal cancer patients underwent esopagectomy(3). …

Learning From The Grandmothers: Incorporating Indigenous Principles Into Qualitative Research, Charlotte Loppie

Aboriginal Policy Research Consortium International (APRCi)

In this article, the author describes the process she undertook to incorporate Indigenous principles into her doctoral research about the midlife health experiences of elder Aboriginal women in Nova Scotia, Canada. By employing qual- itative methods within the context of an Indigenous worldview, she gained knowledge of and developed competence in Aboriginal health research. The emergent partnership among Aboriginal community research facilitators, participating Mi’kmaq women, and the researcher provided many opportunities for the researcher to incorporate the paradigmatic and methodological traditions of Western science and Indigenous cultures. The application of these principles to this study might provide a useful example …

Social Support And Thriving Health: A New Approach To Understanding The Health Of Indigenous Canadians, Chantelle A.M. Richmond, Nancy A. Ross, Grace E. Egeland

Aboriginal Policy Research Consortium International (APRCi)

Objectives. We examined the importance of social support in promoting thriv- ing health among indigenous Canadians, a disadvantaged population.

Methods. We categorized the self-reported health status of 31 625 adult indig- enous Canadians as thriving (excellent, very good) or nonthriving (good, fair, poor). We measured social support with indices of positive interaction, emotional support, tangible support, and affection and intimacy. We used multivariable lo- gistic regression analyses to estimate odds of reporting thriving health, using social support as the key independent variable, and we controlled for educational attainment and labor force status.

Results. Compared with women reporting low levels of …

Public Health Decision Makers’ Informational Needs And Preferences For Receiving Research Evidence, Maureen Dobbins, Susan Jack, Helen Thomas, Anita Kothari

Anita Kothari

Objectives: The purpose of this study was to identify decision-makers’ preferences for the transfer and exchange of research knowledge. This article is focused on how the participants define evidence-based decision-making and their preferences for receiving research evidence to integrate into the decision-making process.

Methods: Semistructured interviews were conducted with a purposive sample of 16 Ontario public health decision-makers from six Ontario public health units in this fundamental qualitative descriptive study. The sample included nine program managers, six directors, and one Medical Officer of Health. Participants were asked to define the term evidence-based decision-making and identify preferred research dissemination strategies. The …