Medicine and Health Sciences Commons^™

Growing Up Our Way : The First Year Of Life In Remote Aboriginal Australia, Sue Kruske, Suzanne Belton, Molly Wardaguga, Conceptual Narjic

Aboriginal Policy Research Consortium International (APRCi)

In this study, we attempted to explore the experiences and beliefs of Aboriginal families as they cared for their children in the first year of life. We collected family stories concerning child rearing, development, behavior, health, and wellbeing between each infant’s birth and first birthday. We found significant differences in parenting behaviors and childrearing practices between Aboriginal groups and mainstream Australians. Aboriginal parents perceived their children to be autonomous individuals with responsibilities toward a large family group. The children were active agents in determining their own needs, highly prized, and included in all aspects of community life. Concurrent with poverty, …

Management Of Type 2 Diabetes, Susan Harch, David Reeve, Carole Reeve

Aboriginal Policy Research Consortium International (APRCi)

Objective: This article describes the evaluation of a new model of partnership care using an audit cycle.

Results: Statistically significant improvements in foot examination, body mass index, urine albumin creatinine ratio, total cholesterol, triglycerides and visual acuity measurements were observed. Significant increases in the proportion of patients achieving cholesterol and triglycerides therapeutic targets occurred. Most other outcome indicators demonstrated a nonsignificant improvement, which may be due to the short time interval in the audit for potential change.

Conclusion: A dedicated chronic disease team and a clinical information system to coordinate culturally appropriate, multidisciplinary chronic disease care enables effective management of …

Using First Nations Children's Perceptions Of Food And Activity To Inform An Obesity Prevention Strategy, Ashlee-Ann E. Pigford, Noreen D. Willows, Nicholas L. Holt, Amanda S. Newton, Geoff D.C. Ball

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Birthweight And Natural Deaths In A Remote Australian Aboriginal Community, Wendy E. Hoy, Jennifer L. Nicol

Aboriginal Policy Research Consortium International (APRCi)

Objectives: To describe associations between birthweight and infant, child and early adult mortality from natural causes in a remote Australian Aboriginal community against a background of rapidly changing mortality due to better health services. Design, participants and setting: Cohort study of 995 people with recorded birthweights who were born between 1956 and 1985 to an Aboriginal mother in a remote Australian Aboriginal community. Participants were followed through to the end of 2006. Main outcome measures: Rates of natural deaths of infants (aged 0 to < 1 year), children (aged 1 to < 15 years) and adults (aged 15 to < 37 years), compared by birth intervals (1956–1965, 1966–1975 and 1976–1985 for infants and children, and 1956–1962 and 1963–1969 for adults) and by birthweight. Results: Birthweights were low, but increased over time. Deaths among infants and children decreased dramatically over time, but deaths among adults did not. Lower birthweights were associated with higher mortality. Adjusted for birth interval, hazard ratios for deaths among infants, children and adults born at weights below their group birthweight medians were 2.30 (95% CI, 1.13–4.70) ), 1.78 (95% CI, 1.03–3.07) and 3.49 (95% CI, 1.50–8.09), respectively. The associations were significant individually for deaths associated with diarrhoea in infants, with cardiovascular and renal disease in adults, and marginally significant for deaths from pulmonary causes in children and adults. Conclusion: The striking improvements in infant and child survival over time must be applauded. We confirmed a predisposing effect of lower birthweights on deaths in infants and children, and showed, for the first time, an association between lower birthweights and deaths in adults. Together, these factors are probably contributing to the current epidemic of chronic disease in Aboriginal people, an effect that will persist for decades. Similar phenomena are probably operating in developing countries.

Patterns Of Mortality In Indigenous Adults In The Northern Territory, 1998–2003: Are People Living In More Remote Areas Worse Off?, Karen Andreasyan, Wendy E. Hoy

Aboriginal Policy Research Consortium International (APRCi)

Objective: ToquantifyIndigenousmortalityintheNorthernTerritorybyremotenessof residence.

Design, setting and participants: Australian Bureau of Statistics mortality data were used to compare rates of death from chronic disease in the NT Indigenous population with rates in the general Australian population over the period 1998–2003. Rates were evaluated by categories of remoteness based on the Accessibility/Remoteness Index of Australia: outer regional areas (ORAs), remote areas (RAs) and very remote areas (VRAs). Main outcome measures: Mortality from cardiovascular disease, diabetes and renal disease; standardised mortality ratios (SMRs); percentage change in annual death rates; changes in mortality between 1998–2000 and 2001–2003.

Results: In 1998–2000, SMRs for all-cause mortality …

Lower Than Expected Morbidity And Mortality For An Australian Aboriginal Population: 10-Year Follow-Up In A Decentralised Community, Kevin G. Rowley, Kerin O'Dea, Ian Anderson, Robyn Mcdermott, Karmananda Saraswati, Ricky Tilmouth, Iris Roberts, Joseph Fitz, Zaimin Wang, Alicia Jenkins, James D. Best, Zhiqiang Wang, Alex Brown

Aboriginal Policy Research Consortium International (APRCi)

Objective: Toexaminemortalityfromallcausesandfromcardiovasculardisease(CVD), and CVD hospitalisation rate for a decentralised Aboriginal community in the Northern Territory. Design and participants: For a community-based cohort of 296 people aged 15 years or older screened in 1995, we reviewed hospital and primary health care records and death certificates for the period up to December 2004 (2800 person-years of follow-up). Mainoutcomemeasures: MortalityfromallcausesandCVD,andhospitalisationwith CVD coded as a primary cause of admission; comparison with prior trends (1988 to 1995) in CVD risk factor prevalence for the community, and with NT-specific Indigenous mortality and hospitalisation rates.

Results: Mortality in the cohort was 964/100 000 person-years, significantly lower than …