HealthBulletin

This section of the Bulletin identifies recent journal articles. If you are aware of any journal articles that would be appropriate for inclusion in this section please contact us.

Bailie R, Togni S, Si D, Robinson G, d'Abbs P (2003)
Preventive medical care in remote Aboriginal communities in the Northern Territory: a follow-up study of the impact of clinical guidelines, computerised recall and reminder systems, and audit and feedback.
BMC Health Services Research;3:15-27

This paper was written in response to a lack of literature on the sustainability of health interventions in disadvantaged populations and remote settings. It was initiated following a multifaceted intervention in remote community health centres in the Northern Territory and endeavours to outline trends in the delivery of preventive medical services. The conclusions focus on improvements through institutionalisation of relevant work practices and enhanced health centre capacity.

Australian Indigenous HealthInfoNet abstract

Cass A, Cunningham C, Snelling P, Wang Z, Hoy W (2003)
Renal transplantation for Indigenous Australians: identifying the barriers to equitable access.
Ethnicity and Health;8(2):111-119

This paper assesses access to renal transplantation among Indigenous Australians and compares it with access within the non-Indigenous population. The assessment examined disparities in access due to lower rates of acceptance onto waiting lists, and movement along the waiting list. The findings indicate that Indigenous Australians face barriers associated with waiting list acceptance and movement within the list.

Australian Indigenous HealthInfoNet abstract

Chang AB, Masel JP, Boyce NC, Wheaton G, Torzillo P (2003)
Non-CF bronchiectasis: clinical and HRCT evaluation.
Pediatric Pulmonology;35(6):477-483

This paper presents the findings of a study of non-CF bronchiectasis in Central Australian Aboriginal children. The study aimed to: describe demographics; evaluate the effectiveness of routine investigations; and determine the relationship between diagnostic techniques. Comparisons in scoring, interpretation, and effectiveness in diagnosis were made between spirometry data and chest high-resolution computed tomography (HRCT) scans. Recommendations highlight the advantages and disadvantages of the various techniques.

Australian Indigenous HealthInfoNet abstract

Clough A (2003)
Enough! or too much. What is 'excessive' kava use in Arnhem Land?
Drug and Alcohol Review;22(1):43-51

This article draws on the findings of a study which aimed to describe the parameters for monitoring health, social and economic effects of kava use in Arnhem Land Aboriginal communities in the Northern Territory. The discussion of the results includes descriptions of the extent and effects of kava use, with recommendations on controlling kava supply.

Australian Indigenous HealthInfoNet abstract

Coory M, Baade P (2003)
Is median age at death a useful way to monitor improvements in mortality among Indigenous Australians?
Australian and New Zealand Journal of Public Health;27(6):627-631

Background: Trends in the median age at death (MAAD) are now being reported in some official government publications. Because trends in MAAD are being published and are being used to support discussions about policy, information is needed about its strengths and limitations.

Methods: We conducted a simulation study based on a Markov model to investigate the relationship between the MAAD and mortality rates. The main time horizon was five years because this is the interval that is relevant for the purposes of reviewing and debating policies and programs, but we also continued the models out to 50 years.

Results: The simulations brought to light three problems with the MAAD. First, for populations with different age structures but the same age-specific mortality rates, the MAAD can differ by more than 20 years. Second, for Indigenous Australians, a two-year increase in the MAAD after five years represents a 30% decrease in the mortality rates, but the same increase in the MAAD for non-Indigenous Australians would mean only a 15% decrease in mortality. Third, large sample sizes are needed to show that trends in the MAAD are statistically significant.

Conclusions: In the absence of better information, trends in the MAAD for Indigenous Australians may provide a way of assessing whether mortality rates are decreasing, but large sample sizes are needed to distinguish real change from statistical noise. Comparisons of trends in the MAAD between Indigenous and non-Indigenous Australians are even more difficult to interpret. Resources should be directed towards improving the validity of rates, for example, through linkage of routine data or investing in additional data collection.

Abstract reproduced with permission of the Australian and New Zealand Journal of Public Health (view website)

Davis SR, Knight S, White V, Claridge C, Davis BJ, Bell R (2003)
Climacteric symptoms among Indigenous Australian women and a model for the use of culturally relevant art in health promotion.
Menopause;10(4):345-351

This paper highlights the findings of a study evaluating climacteric symptoms among rural and remote Indigenous Australian women. The objective of the study was to develop culturally appropriate educational materials relevant to women's mid-life health. The study found that climacteric symptoms were just as common to Indigenous women as to non-Indigenous Australian women, although Indigenous women were less likely to be treated.

Australian Indigenous HealthInfoNet abstract

Dugdale AE (2004)
Brewster DR (2004)
Couzos S, Lea T, Culbong M, Mueller R, Murray R (2004)
Management of chronic suppurative otitis media [letters].
Medical Journal of Australia;180(2):92-93
View full paper (HTML)
View full paper (PDF)

Edwards K (2003)
Chronic suppurative otitis media (CSOM). Ear Toilet has not gone far enough!
Northern Territory Disease Control Bulletin;10(4):11-16
View full paper (PDF)

Gracey M, Cullinane J (2003)
Gastroenteritis and environmental health among Aboriginal infants and children in Western Australia.
Journal of Paediatric Child Health;39(6):427-431

This article presents the findings of a study examining the retrospective rates of hospitalisation of infants and children in Western Australia. The children were admitted for gastroenteritis between 1994 and 2000. The results show that hospitalisation for gastroneteritis is nearly seven times higher for Indigneous children than non-Indigenous children. Also, hospitalisation rates were higher in rural and remote areas than in urban areas. Evidence suggests that Indigenous child deaths from gastroenteritis dropped dramatically between 1970 and 2000.

Australian Indigenous HealthInfoNet abstract

Grove N, Brough M, Canuto C, Dobson A (2003)
Aboriginal and Torres Strait Islander health research and the conduct of longitudinal studies: issues for debate.
Australian and New Zealand Journal of Public Health;27(6):637-641

The National Health and Medical Research Council, Research Agenda Working Group (RAWG), and the literature on Indigenous health have identified the need to fill gaps in descriptive data on Aboriginal and Torres Strait Islander health and noted both the lack of research with urban populations and the need for longitudinal studies. This paper presents some of the broad ethical and methodological challenges associated with longitudinal research in Indigenous health and focuses particularly on national studies and studies in urban areas. Our goal is to advance debate in the public health arena about the application of ethical guidelines and the conduct of longitudinal studies in Aboriginal and Torres Strait Islander communities. We encourage others to offer their experiences in this field.

Abstract reproduced with permission of the Australian and New Zealand Journal of Public Health (view website)

Layland B, Holden B, Evans K, Bailey S (2004)
ICEE/AHMRC NSW Aboriginal Eye and Visioncare Program, Australia [project report].
Rural and Remote Health;4 (online):247. Retrieved from http://rrh.deakin.edu.au
View full paper (HTML)
View full paper (PDF)

This report describes the collaborative Aboriginal Eye and Visioncare Program in New South Wales, involving the establishment of eye clinics in Aboriginal medical services. Organisations involved in the program included the:

International Centre for Eyecare Education (ICEE);
Aboriginal Health and Medical Research Council (AHMRC);
Office for Aboriginal and Torres Strait Islander Health (OATSIH); and
local Aboriginal communities.

The history and extent of eye health problems in NSW Aboriginal communities is also discussed.

Australian Indigenous HealthInfoNet abstract

Mak DB, Johnson GH, Marshall LJ, Mein JK (2004)
Control of genital chlamydial infection in the Kimberley region of Western Australia.
Medical Journal of Australia;180(1):45
View full paper (HTML)
View full paper (PDF)

Parker R (2003)
The Indigenous mental health worker.
Australasian Psychiatry;11(3):295-297

This article presents three real-life scenarios experienced by Aboriginal mental health workers in Australia, as a means of highlighting the problems faced by mental health workers in the field. It also provides a background and a context for the recent statement released by the Royal Australian and New Zealand College of Psychiatrists (RANZCP) on Indigenous mental health workers.

Australian Indigenous HealthInfoNet abstract

Roche P, Krause V, Andrews R, et al. (2003)
Invasive pneumococcal disease in Australia, 2002.
Communicable Diseases Intelligence;27(4):466-477
View full paper (HTML)
View full paper (PDF)

Samaan G, Roche P, Spencer J, National Tuberculosis Advisory Committee (2003)
Tuberculosis notifications in Australia, 2002.
Communicable Diseases Intelligence;27(4):449-458
View full paper (HTML)
View full paper (PDF)

Sayers SM, Mackerras D, Singh G, Bucens I, Flynn K, Reid A (2003)
An Australian Aboriginal birth cohort: a unique resource for a life course study of an Indigenous population. A study protocol.
BMC International Health and Human Rights;3(1):1472-1698

This article describes a longitudinal study of Aboriginal babies born at the Royal Darwin Hospital over the period 1987-1990 and a cross-sectional follow-up between 1998-2001 in over 70 locations. The original concept was to establish an Australian Indigenous cohort for use as a resource for descriptive and analytical studies, particularly for non-communicable diseases. The paper mainly reports the methodology of the study including details of the range of assessments. Cultural, geographic and climatic challenges are explained.

Australian Indigenous HealthInfoNet abstract

Shaw IM, Elston TJ (2003)
Retrospective, 5-year surgical audit comparing breast cancer in Indigenous and non-Indigenous women in far north Queensland.
Australian and New Zealand Journal of Surgery;73(9):758-760

This article presents the findings of a study examining a retrospective 5-year surgical audit comparing breast cancer in Indigenous and non-Indigenous women in far north Queensland. It is claimed that this is the only reported audit of surgical assessment and management in Indigenous and Torres Strait Islander women with breast cancer. The findings identify detection rates in Indigenous and non-Indigenous women.

Australian Indigenous HealthInfoNet abstract

Shepherd F, Battye K, Chalmers E (2003)
Improving access to cardiac rehabilitation for remote Indigenous clients.
Australian and New Zealand Journal of Public Health;27(6):632-636

Objective: To identify barriers to Indigenous patients taking up a rural general practice-based cardiac rehabilitation program. We investigated the accessibility and appropriateness of the program and the role of Indigenous health workers (IHWs) in caring for Indigenous cardiac patients.

Methods: A cross-sectional survey of knowledge and views relating to cardiac rehabilitation was undertaken with 47 Indigenous cardiac patients and 41 health professionals in remote Queensland.

Results: Only three patients were fully engaged in the program. Reasons for non-participation included: lack of knowledge about rehabilitation, low income, and having a large extended family. Although the program incorporated a training component for IHWs covering prevention and follow-up, most did not monitor patients specifically for their heart problems and thought they did not have adequate skills. Shared care was occurring in some settings but without the participation of IHWs.

Conclusions: There was general agreement that IHWs do have a role in cardiac rehabilitation. There is a need for ongoing in-service education or inclusion in training programs. Lack of understanding of the role of IHWs is a barrier to shared care. Cardiovascular disease needs to be addressed as part of the raft of chronic illnesses.

Implications: Training about chronic illnesses and their management needs to be linked to structural adaptations in the delivery of health services to allow efficient use of each professional's skills. Clear role delineation needs to be negotiated to allow all health professionals to carry out their job effectively.

Abstract reproduced with permission of the Australian and New Zealand Journal of Public Health (view website)

Valery P, Purdie D, Chang A, Masters IB, Green AC (2003)
Assessment of the diagnosis and prevalence of asthma in Australian Indigenous children.
Journal of Clinical Epidemiology;56(7):629-635

This study examines the performance of the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire when it was administered as part of a cross-sectional study in Torres Strait Indigenous communities. The prevalence of asthma among Indigenous children in the Torres Strait is reported and recommendations are made for the enhancement of the ISAAC questionnaire.

Australian Indigenous HealthInfoNet abstract

Watson M, Bayley K, Bell JM, et al. (2003)
Laboratory surveillance of invasive pneumococcal disease in Australia in 2001 to 2002 - implications for vaccine serotype coverage.
Communicable Diseases Intelligence;27(4):478-487
View full paper (HTML)
View full paper (PDF)

Wenitong M (2004)
Indigenous health in my own community
Australian Family Physician;33(1/2):11-12
View full paper (PDF)



Australian Indigenous HealthBulletin Vol 4 No 1 January 2004 - March 2004: ISSN 1445-7253 A peer-reviewed electronic journal from the Australian Indigenous HealthInfoNet Journal articles This section of the Bulletin identifies recent journal articles. If you are aware of any journal articles that would be appropriate for inclusion in this section please contact us. Aboriginal and Torres Strait Islander health research and the conduct of longitudinal studies: issues for debate added 15 January 2004 An Australian Aboriginal birth cohort: a unique resource for a life course study of an Indigenous population. A study protocol added 23 January 2004 Assessment of the diagnosis and prevalence of asthma in Australian Indigenous children added 8 March 2004 Chronic suppurative otitis media (CSOM). Ear Toilet has not gone far enough! added 6 February 2004 Climacteric symptoms among Indigenous Australian women and a model for the use of culturally relevant art in health promotion added 5 January 2004 Control of genital chlamydial infection in the Kimberley region of Western Australia added 6 January 2004 Enough! or too much. What is 'excessive' kava use in Arnhem Land? added 30 January 2004 Gastroenteritis and environmental health among Aboriginal infants and children in Western Australia added 30 January 2004 ICEE/AHMRC NSW Aboriginal Eye and Visioncare Program, Australia [project report] added 10 February Improving access to cardiac rehabilitation for remote Indigenous clients added 13 January 2004 Indigenous health in my own community added 2 March 2004 Invasive pneumococcal disease in Australia, 2002 added 5 January 2004 Is median age at death a useful way to monitor improvements in mortality among Indigenous Australians? added 8 January 2004 Laboratory surveillance of invasive pneumococcal disease in Australia in 2001 to 2002 - implications for vaccine serotype coverage added 12 February 2004 Management of chronic suppurative otitis media [letters] added 3 February 2004 Non-CF bronchiectasis: clinical and HRCT evaluation added 15 March 2004 Preventive medical care in remote Aboriginal communities in the Northern Territory: a follow-up study of the impact of clinical guidelines, computerised recall and reminder systems, and audit and feedback added 23 February 2004 Renal transplantation for Indigenous Australians: identifying the barriers to equitable access added 5 January 2004 Retrospective, 5-year surgical audit comparing breast cancer in Indigenous and non-Indigenous women in far north Queensland added 19 February 2004 The Indigenous mental health worker added 17 February 2004 Tuberculosis notifications in Australia, 2002 added 5 January 2004 Bailie R, Togni S, Si D, Robinson G, d'Abbs P (2003) Preventive medical care in remote Aboriginal communities in the Northern Territory: a follow-up study of the impact of clinical guidelines, computerised recall and reminder systems, and audit and feedback. BMC Health Services Research;3:15-27 This paper was written in response to a lack of literature on the sustainability of health interventions in disadvantaged populations and remote settings. It was initiated following a multifaceted intervention in remote community health centres in the Northern Territory and endeavours to outline trends in the delivery of preventive medical services. The conclusions focus on improvements through institutionalisation of relevant work practices and enhanced health centre capacity. Australian Indigenous HealthInfoNet abstract Cass A, Cunningham C, Snelling P, Wang Z, Hoy W (2003) Renal transplantation for Indigenous Australians: identifying the barriers to equitable access. Ethnicity and Health;8(2):111-119 This paper assesses access to renal transplantation among Indigenous Australians and compares it with access within the non-Indigenous population. The assessment examined disparities in access due to lower rates of acceptance onto waiting lists, and movement along the waiting list. The findings indicate that Indigenous Australians face barriers associated with waiting list acceptance and movement within the list. Australian Indigenous HealthInfoNet abstract Chang AB, Masel JP, Boyce NC, Wheaton G, Torzillo P (2003) Non-CF bronchiectasis: clinical and HRCT evaluation. Pediatric Pulmonology;35(6):477-483 This paper presents the findings of a study of non-CF bronchiectasis in Central Australian Aboriginal children. The study aimed to: describe demographics; evaluate the effectiveness of routine investigations; and determine the relationship between diagnostic techniques. Comparisons in scoring, interpretation, and effectiveness in diagnosis were made between spirometry data and chest high-resolution computed tomography (HRCT) scans. Recommendations highlight the advantages and disadvantages of the various techniques. Australian Indigenous HealthInfoNet abstract Clough A (2003) Enough! or too much. What is 'excessive' kava use in Arnhem Land? Drug and Alcohol Review;22(1):43-51 This article draws on the findings of a study which aimed to describe the parameters for monitoring health, social and economic effects of kava use in Arnhem Land Aboriginal communities in the Northern Territory. The discussion of the results includes descriptions of the extent and effects of kava use, with recommendations on controlling kava supply. Australian Indigenous HealthInfoNet abstract Coory M, Baade P (2003) Is median age at death a useful way to monitor improvements in mortality among Indigenous Australians? Australian and New Zealand Journal of Public Health;27(6):627-631 Background: Trends in the median age at death (MAAD) are now being reported in some official government publications. Because trends in MAAD are being published and are being used to support discussions about policy, information is needed about its strengths and limitations. Methods: We conducted a simulation study based on a Markov model to investigate the relationship between the MAAD and mortality rates. The main time horizon was five years because this is the interval that is relevant for the purposes of reviewing and debating policies and programs, but we also continued the models out to 50 years. Results: The simulations brought to light three problems with the MAAD. First, for populations with different age structures but the same age-specific mortality rates, the MAAD can differ by more than 20 years. Second, for Indigenous Australians, a two-year increase in the MAAD after five years represents a 30% decrease in the mortality rates, but the same increase in the MAAD for non-Indigenous Australians would mean only a 15% decrease in mortality. Third, large sample sizes are needed to show that trends in the MAAD are statistically significant. Conclusions: In the absence of better information, trends in the MAAD for Indigenous Australians may provide a way of assessing whether mortality rates are decreasing, but large sample sizes are needed to distinguish real change from statistical noise. Comparisons of trends in the MAAD between Indigenous and non-Indigenous Australians are even more difficult to interpret. Resources should be directed towards improving the validity of rates, for example, through linkage of routine data or investing in additional data collection. Abstract reproduced with permission of the Australian and New Zealand Journal of Public Health (view website) Davis SR, Knight S, White V, Claridge C, Davis BJ, Bell R (2003) Climacteric symptoms among Indigenous Australian women and a model for the use of culturally relevant art in health promotion. Menopause;10(4):345-351 This paper highlights the findings of a study evaluating climacteric symptoms among rural and remote Indigenous Australian women. The objective of the study was to develop culturally appropriate educational materials relevant to women's mid-life health. The study found that climacteric symptoms were just as common to Indigenous women as to non-Indigenous Australian women, although Indigenous women were less likely to be treated. Australian Indigenous HealthInfoNet abstract Dugdale AE (2004) Brewster DR (2004) Couzos S, Lea T, Culbong M, Mueller R, Murray R (2004) Management of chronic suppurative otitis media [letters]. Medical Journal of Australia;180(2):92-93 View full paper (HTML) View full paper (PDF) Edwards K (2003) Chronic suppurative otitis media (CSOM). Ear Toilet has not gone far enough! Northern Territory Disease Control Bulletin;10(4):11-16 View full paper (PDF) Gracey M, Cullinane J (2003) Gastroenteritis and environmental health among Aboriginal infants and children in Western Australia. Journal of Paediatric Child Health;39(6):427-431 This article presents the findings of a study examining the retrospective rates of hospitalisation of infants and children in Western Australia. The children were admitted for gastroenteritis between 1994 and 2000. The results show that hospitalisation for gastroneteritis is nearly seven times higher for Indigneous children than non-Indigenous children. Also, hospitalisation rates were higher in rural and remote areas than in urban areas. Evidence suggests that Indigenous child deaths from gastroenteritis dropped dramatically between 1970 and 2000. Australian Indigenous HealthInfoNet abstract Grove N, Brough M, Canuto C, Dobson A (2003) Aboriginal and Torres Strait Islander health research and the conduct of longitudinal studies: issues for debate. Australian and New Zealand Journal of Public Health;27(6):637-641 The National Health and Medical Research Council, Research Agenda Working Group (RAWG), and the literature on Indigenous health have identified the need to fill gaps in descriptive data on Aboriginal and Torres Strait Islander health and noted both the lack of research with urban populations and the need for longitudinal studies. This paper presents some of the broad ethical and methodological challenges associated with longitudinal research in Indigenous health and focuses particularly on national studies and studies in urban areas. Our goal is to advance debate in the public health arena about the application of ethical guidelines and the conduct of longitudinal studies in Aboriginal and Torres Strait Islander communities. We encourage others to offer their experiences in this field. Abstract reproduced with permission of the Australian and New Zealand Journal of Public Health (view website) Layland B, Holden B, Evans K, Bailey S (2004) ICEE/AHMRC NSW Aboriginal Eye and Visioncare Program, Australia [project report]. Rural and Remote Health;4 (online):247. Retrieved from http://rrh.deakin.edu.au View full paper (HTML) View full paper (PDF) This report describes the collaborative Aboriginal Eye and Visioncare Program in New South Wales, involving the establishment of eye clinics in Aboriginal medical services. Organisations involved in the program included the: International Centre for Eyecare Education (ICEE); Aboriginal Health and Medical Research Council (AHMRC); Office for Aboriginal and Torres Strait Islander Health (OATSIH); and local Aboriginal communities. The history and extent of eye health problems in NSW Aboriginal communities is also discussed. Australian Indigenous HealthInfoNet abstract Mak DB, Johnson GH, Marshall LJ, Mein JK (2004) Control of genital chlamydial infection in the Kimberley region of Western Australia. Medical Journal of Australia;180(1):45 View full paper (HTML) View full paper (PDF) Parker R (2003) The Indigenous mental health worker. Australasian Psychiatry;11(3):295-297 This article presents three real-life scenarios experienced by Aboriginal mental health workers in Australia, as a means of highlighting the problems faced by mental health workers in the field. It also provides a background and a context for the recent statement released by the Royal Australian and New Zealand College of Psychiatrists (RANZCP) on Indigenous mental health workers. Australian Indigenous HealthInfoNet abstract Roche P, Krause V, Andrews R, et al. (2003) Invasive pneumococcal disease in Australia, 2002. Communicable Diseases Intelligence;27(4):466-477 View full paper (HTML) View full paper (PDF) Samaan G, Roche P, Spencer J, National Tuberculosis Advisory Committee (2003) Tuberculosis notifications in Australia, 2002. Communicable Diseases Intelligence;27(4):449-458 View full paper (HTML) View full paper (PDF) Sayers SM, Mackerras D, Singh G, Bucens I, Flynn K, Reid A (2003) An Australian Aboriginal birth cohort: a unique resource for a life course study of an Indigenous population. A study protocol. BMC International Health and Human Rights;3(1):1472-1698 This article describes a longitudinal study of Aboriginal babies born at the Royal Darwin Hospital over the period 1987-1990 and a cross-sectional follow-up between 1998-2001 in over 70 locations. The original concept was to establish an Australian Indigenous cohort for use as a resource for descriptive and analytical studies, particularly for non-communicable diseases. The paper mainly reports the methodology of the study including details of the range of assessments. Cultural, geographic and climatic challenges are explained. Australian Indigenous HealthInfoNet abstract Shaw IM, Elston TJ (2003) Retrospective, 5-year surgical audit comparing breast cancer in Indigenous and non-Indigenous women in far north Queensland. Australian and New Zealand Journal of Surgery;73(9):758-760 This article presents the findings of a study examining a retrospective 5-year surgical audit comparing breast cancer in Indigenous and non-Indigenous women in far north Queensland. It is claimed that this is the only reported audit of surgical assessment and management in Indigenous and Torres Strait Islander women with breast cancer. The findings identify detection rates in Indigenous and non-Indigenous women. Australian Indigenous HealthInfoNet abstract Shepherd F, Battye K, Chalmers E (2003) Improving access to cardiac rehabilitation for remote Indigenous clients. Australian and New Zealand Journal of Public Health;27(6):632-636 Objective: To identify barriers to Indigenous patients taking up a rural general practice-based cardiac rehabilitation program. We investigated the accessibility and appropriateness of the program and the role of Indigenous health workers (IHWs) in caring for Indigenous cardiac patients. Methods: A cross-sectional survey of knowledge and views relating to cardiac rehabilitation was undertaken with 47 Indigenous cardiac patients and 41 health professionals in remote Queensland. Results: Only three patients were fully engaged in the program. Reasons for non-participation included: lack of knowledge about rehabilitation, low income, and having a large extended family. Although the program incorporated a training component for IHWs covering prevention and follow-up, most did not monitor patients specifically for their heart problems and thought they did not have adequate skills. Shared care was occurring in some settings but without the participation of IHWs. Conclusions: There was general agreement that IHWs do have a role in cardiac rehabilitation. There is a need for ongoing in-service education or inclusion in training programs. Lack of understanding of the role of IHWs is a barrier to shared care. Cardiovascular disease needs to be addressed as part of the raft of chronic illnesses. Implications: Training about chronic illnesses and their management needs to be linked to structural adaptations in the delivery of health services to allow efficient use of each professional's skills. Clear role delineation needs to be negotiated to allow all health professionals to carry out their job effectively. Abstract reproduced with permission of the Australian and New Zealand Journal of Public Health (view website) Valery P, Purdie D, Chang A, Masters IB, Green AC (2003) Assessment of the diagnosis and prevalence of asthma in Australian Indigenous children. Journal of Clinical Epidemiology;56(7):629-635 This study examines the performance of the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire when it was administered as part of a cross-sectional study in Torres Strait Indigenous communities. The prevalence of asthma among Indigenous children in the Torres Strait is reported and recommendations are made for the enhancement of the ISAAC questionnaire. Australian Indigenous HealthInfoNet abstract Watson M, Bayley K, Bell JM, et al. (2003) Laboratory surveillance of invasive pneumococcal disease in Australia in 2001 to 2002 - implications for vaccine serotype coverage. Communicable Diseases Intelligence;27(4):478-487 View full paper (HTML) View full paper (PDF) Wenitong M (2004) Indigenous health in my own community Australian Family Physician;33(1/2):11-12 View full paper (PDF)

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