Australian Indigenous HealthBulletin
Vol 5 No 4 October 2005 - December 2005: 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.

Benson J (2005)
Concordance: an alternative term to 'compliance' in the Aboriginal population.
Australian Family Physician;34(10):831-834
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Blair EM, Zubrick SR, Cox AH, on behalf of the WAACHS Steering Committee (2005)
The Western Australian Aboriginal Child Health Survey: findings to date on adolescents.
Medical Journal of Australia;183(8):433-435
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Brown A, Blashki G (2005)
Indigenous male health disadvantage: linking the heart and mind.
Australian Family Physician;34(10):813-819
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Charles J, Britt H, Knox S (2005)
Encounters with Indigenous patients in Australian practice.
Australian Family Physician;34(10):810-811
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Clough AR (2005)
Associations between tobacco and cannabis use in remote Indigenous populations in Northern Australia.
Addiction;100(3):346-353

This cross-sectional study examines the associations between newly adopted cannabis use in remote Indigenous communities and prolonged tobacco use. The study employed opportunistic recruitment among three eastern Arnhem Land communities in the Northern Territory, and measured self-reported life-time and current tobacco, cannabis, and other substance use. The findings show that the quantity of tobacco use increased as the quantity of cannabis use increased in users of both substances. The authors conclude that continued substance use in these populations increases the burden of cardiovascular and respiratory diseases.

Australian Indigenous HealthInfoNet abstract

Condon JR, Armstrong BK, Barnes T, Zhao Y (2005)
Cancer incidence and survival for Indigenous Australians in the Northern Territory.
Australian and New Zealand Journal of Public Health;29(2):123-128

Objective: To compare cancer incidence and survival for the Northern Territory (NT) Indigenous population with that of other Australians, and to assess NT Indigenous incidence time trends.

Methods: Cancer registry data were used to calculate cancer incidence rate ratios (NT Indigenous to total Australian), the average annual change in NT Indigenous cancer incidence and the relative risk of cancer death after diagnosis of cancer (NT Indigenous to combined Western Australian and Tasmanian cases) for 1991-2001.

Results: For NT Indigenous people, incidence rates were high for cancers of the liver, gallbladder, cervix, vulva and thyroid and, in younger people only, for cancers of the oropharynx, oesophagus, pancreas and lung, but low for cancers of the colon and rectum, breast, ovary, prostate, bladder, kidney, melanoma and lymphoma. Incidence rate ratios ranged from 0.1 for melanoma to 7.4 for liver cancer. Incidence increased for breast and pancreatic cancers. Survival was low for almost all specific cancers examined, and for all cancers combined (relative risk of death 1.9, 95% CI 1.7-2.1).

Conclusions: Compared with other Australians, NT Indigenous people have higher, and increasing, incidence for some cancers (particularly smoking-related cancers) and lower survival for most.

Implications: Cancer has a greater impact on NT Indigenous people than other Australians. Well-established cancer risk factors should be more effectively tackled in Indigenous people and known effective screening programs more effectively implemented. Research is urgently required into the reasons why survival from cancer in NT Indigenous people is so much lower than in other Australians.

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

Corkrey R, Parkinson L, Bates L, Green S, Htun AT (2005)
Pilot of a novel cervical screening intervention: interactive voice response.
Australian and New Zealand Journal of Public Health;29(3):261-264

Objective: This paper describes the pilot of an interactive voice response (IVR) cervical screening brief advice interface.

Method: In September 2000, 5,000 households within Cessnock, New South Wales, were contacted by an IVR system. The system randomly selected eligible women aged 18-69, assessed their cervical screening status and provided a tailored message about cervical screening. A computer-assisted telephone interview (CATI) evaluated intervention acceptability. Participation rates, participant demographics, IVR use by women, and IVR costs were also examined.

Results: 549 (12%) women listened to the IVR call and 587 (59%) completed the CATI interview. IVR listeners under-represented younger and older women, and over-represented women who were married, and of Aboriginal descent. The majority of women (98%) found IVR easy to answer and 90% agreed IVR reminders were a good idea. Unscreened and older women used the system more than screened or younger women.

Conclusions: The IVR call was successfully used by a large number of women to obtain information on cervical cancer screening, with higher use by recognised risk groups.

Implications: These results suggest that an IVR reminder might be useful to increase cervical screening rates since those most at risk also used IVR the most. The potential for linking IVR to a database to issue reminders in the same manner as Pap Test Register postal reminders needs to be explored.

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

Couzos S, Davis S (2005)
Inequities in Aboriginal health: access to the Asthma 3+ Visit Plan.
Australian Family Physician;34(10):837-840
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Couzos S (2005)
PBS medications: improving access for Aboriginal and Torres Strait Islander peoples.
Australian Family Physician;34(10):841-844
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D'Souza RM, Butler T, Petrovsky N (2005)
Assessment of cardiovascular disease risk factors and diabetes mellitus in Australian prisons: is the prisoner population unhealthier than the rest of the Australian population?
Australian and New Zealand Journal of Public Health;29(4):318-323
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Introduction: This paper compares the prevalence estimates of diabetes and cardiovascular disease (CVD) risk factors in the Indigenous and non-Indigenous New South Wales (NSW) prisoner population in 1996 and 2001, and also compares the 2001 prevalence estimates with Australian population data.

Methods: In 1996 and 2001, 789 and 916 prisoners, respectively, in NSW underwent a face-to-face interview covering behavioural risks and physical and mental health. Weight, height and blood pressure were recorded and blood was taken for measurement of cholesterol and random blood sugar.

Results: The prevalence of hypertension, hypercholesterolaemia and smoking were lower in the 2001 prison survey as compared with the 1996 survey but the prevalence of smoking was extremely high in both the prison surveys (88% in 1996 and 79% in 2001). There were no differences in the age and sex-adjusted prevalence estimates for any condition except that the prison sample had a higher standardised morbidity ratio for angina than the AusDiab population.

Conclusion: This study highlights the high prevalence of CVD risk factors, particularly in younger prisoners, when compared with the Australian non-prison population.

Implications: Programs should be put in place to routinely screen for chronic disease conditions and to educate Australian prisoners regarding CVD and diabetes risk factors and their long-term management.

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

Eissa S, Lee R, Binns P, Garstone G, McDonald M (2005)
Assessment of a register-based rheumatic heart disease secondary prevention program in an Australian Aboriginal community
Australian and New Zealand Journal of Public Health;29(6):521-525

Objective: To assess specific performance indicators relating to a register-based acute rheumatic fever and rheumatic heart disease (ARF/RHD) prevention program in a remote Australian Aboriginal community in order to identify the most appropriate avenues for improvements in delivery of services.

Methods: Information kept on the central ARF/RHD register was compared with an amalgamated dataset from three other sources. The community clinic charts of identified patients were reviewed for information regarding accuracy of diagnosis and the number of doses of benzathine penicillin received in the last year. Specific follow-up arrangements were assessed and compared with practice guidelines.

Results: The central ARF/RHD register contained the names of 58 of the 72 (81%) people identified in the community as eligible for inclusion. Only 42% (22/52) of people receiving antibiotic prophylaxis had received 80% or more of the recommended doses in the previous year; service delivery was significantly better for females than males (p=0.004). Individuals in priority category 1 (most severe disease) were found to be receiving follow-up and investigation according to guidelines. About half the people in categories 2 (moderate disease) and 3 (mild disease) had been inadequately investigated and/or missed out on follow-up appointments.

Conclusions: The ARF/RHD prevention program in this large remote Aboriginal community is struggling to deliver services to a substantial proportion of people who require them. Specific interventions, especially those related to men's health, may be required to correct the problems.

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

Fuller JD, Martinez L, Muyambi K, Verran K, Ryan B, et al. (2005)
Sustaining an Aboriginal mental health service partnership.
Medical Journal of Australia;183(10):s69-s72
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Hanna JN, Heazlewood RJ (2005)
The epidemiology of acute rheumatic fever in Indigenous people in north Queensland.
Australian and New Zealand Journal of Public Health;29(4):313-317

Objective: To describe the epidemiology and features of acute rheumatic fever (ARF) in Indigenous people in north Queensland from mid-1999 to mid-2004.

Methods: Enhanced surveillance, including regular reminder letters to relevant clinicians and computer searches of hospital discharge diagnoses, was implemented to capture cases of ARF.

Results: Over the five years, 144 episodes of ARF occurred in 133 Indigenous people in seven of the Health Service Districts in north Queensland. The annual incidences of ARF were 61 cases/100,000 Indigenous people in these seven districts, and 54/100,000 throughout north Queensland. The median age of the cases was 12.0 years, and 76% of the cases occurred in children <15 years. More than one-third of the definite cases were recurrences of ARF, and carditis was present in 42% of all cases.

Conclusions: Within north Queensland, the incidences of ARF were greatest in the Cape York and the Torres Strait and Northern Peninsula Area Districts. However, the incidence of ARF in north Queensland is considerably lower than that reported from the Top End of the Northern Territory (NT). Furthermore, there appears to be less chorea and less monoarthritis, but more group A streptococci isolated from throat swabs, in ARF cases in north Queensland compared with those from the Top End of the NT.

Implications: There is a need for greater awareness of ARF and its complications among both ARF patients and primary health care workers in the region, and for more reliable mechanisms for recalling patients for their prophylaxis and clinical reviews.

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

Hermeston WA (2005)
Telling you our story: how apology and action relate to health and social problems in Aboriginal and Torres Strait Islander communities.
Medical Journal of Australia;183(9): 479-481
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Ivers R, Castro A, Parfitt D, Bailie RS, Richmond RL, et al. (2005)
Television and delivery of health promotion programs to remote Aboriginal communities.
Health Promotion Journal of Australia;16(2):155-158
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Kowal E, Anderson I, Bailie R (2005)
Moving beyond good intentions: Indigenous participation in Aboriginal and Torres Strait Islander health research.
Australian and New Zealand Journal of Public Health;29(5):468-470

Indigenous participation in every aspect of health research is increasingly recognised as an important element of any research project that aims to improve Indigenous health. Despite the acceptance of its importance, when the concept of 'Indigenous participation' is mentioned, authors are often imprecise as to the nature and purpose of participation, and its relationship to improved health outcomes. This report attempts to bring some clarity to the variety of meanings we might give Indigenous participation in research. For the purposes of stimulating further debate, we identify four distinct, but overlapping, rationales: pragmatic, moral, interventionist, and epistemological. Each has different implications for how Indigenous participation should be implemented and evaluated. More debate on the meanings and purposes of Indigenous participation will contribute to a refined understanding of its potential benefits to health research.

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

Kruger E, Tennant M (2005)
Oral health workforce in rural and remote Western Australia: practice perceptions.
Australian Journal of Rural Health;13(5):321-326

This paper outlines the findings of a postal survey of registered dental therapists, dental hygienists and dentists working in rural and remote Western Australia. The objectives of the survey were to determine the major factors that influence whether oral health professionals choose to: practise in rural and remote locations; remain in rural practice; or leave rural practice. The results indicated that, other than financial incentives, there are a variety of factors that attract people to rural and remote areas, and the need for professional development is an incentive to remain in rural practice. Issues associated with access to children's educational facilities were the most common reason for leaving rural practice. Based on these findings a broad integrated retention strategy has been recommended to address oral health workforce shortage issues in rural and remote Western Australia.

Australian Indigenous HealthInfoNet abstract

Lim WH, Johnson DW, McDonald SP (2005)
Higher rate and earlier peritonitis in Aboriginal patients compared to non-Aboriginal patients with end-stage renal failure maintained on peritoneal dialysis in Australia: Analysis of ANZDATA.
Nephrology; 10:192-197

This article examines the high rates of peritoneal dialysis (PD) technique failure in Indigenous renal patients in association with independent co-morbid conditions, particularly diabetes mellitus. The findings show that independent of demographic and co-morbid factors, Aboriginal and obese PD patients have a higher rate of peritonitis and a shorter time to first peritonitis. The authors stress that further research is required into the factors contributing to PD-associated infective complications, as PD is often the preferred technique for Indigenous patients due to geographical constraints.

Australian Indigenous HealthInfoNet abstract

Procter NG (2005)
Parasuicide, self-harm and suicide in Aboriginal people in rural Australia: a review of the literature with implications for mental health nursing practice.
International Journal of Nursing Practice;11(5):237-241

This background paper examines the literature on mental health issues underlying increased rates of suicide and parasuicide among Aboriginal people nationally and internationally, together with primary and secondary actions aimed at minimising the risks associated with these issues. The literature review is based on the following beliefs regarding the prevention of mental health problems, mental illness and parasuicide: that an understanding of the risk factors and protective factors should be incorporated; and effective culturally and linguistically appropriate interventions should be developed, disseminated and implemented.

Australian Indigenous HealthInfoNet abstract

Reath J (2005)
The RACGP: supporting GPs to work better in Aboriginal and Torres Strait Islander health.
Australian Family Physician;34(10):845-848
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Shephard MDS, Gill JP (2005)
An innovative Australian point-of-care model for urine albumin: creatinine ratio testing that supports diabetes management in Indigenous medical services and has international application.
Annals of Clinical Biochemistry; 42:208-215

This article outlines the importance of measuring urine albumin:creatinine ratio in Indigenous diabetics, as a diabetes management tool, and for the early detection of end-stage renal failure. A program was established to monitor microalbuminuria in Indigenous diabetics at 30 Aboriginal and Torres Strait Islander medical services across Australia, and health workers were recruited and trained in order to carry out the tests. The findings show desirable performance specifications of the new testing tool with considerable potential for Indigenous and other communities nationally and internationally.

Australian Indigenous HealthInfoNet abstract

Stewart T, McDonald R, Currie B (2005)
Use of the Jones Criteria in the diagnosis of acute rheumatic fever in an Australian rural setting.
Australian and New Zealand Journal of Public Health;29(6):526-529

Objective: To answer the question, are the Jones Criteria being used appropriately in the diagnosis of acute rheumatic fever (ARF) by non-specialist medical staff in a remote Australian setting?

Methods: The medical records of all patients discharged from Katherine Hospital (Northern Territory) with a diagnosis of ARF between January 2000 and April 2004 were retrospectively reviewed for adherence to the Jones Criteria. Data were also collected on specialist follow-up and need for transfer to a tertiary hospital.

Results: Twenty-five patients had a diagnosis of ARF and all were Aboriginal or Torres Strait Islander. Thirty-two per cent did not fulfil the Jones Criteria and of these 63% were recurrent cases. Eighty-eight per cent received specialist follow-up and of those who did not fulfil the Jones Criteria, all were diagnosed as ARF by the specialist. Only 20% required transfer to a tertiary hospital for higher-level care.

Conclusion: The Jones Criteria are being used appropriately to diagnose initial episodes of ARF but less successfully in recurrent episodes. Specialist follow-up is essential but acute episodes can be managed in remote settings, reducing the need to transfer patients to tertiary care with resultant patient dislocation and social isolation.

Implications: The diagnosis of ARF results in long-term penicillin prophylaxis. This is a major public health undertaking that requires correct diagnosis. This study demonstrates that the Jones Criteria are being used appropriately to diagnose ARF in a remote setting. The ability to diagnose and treat Indigenous patients within their local region reduces social isolation and creates a more positive health care experience.

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

Starling RN, O'Connell C, Couzos S (2005)
NACCHO GP Network: enhancing communication in Aboriginal health.
Australian Family Physician;34(10):849-850
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Vindigni D, Parkinson L, Walker B, Rivett DA, Blunden S, Perkins J (2005)
A community-based sports massage course for Aboriginal health workers.
Australian Journal of Rural Health;13(2):111-115

This article describes the outcomes of a pilot community-based and owned sports massage course for Aboriginal health workers, in a large rural Indigenous community in NSW. The pilot course was initiated after it was reported that there were high levels of pain associated with sporting injuries, within the community. Due to the culturally-appropriate framework in which the course was applied, it was found that the course was accepted by the community and had potential for replication in similar settings.

Australian Indigenous HealthInfoNet abstract

Wakerman J, Chalmers EM, Humphreys JS, Clarence CL, Bell AI, et al. (2005)
Sustainable chronic disease management in remote Australia.
Medical Journal of Australia;183(10):s64-s68
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Wong M, Haswell-Elkins M, Tamwoy E, McDermott R, d'Abbs P (2005)
Perspectives on clinic attendance, medication and foot-care among people with diabetes in the Torres Strait Islands and Northern Peninsula area.
Australian Journal of Rural Health; 13:172-177

This article outlines the findings of a descriptive study examining the perspectives and needs of Indigenous people with diabetes in the Torres Strait, and also identifies ways to promote successful self-management of diabetes. Data relating to self-care, clinic attendance, blood glucose monitoring, medication, and foot-care were collected from remote communities in the Torres Strait and northern peninsula area of far north Queensland. The findings show that positive feedback from doctors resulted in higher levels of patient satisfaction, and that many aspects of diabetes management were directly related to levels of understanding and community issues. The authors stress the importance of increased education and personal support in diabetes management within the family and community environment.

Australian Indigenous HealthInfoNet abstract

Wood N, Backhouse J, Gidding HF, Gilbert GL, Lum G, McIntyre PB (2005)
Estimates of chronic hepatitis B virus infection in the Northern Territory.
Communicable Diseases Intelligence;29(3):289-90
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