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1.
JMIR Public Health Surveill ; 6(3): e10959, 2020 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-32673259

RESUMO

BACKGROUND: Pretravel health advice can play a crucial role in improving both travelers' awareness about disease risk and compliance with preventive measures. General practitioners (GPs) and the internet have been reported internationally to be the main sources of health advice for travelers to non-mass gathering (MG) destinations. However, few studies have attempted to investigate the sources of health advice among travelers to MGs including the Hajj pilgrimage, and none of these studies further investigated the impact of pretravel advice on pilgrims' health behaviors. OBJECTIVE: The objective of this study was to investigate the impact of the source of pretravel health advice (from GPs and specialized Hajj travel agents) on Hajj pilgrims' awareness of and compliance with health recommendations, and the incidence of Hajj-associated illnesses. METHODS: A prospective cohort study (before and during Hajj) was conducted among Australian pilgrims aged ≥18 years in 2015. RESULTS: A total of 421 pilgrims participated prior to Hajj, and 391 (93%) provided follow-up data during Hajj. All participants obtained pretravel health advice from one or more sources, with Hajj travel agents (46%) and general practitioners (GPs; 40%) the most commonly reported sources. In total, 288 (74%) participants reported Hajj-related symptoms, of which 86% (248/288) were respiratory symptoms. Participants who obtained pretravel health advice from travel agents were more likely to be aware of the official Saudi recommendations (adjusted odds ratio [aOR] 2.1, 95% CI 1.2-3.8; P=.01), receive recommended vaccines before travel (aOR 2.4, 95% CI 1.4-3.9; P=.01), use hand sanitizers including soap (aOR 2.5, 95% CI 1.1-6.1; P=.03), and wash their hands after touching an ill person during Hajj (aOR 2.9, 95% CI 1.1-7.1; P=.01), compared to those who sought advice from GPs. However, neither advice from travel agents nor GPs was associated with a lower incidence of Hajj-related illnesses. CONCLUSIONS: Advice from travel agents appeared to be accessed by more travelers than that from GPs, and was associated with an increased likelihood of positive travel health behaviors.


Assuntos
Relações Médico-Paciente , Espiritualismo , Medicina de Viagem/normas , Adolescente , Adulto , Idoso , Estudos de Coortes , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Islamismo/psicologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , New South Wales/etnologia , Estudos Prospectivos , Arábia Saudita , Inquéritos e Questionários , Medicina de Viagem/métodos , Medicina de Viagem/estatística & dados numéricos
2.
J Foot Ankle Res ; 13(1): 27, 2020 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-32466778

RESUMO

BACKGROUND: Foot health of Aboriginal and Torres Strait Islander Australians' has not been established. Additionally, studies have shown that there is a lack of engagement of this population with general preventive foot care services. The aim of this study was to establish foot health in Aboriginal and Torres Strait Islander people attending two recently developed, culturally safe podiatry services in rural and regional New South Wales (NSW), Australia. Secondarily the relationship between self-perceived foot health and some medical and demographic characteristics was investigated. METHODS: This descriptive cross-sectional study included participants attending the culturally safe foot health care services managed by the University of Newcastle on the Central Coast or in Wellington, both located in NSW, Australia. At the consultation, participants completed the Foot Health Status Questionnaire (FHSQ) with the assistance of an Aboriginal health care worker, underwent basic vascular and neurological screening, and podiatric treatment. RESULTS: A total of 111 Aboriginal and Torres Strait Islander Australians (48 from the Central Coast, and 63 from Wellington) were included. FHSQ scores for pain (75.7 ± 26.8), function (80.2 ± 25.2), footwear (53.9 ± 33.4), and general foot health (62.0 ± 30.9) were generally good, but below the optimal score of 100. The presence of diabetes (n = 39 of 111 participants or 35.1%) was associated with lower levels of self-perceived foot function (r = - 0.20, n = 107, p = 0.04). CONCLUSION: We found that community-based foot health care services that are culturally safe are utilised by Aboriginal and Torres Strait Islander Peoples not currently at high risk of foot complications. This supports the use of culturally safe foot care services to improve engagement with preventative foot care. Future research should continue to be driven by Aboriginal and Torres Strait Islander Peoples and investigate ways to implement additional screening measures and undertake prospective evaluation of the impact of such services on health related outcomes in these communities.


Assuntos
Serviços de Saúde do Indígena/estatística & dados numéricos , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Podiatria/estatística & dados numéricos , Serviços Preventivos de Saúde/estatística & dados numéricos , Estudos Transversais , Assistência à Saúde Culturalmente Competente , Feminino , , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales/etnologia , Podiatria/métodos , Serviços Preventivos de Saúde/métodos , População Rural/estatística & dados numéricos
4.
Eur J Obstet Gynecol Reprod Biol ; 247: 186-190, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32126410

RESUMO

OBJECTIVE: To evaluate if a decreasing human chorionic gonadotropin (hCG) between day (D) 1 and D7 is an equal or better predictor of tubal ectopic pregnancy (EP) resolution following methotrexate (MTX) treatment than the current standard of care. STUDY DESIGN: This was a retrospective cohort prognostic accuracy study of women with a transvaginal ultrasound (TVS)-confirmed tubal EP (November 2006-December 2015). After single-dose MTX treatment, D4/7 hCG ratios were compared with that of D1/D7 in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) to predict EP resolution. RESULTS: Tubal EP was diagnosed in 301/7350 (4.1%) women who underwent TVS for early pregnancy-related complaints. The patients were managed accordingly: expectant, 84/301 (27.9%); MTX, 65/301 (21.6%); surgery, 152/301 (50.5%). A D1/D7 hCG ratio ≤0.85 predicted successful resolution of tubal EPs (P < 0.001) treated with MTX with sensitivity 0.84 [95% confidence interval (CI), 0.69-0.94]), specificity 0.71 [95%CI, 0.48-0.89], PPV 0.84 [95%CI, 0.69-0.94], NPV 0.84 [95%CI, 0.69-0.94], which is comparable to the prognostic performance of the D4/7 protocol. CONCLUSION: In patients with tubal EP carefully selected for and treated with MTX, it may be reasonable to eliminate the D4 hCG in the follow-up algorithm.


Assuntos
Abortivos não Esteroides/administração & dosagem , Gonadotropina Coriônica/sangue , Metotrexato/administração & dosagem , Gravidez Tubária/tratamento farmacológico , Conduta Expectante/estatística & dados numéricos , Adulto , Feminino , Humanos , New South Wales/etnologia , Gravidez , Gravidez Tubária/sangue , Gravidez Tubária/epidemiologia , Estudos Retrospectivos , Adulto Jovem
5.
JMIR Mhealth Uhealth ; 7(10): e14259, 2019 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-31638591

RESUMO

BACKGROUND: Chronic diseases account for over 70% of health gaps between Aboriginal people and the rest of the Australian population. The 1 Deadly Step program involves community-based events that use a sporting platform and cultural ambassadors to improve chronic disease prevention and management in New South Wales (NSW). OBJECTIVE: This study aimed to evaluate the feasibility and acceptability of a community-based chronic disease screening program for Aboriginal people. METHODS: In 2015, the program was enhanced to include an iPad app for screening assessments, a results portal for nominated care providers, and a reporting portal for program administrators and implemented in 9 NSW community events. A mixed methods evaluation comprising survey data, analytics obtained from iPad and Web portal usage, and key informant interviews was conducted. RESULTS: Overall, 1046 people were screened between April 2015 and April 2016 (mean age 40.3 years, 640 (61.19%) female, 957 (91.49%) Aboriginal or Torres Strait Islander). High chronic disease rates were observed (231 [22.08%] participants at high cardiovascular disease (CVD) risk, 173 [16.54%] with diabetes, and 181 [17.30%] with albuminuria). A minority at high risk of CVD (99/231 [42.9%]) and with diabetes (73/173 [42.2%]) were meeting guideline-recommended management goals. Overall, 297 participants completed surveys (response rate 37.4%) with 85.1% reporting satisfaction with event organization and information gained and 6.1% experiencing problems with certain screening activities. Furthermore, 21 interviews were conducted. A strong local working group and processes that harnessed community social networks were key to implementation success. Although software enhancements facilitated screening and data management, some technical difficulties (eg, time delays in processing blood test results) impeded smooth processing of information. Only 51.43% of participants had a medical review recorded postevent with wide intersite variability (10.5%-85.6%). Factors associated with successful follow-up included clinic managers with overall program responsibility and availability of medical staff for immediate discussion of results on event day. The program was considered highly resource intensive to implement and support from a central coordinating body and integration with existing operational processes was essential. CONCLUSIONS: 1 Deadly Step offers an effective and acceptable strategy to engage Aboriginal communities in chronic disease screening. High rates of risk factors and management gaps were encountered, including people with no previous knowledge of these issues. Strategies to improve linkage to primary care could enhance the program's impact on reducing chronic disease burden.


Assuntos
Doença Crônica/prevenção & controle , Gerenciamento Clínico , Havaiano Nativo ou Outro Ilhéu do Pacífico/psicologia , Adulto , Doença Crônica/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Havaiano Nativo ou Outro Ilhéu do Pacífico/etnologia , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , New South Wales/etnologia , Inquéritos e Questionários
6.
BMC Health Serv Res ; 19(1): 222, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975155

RESUMO

BACKGROUND: Providing culturally safe health care can contribute to improved health among Aboriginal people. However, little is known about how to make hospitals culturally safe for Aboriginal people. This study assessed the impact of an emergency department (ED)-based continuous quality improvement program on: the accuracy of recording of Aboriginal status in ED information systems; incomplete ED visits among Aboriginal patients; and the cultural appropriateness of ED systems and environments. METHODS: Between 2012 and 2014, the Aboriginal Identification in Hospitals Quality Improvement Program (AIHQIP) was implemented in eight EDs in NSW, Australia. A multiple baseline design and analysis of linked administrative data were used to assess program impact on the proportion of Aboriginal patients correctly identified as Aboriginal in ED information systems and incomplete ED visits in Aboriginal patients. Key informant interviews and document review were used to explore organisational changes. RESULTS: In all EDs combined, the AIHQIP was not associated with a reduction in incomplete ED visits in Aboriginal people, nor did it influence the proportion of ED visits made by Aboriginal people that had an accurate recording of Aboriginal status. However, in two EDs it was associated with an increase in the trend of accurate recording of Aboriginality from baseline to the intervention period (odds ratio (OR) 1.31, p < 0.001 in ED 4 and OR 1.15, p = 0.020 in ED 5). In other words, the accuracy of recording of Aboriginality increased from 61.4 to 70% in ED 4 and from 72.6 to 73.9% in ED 5. If the program were not implemented, only a marginal increase would have occurred in ED 4 (from 61.4 to 64%) and, in ED 5, the accuracy of reporting would have decreased (from 72.6 to 71.1%). Organisational changes were achieved across EDs, including modifications to waiting areas and improved processes for identifying Aboriginal patients and managing incomplete visits. CONCLUSIONS: The AIHQIP did not have an overall effect on the accuracy of recording of Aboriginal status or on levels of incomplete ED visits in Aboriginal patients. However, important organisational changes were achieved. Further research investigating the effectiveness of interventions to improve Aboriginal cultural safety is warranted.


Assuntos
Competência Cultural , Serviço Hospitalar de Emergência/normas , Serviços de Saúde do Indígena/normas , Havaiano Nativo ou Outro Ilhéu do Pacífico/etnologia , Melhoria de Qualidade , Adulto , Feminino , Hospitais , Humanos , Masculino , Corpo Clínico Hospitalar/normas , New South Wales/etnologia , Saúde da População Rural , Saúde da População Urbana
7.
Aust N Z J Public Health ; 43(1): 15-17, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30720921

RESUMO

OBJECTIVE: To assess if rates of hospitalised injury in Australian Aboriginal children, and differences in these rates between Aboriginal and non-Aboriginal children, have changed over time. METHODS: We used linked hospital data for New South Wales (NSW), Australia, to construct cohorts of children born in NSW hospitals between 2003-2007 and 2008-2012. We calculated rates of hospitalised injuries per 10,000 person years for Aboriginal and non-Aboriginal children for both cohorts, and compared these using rate differences and rate ratios. RESULTS: Rates of unintentional injury hospitalisation were similar in Aboriginal children in both cohorts and Aboriginal children had 1.7 times higher rates of unintentional injury hospitalisation compared with non-Aboriginal children. Rate ratios between Aboriginal and non-Aboriginal children for leading injury mechanisms, burns, poisonings and transport were similar in both cohorts, with 2.5, 3.0 and 2.4 times higher rates in Aboriginal children in the 2008-2012 cohort, respectively. Conclusions and Implications for public health: Our findings suggest that current injury prevention measures have not been successful in reducing either rates of unintentional injury in Aboriginal children, or injury inequalities between Aboriginal and non-Aboriginal children. We recommend the implementation of targeted Aboriginal led injury prevention measures.


Assuntos
Disparidades em Assistência à Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/tendências , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Ferimentos e Lesões/etnologia , Ferimentos e Lesões/epidemiologia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Previsões , Humanos , Lactente , Recém-Nascido , Masculino , New South Wales/epidemiologia , New South Wales/etnologia , Fatores Socioeconômicos
8.
J Community Psychol ; 47(2): 338-355, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30203846

RESUMO

The study examines the association between sense of place (SOP) attitudes (e.g., place attachment, place identity, and place dependence) and health-related quality of life (HQOL) in a sample of 261 African residents in New South Wales (Australia). Participants completed measures of the Sense of Place Scale, the World Health Organization Quality of Life-BREF questionnaire, and demographic variables. Study findings are as follows: (a) levels of SOP and place attachment are positively associated with all outcomes of HQOL; (b) place identity is also positively related to HQOL in terms of better environmental health, psychological health, and physical health, but not statistically significant for social relationship and general QOL; (c) place dependence is statistically associated with outcomes of HQOL, except for general QOL which remained insignificant in both the unadjusted and adjusted models. Further ad hoc analyses suggest that African residents from Eastern Africa are more likely to develop the "aussie" place identity than those from Central Africa; and (e) African migrants who have been residents of Australia for more than 5 years, and those who are less educated are more likely to have a stronger SOP and to develop place attachment and behavioral place commitments compared with newly arrived and educated migrants, respectively. Study limitations and implications are carefully discussed.


Assuntos
Atitude , Apego ao Objeto , Qualidade de Vida , Características de Residência , Autoimagem , Adolescente , Adulto , África/etnologia , Idoso , Diversidade Cultural , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales/etnologia , Adulto Jovem
9.
J Med Imaging Radiat Oncol ; 63(2): 244-249, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30447047

RESUMO

INTRODUCTION: Despite 3% of Australians identifying as Indigenous, cutaneous malignancies in these patients, including incidence, risk factors and outcomes have not been investigated. This is despite recognition that cancer outcomes in this population are significantly poorer. METHODS: We undertook a retrospective case series of Indigenous Peoples who presented to two urban cancer therapy centres for the management of cutaneous malignancies from 2003 to 2017. Risk factors, tumour-specific characteristics, treatments and outcomes were reviewed. RESULTS: Twenty-two patients identified as Aboriginal and/or Torres Strait Islander. The median age at presentation was 61 years and the majority were male (63.6%) and had skin phototype III (86.4%). Patients presented with basal cell carcinoma (50%), squamous cell carcinoma (31.8%), melanoma (9.1%) and cutaneous sarcomas (9.1%). The majority (68.2%) presented with stage II or higher disease, and there were high rates of immunosuppression (45.5%). At the time of reporting, 68.2% patients were alive, 18.2% had died from their skin cancers and 13.6% had died from unrelated causes. CONCLUSION: This cohort has demonstrated late-stage presentation of skin cancers, with substantial morbidity and mortality from potentially treatable cutaneous malignancies. This parallels other health conditions in Indigenous Australians and has highlighted the need for improved data collection of Indigenous status to better quantify the epidemiology of skin cancer in this population. There is an imperative to improve skin cancer awareness in this population to allow earlier detection and management to ensure better outcomes.


Assuntos
Havaiano Nativo ou Outro Ilhéu do Pacífico , Neoplasias Cutâneas/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , New South Wales/etnologia , Estudos Retrospectivos , Fatores de Risco , Neoplasias Cutâneas/patologia
10.
Western Pac Surveill Response J ; 10(4): 24-30, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32133208

RESUMO

OBJECTIVE: Ongoing transmission of tuberculosis (TB) continues in Indigenous communities in New South Wales (NSW), Australia. In a pilot project, a Public Health Unit TB team partnered with an Aboriginal Community Controlled Health Service (ACCHS) in a community with a cluster of TB to augment screening for latent TB infection (LTBI) using interferon-gamma release assay (IGRA). This study examined screening data and programme outcomes at 12 months post hoc to advise practice and policy formulation. METHODS: We conducted a retrospective, cross-sectional analysis of demographic and clinical data of ACCHS patients, stratified by IGRA testing status. Differences in sex and age distribution between the groups and cases of a genetically and epidemiologically linked TB cluster in Aboriginal people in NSW were assessed using non-parametric tests. RESULTS: Of 2019 Aboriginal and Torres Strait Islander people seen by general practitioners during the study period, 135 (6.7%) participated in the screening. Twenty-four (17.8%) participants were IGRA positive. One person was diagnosed with active TB. Twelve participants received a chest X-ray at the time of the positive test, and six participants had an additional chest X-ray within 12 months. None commenced preventive treatment for LTBI. DISCUSSION: ACCHS screening for LTBI reached individuals in the age group most commonly affected by TB in these Aboriginal communities. No conclusions can be made regarding the population prevalence due to the low screening rate. Further strategies need to be developed to increase appropriate follow-up and preventive treatment.


Assuntos
Tuberculose Latente/diagnóstico , Programas de Rastreamento/métodos , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Humanos , Lactente , Tuberculose Latente/epidemiologia , Tuberculose Latente/etnologia , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Havaiano Nativo ou Outro Ilhéu do Pacífico/etnologia , New South Wales/epidemiologia , New South Wales/etnologia , Projetos Piloto
11.
BMJ Open ; 8(6): e020196, 2018 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-29961007

RESUMO

OBJECTIVE: To determine, using face-to-face diagnostic interviews, the prevalence of common mental disorders (CMD) in a cohort of adult Indigenous Australians, the cultural acceptability of the interviews, the rates of comorbid CMD and concordance with psychiatrists' diagnoses. DESIGN: Cross-sectional study July 2014-November 2016. Psychologists conducted Structured Clinical Interviews for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision Axis I Disorders (SCID-I) (n=544). Psychiatrists interviewed a subsample (n=78). SETTING: Four Aboriginal Medical Services and the general community located in urban, regional and remote areas of Southern Queensland and two Aboriginal Reserves located in New South Wales. PARTICIPANTS: Indigenous Australian adults. OUTCOME MEASURES: Cultural acceptability of SCID-I interviews, standardised rates of CMD, comorbid CMD and concordance with psychiatrist diagnoses. RESULTS: Participants reported that the SCID-I interviews were generally culturally acceptable. Standardised rates (95% CI) of current mood, anxiety, substance use and any mental disorder were 16.2% (12.2% to 20.2%), 29.2% (24.2% to 34.1%), 12.4% (8.8% to 16.1%) and 42.2% (38.8% to 47.7%), respectively-6.7-fold, 3.8-fold, 6.9-fold and 4.2-fold higher, respectively, than those of the Australian population. Differences between this Indigenous cohort and the Australian population were less marked for 12-month (2.4-fold) and lifetime prevalence (1.3-fold). Comorbid mental disorder was threefold to fourfold higher. In subgroups living on traditional lands in Indigenous reserves and in remote areas, the rate was half that of those living in mainstream communities. Moderate-to-good concordance with psychiatrist diagnoses was found. CONCLUSIONS: The prevalence of current CMD in this Indigenous population is substantially higher than previous estimates. The lower relative rates of non-current disorders are consistent with underdiagnosis of previous events. The lower rates among Reserve and remote area residents point to the importance of Indigenous peoples' connection to their traditional lands and culture, and a potentially important protective factor. A larger study with random sampling is required to determine the population prevalence of CMD in Indigenous Australians.


Assuntos
Transtornos Mentais/etnologia , Havaiano Nativo ou Outro Ilhéu do Pacífico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales/etnologia , Prevalência , Queensland/etnologia , População Rural , Adulto Jovem
12.
Alcohol Alcohol ; 53(5): 578-585, 2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-29846496

RESUMO

BACKGROUND AND AIMS: Given ongoing community concern about high rates of alcohol-related crimes (ARCs) experienced by disadvantaged populations, a more specific and nuanced understanding of factors associated with ARCs would help inform the development of more sophisticated programs and policies aimed at reducing ARCs. This study estimates rates of ARCs across all communities in New South Wales (NSW), Australia, using routinely collected police data; investigates whether there are differences between communities; and identifies individual and community characteristics that are significantly associated with higher rates of ARCs. SHORT SUMMARY: This study analysed routinely collected police data in New South Wales, Australia, to identify individual and community characteristics associated with alcohol-related crimes. Young people, Aboriginal Australians, socio-economically disadvantaged communities, remote and regional communities and communities with higher per capita rate of on-venue liquor licenses are at risk of alcohol-related crimes. METHODS: Age standardized rates of ARCs were calculated. A multi-level Poisson regression analysis was conducted to investigate the individual and community factors that were statistically significantly associated with higher rates of ARC, separately for Aboriginal and non-Aboriginal Australians. RESULTS: Rates of ARCs were statistically significantly higher for Aboriginal Australians, young people (aged 13-37 years) and on weekends. ARCs varied significantly across communities, and were significantly higher in remote or regional communities, in communities with a higher per capita rate of on-venue licences, and for socio-economically disadvantaged communities for non-Aboriginal Australians, but not for Aboriginal females. CONCLUSION: This analysis shows that the impact of national-level and jurisdictional-level legislation and policies is uneven across communities and defined populations, leaving young people, socio-economically disadvantaged communities and Aboriginal Australians at increased risk of ARCs. To more equitably reduce the exposure of all Australians to ARC, mechanisms that effectively engage vulnerable communities and defined populations, need to be developed in consultation with them, implemented and evaluated.


Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/tendências , Crime/tendências , Coleta de Dados/tendências , Polícia/tendências , Populações Vulneráveis/etnologia , Adolescente , Adulto , Fatores Etários , Idoso , Crime/estatística & dados numéricos , Coleta de Dados/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Havaiano Nativo ou Outro Ilhéu do Pacífico/etnologia , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , New South Wales/etnologia , Política Pública/tendências , Características de Residência/estatística & dados numéricos , Adulto Jovem
13.
Intern Med J ; 48(3): 269-275, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29083111

RESUMO

BACKGROUND: The prevalence of hypertensive disorders of pregnancy (HDP) in Australia's urban indigenous women is unknown. AIM: To explore the risk factors associated with HDP for a cohort of urban indigenous women in South-Western Sydney, Australia. METHODS: This study was conducted in partnership with the Tharawal Aboriginal Medical Service. Women (18-45 years) were recruited at the clinic and community events. The quantitative questionnaire included obstetric history, personal and family history of hypertension. Anthropometric measurements and blood pressure were conducted. Rates were compared with Australian Bureau of Statistics (ABS) national rates. RESULTS: Eighty-three participants completed the questionnaire. The rate of ever having HDP in a pregnancy was 36.1%. The overall ABS rate was 9.8% and for indigenous women, 14%. The mean maternal age at first pregnancy was 20.8 years (SD 3.7 years). The mean body mass index (BMI) of the sample population (n = 81) was 32.2 kg/m2 (SD 9.5 kg/m2 ) and BMI was not related to HDP (P = 0.197). Of those questioned, 25.3% had an individual history and 63.9% had a family history of hypertension. The effect of family history of hypertension (P = 0.020) (odds ratio (OR) 4.29; 95% confidence interval (CI); 1.42-12.93) and individual history of hypertension (P < 0.001) (OR 15.69; 95% CI; 4.50-54.76) were associated with HDP. CONCLUSION: There was a higher rate of HDP in urban indigenous women compared to the national indigenous prevalence. The family history, or individual history of hypertension was the most significant risk factors and BMI was not identified as a risk factor for HDP in this population.


Assuntos
Índice de Massa Corporal , Hipertensão Induzida pela Gravidez/diagnóstico , Hipertensão Induzida pela Gravidez/etnologia , Havaiano Nativo ou Outro Ilhéu do Pacífico/etnologia , Fumar/etnologia , População Urbana , Adolescente , Adulto , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/etnologia , Pessoa de Meia-Idade , New South Wales/etnologia , Gravidez , Fatores de Risco , Fumar/efeitos adversos , Inquéritos e Questionários , População Urbana/tendências , Adulto Jovem
14.
Aust Dent J ; 62(2): 208-214, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28008634

RESUMO

BACKGROUND: Aboriginal people, and particularly those in rural areas, continue to suffer very high levels of dental disease despite significant reductions in the wider Australian population in the past 30 years. Until recently, there has been a shortage of oral health clinicians and the majority have provided care in major cities. The NSW Government funded various models of care for rural and regional areas and vulnerable population groups including Aboriginal people. This study utilizes a comparative retrospective analysis to compare two models of oral health care for Aboriginal people including those living in rural NSW to inform future policy decisions. METHODS: Two models (Model A - Fly in Fly out and Model B - Collective impact) of public oral health care for Aboriginal patients in NSW were examined using publicly available descriptive information. Two years of funding and Dental Weighted Activity Units (DWAUs) data were analysed for the two different models and regression analysis was used to compare the trends of monthly time series of DWAUs. CONCLUSIONS: Based on the standardized national weighted pricing for public dentistry, model B offers significantly more services for less financial resources.


Assuntos
Assistência Odontológica/organização & administração , Pesquisa sobre Serviços de Saúde , Saúde Bucal , Humanos , Havaiano Nativo ou Outro Ilhéu do Pacífico , New South Wales/epidemiologia , New South Wales/etnologia , Higiene Bucal , Saúde Pública , Estudos Retrospectivos , Serviços de Saúde Rural , População Rural , Serviços Urbanos de Saúde , Populações Vulneráveis
15.
Int J Obes (Lond) ; 40(7): 1089-95, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27121249

RESUMO

BACKGROUND: Adult Aboriginal Australians have 1.5-fold higher risk of obesity, but the trajectory of body mass index (BMI) through childhood and adolescence and the contribution of socio-economic factors remain unclear. Our objective was to determine the changes in BMI in Australian Aboriginal children relative to non-Aboriginal children as they move through adolescence into young adulthood, and to identify risk factors for higher BMI. METHODS: A prospective cohort study of Aboriginal and non-Aboriginal school children commenced in 2002 across 15 different screening areas across urban, regional and remote New South Wales, Australia. Socio-economic status was recorded at study enrolment and participants' BMI was measured every 2 years. We fitted a series of mixed linear regression models adjusting for age, birth weight and socio-economic status for boys and girls. RESULTS: In all, 3418 (1949 Aboriginal) participants were screened over a total of 11 387 participant years of follow-up. The prevalence of obesity was higher among Aboriginal children from mean age 11 years at baseline (11.6 vs 7.6%) to 16 years at 8 years follow-up (18.6 vs 12.3%). The mean BMI increased with age and was significantly higher among Aboriginal girls compared with non-Aboriginal girls (P<0.01). Girls born of low birth weight had a lower BMI than girls born of normal birth weight (P<0.001). Socio-economic status and low birth weight had a differential effect on BMI for Aboriginal boys compared with non-Aboriginal boys (P for interaction=0.01). Aboriginal boys of highest socio-economic status, unlike those of lower socio-economic status, had a higher BMI compared with non-Aboriginal boys. Non-Aboriginal boys of low birth weight were heavier than Aboriginal boys. CONCLUSIONS: Socio-economic status and birth weight have differential effects on BMI among Aboriginal boys, and Aboriginal girls had a higher mean BMI than non-Aboriginal girls through childhood and adolescence. Intervention programs need to recognise the differential risk for obesity for Aboriginal and non-Aboriginal boys and girls to maximise their impact.


Assuntos
Peso ao Nascer , Índice de Massa Corporal , Havaiano Nativo ou Outro Ilhéu do Pacífico , Caracteres Sexuais , Fatores Socioeconômicos , Adolescente , Criança , Feminino , Educação em Saúde/organização & administração , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , New South Wales/epidemiologia , New South Wales/etnologia , Sobrepeso/epidemiologia , Obesidade Pediátrica/etnologia , Obesidade Pediátrica/prevenção & controle , Prevalência , Estudos Prospectivos , Fatores de Risco , Magreza/epidemiologia
16.
Support Care Cancer ; 24(1): 409-418, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26093976

RESUMO

BACKGROUND: Immigrants from culturally and linguistically diverse (CALD) backgrounds diagnosed with cancer face multiple challenges with health systems foreign to them. There is scarce understanding about their needs following cancer treatment in the survivorship phase. Unmet needs were examined in immigrant Chinese and Greek cancer survivors in order to assist development of relevant and useful information resources for these CALD groups. METHODS: Qualitative descriptive design was used. Adult cancer survivors, whose native language was Mandarin, Cantonese or Greek, were recruited through ethnic cancer support groups and cancer specialists in two Australian cities. Six focus groups were conducted, two in each native language group. Recorded responses were transcribed, translated into English, and thematically analysed. RESULTS: Thirty-nine CALD cancer survivors participated from Greek (11), Cantonese (14) and Mandarin (14) backgrounds. Thematic findings included as follows: ongoing cancer-related stressors, cancer misunderstandings, coping strategies, 'survivor' seldom reflects self-appraisal, and additional CALD survivorship information needed. Immigrant cancer survivors may prefer 'recovery' to 'survivorship' descriptors and need information similar to Caucasian cancer survivors alongside as follows: resources for navigating health care, financial and community entitlements; caregiver-directed information to enhance their support; explanations about differences in health care approaches between survivors' original and adopted countries; and acknowledgment of survivorship diversity within CALD groups. CONCLUSIONS: Immigrant cancer survivors' additional requirements to native survivors likely reflect challenges in dealing with foreign environments and varied levels of acculturation within group members. Identification of immigrant cancer survivorship issues may support development of targeted resources for promoting survivors' self-care and capacity for finding, choosing, and using existing support options.


Assuntos
Neoplasias/psicologia , Sobreviventes/psicologia , Adulto , Idoso , Cuidadores , Cultura , Atenção à Saúde , Autoavaliação Diagnóstica , Emigrantes e Imigrantes/psicologia , Etnicidade , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/etnologia , New South Wales/etnologia , Educação de Pacientes como Assunto , Pesquisa Qualitativa , Autocuidado , Vitória/etnologia , /etnologia
17.
BMC Health Serv Res ; 15: 437, 2015 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-26424655

RESUMO

BACKGROUND: For the past two decades, chlamydia has been the most commonly notified infectious disease among young people (15-29 year olds) in Australia, the United States of America and the United Kingdom and rates have increased annually in these three countries. In Australia, rates of chlamydia are three times higher in Aboriginal compared with non-Aboriginal people. Australian sexually transmissible infection guidelines recommend annual chlamydia testing for 15-29 year old females and males. This analysis will examine the incidence and predictors of annual chlamydia testing in 15-29 year olds attending four Aboriginal Community Controlled Health Services (ACCHS) in Australia. METHODS: From 2009-2011, attendance and chlamydia testing data were extracted from the patient system to calculate the number and proportion of 15-29 year olds that were tested for chlamydia and that tested positive for chlamydia by gender (male, female), age-group (15-19, 20-24, 25-29 years), Aboriginal status (Aboriginal, non-Aboriginal people) and by the four ACCHSs sites (1, 2, 3 and 4). A cohort was created to calculate the incidence rate per 100 person-years (PY) and predictors of an annual chlamydia test (a test within 12-months of a previous test/visit) by the above factors using Cox regression. Unadjusted and adjusted hazard ratios (AHR) and their 95 % confidence intervals (CIs) and p-values were calculated with significance at p < 0.05. RESULTS: From 2009-2011, there were 2896 individuals who attended the four ACCHSs. Overall , 17 % (22 % of females and 10 % of males) were tested for chlamydia and 9 % tested positive (8 % of females and 14 % of males). The median time to an annual chlamydia test was 10.7 months. The cohort included 2318 individuals. Overall the incidence rate of an annual chlamydia test was 9.1 per 100 PY (11.6 in females and 5.8 in males). Predictors of an annual chlamydia test were being female (AHR: 1.7, 95 % CI: 1.2-2.2, p < 0.01), being 15-19 years old (AHR: 1.6, 95 % CI: 1.1-2.3, p < 0.01) and attending ACCHS site 2 (AHR: 3.8, 95 % CI: 1.8-8.0, p < 0.01). CONCLUSIONS: This analysis highlights that opportunistic STI testing strategies are needed to increase annual chlamydia testing in young people; especially males.


Assuntos
Infecções por Chlamydia/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Infecções por Chlamydia/etnologia , Serviços de Saúde Comunitária/estatística & dados numéricos , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Havaiano Nativo ou Outro Ilhéu do Pacífico/etnologia , New South Wales/epidemiologia , New South Wales/etnologia , Atenção Primária à Saúde/estatística & dados numéricos , Distribuição por Sexo , Adulto Jovem
18.
BMC Res Notes ; 8: 276, 2015 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-26122212

RESUMO

BACKGROUND: This study is a collaboration between Macquarie University researchers and the Yaegl Aboriginal Community of northern NSW, Australia to investigate the antimicrobial potential of plants used in the topical treatment of wounds, sores and skin infections. Based on previously documented medicinal applications, aqueous and aqueous ethanolic extracts of Alocasia brisbanensis, Canavalia rosea, Corymbia intermedia, Hibbertia scandens, Ipomoea brasiliensis, Lophostemon suaveolens and Syncarpia glomulifera and the aqueous extracts of Smilax australis and Smilax glyciphylla were tested against common wound pathogens, including antibiotic resistant bacterial strains. METHODS: Plant material was prepared as aqueous extractions modelled on customary preparations and using 80% aqueous ethanol. Extracts were assayed against a selection of clinically relevant Gram positive (Streptococcus pyogenes and sensitive and resistant strains of Staphylococcus aureus) and Gram negative (Pseudomonas aeruginosa, Escherichia coli and Salmonella typhimurium) bacteria and a fungus (Candida albicans) using disc diffusion and MTT microdilution methods. Viability of treated microorganisms was determined by subculturing from microdilution assays. RESULTS: The extracts of Corymbia intermedia, Lophostemon suaveolens and Syncarpia glomulifera had promising levels of antimicrobial activity (MIC 31-1,000 µg/mL) against both antibiotic sensitive and resistant Staphylococcus aureus as well as the fungus Candida albicans (clinical isolate). CONCLUSION: Aqueous and 80% aqueous ethanolic extracts of Lophostemon suaveolens, Corymbia intermedia and Syncarpia glomulifera exhibited promising levels of antimicrobial activity against a range of both antibiotic sensitive and resistant strains of microorganisms. This is the first report of antimicrobial activities for C. intermedia and L. suaveolens and the leaves of S. glomulifera. This study demonstrates the value of customary knowledge in the identification of new sources of antimicrobial treatments.


Assuntos
Antibacterianos/farmacologia , Antifúngicos/farmacologia , Etnobotânica/métodos , Fitoterapia/métodos , Extratos Vegetais/farmacologia , Plantas Medicinais , Dermatopatias/tratamento farmacológico , Farmacorresistência Bacteriana Múltipla , Farmacorresistência Fúngica Múltipla , Humanos , Medicina Tradicional , Havaiano Nativo ou Outro Ilhéu do Pacífico/etnologia , New South Wales/etnologia
19.
J Lesbian Stud ; 19(2): 173-91, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25760994

RESUMO

This article examines contemporary lesbians' (and queer women's) urban geographies, drawing from empirical research on Toronto, Canada and Sydney, Australia. Our argument is grounded in research highlighting lesbians' distinctive urban experiences: lesbians have both participated in gay villages and gay male spaces and, importantly, carved out their own urban places, including commercial and residential concentrations. In this article we use new mobilities scholarship to delineate historical and contemporary relational geographies materializing since World War II, which continue to rewrite lesbians' and queer women's inhabitation and experiences of urban landscapes in Toronto and Sydney.


Assuntos
Homossexualidade Feminina/etnologia , Dinâmica Populacional , População Urbana , Adulto , Feminino , Humanos , New South Wales/etnologia , Ontário/etnologia
20.
Int J Eat Disord ; 48(2): 176-86, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24599823

RESUMO

OBJECTIVE: To identify similarities and differences in beliefs about the causes of Bulimia Nervosa (BN) held by Asian (Japanese) women and Western (Australian) women, and hence, to examine the applicability of belief models of eating disorders (ED) across different cultures. METHOD: Four hundred three Japanese and 256 Australian female university students (aged 17-35 years) completed a questionnaire that gauged beliefs about the causes of BN. RESULTS: Among the Australian women, the four-component structure of perceived causes (dieting and eating practices, family dynamics, socio-cultural pressure, and psychological vulnerability) found in Dryer et al. (2012) was replicated. Among the Japanese women, however, a three-component structure (without the psychological vulnerability component) was obtained. The groups also differed in the causal component they most strongly endorsed, that being socio-cultural pressure for the Australian women, and dieting and eating practices for the Japanese women. DISCUSSION: The Japanese participants were found to endorse three out of the four Western-based causal explanations for BN, but the relative importance they placed on those explanations differed from that of the Australian participants. Further research is needed, particularly to establish whether Japanese women simply fail to see psychological vulnerability as a viable cause of BN, or there are in fact cultural differences in the extent to which such vulnerability causes BN.


Assuntos
Atitude Frente a Saúde , Bulimia Nervosa/psicologia , Adolescente , Adulto , Imagem Corporal , Bulimia Nervosa/etnologia , Restrição Calórica/psicologia , Comparação Transcultural , Cultura , Relações Familiares , Comportamento Alimentar/psicologia , Feminino , Humanos , Japão/etnologia , New South Wales/etnologia , Percepção , Satisfação Pessoal , Inquéritos e Questionários , Adulto Jovem
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