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1
Westphal, Darren W. "Epidemiology of Infectious Diseases in Western Australia." Master's thesis, Canberra, ACT : The Australian National University, 2016. http://hdl.handle.net/1885/135771.
Full textAbstract:
I commenced the Master of Philosophy in Applied Epidemiology
(MAE) in February 2015. My field placements were shared between
the Communicable Diseases Control Directorate, Public Health
Division at the Western Australia Department of Health (CDCD) and
the Telethon Kids Institute (TKI), both located in Perth.
Two of the three projects that I completed at the CDCD involved a
statewide protracted mumps outbreak that went on for the duration
of my MAE and reached almost 900 cases. The epidemiology of this
outbreak including a discussion about vaccination is presented in
Chapter 1. This satisfies the outbreak investigation requirement
of the MAE.
Chapter 2 comprises a late draft manuscript that explores the
vaccine effectiveness (VE) of the measles-mumps-rubella vaccine
among paediatric cases during the mumps outbreak. I designed and
carried out a matched case-control study using paediatric
outbreak cases and controls from a population database. I
measured VE using a conditional logistic regression model and
compared it with the screening method. Both methods yielded a
very low VE this population. This is likely due to a multitude of
factors that are discussed in the chapter.
My work at TKI involved a data analysis using
linked-administrative data on a total population birth cohort
involving all children born in Western Australia between
1996-2012. I explored the burden of hospital separations that
resulted from otitis media (OM), the most common infectious
disease in children, and a common related procedure, myringotomy
with ventilation tube insertion (MVTI). I calculated the
age-specific hospitalisation rates for OM and MVTI over the study
years. The second part of this analysis involved investigating
the maternal and infant risk factors and population attributable
fractions for OM-related hospitalisation in early life. This work
was important because of its implications for practice. All of
this is presented in Chapter 3.
Chapter 4 is an evaluation of SmartVax, a novel, real-time
Adverse Events Following Immunisation (AEFI) surveillance system
using SMS text messages to communicate directly with vaccinees
after their vaccination. This was the third project that I
completed at the CDCD. The chapter begins with a peer-reviewed
publication, Continuous active surveillance of adverse events
following immunisation using SMS technology, that describes the
system and analyses data outputs for children <5 years from
2011-2015. I have included the publication first to provide a
brief system overview including summarised surveillance data, to
give context to the evaluation since SmartVax is a relatively new
and developing system. The publication is followed by the formal
evaluation.
Finally, I include a summary of the teaching exercises that I was
involved in during my MAE. The first was a “lesson from the
field” where I prepared an exercise for my fellow scholars. The
exercise was useful for me and the feedback from my colleagues
was positive. The second was a collaborative teaching exercise
about confounding that we taught to the first year MAE scholars
on their last day of courseblock.
These combined activities at both placements have enriched my
understanding of epidemiology while working in health and
research environments.
2
Jaross, Nandor. "Diabetic retinopathy in the Katherine region of the Northern Territory." Title page, contents and abstract only, 2003. http://web4.library.adelaide.edu.au/theses/09PH/09phj376.pdf.
Full textAbstract:
"January 2003." Bibliography: 10.1-10.11 leaves. This thesis presents results from the Katherine Region Diabetic Retinopathy Study (1993-1996). These results provide the first detailed information on the basic epidemiology of diabetic retinopathy and impaired vision in an Aboriginal diabetic population.
3
Wright, Heathcote R. "Trachoma in Australia : an evaluation of the SAFE strategy and the barriers to its implementation /." Connect to thesis, 2007. http://eprints.unimelb.edu.au/archive/00003844.
Full textAbstract:
Thesis (Ph.D.)--University of Melbourne, Dept. of Opthalmology, 2007.Typescript. SAFE Strategy refers to Surgery for trichiasis, Antibiotics for active infection, Facial cleanliness and Environmental improvements. Includes bibliographical references (leaves 233-253). Also available electronically: http://eprints.unimelb.edu.au/archive/00003844.
4
Stoner, Lee, Anna G. Matheson, Lane G. Perry, Michelle A. Williams, Alexandra McManus, Maureen Holdaway, Lyn Dimer, Jennie R. Joe, and Andrew Maiorana. "Principles and strategies for improving the prevention of cardio-metabolic diseases in indigenous populations: An international Delphi study." ACADEMIC PRESS INC ELSEVIER SCIENCE, 2017. http://hdl.handle.net/10150/625942.
Full textAbstract:
The disparity in life expectancy between Indigenous and non-Indigenous populations, including within high-income countries, is driven by a heightened risk of cardio-metabolic diseases. The current study recruited independent panels of experts in Indigenous cardio-metabolic health from Australia, New Zealand and the United States, in order to establish local consensus opinion and initiate dialogue on appropriate prevention strategies. Therefore, a three-round Delphi process was used to consolidate and compare the opinions of 60 experts, 20 from each country. Round one, the experts were asked twelve open-ended questions across six domains: (i) prevention; (ii) consultation; (iii) educational resources; (iv) societal issues; (v) workforce issues; (vi) culture and family. Round two, the experts completed a structured questionnaire based on results from the first round, in which they ranked items according to their importance. Final round, the experts were asked to re-rank the same items after receiving summary feedback about the rank ordering from the previous round. Several themes emerged common to all three countries: (i) socio-economic and education inequalities should be addressed; (ii) educational, behaviour change and prevention strategies should address physical environmental determinants and be responsive to the local context, including being culturally appropriate; and (iii) cultural appropriateness can be achieved through consultation with Indigenous communities, cultural competency training, use of Indigenous health workers, and use of appropriate role models. These findings highlight several key priorities that can be used to initiate dialogue on appropriate prevention strategies. Such strategies should be contextualized to the local Indigenous populations.
5
Adams, Michael John. "Sexual and reproductive health problems among Aboriginal and Torres Strait Islander males." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16599/1/Michael_John_Adams_Thesis.pdf.
Full textAbstract:
Compared to males in almost any social group in all affluent nations, Australia's Aboriginal and Torres Strait Islander men suffer from substantially more serious illnesses and early death. To date, research done by or in collaboration with Indigenous communities has revealed the extent of the problems that arise from diabetes, heart disease, hypertension, cancers, respiratory diseases, psychological disorders, accidental injuries, violence and other causes. Reproductive health, however, rarely has been studied among Indigenous men. To date, research in this field has been limited mainly to studies of sexually transmitted infections. No data has been published on Aboriginal men's symptoms of prostate disease or erectile dysfunction, nor has the clinical screening and treatment of these disorders among these men been assessed. In-depth search of the worldwide web demonstrated that little information on these issues was available from other Indigenous populations. It does appear that Indigenous men in Australia, New Zealand and North America are less likely than European-ancestry men to die from prostate cancer, or for living cases to be recorded on cancer registries. This may arise because Indigenous men genuinely have a lower risk, or because they are not captured by official statistics, or because they do not live long enough to develop severe prostate disease. We also know very little about other reproductive health problems such as sexual dysfunction and specifically erectile difficulties. One reason for our scant knowledge is that research mainly relies on self-report of sensitive information. The aim of the research study was to improve the understanding of sexual and reproductive health problems experienced by Indigenous men. This is best gathered by Aboriginal males who are inside the culture of middleaged and older Indigenous men, but until now this has not been attempted. In this study we adopted the World Health Organization (WHO) definitions for Reproductive and Sexual Health (WHO, 2001). Thus, we consider reproductive system disorders (prostate disease, erectile dysfunction) and related health care-seeking, and also men's perceptions about a "satisfying and safe sexual life". The methodology was framed within an Aboriginal and Torres Strait Islander research protocol that advocates respect for cultural, social and community customs. A mixed method design combined qualitative inquiry (4 focus groups and 18 in-depth interviews) and quantitative survey (n=301) involving men living in remote, rural and urban communities (Tiwi Islands, Darwin and north and south-east Queensland). Survey data were compared to recently published self-reports from 5990 randomly selected men aged over 40 years in Australia (Holden et al., 2005, The Lancet, 366, 218-224. The qualitative interviews revealed that most men were silent about reproductive health. They were unwilling to reveal their inner feelings to wives or partners, and they were unwilling to discuss such issues with doctors and other health care workers. Men's reaction to sexual difficulties included shame, denial, substance abuse and occasionally violence. On a positive note many men said they want to learn about it, so they understand how to cope with such problems. The Indigenous men reported symptoms of erectile dysfunction at least as much as non-Indigenous men in other Australian studies. Bivariate analysis showed that erectile dysfunction was correlated with many health and lifestyle variable. However multivariate analysis revealed that only three factors significantly predicted ED: presence of chronic disease, presence of pain when working, and living in a remote geographic location The quantitative survey data indicate that Indigenous men have more symptoms of prostate disease than non-Indigenous men. The syndrome appears to be poorly managed in clinical practice (e.g. rates of PSA testing and digital-rectal examination are only one-third the rate reported by non-Aboriginal men, despite equivalent likelihood of GP visits). The research study adds to the literature by providing better insight and depth into the issues impacting on Aboriginal and Torres Strait Islander males experiencing reproductive and sexual health difficulties. It also provides a platform to undertake comprehensive research with Aboriginal and Torres Strait Islander men to explore a wider spectrum of questions in this important but neglected area. Implications for education of primary healthcare workers and community-based awareness campaigns for Indigenous males are discussed. Most of all, this study revealed "layers" of silence around sexual and reproductive health of Indigenous men. This includes silence in the scientific establishments in health services, and in the community. It is hoped that this study puts the voices of the men forward to help to break down this silence.
6
Adams, Michael John. "Sexual and reproductive health problems among Aboriginal and Torres Strait Islander males." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16599/.
Full textAbstract:
Compared to males in almost any social group in all affluent nations, Australia's Aboriginal and Torres Strait Islander men suffer from substantially more serious illnesses and early death. To date, research done by or in collaboration with Indigenous communities has revealed the extent of the problems that arise from diabetes, heart disease, hypertension, cancers, respiratory diseases, psychological disorders, accidental injuries, violence and other causes. Reproductive health, however, rarely has been studied among Indigenous men. To date, research in this field has been limited mainly to studies of sexually transmitted infections. No data has been published on Aboriginal men's symptoms of prostate disease or erectile dysfunction, nor has the clinical screening and treatment of these disorders among these men been assessed. In-depth search of the worldwide web demonstrated that little information on these issues was available from other Indigenous populations. It does appear that Indigenous men in Australia, New Zealand and North America are less likely than European-ancestry men to die from prostate cancer, or for living cases to be recorded on cancer registries. This may arise because Indigenous men genuinely have a lower risk, or because they are not captured by official statistics, or because they do not live long enough to develop severe prostate disease. We also know very little about other reproductive health problems such as sexual dysfunction and specifically erectile difficulties. One reason for our scant knowledge is that research mainly relies on self-report of sensitive information. The aim of the research study was to improve the understanding of sexual and reproductive health problems experienced by Indigenous men. This is best gathered by Aboriginal males who are inside the culture of middleaged and older Indigenous men, but until now this has not been attempted. In this study we adopted the World Health Organization (WHO) definitions for Reproductive and Sexual Health (WHO, 2001). Thus, we consider reproductive system disorders (prostate disease, erectile dysfunction) and related health care-seeking, and also men's perceptions about a "satisfying and safe sexual life". The methodology was framed within an Aboriginal and Torres Strait Islander research protocol that advocates respect for cultural, social and community customs. A mixed method design combined qualitative inquiry (4 focus groups and 18 in-depth interviews) and quantitative survey (n=301) involving men living in remote, rural and urban communities (Tiwi Islands, Darwin and north and south-east Queensland). Survey data were compared to recently published self-reports from 5990 randomly selected men aged over 40 years in Australia (Holden et al., 2005, The Lancet, 366, 218-224. The qualitative interviews revealed that most men were silent about reproductive health. They were unwilling to reveal their inner feelings to wives or partners, and they were unwilling to discuss such issues with doctors and other health care workers. Men's reaction to sexual difficulties included shame, denial, substance abuse and occasionally violence. On a positive note many men said they want to learn about it, so they understand how to cope with such problems. The Indigenous men reported symptoms of erectile dysfunction at least as much as non-Indigenous men in other Australian studies. Bivariate analysis showed that erectile dysfunction was correlated with many health and lifestyle variable. However multivariate analysis revealed that only three factors significantly predicted ED: presence of chronic disease, presence of pain when working, and living in a remote geographic location The quantitative survey data indicate that Indigenous men have more symptoms of prostate disease than non-Indigenous men. The syndrome appears to be poorly managed in clinical practice (e.g. rates of PSA testing and digital-rectal examination are only one-third the rate reported by non-Aboriginal men, despite equivalent likelihood of GP visits). The research study adds to the literature by providing better insight and depth into the issues impacting on Aboriginal and Torres Strait Islander males experiencing reproductive and sexual health difficulties. It also provides a platform to undertake comprehensive research with Aboriginal and Torres Strait Islander men to explore a wider spectrum of questions in this important but neglected area. Implications for education of primary healthcare workers and community-based awareness campaigns for Indigenous males are discussed. Most of all, this study revealed "layers" of silence around sexual and reproductive health of Indigenous men. This includes silence in the scientific establishments in health services, and in the community. It is hoped that this study puts the voices of the men forward to help to break down this silence.
7
Oxenford, Alison. "Visual profile of aboriginal & Torres strait islander school children in urban Queensland and their associated vision and reading problems." Thesis, Queensland University of Technology, 2000. https://eprints.qut.edu.au/36752/1/36752_Digitised%20Thesis.pdf.
Full textAbstract:
The reading and school performance of Aboriginal and Torres Strait Islander (A & TSI) children has been reported to be poorer than that of the wider community. The known association between reading and vision formed the basis of the principal hypothesis tested in this thesis that the poor reading performance of these children has a visual basis. Two experiments made up the main study which examined the visual characteristics and reading performance of children attending two different urban schools; the Holy Rosary school, which catered for children from many ("mixed") cultural backgrounds and the St Francis school, whose students were predominantly of A & TSI culture.
In experiment I, the visual characteristics of 41 A & TSI children (13 from the Holy Rosary school, 28 from the St Francis school), aged between 8 and 11 years were measured. In general, A & TSI children exhibited low hyperopic refractive errors and other optometric findings were similarly within normal limits. Agematched data for 13 A & TSI children from each of the two schools was also compared. Horizontal eye movement ability and reading comprehension skills were significantly poorer in the A & TSI children attending the "mixed" (Holy Rosary) school, while the perceptual skills of the A & TSI students attending the "A & TSI" (St Francis) school were significantly worse.
The second experiment investigated the vision and reading performance of A & TSI and non-A & TSI children attending the same school. Age-matched data of 13 A & TSI and 13 non-A & TSI students were analysed. While the visual profiles of the A & TSI and non-A & TSI students were not significantly different, the reading accuracy and comprehension scores were significantly worse in the A & TSI children when compared with the non-A & TSI group. The results from both experiments are consistent with previous reports of poor reading performance in A & TSI children but argue against poor vision being the cause of this reduced reading performance.
As an adjunct to this study, the Turtle chart, designed specifically for use with A & TSI children, was evaluated. The vision of 97 students, 60 A & TSI and 37 non-A & TSI students, aged between 6 and 12 years, was measured using both a standard Bailey-Lovie chart and a Turtle chart. The results obtained with the two charts were highly correlated, indicating that the Turtle chart is a culturally appropriate alternative for the measurement of vision in A & TSI children.
8
Walker, Kate. "Trends in birthweight and infant weights : relationships between early undernutrition, skin lesions, streptococcal infections and renal disease in an Aboriginal community /." Connect to thesis, 1996. http://repository.unimelb.edu.au/10187/2406.
Full textAbstract:
Undernutrition in prevalent in Aboriginal communities, in utero, infancy and childhood. It influences childhood morbidity and mortality and growth patterns. Undernutrition and poor socio-economic status also contribute to endemic and epidemic infectious disease, including scabies and streptococcal infection. It has been suggested that early undernutrition, and streptococcal and scabies infection are risk factors for renal disease, which is at epidemic levels and increasing. This thesis examines the prevalence of undernutrition in newborns and infants in an Aboriginal community over time, and its impact on childhood growth and child and adult renal markers. The association between skin lesions, streptococcal serology, post-streptococcal glomerulonephritis (PSGN) and renal markers as evaluated through a community wide screening program in 1992-1995 is also examined. Birthweights have increased since the 1960s, but they are still much lower than the non-Aboriginal values. Weights in infancy have decreased since the 1960s. At screening in childhood stunting was common, reflecting the presence of long-term poor nutrition in infancy. In both adults and children, birth weight and infant weights were negatively associated with albuminuria measured by the albumin to creatine ratio (ACR).
9
Owen, Julie. "Development of a culturally sensitive program delivering cardiovascular health education to indigenous Australians, in South-West towns of Western Australia with lay educators as community role models." University of Western Australia. School of Population Health, 2006. http://theses.library.uwa.edu.au/adt-WU2006.0061.
Full textAbstract:
[Truncated abstract] Indigenous Australians suffer cardiovascular disease (CVD) at a rate six times greater than the general population in Australia and while the incidence of CVD has been reduced dramatically amongst the majority of non-indigenous Australians and amongst Indigenous populations in other countries in the last 30 years, there has been little change in the figures for Aboriginal Australians, showing that heart health campaigns have little impact, for this group of people. Aims : The principal aims of this study were firstly, to determine and record the barriers to the development and delivery of CVD prevention programs amongst Indigenous Australians and secondly, to develop an alternative, effective and culturally sensitive method of delivering heart health messages. Methods and results : The study was qualitative research undertaken in three South-West towns of Western Australia where the incidence of CVD was high amongst the Aboriginal community members. The use of semi-formal interviews, informal individual consultation, observation, and focus groups were methods implemented to obtain information. The first phase of the research was to identify the barriers which affected the Aboriginal Health Workers’ ability to deliver specialist educational programs. Questionnaires and interviews with the Aboriginal Health Workers and other health professionals in the towns, and community focus groups were undertaken in this phase of the study. The second phase of the research was aimed at developing an alternative strategy for delivering heart health messages. The focus changed to adopt more traditional ways of passing on information in Indigenous communities. The idea of small gatherings of friends or family with a trusted community member presenting the health message was developed. The third phase of the research was to implement this new approach. Lay educators who had been identified within focus groups and by Aboriginal Health Workers were trained in each of the towns and a protocol involving discussions of health issues, viewing a video on CVD, produced by the National Heart Foundation, sharing in a ‘heart healthy’ lunch and partaking in a ‘heart health’ knowledge game which was developed specifically for the gatherings. Several of these gatherings were held in each of the towns and they became known as ‘HeartAware parties’.
10
Stocks, Nigel. "Trachoma and visual impairment in the Anangu Pitjantjatjara of South Australia /." Title page, contents and abstract only, 1992. http://web4.library.adelaide.edu.au/theses/09MD/09mds865.pdf.
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11
Parsons, Meg. "Spaces of disease the creation and management of Aboriginal health and disease in Queensland 1900-1970 /." Connect to full text, 2008. http://hdl.handle.net/2123/5572.
Full textAbstract:
Thesis (Ph. D.)--University of Sydney, 2009.Degree awarded 2009; thesis submitted 2008. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept.of History, Faculty of Arts. Title from title screen (viewed 3 December, 2009). Includes graphs and tables. List of tables: leaf 9. List of illustrations: leaves 10-12. Includes bibliographical references. Also available in print form.
12
Markey, Peter. "The prevalence of ischaemic and rheumatic heart disease and risk factors in Aboriginal and non-Aboriginal footballers /." Title page, contents and abstract only, 1996. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmm345.pdf.
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13
Parsons, Meg. "Spaces of Disease: the creation and management of Aboriginal health and disease in Queensland 1900-1970." University of Sydney, 2009. http://hdl.handle.net/2123/5572.
Full textAbstract:
Doctor of Philosophy(PhD)Indigenous health is one of the most pressing issues confronting contemporary Australian society. In recent years government officials, medical practitioners, and media commentators have repeatedly drawn attention to the vast discrepancies in health outcomes between Indigenous and non-Indigenous Australians. However a comprehensive discussion of Aboriginal health is often hampered by a lack of historical analysis. Accordingly this thesis is a historical response to the current Aboriginal health crisis and examines the impact of colonisation on Aboriginal bodies in Queensland during the early to mid twentieth century. Drawing upon a wide range of archival sources, including government correspondence, medical records, personal diaries and letters, maps and photographs, I examine how the exclusion of Aboriginal people from white society contributed to the creation of racially segregated medical institutions. I examine four such government-run institutions, which catered for Aboriginal health and disease during the period 1900-1970. The four institutions I examine – Barambah Aboriginal Settlement, Peel Island Lazaret, Fantome Island lock hospital and Fantome Island leprosarium – constituted the essence of the Queensland Government’s Aboriginal health policies throughout this time period. The Queensland Government’s health policies and procedures signified more than a benevolent interest in Aboriginal health, and were linked with Aboriginal (racial) management strategies. Popular perceptions of Aborigines as immoral and diseased directly affected the nature and focus of government health services to Aboriginal people. In particular the Chief Protector of Aboriginals Office’s uneven allocation of resources to medical segregation facilities and disease controls, at the expense of other more pressing health issues, specifically nutrition, sanitation, and maternal and child health, materially contributed to Aboriginal ill health. This thesis explores the purpose and rationales, which informed the provision of health services to Aboriginal people. The Queensland Government officials responsible for Aboriginal health, unlike the medical authorities involved in the management of white health, did not labour under the task of ensuring the liberty of their subjects but rather were empowered to employ coercive technologies long since abandoned in the wider medical culture. This particularly evident in the Queensland Government’s unwillingness to relinquish or lessen its control over diseased Aboriginal bodies and the continuation of its Aboriginal-only medical isolation facilities in the second half of the twentieth century. At a time when medical professionals and government officials throughout Australia were almost universally renouncing institutional medical solutions in favour of more community-based approaches to ill health and diseases, the Queensland Government was pushing for the creation of new, and the continuation of existing, medical segregation facilities for Aboriginal patients. In Queensland the management of health involved inherently spatialised and racialised practices. However spaces of Aboriginal segregation did not arise out of an uncomplicated or consistent rationale of racial segregation. Rather the micro-histories of Fantome Island leprosarium, Peel Island Lazaret, Fantome Island lock hospital and Barambah Aboriginal Settlement demonstrate that competing logics of disease quarantine, reform, punishment and race management all influenced the ways in which the Government chose to categorise, situate and manage Aboriginal people (their bodies, health and diseases). Evidence that the enterprise of public health was, and still is, closely aligned with the governance of populations.
14
Funston, Shelly Lee Katherine. "Historicizing the biological, physical data, disease history and New World aboriginal peoples." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ60375.pdf.
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Lux, Maureen Katherine. "Medicine that walks : medicine, disease and canadian plains aboriginal people, 1880-1945 /." Toronto : University of Toronto press, 2001. http://catalogue.bnf.fr/ark:/12148/cb377361168.
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16
Foulds, Heather-Jean. "Community-based physical activity and the risk for cardiovascular disease in Aboriginal Canadians." Thesis, University of British Columbia, 2010. http://hdl.handle.net/2429/28116.
Full textAbstract:
Introduction: Aboriginal individuals continue to experience greater levels of cardiovascular disease (CVD) and diabetes than the Canadian general population, though these diseases were historically rare. Increasing evidence indicates rising sedentary behaviours from the traditional healthy and active lifestyles of this population. Various interventions have been implemented to address the health inequities in Aboriginal peoples with mixed results. Unfortunately, limited research has taken a culturally appropriate community approach to improve the health and well-being of Aboriginal peoples. By implementing a community-based and participatory physical activity (PA) and healthy living program, health and wellness can be improved in a culturally relevant context.
Purposes: The primary purpose of this investigation was to examine the health benefits of a community-based PA and healthy living intervention program for Aboriginal Canadians.
Methods: Participants were recruited through local Aboriginal offices representing male and female participants of wide ranging ages and CVD risk profiles. Each participant completed identical testing days pre- and post-training including a variety of CVD risk factors and four CVD risk scoring systems. Participants were self-assigned to three different community-based PA interventions including walking, walk/running, or running.
Results: Significant improvements in health measures and CVD risk scores were observed for both male and female participants of all age groups. The three PA programs produce similar improvements in health measures and risk scores. Individuals of high, moderate and low CVD risk also experienced similar improvements.
Discussion: High program compliance indicated success for improving PA of this population. Improvements among both genders and a variety of age groups support this program as a successful intervention for males and females of all ages. The similar changes in health status with each of the programs suggest that Aboriginal adults successfully self-select an appropriate PA intervention for health benefits. Moreover, the similarity in improvements among participants of a variety of CVD risk classifications indicates this individualized program was appropriate for improving the health status of individuals of a range of CVD risk profiles.
Conclusion: The self-selected intensities Hearts inTraining program was successful in improving health status and increasing PA for Aboriginal adults of all ages, genders and risk categories.
17
Peberdy, Sally Ann Carleton University Dissertation Geography. "HIV and AIDS and Aboriginal communities in Canada; a socially accountable participatory study." Ottawa, 1992.
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18
Ferguson, Lara. "Deconstructing fetal alcohol syndrome, a critical inquiry into the discourse around alcohol, women, ethnicity, aboriginals and disease." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq22077.pdf.
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Ferguson, Lara (Lara Gail) Carleton University Dissertation Sociology and Anthropology. ""Deconstructing fetal alcohol syndrome: a critical inquiry into the discourse around alcohol, women, ethnicity, aboriginals and disease."." Ottawa, 1997.
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20
Braun, Kali. "Association of killer immunoglobulin-like receptor (KIR) genes with tuberculosis disease in two Canadian cohorts." PLoS ONE, 2013. http://hdl.handle.net/1993/22042.
Full textAbstract:
In Canada, and more specifically in Canadian-born Aboriginals and foreign born populations, high incidence of tuberculosis (TB) causes significant morbidity and mortality. The presence or absence of specific killer immunoglobulin-like receptor (KIR) genes, individually or in conjunction, may be associated with tuberculosis (active, latent, or uninfected disease status) as well as ethnicity of an individual. It is hypothesized that the differences in KIR profiles, gene frequencies, and/or haplotypes in Canadian-born Aboriginal, Canadian-born non-Aboriginal, and foreign born individuals elicits a differential activation or inhibition profile, resulting in differential cytokine expression and eventually contributes to the outcome of TB infection. In this study we examined the enrichment or depletion of KIR genes in different ethnic populations in Manitoba with special focus on active, latent, and uninfected TB status. In addition, we sought to explore the statistical correlation between TB status and inhibitory/stimulatory KIR haplotypes.
21
Singh, Adrian A. "Socio-economic, geographic, and aboriginal and Torres strait islander inequalities in diabetic foot disease and diabetes-related lower extremity amputations." Thesis, Queensland University of Technology, 2018. https://eprints.qut.edu.au/119222/1/Adrian_Singh_Thesis.pdf.
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Diabetic foot disease (DFD) which can result in an amputation is one of the leading reasons why a person with diabetes is hospitalised. With minimal knowledge of the impact of social factors, this study examined hospitalisation related to DFD and eventual amputations in Queensland. A total of 19,790 people in Queensland who were hospitalised for DFD were people from more disadvantaged areas tended to be younger, live in remote areas, of Aboriginal and Torres Strait Islander origin with amputations being significantly higher for persons of Aboriginal and Torres Strait Islander status. It is the first time a study has investigated the pattern of DFD hospitalisation and amputation by social factors.
22
Smith, Kathryn Elizabeth. "Assessment and prevalence of dementia in indigenous Australians." University of Western Australia. School of Primary, Aboriginal and Rural Health Care, 2009. http://theses.library.uwa.edu.au/adt-WU2009.0062.
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Until recently, there was no dementia screening tool for Indigenous Australians and a paucity of information on the extent of dementia in Indigenous Australians. This thesis describes the development and validation of a tool to assess cognitive impairment in remote Indigenous Australians with the primary purpose of determining the prevalence of dementia and other associated conditions in this population. The tool was reevaluated with the larger prevalence sample and a short version of the tool was developed and evaluated. The Kimberley Indigenous Cognitive Assessment (KICA) tool was validated with Indigenous Australians aged over 45 years from the Kimberley region of Western Australia (n=70). The results were later confirmed in a larger sample from the remote Kimberley (n=363), and an additional sample in rural and remote areas of the Northern Territory (n=47). The KICA results were compared to independent consensus diagnoses using DSM-IV and ICD-10. Interpreters were used whenever participants were not proficient in English. These data led to the determination of a cut-off score of 33/34 out of a possible total score of 39 for the cognitive component of the KICA (KICA-Cog), with a sensitivity of 0.93 and specificity of 0.95 and AUC of 0.98. The tool is now widely used within remote areas of Australia. A short version of the KICACog (sKICA-Cog) was developed and found to be a valid brief screening tool for dementia in the Kimberley population, and had a cut-off score of 20/21 out of a possible 25, with a sensitivity of 0.89, specificity of 0.95 and AUC of 0.98. The sKICA-Cog should be used in combination with the KICA cognitive informant questionnaire (KICA-IQ). The KICA-IQ cut-off score of 2/3 out of a possible 16 was determined, with a sensitivity of 0.76 and specificity of 0.84 and AUC of 0.91. Using the validated KICA, the prevalence of dementia and cognitive impairment not dementia (CIND) was determined in a semi-purposive sample consisting of 363 Indigenous Australians aged over 45 years from 6 Aboriginal communities and one town in the Kimberley region. Participants were screened with the full KICA and 165 participants had an independent specialist review with consensus diagnoses. The prevalence of dementia was 12.4%, 5.2 times greater than the Australian prevalence of 2.4%, after age adjustment. The prevalence of CIND was 8.0%. Characteristics associated with dementia included older age, male gender (OR 3.1, 95% CI 1.4, 6.8), no formal education (OR 2.7, 95% CI 1.1, 6.7), smoking (OR 4.5, 95% CI 1.1, 18.6), previous stroke (OR 17.9, 95% CI 5.9, 49.7), epilepsy (OR 33.5, 95% CI 4.8, 232.3) and head injury (OR 4.0, 95% CI 1.7, 9.4). Other factors associated with dementia included incontinence, falls and poor mobility. The KICA is a valid assessment tool for rural and remote Indigenous Australians. The prevalence of dementia amongst Indigenous Australians is substantially higher than generally found in non - Indigenous Australians and other populations in the developed and developing world.
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Clayton, Jeffrey Scott Keirstead Christopher M. "Discourses of race and disease in British and American travel writing about the South Seas 1870-1915." Auburn, Ala., 2009. http://hdl.handle.net/10415/1996.
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Mills, Kyly M. "'Work it out': Evaluation of a chronic condition self-management program for urban Aboriginal and Torres Strait Islander people with or at risk of cardiovascular disease." Thesis, Queensland University of Technology, 2015. https://eprints.qut.edu.au/90737/1/Kyly_Mills_Thesis.pdf.
Full textAbstract:
This thesis evaluates a chronic condition self-management program for Aboriginal and Torres Strait Islander people in urban south-east Queensland who have or are at risk of cardiovascular disease. Outcomes showed short-term improvements for some anthropometry measures which could be a trend for improvement in other anthropometry indicators over the longer term. The program was of particular benefit for participants who had several social and emotional wellbeing conditions. The use of an Aboriginal and Torres Strait Islander conceptual framework was critical in undertaking culturally competent quantitative research in this project.
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Mahoney, Raymond P. "Is identifying as Indigenous good for your health? Investigating the relationship between Indigenous status identification and management of cardiovascular disease." Thesis, Queensland University of Technology, 2017. https://eprints.qut.edu.au/114077/1/Raymond_Mahoney_Thesis.pdf.
Full textAbstract:
Improving the patient journey for Indigenous people has become an important focus to reduce the rates of cardiovascular disease and address underlying factors contributing to the disparities of care between Indigenous and non-Indigenous people. This study has demonstrated that a culturally safe cardiac outreach service staffed by Indigenous and non-Indigenous people is capable of providing timely evidence based care to the standards of best practice. The findings of this study indicate that racism at an interpersonal, individual, organisational and societal level contribute, interact and conspire to influence the Indigenous patient journey within mainstream health services. Identifying as Indigenous is not good for your health because, significantly, the patient journey commences with the collection of Indigenous status, an act of defining race that reinforces the disparity between Indigenous and non-Indigenous people.
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Rheault, Haunnah. "Examining the chronic disease health literacy of First Nations Australians: A mixed methods study." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/228618/8/Haunnah%20Rheault%20Thesis.pdf.
Full textAbstract:
Chronic disease is the most significant contributor to the mortality gap between Australia’s First Nations people and the overall Australian population. This study explored chronic disease self-management and health literacy in First Nations adults living in remote Queensland. Key findings were poor communication by healthcare providers coupled with limited health literacy abilities of individuals were the major barriers to active engagement with managing chronic disease. Providing a supportive health literacy environment and the provision of appropriate health information delivered in a cultural safe way using clinical yarning, may assist with closing the gap in First Nations people.
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Vujcich, Daniel Ljubomir. "Where there is no evidence, and where evidence is not enough : an analysis of policy-making to reduce the prevalence of Australian indigenous smoking." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:f2d8fbe9-b506-4747-993a-0657cb1df7bf.
Full textAbstract:
Background: Evidence-based policy making (EBPM) has become an article of faith. While critiques have begun to emerge, they are predominately based on theory or opinion. This thesis uses the 2008 case study of tobacco control policy making for Indigenous Australians to analyse empirically the concept of EBPM. Research questions: (1) How, if at all, did the Government use evidence in Indigenous tobacco control policy making? (2) What were the facilitators of and barriers to the use of evidence? (3) Does the case study augment or challenge the apparent inviolability of EBPM? Methods: Data were collected through: (1) a review of primary documents largely obtained under the Freedom of Information Act 1982; and (2) interviews with senior politicians, senior bureaucrats, government advisors, Indigenous health advocates and academics. Results: Historically, Indigenous smoking was not problematised because Indigenous people faced other urgent health/social problems and smoking was considered a coping mechanism. High prevalence data acquired salience in 2007/08 in the context of a campaign to reduce disparities between Indigenous and non-Indigenous health outcomes. Ensuing policy proposals were based on recommendations from literature reviews, but evidence contained in those reviews was weak; notwithstanding this, the proposals were adopted. Historical experiences led policy makers to give special weight to proposals supported by Indigenous stakeholders. Moreover, the perceived urgency of the problem was cited to justify a trial-and-evaluate approach. Conclusion: While the policies were not based on quality evidence, their formulation/adoption was neither irrational nor reckless. Rather, the process was a justifiable response to a pressing problem affecting a population for which barriers existed to data collection, and historical experiences meant that evidence was not the only determinant of policy success. The thesis proposes a more nuanced appraoch to conceptualising EBPM wherein evidence is neither a necessary nor a sufficient condition for policy. The approach recognises that rigorous evidence is always desirable but that, where circumstances affect the ability of such research being conducted, consideration must be given to acting on the basis of other knowledge (e.g. expert opinion, small-scale studies). Such an approach is justifiable where: (1) inaction is likely to lead to new/continued harm; and (2) there is little/no prospect of the intervention causing additional harm. Under this approach, non-evidentiary considerations (e.g. community acceptability) must be taken into account.
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Veale, Antony John. "Chronic lung disease in Australian Aborigines." Phd thesis, 1993. http://hdl.handle.net/1885/144192.
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Dowling, Peter J. ""A great deal of sickness": Introduced diseases among the Aboriginal people of colonial Southeast Australia." Phd thesis, 1997. http://hdl.handle.net/1885/7529.
Full textAbstract:
Previous palaeopathological studies have sought to build up a picture of Australian Aboriginal health before European settlement in 1788 and epidemiological studies of Aboriginal health in the twentieth century are now legion. But, despite a growing body of literature on Aboriginal history set in the intervening colonial period, our knowledge of Aboriginal health following European colonisation remains understudied. This thesis is a contribution to filling that gap through an examination of documentary and skeletal evidence in the changing bio-chemical situation experienced by Aboriginal populations of Southeast Australia from 1788 to 1900.
This thesis examines one of the major biological components of this change – disease that were introduced unto Australian Aboriginal populations during the process of colonisation. The epidemiology, timing, diffusion of diseases are considered with specific attention given to infectious and respiratory diseases that were responsible for causing major epidemics of morbidity and mortality.
The medical model for the contact period in the late 18th and 19th centuries is proposed. This model considers three major stages in the disease environment of Aboriginal populations in Southeast Australia; a pre-contact stage with endemic pathogens causing chronic diseases and limited epidemics, an early contact stage where introduced exotic human diseases cause severe epidemics of infectious and respiratory diseases among Aboriginal populations, and a third stage where remaining Aboriginal populations were institutionalised on government and mission settlements and were subjected to a high level of morbidity and mortality form the introduced diseases.
The major epidemic diseases during the early stage were smallpox, syphilis, tuberculosis, influenza, and measles. Each of these diseases was responsible for excessive morbidity and mortality. During the period of institutionalisation infectious and respiratory diseases were responsible for over 50% of recorded deaths on 8 separate Aboriginal settlements in Southeast Australia. The major diseases recorded as causes of death were tuberculosis, bronchitis, pneumonia, diarrhoea and dysentery.
Aboriginal and non-Aboriginal Australian infant mortality rates are calculated to provide an indicator to compare the state of health of the two populations. Aboriginal rates were high when compared to the non-Aboriginal populations of Victoria and South Australia. The rates reveal a substantial health differential between Aboriginal and non-Aboriginal populations. Aboriginal infant mortality improved into the latter quarter of the twentieth century but the corresponding improvement in non-Aboriginal infant mortality has been at a much higher rate. The gap between the health status of each has widened rather than narrowed over the last one hundred years.
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Dowling, Peter J. "Violent epidemics : disease, conflict and Aboriginal population collapse as a result of European contact in the Riverland of South Australia." Master's thesis, 1990. http://hdl.handle.net/1885/114505.
Full textAbstract:
Many researchers have recognized the value of
investigating the history of race contact in Australia,
but too few have sought to explain in detail why the
Aboriginal population declined so much and so rapidly
when colonization advanced across the continent.
The central aim of this thesis is to identify and assess
the impact of the major causes of Aboriginal population
collapse in the Riverland (Murray River) region of South
Australia. It is estimated that prior to 1800 the
population density of the Riverland was between 0.3 and
0.5 km^ per person with a total population for the region
of around 3000. In 1881 the South Australian State Census
enumerated just 14 Aboriginal people for the Riverland
region. The population collapse has been viewed in two
stages. The first has been termed pathological contact
and is considered to be the major cause of the collapse.
Introduced venereal syphilis, gonorrhoea and smallpox
spread ahead of the major European frontiers of South
Australia causing extreme mortality among the Riverland
Aborigines. The second stage began after European
settlement of South Australia. Violent clashes were
quick to erupt on the overland cattle route which linked
the settlement of Adelaide with the Eastern settlements.
The combined effect resulted in an increase in the
mortality rate, a decrease in the fertility rate and
social and economic disruption. The population was
unable to recover.
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Saulo, Dina Raus. "Infectious Diseases Among Marginalised Populations." Master's thesis, 2015. http://hdl.handle.net/1885/107141.
Full textAbstract:
From February 2013 to November 2014 I undertook a field placement
at the Kirby Institute for Infection and Immunity in Society (the
Kirby Institute), as a part of a Master of Philosophy in Applied
Epidemiology (MAE). This bound volume is the product of projects
undertaken while at the Kirby Institute in the Justice Health
Research Program and the Public Health Interventions Research
Group. Within are six chapters which demonstrate work undertaken,
lessons learnt, knowledge gained and MAE requirements met.
Due to my placement predominantly in the justice health research
program, three out of four major projects have a focus on blood
borne viruses and associated risk factors among offender
populations. I evaluated the national prison entrant’s blood
borne virus and risk behaviour survey (NPEBBVS), the only
multi-jurisdictional prison BBV monitoring mechanism nationally.
As a data analysis project I explored hepatitis B core antibody
and hepatitis C antibody prevalence and associated risk factors
among Indigenous and non-Indigenous prison entrants from the
NPEBBVS. Findings from this chapter were presented at a number of
conferences and events. As an acute public health problem, I had
the opportunity to investigate hepatitis C (HCV) incidence cases
in a prison facility. We developed a case series study using
mixed methods to collect data on the unusual cluster of HCV
cases. I conducted both quantitative and qualitative interviews
with participating inmates to gather prisoner’s perspective of
HCV incidence, understanding routes of transmission in the prison
setting and possible strategies in decreasing exposure and risk.
From the start of 2013 I was involved in the ‘vaccine impact in
the Indigenous population’ (VIP- I) study with a large group of
investigators. The aim of VIP-I was to evaluate the effectiveness
of the HPV vaccine among Indigenous women in Australia. My role
in the study was as a field coordinator, chapter 5 demonstrates
my involvement from the development stage onwards. This chapter
is largely methodological, only preliminary results are presented
as recruitment is still ongoing.
Teaching experience during the MAE included; lessons from the
field and a group teaching session with MAE peers. I worked
individually on a project management module for the lesson from
the field exercise, my fellow MAE cohort completed this module
which touched on interdisciplinary collaboration in research. The
group teaching experience was created and conducted with two
fellow MAE scholars, we built a framework to distinguish real or
artificial rate change when interpreting time series data.
The projects within this thesis contribute to the Kirby
Institutes area of work with marginalised at risk populations. I
have been fortunate to be a part of a number of projects that
have potential to impact public health policy and programs for
both Indigenous and offender populations.
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Briscoe, Gordon. "Disease, health and healing : aspects of indigenous health in Western Australia and Queensland, 1900-1940." Phd thesis, 1996. http://hdl.handle.net/1885/13158.
Full textAbstract:
In this thesis I examine aspects of disease, health and healing among the indigenous people in Western Australia and Queensland from 1900 to 1940. I argue that diseases have helped to shape and influence the
interaction between the indigenous people and the various members of the settler community most concerned with them - government protectors, missionaries, pastoralists and health workers.
In developing this argument I draw on the distinction made by Stephen J. Kunitz between the universalistic and particularistic approaches to historical epidemiology. Kunitz argues that the development of physiology and bacteriology transformed the practice of medicine by revealing universalistic 'natural histories' of diseases and their causative agents, but that this approach should be tempered by attention to the particular individual, cultural and institutional
circumstances of disease occurrence. Diseases have a past, a present and a future of their own, and when considered within the context of human social history, are seen to be a powerful motivate force in human affairs. My approach involves examining the history of diseases, health and healing among the indigenous peoples using models of causation, some of which are biomedical, some are anthropological and others are
demographic and epidemiological. There are differences between such models. The biomedical model is 'universalistic' and 'scientific', based on general principles subject to proof or denial through empirical research. In the same way, the demographic and epidemiological models are also universalistic. The anthropological model, however, is articularistic' in that each situation is unique and is explained by its history and internal dynamics, not by reference to general principles. The combination of the biomedical, demographic and epidemiological methods with those of
social history allows an otherwise silent indigenous population to be brought into the historical narrative from which they would otherwise have been excluded.
In Western Australia, contrary to previous thinking, the total number of Aborigines increased during the study period. In particular, the number of females and older males increased under the influence of protection laws. The increases contradict the popular belief that the indigenous populations were still in decline. However, the spread of disease and the growing population worsened the already poor personal and public hygiene practices, creating the mistaken impression that the indigenous populations were declining. Indeed, diseases such as leprosy, respiratory and sexually transmitted diseases had by the 1930s reached epidemic proportions, which suggested that the indigenous people were a dying race. The indigenous populations already contained some pathogenic infections prior to contact with Europeans. The Aborigines had developed a means, however rudimentary, of predicting how sick people reacted to an illness and of determining what the disease might be that healers treated. But following European contact, other diseases came from contact
not only with Europeans but also with Asians, who introduced leprosy into mining camps and Kanakas, who introduced leprosy into the cane plantations and tuberculosis into the Cape York regions. Protection policies intensified the effects of the diseases. In
Queensland, the government applied its protection policies with increasing vigour over the period, resulting in most Aborigines living on government
·relief depots, missions and reserves by the 1930s. Demographic analysis reveals that Queensland consistently overestimated its indigenous populations. Death, disease, health and heating among indigenous groups, therefore, came to have social and political dimensions which few, if any, people recognised at the time. In hindsight, however, we can appreciate
that the assumption behind health programs was that the indigenous populations should be the passive, but grateful, recipients of welfare rather than historic actors in their own right. The consequences in terms of disease dynamics were profound. The associated practice of gathering together sick, infirm and infected people in 'disease compounds' created reservoirs of exotic diseases to infect newcomers with low immunity. The social consequences of weakened populations meant, in turn, higher numbers of inmates who succumbed to virulent infections. Even in the absence of 'disease compounds', overcrowding of depots
and inadequate health services based mostly on religious compassion (on both mission and government compounds) were instruments in promoting increased infection. After 1920 professional services supervised by government protectors and health officials became the norm, but in general, Aborigines were not allowed access to normal hospital facilities. During epidemics, overcrowding of depots and settlements meant a greater susceptibility to respiratory and sexually transmitted diseases, which became endemic, as well as to other infections such as hookworm and leprosy.
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Yu-Jen, Tsai, and 蔡裕仁. "The related study on the parasite diseases of resident health between the aboriginal tribes and life of environmental animals." Thesis, 2000. http://ndltd.ncl.edu.tw/handle/02910027215694542780.
Full textAbstract:
碩士台北醫學院
醫學研究所
88
From 1997 to 2000, 160 blood samples(dog 114；cat 2；mouse 12；pigeon 17；goat 3；bat 1；wild boars 3 and flying squirrel 8 ) and 79 stool samples (dog 20；mouse 12；pigeon 30；guinea pig 3；goat 2；wild boars 4 and flying squirrel 8 ) were periodically collected from the animals lived with and hunted by the aboriginal tribes people of 5 villages in Taiwan (Nan Au village in Yi Lan county：Dung Au, Nan Au,Bi Hou,Jin Yue,Wu Ta, Jin Yang and Au Hau；Jin Feng village in Tai Dung county：Jeng Shing,Jia Lan,Shin Shing,Bin Mau and Li Chiou；Hai Duan village in Tai Tung：Hai Duan,Kan Ding,Jia Na Wu Lu,Li Dau,Guang Yuan,Jin Ping andChu Lai；Da Jen village in Tai Tung：Tai Ban,Tu Ban,Shin Hua,An Shuo,Nan Tian, and Sen Yung；Da Wu village in Tai Tung：Shang Wu,Da Wu,Da Ju,Nan Shing, and Da Niau； coast mountain of Hua Lian county). The dog lived with people showed that the infection rates of Toxoplasma gondii, Dirofilaria immitis ,Hepatazoon canis, Ancylostoma spp. ,Toxocara canis and Trichuris vulpis are 21.9%(25/114), 6.1%(7/114), 1.8%(2/114), 35.0% (7/20), 20.0%(4/20), and 5.0%(1/20), respectively. Meanwhile, the Haemoproteus spp. of pigeon is 41.2%(7/17) and the Babesia spp. of mouse is 41.7%(5/12). About the mouse stood, it showed that the infection rates of Ancylostoma spp., Strongyloides ratti and Diphyllobothrium spp. are 16.7%(2/12), 25.0%(3/12) , and25.0%(3/12) , respectively. Meanwhile the multi-infection rates of Strongyloides ratti and Diphyllobothrium spp. are 8.3% (1/12), and 25.0% (3/12). The Strongyloides papillosus of goat is 50.0%(1/2). The Strongyloides ratti of guinea pig is 33.3% (1/3). There were only 2 blood samples of wild boars and flying squirrel. The infection rates of both Toxoplasma gondii and Suifilaris suis of wild boars are 33.3%(1/3). The total parasitic infection rate is 75.0% and 100% in stool samples. The wild boars results showed that all the infection rates are 50.0%(2/4) to Ascaris suum, Trichuris suis, Strongyloides ransomi and Hyostrongylus rubidus, except the Ascarops strongylina is 25.0 %(1/4). The investigation of flying squirrel showed the infection rates of Trichuris spp., Syphacia spp., Coccidia spp., Strongyloides ratti and Nippostrongylus muris are 25.0%(2/8), 87.5%(7/8), 75.0%(6/8), 50.0%(4/8), and 37.8%(3/8), respectively. The 2, 3 and 4 multi- infection of wild boars are 25.0%(1/4). The 2, 3 and 4 multi- infection of flying squirrel are 50.0%(4/8), 25.0%(2/8), and 25.0%(2/8), receptively. In this investigation, the data is accumulated progressively and matched with the current study location and the main purpose is for establishing the animal''s parasitic data of aboriginal tribes'' area in Taiwan and link to Geography Information System. Then the infectious disease, public health, epidemiology and epidemic situation of human and animal in aboriginal tribes could be monitored and controlled instantly and the hygiene education of the tribes could be improved and the parasite disease induced by other disease could also be reduced.
34
Shwetz, Katherine. "Communicable Stories: HIV in Canadian Aboriginal Literature." 2011. http://hdl.handle.net/10222/14199.
Full textAbstract:
The devastation wrought by the HIV/AIDS epidemic in Aboriginal communities is both physical and metaphorical, as the stigmas associated with the virus mediate the way it is both understood and experienced. This thesis examines the role of HIV in Canadian Aboriginal literature, with an eye to the specific ways that these narratives about HIV relate back to real-world understandings of the epidemic. The works of Tomson Highway, Jordan Wheeler, Beth Brandt, and Gregory Scofield demonstrate how HIV/AIDS is frequently tied to colonial histories and personal experiences of disconnect, alienation, and abuse. HIV operates at the boundaries of these texts, drawing connections between otherwise disparate narratives, highlighting stigmas within communities, and focussing on differently marginalized communities of Aboriginal people in Canada. These authors draw from traditional understandings of storytelling, using narrative to incite important discussions about HIV/AIDS, and to work towards greater acceptance and inclusion of HIV-positive people in Aboriginal communities.
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Hogg, Robert Stephen. "Australian Aboriginal mortality and coronary heart disease : a demographic inquiry." Phd thesis, 1991. http://hdl.handle.net/1885/117245.
Full textAbstract:
This thesis has attempted to evaluate whether Australian Aboriginal mortality patterns
are different from those exhibited by indigenous groups in other countries or by the
general Australian population; and whether the high rate of coronary heart disease
among Australian Aborigines is attributable to the underlying prevalence of specific
lifestyle (risk) factors. At a macro-level, I have compared contemporary mortality
patterns of and risk factor prevalence levels among Australian Aborigines and other
indigenous groups. At a micro-level, I have made the same comparisons between
Aborigines living in western New South Wales (especially those in Bourke) and other
Australians.
This study has made four important points regarding these issues. The first point is that
although Australian Aborigines and other indigenous groups have similar patterns of
high adult mortality, the relative importance of some more notable causes of death is
strikingly different. The second point is that Aborigines have much higher total and
age-specific death rates than other Australians, especially during adulthood and most
notably from circulatory system diseases. The third point is that, compared with the
general Australian population, Bourke Aborigines have much higher risk factor
prevalence levels for a number of coronary heart disease risk factors. The fourth and
final point is that Bourke Aboriginal risk factor prevalence levels tend to vary quite
considerably by several demographic, environmental, and social-cultural conditions
(risk markers) — more specifically, by age, location, employment status, and pay
period.
Overall, these findings suggest that the mortality pattern of Australian Aborigines is
experienced by no other population; and that lifestyle factors, which are influenced by
often uncontrollable conditions, can at least partially account for the observed high rate
of coronary heart disease.
36
West, Matthew. "“Footprints for Life” foot health of Aboriginal and Torres Strait Islander Peoples." Thesis, 2021. http://hdl.handle.net/1959.13/1445698.
Full textAbstract:
Research Doctorate - Doctor of Philosophy (Phd)The limited available data shows Aboriginal and Torres Strait Islander Peoples have disproportionately high rates of diabetes-related foot disease, and experience amputation up to 38 times more frequently than non-Indigenous Australians. The high rate of diabetes-related foot disease in this population results in reduced quality of life, elevated hospitalisation rates and associated expenditure, and significantly contributes to preventable deaths. The reasons for higher rates of diabetes-related foot disease in Aboriginal and Torres Strait Islander Peoples are complex, with a lack of available culturally safe care, low socioeconomic status and poor engagement with Western health services significantly contributing to the current catastrophic outcomes. To effectively address diabetes-related foot disease in Aboriginal and Torres Strait Islander Peoples, a better understanding of the extent of the problem is required, and, there needs to be improved access to culturally safe foot care through better service provision and a more culturally capable health workforce. This thesis had the overarching aims of establishing the foot health of Aboriginal and Torres Strait Islander Peoples in the local Central Coast community, and developing methods to improve access to, and delivery of, culturally safe foot care. This thesis investigated, via systematic review, the current state of diabetes-related foot disease in Aboriginal and Torres Strait Islander Peoples and the availability and effectiveness of foot care services to reduce diabetes-related foot complications in this population. The reviews demonstrated there is a lack of nationwide data relating to diabetes-related foot disease in Aboriginal and Torres Strait Islander Peoples, and, that most data focuses on amputation rates, with little information available regarding specific types of diabetes-related foot complications. Nevertheless we found Aboriginal and Torres Strait Islander Peoples had between a 3 to 6 fold increased likelihood of both foot ulcer and minor or major amputation, and, that these occurred at a younger age. Furthermore, we found no evidence of state- or nation-wide foot health programs for prevention of diabetes-related foot disease in Aboriginal and Torres Strait Islander Peoples. Existing services were localised and there was little evaluation of the acceptability of these programs, levels of community engagement or impact on foot disease. Subsequently through an extensive community consultation process we used an effective co-design approach to develop a foot care service embedded in an undergraduate podiatry program. Key design elements included; integrating ongoing community consultation; involvement of Aboriginal health workers and practitioners connected to their local community; recognising the role of community in cultural capability training of health students; and, creating a flexible and accessible care model that is aligned with the community foot care priorities. To conduct a comprehensive evaluation of the foot care service model, we used culturally appropriate methods to determine the Aboriginal and Torres Strait Islander perspective of program success through research yarns and customised surveys, as well as service utilisation data. These data demonstrated that service elements including yarning circles and group appointments, as well as student placements, increased participant engagement with, and ownership of the clinic. Increasing accessibility to the clinic was flagged as a mechanism to further increase engagement. In addition, student placement in a culturally safe clinic significantly improved students’ understanding of multiple aspects of cultural capability (e.g. understanding of culture, history, and their interrelationship with health and health care delivery), and level of confidence with providing culturally appropriate and safe foot care. In summary this research highlights the devastating impact of diabetes-related foot disease for Aboriginal and Torres Strait Islander people and the importance of a co-designed approach to delivery of culturally safe foot health care, as well as the central role of immersive experiences for developing a culturally safe future podiatry workforce.
37
Wang, Sun-Lin, and 王秀玲. "The Relationship of Betel Quid Abuse and Oral Diseases in Aborigines and Non-Aborigines in Taitung County." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/55320043758353954780.
Full textAbstract:
碩士高雄醫學大學
口腔衛生科學碩士在職專班
92
Background Because of its unique cultural background, we consider Taitung County as the most typical area, where serious betel quid abuses were found, for us to do research and took samples. Nowadays, among the aboriginal tribes in Taitung, people are facing mental, physical, social family and career problems caused by betel quid, alcohol and nicotine abuses. Researches about the effects of chewing betel quid were mostly talking about the epidemiology、morbific stratovision、genetic determinant and cytopathic pre-cancer of oral cancer, however, they seldom showed the caries disease easily found on betel quid abusers. Purposes The main purpose of this research aimed at the abusing situation between aborigine and non-aborigine citizens of Taitung; secondly, the condition of drinking and smoking habits of the betel quid abusers, and the possible causes of oral diseases among the aborigine and non-aborigine betel quid abusers of Taitung. Methods 172 residents, including 92 aborigines (54.07%) and non-aborigines (45.93%), 49% male and 51% female, older than 18, were the objects of our research. We applied the MS Access to set up files and JMP to analyze the information. Results We found that 67% of betel quid abusers were above 50 years old, 49% were non-educated, they had started chewing mostly before 20 years old, and kept this habit for more than 20 years. 38.46% of aborigines had the habits of chewing betel quid and smoking, 48.15% with drinking habit; 47.62% betel quid abusers had the habit of smoking and 28.57% abusers had drinking habit. According to the research of the substance abuse module, we found that the age of the abusers was decreased, but the number of people was rising up. we also noticed that the CPI and oral health index had positive correlation with the habit of chewing betel quid . The CPI and LOA of the abusers were increasing, depending on the state of chewing. According to the higher rate of caries filling of non-abusers, we found that the habit of oral health of the abusers was getting worse. Conclusion To sum up, the rate of drinking, smoking and betel quid abusing of aborigines is higher than that of the non-aborigines; and the index of oral health of the non-aborigines is higher than aborigines; therefore, In order to promote the betel quid abuse, we should enhance the resident area of the aborigines on advertising the harm of betel quid abuse, and teach them the ways of getting rid of it. Key word：Aboriginal，non- aboriginal，betel abuse，dental disease
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Pan, Erh-Chieh, and 潘爾捷. "An Investigation of the Association betweenStress Coping and Periodontal DiseaseIn Aboriginal Communities." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/56828008369330394538.
Full textAbstract:
碩士高雄醫學大學
口腔衛生科學研究所碩士在職專班
94
ABSTRACT Background: In recent years, health problems encountered by Taiwanese aboriginal people have become an important issue Taiwan. In general, aboriginal people undertook worse medical care conditions and social economic status. Therefore, aboriginal people confront considerable difficulties in adapting to the occupation and daily life. Various stresses cause physiological and psychological changes, which may lead to disease development. Periodontal diseases are common oral diseases in adults. As a result, it is important that whether the aboriginal people have periodontal diseases which are more serious than those affected by people not applying stress copings. Objectives: The purposes of this study included: 1) to investigate the current situation of mental health and stress coping; 2) to investigate the current situation of the periodontal diseases; 3) to explore the relationship between stress coping and mental health with periodontal diseases in aboriginal people. Methods: This study used the aboriginal data from the “Oral Health Survey for Adults and Senior Citizens in Taiwan, 2003-3005”. The study design was a stratified multi-stage cluster samplings. The aboriginal areas included northern (covering western mountain townships from north of Chiayi County), southern (covering mountain townships in Kaohsiung and Pingtung Counties) and eastern mountain townships (covering mountain townships in Hualien and Taitung Counties). Mental problems, stress coping, and so on were measured by Chinese Health Questionnaire (CHQ-12). Community periodontal index (CPI) and periodontal loss of attachment (LOA) were assessed by oral examination. Results: The logistic regression analysis showed that the probability of the occurrence of mental health problems of women was 1.65 times (p=0.1609) than that of men (CHQ≧3). Moreover, the decrease of salary correlated significantly with the abnormal increase of smoking, drinking and betel chewing. Besides, the probability of the occurrence of periodontal diseases aboriginal people with aged 35-49 was 3.89 times than that of those aged 18-34 (p=0.0031). And the probability of the occurrence of periodontal diseases of aboriginal people aged 50-64 was 6.52 times than that of those aged 18-34 (p=0.0282). Nevertheless, there was no statistical significance after mental health factors and the stress coping strategies were adjusted. Age correlated positively with periodontal attachment loss, whose probability of occurrence was 9.42 times in those aged 50-64 compared with that of those aged than (p=0.0038) and 17.46 times in those aged over 65 compared with those aged 18-34 (p=0.0026). The increase of betel chewing correlated positively and significantly with periodontal attachment loss after mental health factors were adjusted (OR=4.66, p=0.0028). Conclusions: It was found in this study that the periodontal diseases of aboriginal people significantly correlated with age and social-economic status (income). But there was no statistical significance regarding habits of betel quid chewing, cigarette smoking and alcohol drinking as well as mental health. However, it was found that age and periodontal attachment loss correlated positively and significantly with the increase of betel quid chewed when stress was encountered. Keywords: stress coping, aborigine, periodontal diseases, Chinese Health Questionnaire
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Arnold, Anna-Lena. "Applied Epidemiology in Aboriginal and Torres Strait Islander Health." Master's thesis, 2016. http://hdl.handle.net/1885/110475.
Full textAbstract:
My placement for the Master of Philosophy in Applied Epidemiology (MAE) degree was with the Evidence and Evaluation section, within the Indigenous Health Division, Australian Government Department of Health. In this thesis, I present projects undertaken which fulfil the requirements of the MAE program. Data analysis project: The Northern Territory Aboriginal Health Key Performance Indicators (NT AHKPIs) are a collection of key performance indicators that measure primary health care (PHC) performance. I conducted a descriptive analytical study of the NT AHKPIs. The data that inform the NT AHKPIs are not currently in the public domain, this chapter is therefore a closed chapter. Evaluation project: I evaluated the NT AHKPIs to assess the extent to which the NT AHKPIs are addressing their intended goals and to determine whether they were being used for other purposes; my approach to the evaluation was utilisation focused. Preliminary findings show that the KPIs are useful to inform service planning and continuous quality improvement, but there is room for improvement. Findings were reported back to the NT AHKPI steering committee to inform ongoing strengthening of the NT AHKPI system. Epidemiological study: Anaemia in Aboriginal and Torres Strait Islander children in the NT is a public health problem. I undertook a study to describe the application of best practice guidelines for screening and management of children aged 6 months to 3 years with anaemia in the NT. Findings show that of 5,543 children, 63% were screened for anaemia. The prevalence of anaemia was 40% - a ‘severe’ public health problem as defined by the World Health Organisation (WHO). A very low proportion of anaemic children were recorded as treated according to best practice guidelines, however, our findings are subject to multiple potential biases and these findings need to be validated. Outbreak investigation: I was a member of the Communicable Disease Network Australia team that investigated an unusual cluster of Ralstonia bacteraemia from 1 April to 26 June 2014 in three states in Australia. The objectives of this investigation were to assess the possibility of a causal association between the administration of propofol and Ralstonia bacteraemia, and to identify sources of the infections. The propofol solution passed all sterility and contamination tests, but 18% of the flip-off caps and external surfaces of the rubber stoppers were contaminated with a variety of bacterial species including R. mannitolylitica. These isolates were genetically indistinguishable from three out of eight isolates from patients with R. mannitolylitica bacteraemia. Findings from this study highlighted the need for proper aseptic techniques when administering intravenous injections. I spent ten weeks in Sierra Leone supporting the WHO’s response to the Ebola virus disease outbreak (EVD). I summarise my role and responsibilities in the outbreak, including a description of our investigation of a cluster of cases with EVD.
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Teng-Chi, Yang, and 楊登琦. "A Study on Alcohol Drinking Related Liver Diseases and Gout in HuaLien Aborigines." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/66423805009012794834.
Full textAbstract:
碩士長庚大學
醫務管理學研究所
93
Epidemiological studies have revealed that the aborigines usually have more health problems than non- aborigines. From the analyses of disease prevalence and mortality rate of aborigines in Hualian Mountain- County, we found that they have serious health problems such as alcohol drinking, chronic liver diseases, liver cirrhosis and gout. The purpose of this study is to investigate the prevalence of chronic hepatic disorders, liver cirrhosis, and gout, and their relationship with alcohol drinking in adult aborigines (age above 20 years old) in two Hualian Mountain-County. This is a cross-sectional design collecting exposure and disease data retrospectively. A total of 1163 subjects were recruited in 1999. These data were collected through a detailed questionnaire survey, boold tests, and abdominal sonography, to evaluate the relationship among drinking habits, basic characteristics of individuals, and health conditions. The results of statistical analyses have demonstrated that the prevalence rates of alcohol drinking anong abnormal were 58.47%. They are correlated with different genders, ages, insurances, races, degrees of education, marriage status. The higher risk groups were found in males, from 35 to 49, junior high school/ high school education, without insurance, and without marriage. The prevalence rates of liver desfunctions and gout were 38.95% and 42.99%, respectively. They are greatly related with alcohol drinking habits, and so as to quantity and frequency of alcohol consumption. Concerning liver dysfunctions,the factors are genders, ages, insurances, races, hepatitis B surface antigen (HBsAg) infection, hepatitis C virus (HCV) infection, alcohol intake amount. To analyze the interact effects alcohol drinking, hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) infection to the occurrence of liver dysfunction, we found that the odds ratio of liver dysfunction was higher in hepatitis B surface antigen (HBsAg) than those who are non-carriers. The odds ratio of liver dysfunction for those who were hepatitis C virus (HCV) infected was 6.11 to 3.66 times higher than those who were not infected. The factors related to gout were genders, races, hepatitis C virus (HCV) infection, alcohol consumption. We found that the odds ratio of gout for alcohol consumption over 1000c.c is 1.63 times higher than those who are not. We found that the odds ratio of gout for hepatitis B surface antigen (HBsAg) infection was 1.35 times higher than those who are not. The odds ratio of gout for hepatitis C virus (HCV) infection was 1.78 to 3.07 times higher than those who were not infected. In conclusion, we found the prevalence rates of selected diseases anong aborigines were higher than non-aborigines. The health problems encounted in future public health works a alcohol drinking, chronic liver diseases, liver cirrhosis, and gout. The intervention on alcohol drinking behavior among aboriginals is a major concern of future health programs.
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Yeh, Lien-Chin, and 葉聯璟. "Genetic Disease Studies of Orchid Tao Aborigines-Molecular enzymatic studies of homocystinuria." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/4p369v.
Full textAbstract:
碩士中原大學
生物科技研究所
98
Homocystinuria due to cystathionine beta-synthase (CBS) deficiency is an autosomal recessive disorder of methionine metabolism that produces increased levels of urinary homocysteine and methionine. Human CBS is a heme protein that catalyzes the condensation of serine and homocysteine to form cystathionine in a pyridoxal phosphate-dependent reaction. Missense mutations in the CBS gene are the most common causes of clinical homocystinuria in humans. The D47E mutation was identified in a homocystinuric patient from Orchid Tao Aborigines. To understand how this mutation causes disease in human, we used Epstein-Barr virus (EBV) Transformed Human B Lymphocyte cell lines: heterozygote mutant (+/-), homozygote mutant (-/-) and wild type (+/+). First we performed the D47E gene RFLP using restriction enzymes Alu I and Sfan I to cleave the amplified DNA fragments and run the electrophoresis to distinguish between mutant and normal cell lines. After confirmation of the genotype of these cell lines, we want to know how the D47E mutant affects the CBS protein expression levels. Based on RT-PCR analysis, wild type mRNA levels were higher compared with the mutant cell lines. Next we performed the Western Blot to observe the CBS protein expression levels to confirm the results obtained from RT-PCR. D47E mutant cause protein misfolding determined by Native-PAGE. Finally we want to know if D47E mutant residue is important for structural and functional integrity of CBS enzyme as well as its activity. This biochemical characterization of the D47E mutant could be addressed for further insights into structure-function correlations in CBS.
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Cormick, Alyssa. "Health Journey Mapping to Identify Strength and Resilience as experienced by an Aboriginal Woman with Kidney Disease." Thesis, 2021. https://hdl.handle.net/2440/133191.
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This item is only available electronically.The narrative told about Aboriginal and Torres Strait Islander peoples’ health often focuses on ill health, with large gaps in measured health outcomes between First Nations and non-Indigenous Australians. For chronic kidney disease, it is estimated that the burden of disease for First Nations peoples is seven times greater that of non-Indigenous Australians. However, First Nations definitions of health are not purely biomedical focusing on illness and disease. They are instead inclusive of all aspects of an individual’s lived experience, including their connection to body, mind, spirit, community, family, culture, and land. Using a Western scientific lens to examine the health of First Nations peoples further colonises their experiences and fails to portray their lived reality. Research can employ a narrow approach when identifying the lived experiences of First Nations, however decolonised research methods offer new approaches to hearing their untold stories. This project was conducted collaboratively with a female member of the Aboriginal Kidney care together: improving outcomes now (AKction) Reference Group, to map and identify how she thrived in her journey despite having kidney disease. Research yarning, a culturally appropriate research method, and thematic analysis were conducted with her collaboration to answer how she demonstrated strength and resilience throughout her journey. Findings highlighted that her kidney health journey was complex, with kidney health forming only one aspect of her journey. The participant demonstrated resilience while facing complex challenges, using her connections, actions, and mindset to thrive and not just survive her journey.
Thesis (B.PsychSc(Hons)) -- University of Adelaide, School of Psychology, 2021
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Jayakody, Amanda A. "Reducing high rates of unplanned hospital readmissions among Aboriginal and Torres Strait Islander people with chronic disease." Thesis, 2020. http://hdl.handle.net/1959.13/1439011.
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Research Doctorate - Doctor of Philosophy (PhD)Aboriginal and Torres Strait Islander people, hereinafter respectfully referred to as Aboriginal people, a have a rich heritage and diverse cultures. They have a strong connection to their community and country. However, Aboriginal people have suffered long-lasting effects from colonisation, dispossession of land and racism with devasting impacts, particularly for health outcomes. In Australia, Aboriginal people have up to three-fold higher rates of chronic disease compared to non-Aboriginal people. Given the high risk of frequent avoidable admissions and unplanned hospital readmissions for people with chronic diseases, it is not surprising that Aboriginal people also have higher rates of these types of hospitalisations compared to non-Aboriginal people. High rates of avoidable admissions and unplanned readmissions reflect sub-optimal community healthcare and poor hospital care. However, little research has explored these types of potentially unnecessary hospitalisations for Aboriginal people with chronic disease in Australia’s most populous state of New South Wales (NSW). This thesis explores frequent avoidable admissions and unplanned readmissions among Aboriginal people by focusing on three key aims. The first was to examine the prevalence and trends of frequent avoidable admissions and unplanned readmissions of Aboriginal and non-Aboriginal people residing in NSW, utilising linked hospital administrative data. International research examining the factors associated with unplanned readmissions in general populations indicate the importance of factors such as chronic disease management, a regular general practitioner, good health literacy and medication adherence. Therefore, the second aim of this thesis was to identify perceptions of Aboriginal people regarding potential contributors to chronic-disease-related unplanned readmissions. In-depth interviews were conducted with a sample of Aboriginal people who had been readmitted to hospital. Telephone follow-up has been used alongside other intervention components, such as tailored discharge planning and patient education, with the aim of reducing unplanned readmissions in surgical and general medicine patients. The final aim of this thesis was to examine the potential impact of telephone follow-up in reducing unplanned readmissions rates for patients with chronic disease. This involved a systematic review of the research literature on the impact of telephone follow-up, and an evaluation of a program utilising telephone follow-up for Aboriginal people. The implications of the findings of this work are discussed in relation to hospital and community health service practices and state-wide data monitoring. Further explorative research and a community-led multicomponent telephone follow-up enhancement intervention are proposed.
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Hays, Russell John. "Helminth infection and metabolic disease: Strongyloides stercoralis infection and type 2 diabetes mellitus in an Aboriginal community." Thesis, 2018. https://researchonline.jcu.edu.au/55994/1/JCU_55994-hays-2018-thesis.pdf.
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Recent years have seen an upsurge in interest in the relationship between helminth infections and metabolic diseases such as insulin resistance and type 2 diabetes mellitus (T2DM). Limited clinical and laboratory studies have suggested that chronic helminth infections may protect against the development of T2DM, and have suggested an immunometabolic mechanism for such an effect.
Aims: This thesis seeks to examine the relationship between Strongyloides stercoralis infection and T2DM in an Australian Aboriginal community, and to examine the importance of this relationship in the context of efforts to treat and control this infection.
Methods: The thesis reports on a cross sectional observational study of adults attending the health centres in an Aboriginal community, testing them for both strongyloides infection and T2DM, and establishing the nature of the relationship between these two conditions. A cohort of infected and un-infected subjects is thereby established and followed over a three-year period, enabling characterization of both the treatment outcomes for this infection at 6 months and three years in the context of T2DM, and the effects that treatment for strongyloides has on subsequent metabolic parameters. In addition, the relationship between S. stercoralis infection, T2DM and eosinophilia is examined, and limited studies into the cytokine responses in treated individuals are performed
Results: The study demonstrates a strong negative association between pre-existing S. stercoralis infection and T2DM. It shows T2DM is a predictor of treatment failure for S. stercoralis at 6 months, and demonstrates that eosinophilia is not a reliable predictor of S stercoralis infection in this community, but is a more constant finding in those patients with S. stercoralis and T2DM. The three-year follow up shows that ivermectin is an extremely effective treatment for S. stercoralis infection in this community, and demonstrates that treatment of S. stercoralis infection is associated with an increased risk of developing T2DM and impaired glucose tolerance when compared to an uninfected and untreated group.
Conclusions: The thesis provides evidence to support a protective effect for S. stercoralis infection against T2DM and suggests an immunometabolic model to explain the negative association which has been found. These findings are discussed in the context of ongoing efforts to control and eliminate strongyloides infection in Australian Aboriginal communities.
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Liu, Juan. "Metabolic syndrome in Aboriginal Canadians: Prevalence, determinants, association with cardiovascular disease risk factors, and comparison of diagnostic criteria." 2006. http://link.library.utoronto.ca/eir/EIRdetail.cfm?Resources__ID=442240&T=F.
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Carr, Jennifer Justine. "Walking and moving around for Aboriginal families with Machado-Joseph disease living in the Top End of Australia." Thesis, 2020. https://researchonline.jcu.edu.au/76809/1/JCU_76809_Carr_2020_thesis.pdf.
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Jennifer Carr worked with Aboriginal families with Machado-Joseph disease (MJD) in the Top End of Australia to co-design and pilot a physical activity and lifestyle program. The 'Staying Strong Toolbox' program significantly improved mobility, ataxia and quality of life, will be implemented in Australia and shared with families with MJD worldwide.
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Harper, Sherilee Lynn. "WEATHER, WATER, AND INFECTIOUS GASTROINTESTINAL ILLNESS IN THE CONTEXT OF CLIMATE CHANGE IN NUNATSIAVUT, CANADA." Thesis, 2009. http://hdl.handle.net/10214/2023.
Full textAbstract:
Climate change is expected to cause changes in precipitation and runoff patterns, likely increasing the risk of waterborne infectious disease in some areas. In this context, the research objectives were to describe links between weather, water quality, and infectious gastrointestinal illnesses (IGI) in Nunatsiavut, Canada, which necessarily involved evaluating the quality and usefulness of data captured by the local health registry system.
For this evaluation, IGI was used as a reference syndrome. Community-based meteorological stations captured weather data; trained local personnel conducted water quality testing. Clinic records provided IGI-related data (2005-2008). This study is the first to systematically gather and describe baseline empirical data on weather, water quality, and health in Nunatsiavut. It showed the necessity of improving Inuit health data quality and monitoring environmental health variables consistently and systematically across all Arctic regions. These data are critical to inform adaptation strategies for managing impacts of climate change on health.
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Rémond, Marc Gerard Wootton. "Informing the prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease in Aboriginal Australian and Torres Strait Islander populations." Thesis, 2014. https://researchonline.jcu.edu.au/42251/1/42251-remond-2014-thesis.pdf.
Full textAbstract:
Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are auto-immune conditions associated with prior exposure to Group A streptococcus (GAS). ARF is an acute condition associated with fever and joint, brain, skin and heart inflammation. RHD is its chronic sequela and is characterised by permanent heart valve damage which can, in turn, lead to heart failure and an increased risk of endocarditis and stroke. To avoid such complications interventions may be required to repair or replace damaged valves.
ARF and RHD are preventable diseases rarely encountered in mainstream Australia. However, Aboriginal Australian and Torres Strait Islander peoples have amongst the highest reported rates of ARF/RHD in the world with significant morbidity and mortality.
This thesis comprises complementary projects and articles that can inform the community and health service response to prevention, diagnosis and management of ARF/RHD with a particular focus on Indigenous Australians.
Prevention: Three systematic reviews are presented that examine strategies to improve primary and secondary prevention of ARF/RHD. High quality studies are often lacking and much of the evidence informing strategies to prevent ARF/RHD is limited or absent. Available evidence indicates primordial prevention via improvements in social, economic and environmental conditions is key. While primary prevention may be achieved through improved diagnosis and early treatment of GAS pharyngitis, implementation can be difficult and research into the development of a GAS vaccine remains crucial.
Effective secondary prevention of ARF/RHD is possible with long-acting benzathine penicillin (LAB). Nonetheless, delivery of LAB is highly variable and frequently poor. Further work is needed to enhance health care systems to maximize uptake of LAB and to identify more effective formulations or delivery devices for administration.
Diagnosis: The utility of screening for RHD via echocardiography (heart ultrasound) to detect early disease is topical as this may facilitate early administration of secondary prophylaxis thereby limiting disease progression. A review of the feasibility of implementing RHD screening in Australia is presented and a number of limiting factors are highlighted. These include a lack of an agreed case definition and a limited understanding of the significance, natural history and potential treatment of early and subclinical RHD. Further, the delivery of secondary prevention is often suboptimal and the impact of additional cases on health services, and the psychosocial health of patients and families, can be substantial.
The refinement of a screening-based case definition for RHD, and particularly the significance of minor heart valve abnormalities, was informed by the Rheumatic Fever Follow-up Study (RhFFUS). Children with prior Borderline RHD (defined under World Heart Federation (WHF) criteria) were up to nine times more likely to experience ARF compared with children with a normal echocardiogram. Their risk of having progressive valve damage was also significantly greater and 1 in 6 developed Definite RHD. In contrast, children with less severe valve abnormalities not satisfying criteria for Borderline RHD were at no greater risk of ARF or echocardiographic progression of valvular lesions.
These results provide cogent evidence that, in some children, valvular changes consistent with Borderline RHD detected on screening echocardiograms represent the earliest stage of Definite RHD. Such children may benefit from secondary prophylaxis or enhanced surveillance through regular echocardiographic monitoring to assess for progression of disease. Moreover, these results lend support to the validity of WHF criteria that distinguish Borderline RHD from other minor echocardiographic changes, as it is only in the former group that there is a greater risk of ARF and valvular lesion progression. Nonetheless, the fact that individuals with minor echocardiographic changes not satisfying criteria for Borderline RHD still had an increased risk of developing Definite RHD suggests that such individuals should be initially monitored with echocardiography to ensure they do not progress.
Management: The final component of this thesis comprises two papers that describe projects that were undertaken to inform potential improvements in the management of ARF/RHD. The first compared the quality of care provided to patients in the Kimberley and far north Queensland where differing models of care were operating. This highlighted more severe disease in the Kimberley and greater specialist follow-up and prescription and receipt of secondary prophylaxis in far north Queensland. This supported an association between far north Queensland's single-provider model of care and centralised RHD control programme and improved patient care, potentially fewer cases of severe disease, and reduced need for surgical and other interventions. Since this study was completed, a centralized RHD control and management programme has been implemented in the Kimberley.
The second project related to the use of prophylactic antibiotics to prevent bacteremia, and potentially infective endocarditis (IE), in patients with RHD undergoing high-risk procedures. While this is recommended for Indigenous patients with RHD under Australian guidelines, American guidelines were recently amended to recommend prophylaxis only in people with prosthetic valves and not in those with "native-valve" RHD. A review of infective endocarditis cases in northern Australia was undertaken to determine whether native valve RHD was associated with an increased risk of IE. Results of this study showed that those with native valve RHD were at increased risk of IE (RR 58) compared to individuals without native valve RHD. Interestingly, the risk of IE in non-Indigenous patients with RHD was found to be 3.7 times higher than in Indigenous Australians with RHD. This study led to recommendations to broaden current Australian guidelines so as to offer prophylactic antibiotics to all persons with RHD undergoing procedures associated with a high risk of bacteraemia.
In conclusion, this thesis provides a number of new insights to address existing knowledge gaps regarding prevention, diagnosis and management of ARF/RHD. It is hoped that continued work on developing a GAS vaccine will eventually deliver an effective and safe method of primary prevention. In the interim the continued focus on early and accurate diagnosis of ARF/RHD and best-practice management (particularly improving uptake of secondary prophylaxis) should be pursued. Overarching these health initiatives must be a commitment to improving the socioeconomic and environmental status of Aboriginal Australian and Torres Strait Islander peoples living in remote communities as a means of effecting ARF/RHD primordial prevention.
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Hsu, Chin-Ping, and 徐菁苹. "Disease Cognition and Heal Behavior for Aborigines in Taiwan : In the Case of Atayal Tribe in Fushing Township of Taoyuan County." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/41575773662283709362.
Full textAbstract:
碩士元智大學
資訊社會學研究所
95
Over the years in the health status of the aboriginal people, including average life expectancy, mortality, health indicators, such as the incidence of major diseases, the aboriginal people in Taiwan were more vulnerable. The health issue of the aboriginal people catches more attention in recent years. Even though, not only the problems of unequal distribution of medical resources are unsolved, but it is also important a cultural-blinded health strategy is addressed. An fully understanding of aboriginal culture is important, thus we be able to establish a culture-friendly policy for aboriginal health education and medical systems. The purpose of this study is based on exploring the values of the aboriginal origins, regarding health and diseases. We will also look into how they explain and deal with diseases. It will provide us with a understanding of how we could approach in the future health education for the aboriginal people. Using a snowball sampling method,the data gathering method for this study is in-depth interviews. Two informers helped us to get in touch with the Atayal tribe as well as to act as interpreters. One of them is a health care worker of the Fushing Village while the other is a resident living in the Fushing village. Under their introduction, we had interviewed 22 aboriginal people belong to the Ayatal tribe in Fushing Village. Our questions include their views toward health and disease, how they explain and deal with disease, their views on the medical system of Taiwan as well as their trust on the system. Major findings are as follows : 1. The Atayal tribe believes that the disease is a part of the natural cycle of life. Therefore, when people is ill, they do not try to get rid of disease from life, but try to regard it as part of the life cycle. 2. For the Atayal people, “feeling of pain” is a cru signal for them to look for medical help. 3. To the Atayal people, mental health is the basic element of healthy people. 4. The Atayal people explain the reason for diseases which come from four factors - psychological, cultural, biological as well as environmental factors. 5. Western medicine system is the major approach for the Atayal people to acute diseases. 6. In early stages of disease, Atayal people will not take immediate action to seek medical help. They will resolve by self-recovery approach, using their willpower to let the body recover by itself.
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Shephard, Mark Douglas Samuel. "The development and application of point-of-care pathology testing (POCT) models for the early detection and management of diabetes and renal disease in indigenous medical services." 2007. http://hdl.handle.net/2440/57428.
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Title page, table of contents and abstract only. The complete thesis in print form is available from the University of Adelaide Library.The key research question examined in this thesis was: Could POCT ( point-of-care pathology testing) models that were analytically sound and clinically and culturally effective be established in Australian Indigenous medical services for the prevention and management of diabetes and renal disease? The systematic approach to answer this overarching research question included the scientific validation of the analytical performance of suitable point-of-care (POC) devices, the development of a culturally appropriate education and training program for Aboriginal Health Workers (and nurses) as POCT operators, the implementation of a quality management framework for maintaining surveillance of the analytical quality of POCT results, and an assessment of qualitative and quantitative research outcomes to determine the clinical and cultural effectiveness of POCT.
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Thesis (Ph.D.) -- University of Adelaide, School of Population Health and Clinical Practice, 2007