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McCullough K, Doleman G, Dunham M, Whitehead L, Porock D. Are remote health clinics primary health care focused? Validation of the Primary Health Care Engagement (PHCE) Scale for the Australian remote primary health care setting. Prim Health Care Res Dev 2024; 25:e3. [PMID: 38179608 PMCID: PMC10790365 DOI: 10.1017/s1463423623000592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/02/2023] [Indexed: 01/06/2024] Open
Abstract
AIM To test and validate a measure of primary health care (PHC) engagement in the Australian remote health context. BACKGROUND PHC principles include quality improvement, community participation and orientation of health care, patient-centred continuity of care, accessibility, and interdisciplinary collaboration. Measuring the alignment of services with the principles of PHC provides a method of evaluating the quality of care in community settings. METHODS A two-stage design of initial content and face validity evaluation by a panel of experts and then pilot-testing the instrument via survey methods was conducted. Twelve experts from clinical, education, management and research roles within the remote health setting evaluated each item in the original instrument. Panel members evaluated the representativeness and clarity of each item for face and content validity. Qualitative responses were also collected and included suggestions for changes to item wording. The modified tool was pilot-tested with 47 remote area nurses. Internal consistency reliability of the Australian Primary Health Care Engagement scale was evaluated using Cronbach's alpha. Construct validity of the Australian scale was evaluated using exploratory factor analysis and principal component analysis. FINDINGS Modifications to suit the Australian context were made to 8 of the 28 original items. This modified instrument was pilot-tested with 47 complete responses. Overall, the scale showed high internal consistency reliability. The subscale constructs 'Quality improvement', 'Accessibility-availability' and 'population orientation' showed low levels of internal consistency reliability. However, the mean inter-item correlation was 0.31, 0.26 and 0.31, respectively, which are in the recommended range of 0.15 to 0.50 and indicate that the items are correlated and are measuring the same construct. The Australian PHCE scale is recommended as a tool for the evaluation of health services. Further testing on a larger sample may provide clarity over some items which may be open to interpretation.
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Affiliation(s)
- Kylie McCullough
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Perth, Western Australia
| | - Gemma Doleman
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Perth, Western Australia
| | - Melissa Dunham
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Perth, Western Australia
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Perth, Western Australia
| | - Davina Porock
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Perth, Western Australia
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Welford A, McCallum GB, Hodson M, Johnston H. Physiotherapy management of first nations children with bronchiectasis from remote top end communities of the northern territory: a retrospective chart audit. Front Pediatr 2023; 11:1230474. [PMID: 37900672 PMCID: PMC10613054 DOI: 10.3389/fped.2023.1230474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/15/2023] [Indexed: 10/31/2023] Open
Abstract
Background Bronchiectasis is a chronic pulmonary disorder which is prevalent among Australian First Nations people in the Northern Territory (NT). Current guidelines recommend physiotherapy as part of multi-disciplinary management of children with bronchiectasis, however in our setting, involvement of physiotherapy remains unknown. We thus undertook a retrospective chart audit to examine physiotherapy management of First Nations children (<18 years) from remote First Nations communities in the Top End of the NT at the index bronchiectasis diagnosis and 12 months following diagnosis. Methods Participants were identified from a larger prospective study of children investigated for bronchiectasis at Royal Darwin Hospital, NT (2007-2016). Children were included if they were First Nations, aged <18 years, had a radiological diagnosis of bronchiectasis on high resolution computed tomography scan and lived in a remote community serviced by NT Government health clinics. The medical records from NT Government hospitals, health clinics and where possible other medical service attendance were reviewed for physiotherapy referral and management at the time of bronchiectasis diagnosis and in the following 12 months in the community. Results Of 143 children included, the mean age was 3.1 (standard deviation 2.4) years and 84 (58.7%) were males. At the index diagnosis, 76/122 (62.3%) children were reviewed by a physiotherapist, consisting of airway clearance techniques (83.8%), physical activity/exercise (81.7%) and caregiver education (83.3%), with only 7/127 (5.5%) having evidence of referral for community-based physiotherapy. In the following 12 months, only 11/143 (7.7%) children were reviewed by a physiotherapist, consisting of airway clearance techniques (54.5%), physical activity/exercise (45.5%) and caregiver education (36.4%). Conclusion This study demonstrates a significant gap in the provision of physiotherapy services in our setting and the need to develop a standardized pathway, to support the best practice management of children with bronchiectasis in remote Top End communities of the NT.
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Affiliation(s)
- A Welford
- Community Allied Health Team, Top End Population and Primary Healthcare, NT Health, Darwin, NT, Australia
| | - GB McCallum
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - M Hodson
- Community Allied Health Team, Top End Population and Primary Healthcare, NT Health, Darwin, NT, Australia
| | - H Johnston
- Community Allied Health Team, Top End Population and Primary Healthcare, NT Health, Darwin, NT, Australia
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van Burgel E, Holden S, Ferguson M, Cullerton K, McCartan J, Turner N, Cubillo B, Day G, Brimblecombe J. Food security in Aboriginal and Torres Strait Islander communities in remote Australia during the COVID-19 pandemic: An analysis of print news media and press releases. Aust N Z J Public Health 2023; 47:100058. [PMID: 37201415 DOI: 10.1016/j.anzjph.2023.100058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/27/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVE This article aims to examine the framing of the issue of food security in very remote Aboriginal and Torres Strait Islander communities in print media and press releases during the beginning of the COVID-19 pandemic in 2020. METHODS Newspaper articles were identified following a systematic search of the Factiva database, and press releases were identified from manual search of key stakeholder websites from January to June 2020 and analysed using a combined adapted framework of the Bacchi's What's the Problem Represented to be? Framework and the Narrative Policy Framework. RESULTS A food delivery "problem" dominated representations in press releases, and food supply at store level had prominence in print media. Both presented the cause of food insecurity as a singular, identifiable point in time, framed the issue as one of helplessness and lack of control, and proposed policy action. CONCLUSIONS The issue of food security was represented in the media as a simple issue requiring an immediate fix, as opposed to a complex issue requiring a systems-level and sustained policy response. IMPLICATIONS FOR PUBLIC HEALTH This study will help to guide future media dialogue to impact on both immediate and longer-term solutions to food insecurity in very remote Aboriginal and Torres Strait Islander communities in Australia.
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Affiliation(s)
- Emma van Burgel
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia.
| | - Stacey Holden
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia.
| | - Megan Ferguson
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia; School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
| | - Katherine Cullerton
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
| | - Julia McCartan
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia.
| | - Nicole Turner
- Indigenous Allied Health Australia, Deakin, ACT, Australia; NSW Rural Doctors Network, Sydney, NSW, Australia.
| | - Beau Cubillo
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia.
| | - Georgia Day
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia.
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia; Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia.
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Abraão LM, Fortaleza CMCB, Camargo CH, Barbosa TA, Pereira-Franchi EPL, Riboli DFM, Hubinger L, Bonesso MF, Medeiros de Souza R, Ribeiro de Souza da Cunha MDL. Staphylococcus aureus and CA-MRSA Carriage among Brazilian Indians Living in Peri-Urban Areas and Remote Communities. Antibiotics (Basel) 2023; 12:antibiotics12050862. [PMID: 37237765 DOI: 10.3390/antibiotics12050862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
The emergence of Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections among indigenous populations has been reported. Usually, indigenous communities live in extreme poverty and are at risk of acquiring infections. In Brazil, healthcare inequality is observed in this population. To date, there are no reports of CA-MRSA infections, and no active search for asymptomatic S. aureus carriage has been conducted among Brazilian Indians. The aim of this study was to investigate the prevalence of colonization with S. aureus and CA-MRSA among Brazilian Indians. We screened 400 Indians (from near urban areas and remote hamlets) for S. aureus and CA-MRSA colonization. The isolates were submitted to clonal profiling by pulsed-field gel electrophoresis (PFGE), and selected isolates were submitted to multilocus sequence typing (MLST). Among 931 specimens (nasal and oral) from different indigenous individuals in remote hamlets, S. aureus was cultured in 190 (47.6%). Furthermore, CA-MRSA was found in three isolates (0.7%), all SCCmec type IV. PFGE analysis identified 21 clusters among the S. aureus isolates, and MLST analysis showed a predominance of sequence type 5 among these isolates. Our study revealed a higher prevalence of S. aureus carriage among Shanenawa ethnicity individuals (41.1%). Therefore, ethnicity appears to be associated with the prevalence of S. aureus in these populations.
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Affiliation(s)
- Lígia Maria Abraão
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Medical School (FMB) of Sao Paulo State University (UNESP), Botucatu 18618-970, Brazil
- Nursing Research and Care Practices, Hospital Samaritano Higienopolis, São Paulo 01232-010, Brazil
| | - Carlos Magno Castelo Branco Fortaleza
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Medical School (FMB) of Sao Paulo State University (UNESP), Botucatu 18618-970, Brazil
| | | | - Thaís Alves Barbosa
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Medical School (FMB) of Sao Paulo State University (UNESP), Botucatu 18618-970, Brazil
| | - Eliane Patrícia Lino Pereira-Franchi
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Medical School (FMB) of Sao Paulo State University (UNESP), Botucatu 18618-970, Brazil
| | - Danilo Flávio Moraes Riboli
- Department of Chemical and Biological Sciences, Biosciences Institute, UNESP-Universidade Estadual Paulista, Botucatu 18618-691, Brazil
| | - Luiza Hubinger
- Department of Chemical and Biological Sciences, Biosciences Institute, UNESP-Universidade Estadual Paulista, Botucatu 18618-691, Brazil
| | - Mariana Fávero Bonesso
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Medical School (FMB) of Sao Paulo State University (UNESP), Botucatu 18618-970, Brazil
| | | | - Maria de Lourdes Ribeiro de Souza da Cunha
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Medical School (FMB) of Sao Paulo State University (UNESP), Botucatu 18618-970, Brazil
- Department of Chemical and Biological Sciences, Biosciences Institute, UNESP-Universidade Estadual Paulista, Botucatu 18618-691, Brazil
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Barloggio N, Jean FH, Thelus BA, Jocenais P, Wirth GJ Jr, Boothby N, Schuenke-Lucien K, Rigutto-Farebrother J. Improving Iodine Intake in Rural Haiti through Social Enterprise: A Cross-Sectional Study in the Central Plateau. Nutrients 2023; 15. [PMID: 36904092 DOI: 10.3390/nu15051092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/02/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Iodine intake in Haiti has increased in recent years thanks to the "Bon Sel" social enterprise approach to salt fortification and distribution by the market segment. However, it was uncertain whether this salt reached remote communities. This cross-sectional study aimed to assess the iodine status of school-age children (SAC) and women of reproductive age (WRA) in a remote region of the Central Plateau. A total of 400 children (9-13 years) and 322 women (18-44 years) were recruited through schools and churches, respectively. Urinary iodine (UIC) and urinary creatinine (UCC) concentrations were measured in spot samples, and thyroglobulin (Tg) on dried blood spots. Their iodine intake was estimated, and dietary information collected. The median (IQR) UIC in SAC was 130 µg/L (79-204, n = 399), and in WRA, 115 µg/L (73-173, n = 322). The median (IQR) Tg in SAC was 19.7 µg/L (14.0-27.6, n = 370), and in WRA, 12.2 µg/L (7.9-19.0, n = 183); 10% of SAC had Tg > 40 µg/L. Estimated iodine intake was 77 µg/day and 202 µg/day in SAC and WRA, respectively. Iodized table salt was rarely consumed, though bouillon was used daily; this is hypothesized to be a major contributor to dietary iodine intake. Iodine intake in this remote region seems to have improved considerably since the 2018 national survey, though SAC remain at risk. These results point to the potential effectiveness of using social business principles to deliver humanitarian solutions.
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Chaber A, Easther R, Cumming B, Irving R, Keyburn AL, Smart C, O'Handley R, Lignereux L. Ehrlichia canis rapid spread and possible enzooty in northern South Australia and distribution of its vector Rhipicephalus linnaei. Aust Vet J 2022; 100:533-538. [PMID: 36053779 PMCID: PMC9804231 DOI: 10.1111/avj.13201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 06/24/2022] [Accepted: 07/31/2022] [Indexed: 01/05/2023]
Abstract
Recent concerns have arisen in Australia regarding detections of the exotic bacterium Ehrlichia canis which has resulted in ehrlichiosis outbreaks. In Australia, it is spread by the tropical brown dog tick Rhipicephalus linnaei, formerly Rhipicephalus sanguineus sensu lato tropical lineage. Previously, the tick has been recorded in South Australia in the Coober Pedy and the Oodnadatta areas. This study, which includes historical specimens data held in historical Australian arthropod collections, along with 10 sampled remote communities, confirms the wide distribution range of this species within the State. E. canis was detected by PCR in the ticks. The percentage of dogs hosting PCR-positive ticks increased from 2.8% (95% confidence interval [CI]: 0.3 to 9.7) in November-December 2020 to 62.9% (95% CI: 44.9 to 78.5) end of February 2021, initially in two then in seven Anangu Pitjantjatjara Yankunytjatjara lands communities in the far northern regions of South Australia. Our results suggest a rapid spread of the pathogen. No evidence of E. canis was found in nine regional communities. The extended tropical brown dog tick distribution indicates a greater area where E. canis may occur and may require management to minimise the impacts of ehrlichiosis outbreaks. Without the implementation of effective detection and control programs, this extended distribution of R. linnaei is likely to result in the spread of the bacterium to other regions.
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Affiliation(s)
- A‐L Chaber
- School of Animal and Veterinary Sciences, Roseworthy CampusThe University of AdelaideAdelaideSouth AustraliaAustralia
| | - R Easther
- School of Animal and Veterinary Sciences, Roseworthy CampusThe University of AdelaideAdelaideSouth AustraliaAustralia
| | - B Cumming
- Animal Management in Rural and Remote Indigenous Communities (AMRRIC)4/41 Sadgroves Crescent, Winnellie, Larrakia CountryNorthern Territory0820Australia
| | - R Irving
- Animal Management in Rural and Remote Indigenous Communities (AMRRIC)4/41 Sadgroves Crescent, Winnellie, Larrakia CountryNorthern Territory0820Australia,Adelaide Northern Veterinary Group854 North East Road, ModburySouth Australia5092Australia
| | - AL Keyburn
- Bioassay Research and Development TeamCommonwealth Scientific and Industrial Research Organisation, Australian Centre for Disease PreparednessPrivate Bag 24, GeelongVictoria3220Australia
| | - C Smart
- Animal Management in Rural and Remote Indigenous Communities (AMRRIC)4/41 Sadgroves Crescent, Winnellie, Larrakia CountryNorthern Territory0820Australia
| | - R O'Handley
- School of Animal and Veterinary Sciences, Roseworthy CampusThe University of AdelaideAdelaideSouth AustraliaAustralia
| | - L Lignereux
- School of Animal and Veterinary Sciences, Roseworthy CampusThe University of AdelaideAdelaideSouth AustraliaAustralia
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Donohue M, McDowall A. A discourse analysis of the Aboriginal and Torres Strait Islander COVID-19 policy response. Aust N Z J Public Health 2021; 45:651-657. [PMID: 34529868 PMCID: PMC8652513 DOI: 10.1111/1753-6405.13148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To analyse the implicit discourses within the COVID-19 policy response for Aboriginal and Torres Strait Islander remote communities. METHOD This paper uses Bacchi's 'What is the Problem Represented to Be' framework to analyse the Emergency Requirements for Remote Communities Determination under Subsection 477(1) of the Biosecurity Act 2015 (Cth). RESULTS Despite the leadership of community-controlled health services and regional councils, and the actions of Aboriginal and Torres Strait Islander communities, the policy response constructs Aboriginal and Torres Strait Islander people as vulnerable and mobility as a problem that needs a law and order response. CONCLUSIONS The policy response perpetuates an ongoing paternalistic discourse where Aboriginal and Torres Strait Islander people must be controlled for the sake of their health, informed by notions of Indigeneity as deficient. This stands in contrast with the work of community-controlled health organisations, advocacy by Aboriginal and Torres Strait Islander people for and against restrictions, and examples of communities protecting themselves. Implications for public health: Unilateral government intervention creates limiting discourses of Aboriginal and Torres Strait Islander people. In contrast, ongoing COVID-19 responses can build on the strengths of and work done by Aboriginal and Torres Strait Islander families, leaders, and communities.
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Affiliation(s)
- Monica Donohue
- Indigenous Education and Research Centre, James Cook University, Douglas, Queensland
| | - Ailie McDowall
- Indigenous Education and Research Centre, James Cook University, Douglas, Queensland,Correspondence to: Dr Ailie McDowall, Indigenous Education and Research Centre, James Cook University, Building 301, James Cook University, Douglas QLD 4811
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Karepalli VK, Brown M, Sajiv C, Fernandes D, Thomas S, George P, Nayar S, Pawar B. Barriers and challenges of returning patients back to community after renal transplantation in Central Australia. Intern Med J 2021; 51:1479-1484. [PMID: 33462991 DOI: 10.1111/imj.15196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/01/2020] [Accepted: 01/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The majority of patients living in remote communities of Central Australia must relocate to Alice Springs for their dialysis treatments. There is limited information available about the challenges and barriers that Aboriginal patients encounter in the process of returning back to their communities after renal transplantation. AIM To determine the length of stay of patients in Alice Springs and challenges faced subsequent to renal transplantation, before they could safely return to their remote communities. METHODS All transplant recipients from 2012 who are aged 18 years were analysed retrospectively. RESULTS Thirty-six patients received renal transplantation from Central Australia. Of them, 25 were from very remote communities of whom 24 were Aboriginal. Average length of stay in Alice Springs post-transplantation prior to returning to community was 17.2 weeks (121 days). The most common challenge faced prior to returning to community was the need for monitoring and titration of immunosuppressive medication (100%) followed by infections (90%) and admissions to hospital (85%). The other common barrier was optimising glycaemic control (80%). Less common barriers included proficiency with self-monitoring of blood sugar levels (50%), social factors (40%), blood pressure control (25%), leukopenia (25%), safe housing (20%) and rejection episodes (15%). CONCLUSIONS Multiple challenges are faced during post-transplantation period in Alice Springs that prolong the time before recipients from remote communities can return home. Some barriers such as titration of immunosuppression are inherent in the transplant journey. However, some factors might be modifiable prior to transplantation.
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Affiliation(s)
- Vijay K Karepalli
- Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Megan Brown
- Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Cherian Sajiv
- Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - David Fernandes
- Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Sajan Thomas
- Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Pratish George
- Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Sajith Nayar
- Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Basant Pawar
- Alice Springs Hospital, Alice Springs, Northern Territory, Australia
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Robinson GW, Lee E, Silburn SR, Nagel P, Leckning B, Midford R. School-Based Prevention in Very Remote Settings: A Feasibility Trial of Methods and Measures for the Evaluation of a Social Emotional Learning Program for Indigenous Students in Remote Northern Australia. Front Public Health 2020; 8:552878. [PMID: 33282808 PMCID: PMC7706087 DOI: 10.3389/fpubh.2020.552878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/12/2020] [Indexed: 11/22/2022] Open
Abstract
Purpose: Skills for Life (SFL) is a social-emotional curriculum for Indigenous middle school students that was co-developed with educators and community members in a remote community of northern Australia. This preliminary study aimed to test the feasibility of processes and methods of data-gathering, the reliability of youth self-report measures, and to identify the direction of effects for an evaluation of a longer-term pilot of the curriculum. Design/Methodology/Approach: Indigenous Students in years 7–9 of a remote school participated in SFL over 2 years. The Strengths and Difficulties Questionnaire (SDQ), Kessler 6 (K6), and a purpose-designed Connected Self Scale (CSS) were administered to 63 students pre- and post-program. Findings: Only the K6, Prosocial behavior (SDQ), and two CSS subscales showed sufficient internal consistency for analysis. Change was positive but non-significant for SDQ and CSS. There was evidence of a dosage effect: students receiving the intervention over 2 years showed greater reduction in psychological distress than other students. There was no evidence of iatrogenic effects. Conclusions: The feasibility pilot is a critically important phase in the development of evaluation design and cjhoice of evaluation measures for challenging remote settings. This study found that evaluation of SFL with culturally and linguistically distinct Indigenous middle school students using self-report measures is feasible. However, the SDQ may not be suitable for this project. High levels of psychological distress suggest the need to investigate sources of life stress and potential supports for adolescent resilience in this context. This preliminary pilot aimed to trial methods and measures for evaluation of a social-emotional curriculum developed specifically for remote Australian Indigenous students who are at risk of poor psychosocial outcomes. No studies have examined the appropriateness of standardized self-report measures for evaluation of SEL with this student population in remote school settings.
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Affiliation(s)
| | - Eunro Lee
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Sven Robert Silburn
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Patricia Nagel
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Bernard Leckning
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Richard Midford
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,National Drug Research Institute, Curtin University, Perth, WA, Australia
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O'Rourke MB, Padula MP. An Inexpensive, simple calibration method for MALDI TOF/TOF systems. J Mass Spectrom 2019; 54:1003-1007. [PMID: 31697866 DOI: 10.1002/jms.4467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/14/2019] [Accepted: 10/21/2019] [Indexed: 06/10/2023]
Abstract
The array of analytes that can be measured by MADLI MS has created an equally vast range of calibration mixtures. The inherent problem with this is that acquiring all of them at commercial rates can be prohibitively expensive. With this in mind, we have created a low-cost alternative to the most commonly used peptide calibrants. We were able to achieve an overall 78 ppm mass accuracy across a mass range of 900 to 2500 Da which was comparable to the mass accuracy achievable with commercial peptide mixes and hence has become a viable alternative.
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Affiliation(s)
- Matthew B O'Rourke
- Northern Clinical School, Bowel Cancer and Biomarker Lab, Faculty of Medicine and Health, The University of Sydney Lvl 8, Kolling Institute, Royal North Shore Hospital, Sydney, NSW, 2065, Australia
- Proteomics Core Facility, Faculty of Science, The University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
| | - Matthew P Padula
- Proteomics Core Facility, Faculty of Science, The University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
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Whitney E, Schnabel WE, Aggarwal S, Huang D, Wies RW, Karenzi J, Huntington HP, Schmidt JI, Dotson AD. MicroFEWs: A Food-Energy-Water Systems Approach to Renewable Energy Decisions in Islanded Microgrid Communities in Rural Alaska. Environ Eng Sci 2019; 36:843-849. [PMID: 31346306 PMCID: PMC6653800 DOI: 10.1089/ees.2019.0055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/29/2019] [Indexed: 06/10/2023]
Abstract
In recent years, there has been increased recognition of the importance of a nexus approach to optimize food, energy, and water (FEW) security at regional and global scales. Remote communities in the Arctic and Subarctic regions in Alaska provide unique examples of closed and isolated systems, wherein the FEW nexus not only needs to be examined to lend resilience to these vulnerable communities but that could also serve as small-scale test beds for a wider and systematic understanding of the FEW nexus. In this short communication, looking at the FEW nexus in Cordova, Alaska, through an energy lens, we introduce an approach (referred to as the "MicroFEWs approach") that may assist remote communities in Alaska in making informed decisions regarding the use of renewable energy to increase FEW security. Our example uses the MicroFEWs approach to assess the impacts of increased renewable energy generation on FEW security in the community, more specifically to food security through potential changes to the community's fish processing industry. This approach can serve as a basis for investigating the FEW nexus in varying contexts and locales.
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Affiliation(s)
- Erin Whitney
- Alaska Center for Energy and Power, University of Alaska Fairbanks, Fairbanks, Alaska
- Institute of Northern Engineering, University of Alaska Fairbanks, Fairbanks, Alaska
| | - William E. Schnabel
- Institute of Northern Engineering, University of Alaska Fairbanks, Fairbanks, Alaska
| | - Srijan Aggarwal
- Institute of Northern Engineering, University of Alaska Fairbanks, Fairbanks, Alaska
- Department of Civil and Environmental Engineering, University of Alaska Fairbanks, Fairbanks, Alaska
| | - Daisy Huang
- Alaska Center for Energy and Power, University of Alaska Fairbanks, Fairbanks, Alaska
- Institute of Northern Engineering, University of Alaska Fairbanks, Fairbanks, Alaska
- Department of Mechanical Engineering, University of Alaska Fairbanks, Fairbanks, Alaska
| | - Richard W. Wies
- Alaska Center for Energy and Power, University of Alaska Fairbanks, Fairbanks, Alaska
- Institute of Northern Engineering, University of Alaska Fairbanks, Fairbanks, Alaska
- Department of Electrical and Computer Engineering, University of Alaska Fairbanks, Fairbanks, Alaska
| | - Justus Karenzi
- Department of Electrical and Computer Engineering, University of Alaska Fairbanks, Fairbanks, Alaska
| | | | - Jennifer I. Schmidt
- Institute of Social and Economic Research, University of Alaska Anchorage, Anchorage, Alaska
| | - Aaron D. Dotson
- Department of Civil Engineering, University of Alaska Anchorage, Anchorage, Alaska
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12
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Ali SH, Foster T, Hall NL. The Relationship between Infectious Diseases and Housing Maintenance in Indigenous Australian Households. Int J Environ Res Public Health 2018; 15:E2827. [PMID: 30545014 DOI: 10.3390/ijerph15122827] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/02/2018] [Accepted: 12/05/2018] [Indexed: 11/17/2022]
Abstract
This research aimed to identify systemic housing-level contributions to infectious disease transmission for Indigenous Australians, in response to the Government program to ‘close the gap’ of health and other inequalities. A narrative literature review was performed in accordance to PRISMA guidelines. The findings revealed a lack of housing maintenance was associated with gastrointestinal infections, and skin-related diseases were associated with crowding. Diarrhoea was associated with the state of food preparation and storage areas, and viral conditions such as influenza were associated with crowding. Gastrointestinal, skin, ear, eye, and respiratory illnesses are related in various ways to health hardware functionality, removal and treatment of sewage, crowding, presence of pests and vermin, and the growth of mould and mildew. The research concluded that infectious disease transmission can be reduced by improving housing conditions, including adequate and timely housing repair and maintenance, and the enabling environment to perform healthy behaviours.
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Graham VE, Clough AR. Cannabis Use Among Remote Indigenous Australians: Opportunities to Support Change Identified in Two Waves of Sampling. Front Public Health 2018; 6:310. [PMID: 30450354 PMCID: PMC6225832 DOI: 10.3389/fpubh.2018.00310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/09/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Cannabis harms among Indigenous populations in Australia, New Zealand, Canada and the United States may be magnified by poorer health and heavy use. However, little direct evidence is available to evaluate cannabis' impacts. In communities in remote northern Queensland (Australia) where cannabis has become endemic, opportunities to support change were investigated. Methods: Opportunistically recruited participants (aged 15-49 years) discussed their cannabis use history in interviews in two waves of population sampling in Cape York (Queensland). Wave 1 included 429 people (235 males and 194 females); and wave 2 included 402 people (228 males and 174 females). Current users (used cannabis during the year before interview) described frequency of use, amount consumed, expenditure and dependence symptoms. Other substance use was recorded for 402 people at wave 2. Results: Wave 1: 69% reported lifetime use and 44% current use. Males (55%) were more likely than females (30%) to be current users (P < 0.001). Most (96%) current users described at least weekly use; nearly half (48%) were "heavy" users (≥6 cones/session at least once/week) and 77% met cannabis dependence criteria. Three communities spent up to $AUD14,200/week on cannabis, around $AUD2.0 million/year, or around 9% of community people's total income on cannabis. The majority (79%) of current users wanted to quit or reduce their cannabis use. Wave 2: no difference was observed in the proportion of lifetime (69%, |z| = 0.04, P = 0.968) or current cannabis users (39%, |z| = 1.39, P = 0.164); nor current use among males (71%, |z| = 0.91, P = 0.363) or females (62%, |z| = 0.36, P = 0.719). However, a significant reduction in current users by 15% (|z| = 2.36, P = 0.018) was observed in one community. Of 105 wave 1 current users re-assessed in 2, 29 (27%) had ceased use. These participants reported cost and family commitments as reasons to change and that social support and employment enabled abstinence. Current and lifetime cannabis use were closely associated with all other substance use, particularly tobacco and alcohol (both P > 0.001). Conclusions: High rates of heavy cannabis use in remote Australian Indigenous communities warrant action. Successful cessation among some individuals suggests that significant opportunities are available to support change even where cannabis use may be endemic.
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Affiliation(s)
- Veronica E Graham
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD, Australia
| | - Alan R Clough
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
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14
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Rollin A, Ridout B, Campbell A. Digital Health in Melanoma Posttreatment Care in Rural and Remote Australia: Systematic Review. J Med Internet Res 2018; 20:e11547. [PMID: 30249578 PMCID: PMC6231739 DOI: 10.2196/11547] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/28/2018] [Accepted: 08/30/2018] [Indexed: 11/13/2022] Open
Abstract
Background The melanoma incidence and mortality rates in rural and remote communities are exponentially higher than in urban areas. Digital health could be used to close the urban/rural gap for melanoma and improve access to posttreatment and support care services. Objective The aim of this review was to understand how digital health is currently used for melanoma posttreatment care and determine the benefits for Australian rural and remote areas. Methods A systematic search of PubMed, Medline, PsycINFO, and Scopus was conducted in March 2018. Findings were clustered per type of intervention and related direct outcomes. Results Five studies met the inclusion criteria, but none investigated the benefits of digital health for melanoma posttreatment care in rural and remote areas of Australia. Some empirical studies demonstrated consumers’ acceptance of digital intervention for posttreatment care. The findings did not take into consideration individual, psychological, and socioeconomic factors, even though studies show their significant impacts on melanoma quality of aftercare. Conclusions Digital interventions may be used as an adjunct service by clinicians during melanoma posttreatment care, especially in regions that are less-resourced by practitioners and health infrastructure, such as rural and remote Australia. Technology could be used to reduce the disparity in melanoma incidence, mortality rates, and accessibility to posttreatment care management between urban and rural/remote populations.
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Affiliation(s)
- Audrey Rollin
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Brad Ridout
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Andrew Campbell
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
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15
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Miller KJ, Couchie C, Ehman W, Graves L, Grzybowski S, Medves J. N o 282-Soins de maternité en région rurale. J Obstet Gynaecol Can 2017; 39:e566-e575. [PMID: 29197494 DOI: 10.1016/j.jogc.2017.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Wilson LA, Pakes B, Murphy MSQ, Atkinson KM, Bell C, Wilson K. Connecting remote populations to public health: the case for a digital immunisation information system in Nunavut. Int J Circumpolar Health 2017; 76:1358566. [PMID: 28782441 PMCID: PMC5549827 DOI: 10.1080/22423982.2017.1358566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/18/2017] [Indexed: 10/29/2022] Open
Abstract
Despite the best efforts of local healthcare workers and health officials, Nunavut, a large geographical region in Northern Canada, has struggled with outbreaks of vaccine-preventable diseases (VPD). We contend that the implementation of an immunisation information system (IIS) could strengthen prevention and response efforts to this and future outbreaks of vaccine-preventable diseases. Developing an IIS in Nunavut that builds on the existing CANImmunize infrastructure would reduce the cost and complexity of developing a new IIS, and allow Nunavut to benefit from the ongoing efforts to secure data on the CANImmunize platform. Such a system would enable the identification of individuals and subpopulations at highest risk of infection based on vaccine series completion and permit the exploration of the underlying causes of outbreaks in the territory through consideration of demographic and temporal factors. Confirmed high rates of vaccination in the context of an outbreak would indicate potential issues with vaccine efficacy while low rates of vaccination would suggest that efforts should be devoted to increasing vaccine coverage. This approach could also lay the foundation for infrastructure expansion to other remote and/or Indigenous communities where geographical and accessibility issues complicate health care utilisation and monitoring, both in Canada and internationally.
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Affiliation(s)
- Lindsay A. Wilson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Barry Pakes
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Malia S. Q. Murphy
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Katherine M. Atkinson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Cameron Bell
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Kumanan Wilson
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
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17
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Robertson J, Pointing BS, Stevenson L, Clough AR. "We made the rule, we have to stick to it": towards effective management of environmental tobacco smoke in remote Australian Aboriginal communities. Int J Environ Res Public Health 2013; 10:4944-66. [PMID: 24157514 PMCID: PMC3823346 DOI: 10.3390/ijerph10104944] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 08/16/2013] [Accepted: 09/02/2013] [Indexed: 11/17/2022]
Abstract
Smoking prevalence in remote Australian Aboriginal communities remains extraordinarily high, with rates reported of up to 82%. Widespread exposure to environmental tobacco smoke (ETS) is exacerbated by overcrowded housing. Implementation of existing smoke-free policies is challenged by the normalization of smoking and a lack of appropriate regulation resources. This paper celebrates a grassroots approach to control of environmental tobacco smoke (ETS) in these settings. We report on selected findings from a tobacco intervention study in Arnhem Land, Northern Territory in 2007-2012. In community-level tobacco use surveys at baseline (n = 400 ≥ 16 years), participants reported concern about the constant exposure of non-smokers to tobacco smoke. Suggestions for action included restricting smoking in private and public spaces. We selected three case studies illustrating management of ETS from observational data during the study's intervention phase. Using a critical realist approach, the context and mechanisms that contributed to specific strategies, or outcomes, were examined in order to develop a hypothesis regarding more effective management of ETS in these environments. Our results suggest that in discrete, disadvantaged communities, enhanced local ownership of smoke-free policies and development of implementation strategies at the grassroots level that acknowledge and incorporate cultural contexts can contribute to more effective management of ETS.
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Affiliation(s)
- Jan Robertson
- Tropical Medicine & Rehabilitation Sciences, School of Public Health, James Cook University, Cairns, Queensland 4870, Australia; E-Mails: (L.S.); (A.R.C.)
- Midwifery & Nutrition, School of Nursing, James Cook University, Cairns, Queensland 4870, Australia
| | - Boris Shane Pointing
- Cairns Institute, James Cook University, Cairns, Queensland 4870, Australia; E-Mail:
| | - Leah Stevenson
- Tropical Medicine & Rehabilitation Sciences, School of Public Health, James Cook University, Cairns, Queensland 4870, Australia; E-Mails: (L.S.); (A.R.C.)
| | - Alan R. Clough
- Tropical Medicine & Rehabilitation Sciences, School of Public Health, James Cook University, Cairns, Queensland 4870, Australia; E-Mails: (L.S.); (A.R.C.)
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Finnemore BI. Residency training north of the treeline. Can Fam Physician 1988; 34:1547-1548. [PMID: 21253029 PMCID: PMC2218162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Several opportunities exist for medical residents to spend some of their elective time in remote Northern settings. This short article focuses on some of the unique features of such an experience: lack of technological support, temporarily becoming a member of a cultural minority, cross-cultural communication problems, adverse climatic conditions. Some of the rewards are also described. Although such an experience is not for the faint hearted, it can broaden and strengthen the knowledge base required by the primary-care physician in any setting.
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