Remote Australia Online

A key challenge to providing quality developmental care in remote Aboriginal primary health care (PHC) centers has been the absence of culturally appropriate developmental screening instruments. This study focused on the cross-cultural adaptation of the Ages and Stages Questionnaires, 3rd edition (ASQ-3), with careful attention to language and culture. We aimed to adapt the ASQ-3 for use with remote dwelling Australian Aboriginal children, and to investigate the cultural appropriateness and feasibility of the adapted ASQ-3 for use in this context. We undertook a qualitative study in two remote Australian Aboriginal communities, using a six-step collaborative adaptation process. Aboriginal Health Workers (AHWs) were trained to use the adapted ASQ-3, and follow-up interviews examined participants? views of the cultural acceptability and usefulness of the adapted instrument. The adapted ASQ-3 was found to have high face validity and to be culturally acceptable and relevant to parents, AHWs, and early childhood development experts.

There is increasing evidence to suggest that, among those with chronic hepatitis B virus infection, the natural history and rate of progression to cirrhosis and hepatocellular carcinoma is influenced by hepatitis B virus genotype. The unique hepatitis B virus genotype C4 circulates among Indigenous Australians. The aim of this work is to describe the process of establishing this cohort and review the first 6 years of available data in an effort to understand the real-world clinical care and natural history of this subgenotype.We followed a longitudinal cohort of Indigenous Australians from the Northern Territory of Australia with established subgenotype C4 infections. We assigned phases of disease according to Gastroenterological Society of Australia and Asian Pacific Association for the Study of the Liver criteria using clinical and laboratory information that had been collected for clinical management.Of 193 patients followed over a median of 38 months, 58 (30%) individuals transitioned from 1 disease phase to another, 10 (5%) cleared hepatitis B e antigen, and 6 cleared hepatitis B surface antigen (3%). In this relatively young cohort (median age 40.3 years), 26 (13%) had cirrhosis by the end of the follow up period, with the majority of these being in the immune control phase of disease.In this cohort of hepatitis B subgenotype C4 patients, we report an aggressive and dynamic clinical phenotype. High rates of cirrhosis at a young age appear to occur in the early phases of disease.

Collaboration is a key component of high-quality health systems and is particularly important when facing so-called wicked issues. This chapter examines cross-sector collaboration as a function of the notion of ‘boundary work’. It examines the wicked issue of the prevalence of crusted scabies in Indigenous populations living in remote communities in the Northern Territory of Australia, which will require significant collaborative work across a range of different organisational and institutional boundaries if it is to be successful. We research a new approach driven by a philanthropic organisation called One Disease and find this programme has been successful in many respects principally because of this organisation’s ability to work closely with a range of stakeholders.

Seeking to fully know the other can have the effect of minimising the wholly different gestalt of the other’s lifeworld. This mode of knowing can thereby be a means of reduction, generalisation, possession, and control. In this essay, the author analyses a contemporary ethnography of Warlpiri women’s song-poems, Jardiwanpa Yawulyu: Warlpiri Women’s Songs from Yuendumu (2014). This ethnography is theorised as a mode of open text that animates a collision of epistemologies: those of Western settler culture, and those of the Warlpiri women who collaboratively authored the book. The author emphasises the cultural lenses that she brings to the intellectual and emotional work of reflexive close reading, and insists that her own position as whitefella, settler, Westerner, combined with the necessary partiality of the text, renders her incapable of any sort of comprehensive access to the ‘total poem,’ the ritual situation, which the book represents.

Boarding schools can provide quality secondary education for Aboriginal students from remote Aboriginal Australian communities. However, transition into boarding school is commonly challenging for Aboriginal students as they need to negotiate unfamiliar cultural, social and learning environments whilst being separated from family and community support. Accordingly, it is critical for boarding schools to provide programs that enhance the social and emotional skills needed to meet the challenges. This study evaluated a 10-session social and emotional learning (SEL) program for Aboriginal boarders and identified contextual factors influencing its effectiveness. The study combined a pre-post quantitative evaluation using diverse social and emotional wellbeing measures with 28 students between 13–15 years (10 female, 11 male, 7 unidentified) and qualitative post focus groups with 10 students and episodic interviews with four staff delivering the program. Students' social and emotional skills significantly improved. The qualitative findings revealed improvements in students seeking and giving help, working in groups, managing conflict, being assertive and discussing cultural issues. The focus groups and interviews also identified program elements that worked best and that need improvement. Secure relationships with staff delivering the program and participation in single sex groups stood out as critical enablers. The findings lend evidence to the critical importance of collaborative design, provision and evaluation of SEL programs with Aboriginal peoples.

Standardized testing and school achievement: The case of Indigenous-language speaking students in remote Australia

The health of Indigenous Australians is dramatically poorer than that of the non-Indigenous population. Amelioration of these differences has proven difficult. In part, this is attributable to a conceptualisation which approaches health disparities from the perspective of individual-level health behaviours, less so the environmental conditions that shape collective health behaviours. This ecological study investigated associations between the built environment and cardiometabolic mortality and morbidity in 123 remote Indigenous communities representing 104 Indigenous locations (ILOC) as defined by the Australian Bureau of Statistics. The presence of infrastructure and/or community buildings was used to create a cumulative exposure score (CES). Records of cardiometabolic-related deaths and health service interactions for the period 2010–2015 were sourced from government department records. A quasi-Poisson regression model was used to assess the associations between built environment “healthfulness” (CES, dichotomised) and cardiometabolic-related outcomes. Low relative to high CES was associated with greater rates of cardiometabolic-related morbidity for two of three morbidity measures (relative risk (RR) 2.41–2.54). Cardiometabolic-related mortality was markedly greater (RR 4.56, 95% confidence interval (CI), 1.74–11.93) for low-CES ILOCs. A lesser extent of “healthful” building types and infrastructure is associated with greater cardiometabolic-related morbidity and mortality in remote Indigenous locations. Attention to environments stands to improve remote Indigenous health.

Objective: to compare the cost-effectiveness of two models of service delivery: Midwifery Group Practice (MGP) and baseline cohort. Design: a retrospective and prospective cohort study. Setting: a regional hospital in Northern Territory (NT), Australia. Methods: baseline cohort included all Aboriginal mothers (n=412), and their infants (n=416), from two remote communities who gave birth between 2004 and 2006. The MGP cohort included all Aboriginal mothers (n=310), and their infants (n=315), from seven communities who gave birth between 2009 and 2011. The baseline cohort mothers and infant's medical records were retrospectively audited and the MGP cohort data were prospectively collected. All the direct costs, from the Department of Health (DH) perspective, occurred from the first antenatal presentation to six weeks post partum for mothers and up to 28 days post births for infants were included for analysis. Analysis: analysis was performed with SPSS 19.0 and Stata 12.1. Independent sample of t-tests and χ2 were conducted. Findings: women receiving MGP care had significantly more antenatal care, more ultrasounds, were more likely to be admitted to hospital antenatally, and had more postnatal care in town. The MGP cohort had significantly reduced average length of stay for infants admitted to Special Care Nursery (SCN). There was no significant difference between the two cohorts for major birth outcomes such as mode of birth, preterm birth rate and low birth weight. Costs savings (mean A$703) were found, although these were not statistically significant, for women and their infants receiving MGP care compared to the baseline cohort. Conclusions: for remote dwelling Aboriginal women of all risk who travelled to town for birth, MGP was likely to be cost effective, and women received better care and resulting in equivalent birth outcomes compared with the baseline maternity care.

Cystic fibrosis (CF) is a common life-limiting genetic condition. As the disease progresses access to specialist tertiary multi-disciplinary care services may become necessary. For patients living in regional/remote Australia, accessing such services may be a challenge. Here, we describe long-term outcomes for CF patients according to their access to specialist CF centre care in childhood.

Purpose Remote and regional Australia have comparatively fewer mental health services than their urban counterparts, what is more, mental health remains profoundly stigmatised. This study aims to understand how, if at all, the process of group art-making then publicly displaying the artworks can contribute to stigma reduction for young people (YP) experiencing mental health challenges in regional Australia. Design/methodology/approach Interviews were conducted with six young artists who use regional mental health services and 25 people who viewed their displayed art using a thematic analysis of the coded interview data.Findings Findings of this study demonstrated how art-making as a process increased self-esteem, social interaction and artistic expression; while the viewers experienced an emotional connection to the art. The viewer’s response enhanced YP’s confidence in their abilities.Originality/value Incorporating art-making and exhibiting the art in public spaces could be incorporated into YP’s mental health services to support well-being and inform the perception the general public hold of mental health, thus reducing stigma.

This article deals with an aspect of the nuclear fuel cycle, namely nuclear waste, by examining a recent proposal by the South Australian government to host an international high-level nuclear waste underground permanent repository in its “desert” outback region. The rub, though, is that the outback is no desert but has been the ancestral home of Aboriginal peoples for thousands of years and continues to be so, despite the disruptive effects of British colonialism. The article interrogates India’s stake in the proposal and the revival of Australia’s pro-nuclear lobby. In 2007, the Australian Liberal Party“unanimously endorsed a resolution supporting the establishment of a foreign nuclear waste dump ... in the geotechnically stable and remote areas that Australia has to offer” (Green, “Why Australia”). Australia, one of the world’s main uranium suppliers, and India’s fast-growing economy, with its emerging nuclear energy, uranium-hungry policy, are bound to engage with one another. But this would mean forgetting about a long history of antinuclear indigenous resistance on both sides of the Indian Ocean, demanding the recognition of native land rights and an end to “radioactive racism.”

A team from three Australian organisations, Northcott Innovation, Northcott and AbilityMade, are currently developing a service model for delivering orthotic services to children who live in remote areas of New South Wales, Australia, a state spanning 809,000 km². The benefits of the application of three-dimensional (3D) technologies are current and realised in the Prosthetics and Orthotics (P&O) industry. One of the numerous benefits of using 3D technology in this industry is applying it in remote and regional areas with limited access to P&O services. The team aims to provide a solution for high quality lower limb orthoses and orthotic services for children with disability who live in remote and regional areas, therefore shaping Assistive Technology (AT) systems around the people who need to use AT products. People with physical disabilities, like cerebral palsy, often need to wear lower limb orthoses to aid mobility and pain management. Currently, it is estimated that globally, 17 million people have cerebral palsy (1). The projection at this stage is that only 1 in 10 people will receive the orthoses they need due to: high cost, reduced availability, limited trained personnel, and constraints within policy and financing (2). During 2017 - 2018, seven organisations took part in an Australian clinical trial to explore the clinical validity of applying 3D technology to the clinical assessment, fabrication and fitting of lower limb orthoses. This trial included the development of a purpose built instantaneous scanner, the use of 3D modelling software and the 3D printing of Ankle Foot Orthoses (AFOs) for Australian children with disability between the ages of 2 and 8 years. Outcomes of the clinical trial indicated that: i) 3D printed AFOs were biomechanically equivalent to traditionally fabricated AFOs; ii) the mechanical properties of Nylon 11 and Nylon 12 are sufficiently robust to act as a clinically viable alternative to Polypropylene plastic; and, iii) children and parents/carers participating in the trial found digital scanning to be significantly less distressing and anxiety-inducing compared to the traditional plaster-casting process. The team comprising of Northcott Innovation, Northcott and AbilityMade therefore has adequate evidence for the clinical application of the 3D technologies as explained above. It is believed that the application of this technology in regional and remote locations can bring high quality P&O services and products to people where they live. The team will provide literature evidence to support how the proof of concept and proposed service model complies with Australian Disability standards, the Australian National Disability Insurance Agency’s (NDIA) Remote and Regional Strategy as well as P&O practice and service standards. The team will further provide a proof of concept explaining the approach followed through the use of data from their service model. It is expected that the service model will provide P&O services to people who live in remote and regional locations. The solution will be people centred, holistic and provide high quality products and experiences for customers in their local environments, hence creating sustainable high-quality systems. There is a further expectation that this service model could hold potential for further/other AT products and services, evolving it fully to an AT system which is centred on the holistic needs of a person. This could mean that a person needing more than one type of AT would not need to consult with numerous clinicians at several different appointments as the current practice demands.

Debate about alcohol and other drugs (AODs), particularly those that are illicit and/or subject to abuse, is pervasive in the community, media and at policy-level alike. While AOD use is commonly linked to the hedonistic social spaces of urban youth, especially with drugs like crystal methamphetamine ('ice'), it is clear substance misuse is not merely a 'city problem'. Considerations of place and space, particularly the notion of what it means to be rural, are central to understanding the diverse landscape of AOD use. This paper examines key determinants that shape the experience of rural AOD (mis)use and its influence on crime and criminality. Broad application of Shaw and McKay's (1942) social disorganisation theory enables examination of rural AOD use and related crime in Australia through a lens of social organisation. Using this lens, the article employs a narrative review methodology to explore three key elements of the rural landscape: (i) accessibility of services; (ii) social and cultural pressures; and (iii) the structural and/or physical constraints of rural geography. Critical examination of these elements and associated narratives reveals the need for recognition of the human struggle linked to AOD use and related crimes as a dimension of both rural life and criminality. The article argues that the appropriate response to rural AOD use requires a paradigmatic shift from traditional law enforcement approaches to principles of harm reduction and public health. However, greater work is needed to produce evidence-based policy, address the causes of rural AOD use and provide meaningful support to this growing cohort of vulnerable members of the community.

Introduction The aim of this paper was to describe the characteristics of paediatric patients who underwent an aeromedical retrieval within Australia (gender and Indigenous status) for suspected appendicitis between 1 July 2014 and 30 June 2018 (4 years). By understanding these trends, we hope to further justify the need for point-of-care ultrasound training for clinicians working in rural and remote Australia. Method Participants included Royal Flying Doctor Service (RFDS) patients aged 0?18 years (inclusive) who underwent an aeromedical retrieval for suspected appendicitis within Australia. Data were collected and coded on each patient?s inflight working diagnosis, using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) coding method. A combination of descriptive statistics and chi-square analyses was used in data analysis, with significance considered at <0.05. Results There were 384 children with a working diagnosis of suspected appendicitis, including 191 (49.7%) males and 193 (50.3%) females, with 133 (34.6%) patients identifying as Aboriginal and/or Torres Strait Islander (hereafter referred to as Indigenous) Australians. The aeromedical retrievals were from rural and remote locations to inner-regional or metropolitan hospitals, with an average distance flown of 339.0 (SD = 206.4) kilometres. The RFDS most frequently retrieved for acute appendicitis (n = 159; 41.4%), acute abdominal pain (n = 127; 33.1%), and unspecified appendicitis (n = 84; 21.9%). There were non-significant (P = 0.9) diagnostic differences between genders. Non-Indigenous patients were overrepresented, compared with Indigenous patients, in relation to a transfer with a diagnosis of acute appendicitis (P = <0.01), whereas Indigenous patients were overrepresented, compared with non-Indigenous patients, in relation to transfers with diagnoses of acute abdomen pain and unspecified appendicitis (P = <0.01). Conclusion A significant number of paediatric patients are aeromedically retrieved from rural and remote locations with a diagnosis of appendicitis or acute abdominal pain. Future research should consider whether training in abdominal point-of-care ultrasound reduces retrievals.

In Australia, children living in remote Aboriginal communities experience high rates of skin infections and associated complications. Prompt presentation to primary care health services is crucial for early diagnosis and treatment. We performed a qualitative study in four remote Aboriginal communities in the Pilbara region of Western Australia to explore factors that affected health service utilisation for childhood skin infections in this setting. The study consisted of semistructured interviews and focus group discussions with parents and carers (n = 16), healthcare practitioners (n = 15) and other community service providers (n = 25). We used Andersen’s health service utilisation model as an analytical framework. Our analysis captured a wide range of barriers that may undermine timely use of health services for childhood skin infections. These included general factors that illustrate the importance of cultural competency amongst healthcare providers, patient-centred care and community engagement. Relating specifically to health service utilisation for childhood skin infections, we identified their apparent normalisation and the common use of painful benzathine penicillin G injections for their treatment as important barriers. Health service utilisation in this setting may be enhanced by improving general awareness of the significance of childhood skin infections, actively engaging parents and carers in consultation and treatment processes and strengthening community involvement in health service activities.

Aims In this retrospective study we evaluated the demographic and clinical characteristic of adult Aboriginal Australian patients with a clinical diagnosis of COPD with and without bronchiectasis from the remote communities of the Northern Territory of Australia. Method Clinical records were reviewed to extract information on demographics, respiratory and medical co-morbid conditions, COPD directed treatment, hospital admission frequency and exacerbations. Chest radiology were reviewed to evaluate the presence or absence of bronchiectasis. Spirometry results, sputum culture and cardiac investigations were also recorded. Results Of the 767 patients assessed in the remote community respiratory outreach clinics 380 (49%) patients had a clinical diagnosis of COPD. Chest X-Ray and CT scan were available to evaluate the presence of bronchiectasis in 258 patients. Of the 258/380 patients 176/258 (68.2%) were diagnosed to have COPD alone and 82/258 (31.8%) had bronchiectasis along with COPD. The mean age was 56 and 59?years among patients with and without bronchiectasis respectively and 57 % were males with bronchiectasis. Patients with bronchiectasis had lower BMI (22v24), frequent hospital admissions (2.0vs1.5/year) and productive cough (32.1v28.9%). Spirometry showed 77% had FEV1/FVC ratio <?0.7. In 81% and 75% of patients with and without bronchiectasis the FEV1/FVC ratio was <?0.7 and the mean FEV1 was 39% and 43 % respectively. Conclusion About 32% of Aboriginal Australians had co-existent bronchiectasis with COPD Lower BMI, productive cough, frequent hospital admission and marginally more severe reduction in lung function was noted among patients with COPD and bronchiectasis compared to those with COPD in isolation. This article is protected by copyright. All rights reserved.

BACKGROUND: Hospitals and other health care providers frequently experience difficulties contacting patients and their carers who live remotely from the town where the health service is located. In 2016 Nurse Navigator positions were introduced into the health services by Queensland Health, to support and navigate the care of people with chronic and complex conditions. One hospital in Far North Queensland initiated an additional free telephone service to provide another means of communication for patients and carers with the NNs and for off-campus health professionals to obtain details about a patient utilising the service. Calls made between 7am and 10pm, seven days per week are answered by a nurse navigator. AIM: To report utilisation of the service by navigated clients and remotely located clinicians compared to use of navigators' individual work numbers and direct health service numbers. We report the reason for calls to the free number and examine features of these calls. METHODS: Statistical analysis examined the call reason, duration of calls, setting from where calls originated and stream of calls. Interactions between the reasons for calls and the features of calls, such as contact method, were examined. RESULTS: The major reason for calls was clinical issues and the source of calls was primarily patients and carers. Clinical calls were longer in duration. Shorter calls were mainly non-clinical, made by a health professional. Setting for calls was not related to the reason. The most frequent number used was the individual mobile number of the NN, followed by the hospital landline. Although the free number was utilised by patients and carers, it was not the preferred option. CONCLUSION: As patients and carers preferred to access their NN directly than via the 1800 number, further research should explore options best suited to this group of patients outside normal business hours.

Native title agreement-making or “contractualism” has become one of the dominant legible frames by which to understand Indigenous-settler relations in Australia, simultaneously providing benefits to Aboriginal groups yet constraining opportunities to configure these relations differently (Neale). In this paper, I examine the very first mining agreement of its kind in Australia: the Ranger uranium mine agreement negotiated in1978. Borrowing Russian literary theorist Bakhtin’s analytic, I argue that the agreement is a “chronotope” with specific spatiotemporal dimensions. I focus on two key temporalities of the chronotope –the urgent temporality of development authorisation that conditions how, when and where agreements are produced, and the forward-looking “temporal inertia” that prospectively embeds these practices as precedents to be replicated in future mining negotiations. These two temporal logics shaped and were shaped by the spatial dynamics of the institutions tasked with negotiating the agreement, as events shifted back and forth between different venues. Exploring “how different legal times create or shape legal spaces and vice versa” (Valverde 17) reveals the productive and hegemonic conditions of the agreement chronotope in Indigenous-state relations in Australia as well as the compromised conditions for Indigenous institutional survival in the entropic north of Australia and beyond.

Background Australian healthcare quality and safety accreditation standards recommend health services partner with health care users, to ensure the highest quality of care. Aboriginal Australians with chronic and end stage kidney disease have high health care access needs. Aim To describe the experiences of health care users of a large government kidney healthcare service provider. Methods Within a government renal health service in the Top-End of the Northern Territory, we undertook a qualitative study involving in-depth interviews with 26 adult clients from urban, regional and remote settings who were living with kidney health conditions. Results Client characteristics included a mean age of 55 years, 55% female and 81% identifying as Aboriginal. The kidney related conditions of client participants included CKD (11, 42.3%), haemodialysis (12, 46.2%), peritoneal dialysis (1, 3.9%), and transplant (2, 7.7%). Key themes emerging from patient interviews related to perceived gaps for clients and carers including: 1) knowledge gaps about the health condition, 2) the impact of relocation in order to access centrally-based renal care, 3) healthcare staff professionalism and qualities and 4) service environments. Overall, the experiences centred on a greater need for client-centred, respectful and culturally based healthcare support. Clients recommended the need for patient-led collective care, including sustaining an Indigenous Patient Reference Group to support ongoing healthcare service decision processes. Participants included in almost equal proportion, clients with CKD (without dialysis) and clients utilising renal replacement therapy, which adds significant weight to the client-identified recommendations for highest quality of kidney care across a wide spectrum of kidney function. Conclusion Four major themes identified by clients related to their experience with renal care provided by this major regional health care provider: knowledge gaps of their own condition, the lived impacts of relocating to access health care, service environments, and Health Care Provider Quality. An Indigenous Patient Reference Group was one mechanism recommended to support the co-design of preferred care models.

In this paper, we present findings from an eighteen-month research project conducted in a remote community school in Western Australia. The data from this project includes documentation pertaining to the practices of educators engaging with Aboriginal Elders and children on Country. The aim of the project was to document the transformative potential of learning on Country for young Aboriginal children (4-8 years). We discuss our findings in the context of Pink Floyd’s metaphor of formal education being built and maintained as a Wall in which children are ‘just another brick’. We argue that education is an institution that produces and reproduces inequalities for Aboriginal children through conforming and colonial pedagogical practices. To support our analysis and framing of this research we draw on Habermas’ knowledge interests (1978) and MacNaughton’s curriculum positions (2003). Using this framework, we propose that transformative pedagogies necessitate the school and the community to be ‘ready, willing and able’ to engage in an approach to learning and teaching that is grounded in ‘Country’. We juxtapose the conforming pedagogies of the Wall with the transforming pedagogies represented by Pink Hill, a sacred feature of the landscape alongside the community where the research took place.

In this introductory chapter, we establish this book as a story of relationships, intersecting lives and experiences, as they have taken place in a remote township in northern Australia, between local Indigenous residents and a group of researchers. These researchers include three anthropologists, an artist, archaeologist, and literary scholar, each of whom has shared in the documenting of Indigenous people’s lives through the interface of ethnography, relational encounters, and knowledge sharing. The introduction outlines why this book commits to a high level of reflexivity and consideration of how we build knowledge, share knowledge, how we encounter new knowledge, and how well we are positioned to understand the lived experiences of others, while making ourselves fully available to personal change.

There is an abundance of critique in tourism studies, human geography and the social sciences that take tourism-driven depictions of place as their object. Indeed, the problematics of touristic imaginaries tend to fix, obscure and exclude object-subjects that more-or-less sit familiarly within/out frames of representation. Beyond the frame, beyond critique, there are practices that are less observed ? practices that radically challenge the potency of ubiquitous ?good life? narratives. This paper draws upon visual ethnographic research methods in a frequently photographed but narrowly experienced place. Broome, in the remote Kimberley region of Australia, is an idyllic small urban town with a large tourism economy and operates as a service hub for extractive resource industries inland and offshore. Through the use of picture postcards and participant-driven photography, this paper presents a narrative of ?the beach? that demonstrates the fragility of normative ?good life? tropes. By amplifying practices of inhabiting the beach that exceed representational critique and stimulate other ways of authoring place, this paper looks for an activism that resists settling on colonial ways of knowing place.

To compare body size measurements in Australian Aboriginals living in three remote communities in the Northern Territory of Australia with those of the general Australian population. Height, weight, waist and hip circumferences and derivative values of body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHT), and waist-weight ratios (WWT) of adult Aboriginal volunteers (n = 814), aged 25 to 74 years were compared with participants in the nationally representative ?AusDiab? survey (n = 10,434). The Aboriginal body habitus profiles differed considerably from the Australian profile. When compared to Australian females, Aboriginal females were taller and had lower hip circumference but had higher WC, WHR, WHT, and WWT (P < 0.01 for all). When compared with their Australian counterparts, Aboriginal males were shorter, had lower body weight, WC, hip circumference, BMI, and WHT but had higher WHR and WWT (P < 0.001 for all). Significantly more Aboriginal females were classified as overweight and or obese using cutoffs defined by WC and by WHR than by BMI. Aboriginal males were less often overweight and/or obese by BMI than their counterparts, but were significantly more often overweight or obese by WHR. There were significant variations in body size profiles between Aboriginal communities. However, the theme of excess waist measurements relative to their weight was uniform. Aboriginal people had preferential central fat deposition in relation to their overall weight. BMI significantly underestimated overweight and obesity as assessed by waist measurements among Aboriginals. This relationship of preferential central fat deposition to the current epidemic of chronic diseases needs to be explored further. Am. J. Hum. Biol., 2008. ? 2008 Wiley-Liss, Inc.

Background: There is consistent evidence highlighting the mal-distribution of the health workforce between urban and rural and remote regions. To date, addressing this mal-distribution has focused on medicine and nursing with limited initiatives targeted at allied health. Therefore, the aim of this research was to explore the enablers of and barriers to transition to rural practice by allied health professionals across South Australia in Australia. Method: Qualitative descriptive methodology was used to underpin this research. Individual, in-depth semi-structured interviews were conducted with employers, managers and allied health professionals from rural regions of South Australia who were identified using purposive maximum variation sampling strategy. Results: A total 22 participants shared their perspectives on the enablers of and barriers to transition to rural practice by allied health professionals across South Australia. Thematic analysis of the interview data resulted in a number of key issues impacting transition to rural-based practice. These findings could be broadly categorised into three stages during the transition: ‘before’; ‘during’ and ‘after’. Discussion: This study identified a range of enablers of and barriers to transition to rural practice by allied health professionals. Five overarching themes – nature of rural practice, exposure to rural ‘taster’, social/lifestyle, job availability/characteristics, and mentor and support were identified. In particular, exposure to rural ‘taster’, social/lifestyle, and mentor and support were the key themes reported by the stakeholders. The multifactorial nature of the barriers and enablers highlight the complexity underpinning how AHPs transition to rural-based practice. These barriers/ enablers are often inter-linked and continually evolving which pose significant challenges for health care stakeholders to successfully addressing these. Conclusion: This research sheds light on the complexities that confront and successful strategies that are required for health care stakeholders when considering how best to support allied health professional transition to rural practice.

Background Chronic wet cough, the most common symptom of a disease spectrum that encompasses protracted bacterial bronchitis (PBB) and bronchiectasis, is common among Aboriginal children. In the absence of any community prevalence data, and with the high burden of respiratory disease and the European Respiratory Society task force's recommendation to identify disease burden, we determined the prevalence of chronic wet cough and PBB in young Aboriginal children in four remote communities in north Western Australia.Methods A whole-population, prospective study was conducted. Aboriginal children aged ≤7 years were clinically assessed for chronic wet cough by paediatric respiratory clinicians between July 2018 and May 2019. Where children had a wet cough but parents reported a short or uncertain cough duration, children were followed up 1 month later. A medical record audit 6 weeks to 3 months later was used to determine those children with chronic wet cough who had PBB (based on response to antibiotics).Results Of the 203 children, 191 (94%; median age 3.5 years, range 0–7 years) were enrolled. At the initial visit, chronic wet cough was present in 21 (11%), absent in 143 (75%) and unknown in 27 (14%). By follow-up, the total prevalence of chronic wet cough was 13% (95% CI 8–19%) and 10% (95% CI 7–17%) for PBB. Chronic wet cough was more common in the two communities with unsealed roads (19%) compared to the two with sealed roads (7%).Conclusion Given the relatively high prevalence, strategies to address reasons for and treatment of chronic wet cough and PBB in young Aboriginal children in remote north Western Australia are required.Prevalence of chronic wet cough and protracted bacterial bronchitis in Aboriginal children in remote, north Western Australia is high. There is a need to implement strategies to detect and manage these entities and measure prevalence in other settings. http://bit.ly/33QLzDA