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San Diego, CA, United States

Background: Amongst a long list of health issues driving the disparity experienced by Indigenous Australians, cardiovascular disease (CVD) remains the primary target. It is the principal cause of death and of excess death among Indigenous people in Australia, and accounts for almost one-third of the life expectancy gap. Most attention has focused on the higher burden of traditional risk factors experienced by Indigenous people to explain CVD disparity. Far less attention has focused on the quality and outcomes of health system performance in explaining these differentials.The CASPA study was a retrospective, mixed-methods clinical registry and quality improvement program established in the NT of Australia, focused on the patterns, burdens, provision of care, experience of services, adverse outcomes and their determinants among 492 patients (214 Indigenous and 278 non-Indigenous). Results: Indigenous patients were significantly younger and more likely to have existing CVD risk factors and co-morbid chronic disease. During hospitalisation they received similar rates of evidence-based care with the exception of lower rates of diagnostic angiography (36.2% vs. 47.6%, p = 0.012), lower rates of in-patient cardiac rehabilitation (8.9% vs. 15.3%, p = 0.03) and lower prescription of discharge statin (44.8% vs. 57.8%, p = 0.006). Indigenous patients were more likely to die during two years of follow-up (30% vs. 17.8%, p = 0.002). Both Indigenous and non-Indigenous patients were similarly under-prescribed evidence based therapy after discharge. Exploratory qualitative examination of the experience of Indigenous patients in Alice Springs identified significant barriers to care across the continuum. Conclusion: Improvements in the delivery of known effective therapies will make a significant impact on adverse outcomes in Indigenous and non-Indigenous patients alike. Comprehensive and sustained prospective data collection to compliment system reform is essential to improve outcomes and reduce disparity in CVD outcomes experienced by Indigenous Australians. © 2010.

Echeverri J.A.,National University of Colombia | Roman-Jitdutjaano O.E.,Indigenous
Environmental Research Letters | Year: 2013

This letter addresses the indigenous discourse on a set of plant species used by the Witoto Indians of Northwest Amazonia to extract ash or vegetable salt, obtained from the combustion of the tissues of vegetable species, filtering of the ashes, and desiccation of the resulting brine. It aims to demonstrate how the study of the human condition is carried out through a reading of natural entities. The method employed is the indexical analysis of a discourse uttered by the elder Enokakuiodo in the Witoto language from 1995 to 1998, in a verbal genre called rafue, one of several genres of the 'language of the yard of coca'. The species used to extract ash salt are conceived of as coming from the body of the Creator and as an image of the human body. The rafue of salt performs, in words and gestures, a narrative of human affects and capacities by reading ecological, biological, cultural and linguistic indices from a set of plant species. This discourse on plant species is a discourse on the control and management of bodily affects and capacities, represented as ash salts, that are lessons about sexual development which the Creator left for humanity as a guide - a 'sexual education'. © 2013 IOP Publishing Ltd.

Foley W.,Indigenous
Australian Journal of Primary Health | Year: 2010

This article reports on ethnographic study of urban Aboriginal family food and implications for nutrition promotion. Data were collected over 2 years through in-depth interviews and participant observation in groups conducted through Indigenous organisations in a suburb of Brisbane. Issues when organising family food include affordability, keeping family members satisfied and being able to share food, a lack of cooking ideas, the accessibility of nutrition information, additional work involved in ensuring healthy eating, and a desire for convenience. Many different health professionals provide nutrition advice, often directing it towards individuals and not providing adequate guidance to facilitate implementation. The easiest advice to implement worked from existing household food practices, skills and budget. Cooking workshops helped to provide opportunities to experiment with recommended foods so that women could confidently introduce them at home. Aboriginal women are concerned about healthy eating for their families. Disadvantage can limit dietary change and the complexity of family food work is often underestimated in nutrition promotion. Household, rather than individual, framing of nutrition promotion can lead to more sustainable healthy eating changes. © 2010 La Trobe University.

Whiteside T.G.,Indigenous | Boggs G.S.,Charles Darwin University | Maier S.W.,Charles Darwin University
International Journal of Applied Earth Observation and Geoinformation | Year: 2011

The development of robust object-based classification methods suitable for medium to high resolution satellite imagery provides a valid alternative to 'traditional' pixel-based methods. This paper compares the results of an object-based classification to a supervised per-pixel classification for mapping land cover in the tropical north of the Northern Territory of Australia. The object-based approach involved segmentation of image data into objects at multiple scale levels. Objects were assigned classes using training objects and the Nearest Neighbour supervised and fuzzy classification algorithm. The supervised pixel-based classification involved the selection of training areas and a classification using the maximum likelihood classifier algorithm. Site-specific accuracy assessment using confusion matrices of both classifications were undertaken based on 256 reference sites. A comparison of the results shows a statistically significant higher overall accuracy of the object-based classification over the pixel-based classification. The incorporation of a digital elevation model (DEM) layer and associated class rules into the objectbased classification produced slightly higher accuracies overall and for certain classes; however this was not statistically significant over the object-based using spectral information solely. The results indicate object-based analysis has good potential for extracting land cover information from satellite imagery captured over spatially heterogeneous land covers of tropical Australia. © 2011 Elsevier B.V.

Objectives: The structural aging of the population and withdrawal of older people from the labor force have become common themes within Western social policy discourse and have particular relevance to policy development around health and aging. The current study examines whether particular occupation types are associated with both poor health and an increased likelihood of labor force exit. Methods: Longitudinal data are used to examine workforce participation among older Australians (aged between 55 and 64, in 2002). Results: Older workers in trades, labor, and production occupations, the majority of whom are men, have poorer general health than their counterparts in other occupations and are also the most likely to exit the workforce. Discussion: These findings suggest that a number of older men in Australia (and, indeed, elsewhere) may face both poor health and limited employment opportunities in areas that match their abilities and experience. These individuals may experience a number of years out of the labor force, highlighting a role for targeted policies and programs. © SAGE Publications 2012.

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