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Remote Communities (remote + community)

Distribution by Scientific Domains

Medical Sciences	90%
Humanities and Social Sciences	9%

Selected Abstracts

Associations between tobacco and cannabis use in remote indigenous populations in Northern Australia

ADDICTION, Issue 3 2005
Alan R. Clough
ABSTRACT Aims To assess whether cannabis use, recently taken up by many indigenous Australians in remote communities, has reinforced tobacco use. Design Cross-sectional study. Setting Three eastern Arnhem Land communities (Northern Territory, NT); total population = 3384, in 2001. Participants From 1247 people aged 17,36 years, 190 (120 males, 70 females) were opportunistically recruited. Measurements Self-reported life-time and current tobacco, cannabis and other substance use were confirmed by local health workers and using clinic records. Participants reported level of substance use, frequency and duration (years used). Associations with tobacco use were calculated (odds ratios: OR) using logistic regression with age, sex, alcohol use and a history of petrol sniffing as confounders. Findings In univariate analyses current tobacco users were more likely than non-users to be using cannabis (OR = 3.1, 1.5,6.2, P = 0.002) and this association remained in multivariate analyses (OR = 3.0, 1.4,6.8, P = 0.006). Tobacco use was associated with the number of years of cannabis use (P = 0.035). The likelihood that tobacco users were also cannabis users increased as quantity of cannabis used increased (P = 0.008). Current tobacco use was no more likely in those who initiated cannabis from 1998 onwards than in those who initiated cannabis before 1998 (OR = 1.1, 0.4,3.2, P = 0.881). One-third of life-time users of both tobacco and cannabis initiated their use at or near the same time, and very few of these (12%) had discontinued either cannabis or tobacco. Conclusions Cannabis appears to have influenced the continued use of tobacco in these populations with possible additional burdens for cardiovascular and respiratory diseases and challenges for interventions. [source]

Pandemic influenza communication: views from a deliberative forum

HEALTH EXPECTATIONS, Issue 3 2009
Wendy A. Rogers BA (Hons) BM.BS PhD MRCGP FRACGP
Abstract Objective, To use a deliberative forum to elicit community perspectives on communication about pandemic influenza planning, and to compare these findings with the current Australian national communication strategy. Design, Deliberative forum of 12 persons randomly selected from urban South Australia. Forum members were briefed by experts in infection control, virology, ethics and public policy before deliberating on four key questions: what, how and when should the community be told about pandemic influenza and by whom? Results, The forum recommended provision of detailed and comprehensive information by credible experts, rather than politicians, using a variety of media including television and internet. Recommendations included cumulative communication to build expertise in the community, and specific strategies to include groups such as young people, people with physical or mental disabilities, and rural and remote communities. Information provided should be practical, accurate, and timely, with no ,holding back' about the seriousness of a pandemic. The forum expressed confidence in the expert witnesses, despite the acknowledged uncertainty of many of the predictions. Discussion and Conclusion, The deliberative forum's recommendations were largely consistent with the Australian national pandemic influenza communication strategy and the relevant literature. However, the forum recommended: release of more detailed information than currently proposed in the national strategy; use of non-political spokespersons; and use of novel communication methods. Their acceptance of uncertainty suggests that policy makers should be open about the limits of knowledge in potentially threatening situations. Our findings show that deliberative forums can provide community perspectives on topics such as communication about pandemic influenza. [source]

Maternity waiting homes in Southern Lao PDR: The unique ,silk home'

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2008
Elizabeth Eckermann
Abstract The concept of maternity waiting homes (MWH) has a long history spanning over 100 years. The research reported here was conducted in the Thateng District of Sekong Province in southern Lao People's Democratic Republic (PDR) to establish whether the MWH concept would be affordable, accessible, and most importantly acceptable, as a strategy to improve maternal outcomes in the remote communities of Thateng with a high proportion of the population from ethnic minority groups. The research suggested that there were major barriers to minority ethnic groups using existing maternal health services (reflected in very low usage of trained birth attendants and hospitals and clinics) in Thateng. Unless MWH are adapted to overcome these potential barriers, such initiatives will suffer the same fate as existing maternal facilities. Consequently, the Lao iteration of the concept, as operationalized in the Silk Homes project in southern Lao PDR is unique in combining maternal and infant health services with opportunities for micro credit and income generating activities and allowing non-harmful traditional practices to co-exist alongside modern medical protocols. These innovative approaches to the MWH concept address the major economic, social and cultural barriers to usage of safe birthing options in remote communities of southern Lao PDR. [source]

Missed opportunities for a diagnosis of acute otitis media in Aboriginal children

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 7 2003
KB Gibney
Objective: Severe otitis media and its sequelae are common in rural and remote Aboriginal children. Identification of acute otitis media (AOM) is likely to reduce the number of children who go on to develop chronic suppurative otitis media and associated complications. The aim of this study was to compare the diagnoses made by researchers with that documented in the medical records of children admitted to the paediatric isolation ward of the Royal Darwin Hospital, Darwin, Northern Territory. Methods: Children aged <8 years admitted to Royal Darwin Hospital were eligible for assessment by pneumatic otoscopy, video-otoscopy and tympanometry. A diagnosis was made for each child according to the state of their worst ear. Comparisons were made between the researcher diagnoses of ear disease and those documented in the hospital notes by medical staff. Results: Thirty-one children were enrolled during 32 admissions. Most were aged <2 years, Aboriginal, and resided in remote communities. Sixty-one video-otoscopic assessments were attempted and sufficiently good images to allow diagnosis were obtained in 105 of 122 ears. Acute otitis media was diagnosed by the research team in 20 of 32 child admissions. Of 29 children who had ear examinations documented by hospital staff, only seven had a diagnosis of AOM recorded. Overall, the research team were almost three times more likely to make this diagnosis (relative risk 2.9, 95% confidence interval 1.6, 5.2). This difference was unlikely to have occurred by chance (P = 0.0002, McNemar's Chi-squared test). Conclusions: In this small study, young Aboriginal children with clear bulging of their tympanic membrane were not diagnosed with AOM by medical staff. Further training in diagnosis, including cleaning of the ear canal, may lead to more accurate assessment and appropriate recommendations for ongoing management. [source]

The greying of resource communities in northern British Columbia: implications for health care delivery in already-underserviced communities

THE CANADIAN GEOGRAPHER/LE GEOGRAPHE CANADIEN, Issue 1 2005
Neil Hanlon
The delivery of ,rural' health care services has long confronted the geographic problems of distance, low user densities, low-order facilities and caregiver shortages. As a result, rural and remote communities across Canada have struggled with health care delivery. For rural and remote communities in resource hinterlands, population ageing driven by industrial restructuring presents a significant departure from past experience. Drawing on examples from northern British Columbia (BC), this paper examines this context of ageing in rural and remote locations with the purpose of highlighting impending challenges for health care service provision. In the first part of this paper, we provide a demographic overview of population change and ageing in northern BC. In the second part, we present data on the availability of services throughout the region to support seniors who age-in-place. Population ageing, in areas that have never dealt with this issue before, highlights not only important servicing questions but also important policy questions about how to provide for needs that the policy and community context are not presently equipped to meet. Ce n'est pas d'hier que la prestation de services de soins de santé en milieu «rural» doit composer avec les problèmes géographiques liés aux distances, à la faible densité d'usagers, aux établissements de bas ordre et à la pénurie de personnel soignant. C'est pourquoi, pour les collectivités rurales et éloignées du Canada, la prestation de soins de santé constitue un problème de longue date. Pour ces collectivités rurales et éloignées de l'arrière-pays industriel, le vieillissement de la population découlant de la restructuration industrielle représente une dérogation notable à l'ordre normal des choses. En s'appuyant sur des exemples du Nord de la Colombie-Britannique, le présent article examine le contexte du vieillissement en milieu rural et éloigné afin de faire ressortir les défis imminents à la prestation de services de soins de santé. La première partie de l'article présente un aperçu démographique du changement et du vieillissement de la population dans le Nord de la Colombie-Britannique. La seconde partie présente des données sur la disponibilité, dans la région, de services de soutien aux personnes âgées qui «vieillissent sur place». Pour les régions qui ne s'y sont pas encore attardées, le vieillissement de la population soulève non seulement d'importantes questions ayant trait à la prestation de services, mais aussi des questions de politiques visant la réponse à des besoins auxquels le contexte communautaire et le cadre de politique actuels ne répondent pas. [source]

Teledermatology: Influence of zoning and education on a clinician's ability to observe peripheral lesions

AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 3 2002
Keng Chen
SUMMARY Teledermatology can benefit rural and remote communities, where specialist dermatological services may not be readily available. Regarding store-and- forward teledermatology, we hypothesized that the site of a lesion in an image (zoning) may influence a clinician's ability to observe target lesions, and that education on image viewing may improve use of this technology. We examined this by conducting both pre- and post-education studies. The education on image viewing consisted of a presentation on the outcome of the first study-survey on image viewing. The first study demonstrated that zoning influences a clinician's visual attention and that significant, concurrent lesions in the periphery may be missed. The second study demonstrated that brief education could produce a measurable change in observing peripheral lesions. These findings have medico-legal implications and suggest that further education in the use of such technology is necessary in order to optimize patient care and prevent potential errors. [source]

Chronic disease profiles in remote Aboriginal settings and implications for health services planning

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2010
Wendy E. Hoy
Abstract Objective: To report the short-term experiences and outcomes of a program to support chronic disease management in three remote communities in Top End Northern Territory and in two Aboriginal Medical Services (AMSs) in Western Australia, and to discuss the implications of findings for health service delivery and policy. Methods: Programs were health-worker centred. They espoused regular screening of all adults for chronic disease, initiation and modification of treatment where indicated and rigorous documentation. Process measures were documented and rates of hypertension, renal disease and diabetes among adults were calculated. Results: Rates of hypertension, proteinuria and diabetes rose throughout adult life and multiple diagnoses were common. Most people with these conditions were young or middle age adults. Rates were uniformly excessive relative to AusDiab data, but varied greatly among settings. Adherence to protocols improved, many new diagnoses were made, treatments were started or modified and blood pressures in treated hypertensive people fell. In the NT, productivity was seriously limited by lack of health workers and their absenteeism. In the WA AMSs, executive and staff support carried the programs forward to a sustainable future, despite various challenges. Conclusions: Integrated chronic disease testing must be repeated throughout adult life for timely diagnosis. Health workers can perform all tasks well, with appropriate supports. Blood pressure outcomes alone predict lower cardiovascular and renal mortality. The findings support incorporation of chronic disease into lifetime health care plans. [source]

Lessons for Aboriginal tobacco control in remote communities: an evaluation of the Northern Territory ,Tobacco Project'

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2010
David Thomas
Abstract Objective: To evaluate a Northern Territory (NT) government-led pilot ,Tobacco Project' in six remote communities. Methods: Monthly surveys of staff, semi-structured interviews with staff and community members, observation of the delivery of tobacco control interventions, review of Project documents, and monitoring of tobacco consumption using sales (or wholesale orders) of tobacco. Results: There was a substantive amount of tobacco control activity delivered in three of the Project communities. In two of these locations, the majority of work was primarily driven and undertaken by resident staff. Overall, most of the Project's efforts related to community education and awareness-raising. There was variable impact of the Project on tobacco consumption across the six communities. More tobacco control activity was consistently associated with a greater reduction in tobacco consumption. An important predictor of local activity was the presence of strong community drivers. A significant obstacle to the Project was the lack of new resources. Conclusions: Despite the minimal impact of this Project on tobacco consumption overall, there was a consistent association between on-the-ground tobacco control activity and reductions in tobacco consumption. Implications: New initiatives will not only need to provide new funding, but identify and then support local staff, who are central to improving local tobacco control activity and so reducing smoking and smoking-related illnesses and deaths. [source]

Engaging with Aboriginal communities in an urban context: some practical suggestions for public health researchers

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2009
Priscilla Pyett
Objective: In this paper, one Indigenous and two non-Indigenous public health researchers reflect on our combined experience of over thirty years in Aboriginal health, in order to develop some practical guidelines, particularly for researchers working with urban Indigenous population groups. Approach: Public health research is important not only to address the health inequities experienced by Australia's Indigenous populations, but also to build knowledge and confidence and to inform practice in Aboriginal community-controlled health organisations. Ethical guidelines and previous research experience demonstrate that researchers need to engage with the communities that may be involved in or affected by the research they propose. Although more than half of Australia's Aboriginal and Torres Strait Islander population live in urban and regional centres, most research and commentaries address the health and social issues of remote communities. Researchers often do not know how to engage with urban Aboriginal communities and how to approach the particular research challenges within this context. Conclusion and Implications: The practical guidelines suggested in this paper may assist public health researchers to conduct ethical health research that is planned and carried out in a culturally appropriate way and that will benefit urban Aboriginal people. While not intended to be prescriptive, we believe that the lessons learned in Victoria will be applicable to other urban Indigenous contexts around Australia. [source]

Water supply and sanitation in remote Indigenous communities-priorities for health development

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2004
Ross S. Bailie
Objective:To review available national and State/Territory survey data on water supply and sanitation in remote Indigenous Australian communities and to discuss the findings in terms of priorities for health and infrastructure development. Methods:Descriptive analysis of data on relevant variables from available data sources. Results:All relevant published reports arose from only two data sources: the Community Housing and Infrastructure Needs Surveys, and from a Northern Territory-wide survey of community-owned dwellings. The data show that many communities do not have a reliable water supply and experience frequent and prolonged breakdown in sewerage systems. For example, 12% of communities of 50 people or more experienced five or more periods of water restrictions in a one-year period, and 10% of communities experienced sewage overflow or leakage 20 or more times in a one-year period. Items of basic household infrastructure regarded as essential for household hygiene are missing or not functional in many community-owned dwellings. For example, in about one-third of houses bathroom taps and toilet drainage required major repairs. Conclusion and Implications:Given the widely accepted importance of water and sanitation to health, the data support the contention that poor environmental conditions are a major cause of poor health in remote communities and provide some measure at a national level of the magnitude of the problem. Action to ensure easy access to adequate quantities of water and secure sanitation should receive greater priority. There is need for better quality information systems to monitor progress, equity and accountability in the delivery of water and sanitation services. [source]

The urban and rural divide for women giving birth in NSW, 1990,1997

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2000
Christine L. Roberts
ABSTRACT OBJECTIVE: To examine trends in the pregnancy profile and outcomes of urban and rural women. METHODS: Data were obtained from the NSW Midwives Data Collection on births in NSW, 1990,1997. Associations between place of residence (urban/rural) and maternal factors and pregnancy outcomes were examined, including changes over time. RESULTS: From 1990 to 1997 there were 685,631 confinements in NSW and these mothers resided as follows: 76% metropolitan, 5% large rural centres, 8% small rural centres, 11% other rural areas and 1% remote areas. Rural mothers were more likely to be teenagers, multiparous, without a married or de facto partner, public patients and smokers. Births in rural areas declined, particularly among women aged 20,34 years. Infants born to mothers in remote communities were at increased odds of stillbirth and tow Apgar scores (all women) and small,for,gestational,age (SGA) (Indigenous women only). CONCLUSIONS: The profile of pregnant women in rural NSW is different from their urban counterparts and is consistent with relative socioeconomic disadvantage and possibly suboptimal maternity services in some areas. While increased risk of SGA is associated with environmental factors such as smoking and nutrition, the reasons for increased risk of stillbirth are unclear. Although there does not appear to be an increased risk of preterm birth for rural women this may be masked by transfer of high,risk pregnancies interstate. IMPLICATIONS: Maternity services need to be available and accessible to all rural women with targeting of interventions known to reduce low birthweight and perinatal death. [source]

Health reform and the immediate needs of rural and remote communities

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2010
Gordon Gregory
No abstract is available for this article. [source]

Mental health and well-being within rural communities: The Australian Rural Mental Health Study

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2010
Brian J. Kelly
Abstract Objective:,This paper outlines the methods and baseline data from a multisite cohort study of the determinants and outcomes of mental health and well-being within rural and remote communities. Methods:,A stratified random sample of adults was drawn in non-metropolitan New South Wales using the Australian Electoral Roll, with the aim of recruiting all adult members of each household. Surveys assessed psychological symptoms, physical health and mental disorders, along with individual-, family/household- and community-level characteristics. A stratified subsample completed a telephone-administered World Mental Health-Composite International Diagnostic Interview (World Mental Health-3.0). Proxy measures of child health and well-being were obtained. Follow up of this sample will be undertaken at one, three and five years. Results:,A total of 2639 individuals were recruited (1879 households), with 28% from remote/very remote regions. A significant relationship was found between recent distress (Kessler-10 scores), age and remoteness, with a linear reduction of Kessler-10 scores with age and the lowest mean scores in remote regions. Conclusions:,Existing rurality categories cannot address the diverse socio-cultural, economic and environmental characteristics of non-metropolitan regions. While it has limitations, the dataset will enable a fine-grained examination of geographic, household and community factors and provide a unique longitudinal dataset over a five-year period. [source]

Approach to treatment of mental illness and substance dependence in remote Indigenous communities: Results of a mixed methods study

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 4 2009
Tricia Nagel
Abstract Objective:,To develop and evaluate a culturally adapted brief intervention for Indigenous people with chronic mental illness. Design:,A mixed methods design in which an exploratory phase of qualitative research was followed by a nested randomised controlled trial. Setting:,Psycho-education resources and a brief intervention, motivational care planning (MCP), were developed and tested in collaboration with aboriginal mental health workers in three remote communities in northern Australia. Participants:,A total of 49 patients with mental illness and 37 carers were recruited to a randomised controlled trial that compared MCP (n = 24) with a clinical control condition (treatment as usual, n = 25). Intervention:,The early treatment group received MCP at baseline and the late treatment group received delayed treatment at six months. Main outcome measures:,The primary outcome was mental health problem severity as measured by the health of the nation outcome scales. Secondary measures of well-being (Kessler 10), life skills, self-management and substance dependence were chosen. Outcome assessments were performed at baseline, six-month, 12-month and 18-month follow up. Results:,Random effects regression analyses showed significant advantage for the treatment condition in terms of well-being with changes in health of the nation outcome scales (P < 0.001) and Kessler 10 (P = 0.001), which were sustained over time. There was also significant advantage for treatment for alcohol dependence (P = 0.05), with response also evident in cannabis dependence (P = 0.064) and with changes in substance dependence sustained over time. Conclusions:,These results suggest that MCP is an effective treatment for Indigenous people with mental illness and provide insight into the experience of mental illness in remote communities. [source]

Australian issues in the provision of after-hours primary medical care services in rural communities

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2006
Kathryn Zeitz
Abstract Objective:,In 2003 the Rural Doctors Workforce Agency in South Australia (SA) facilitated the ,SA Rural Hospital After Hours Triage Education and Training Program'. It was designed to improve communication between rural general practitioners (GPs) and nurses undertaking after-hours triage, provide training in triage for rural nurses and develop local collaborative after-hours primary medical care models that can be applied in other settings. Design:,The program consisted of a series of three workshops. The first workshop provided an opportunity for GPs and nurses to discuss local issues relating to after-hours primary medical care service delivery. This was followed by a one-day workshop on triage for nurses. A follow-up refresher workshop was conducted approximately six months later. Setting:,Twenty-three rural communities in SA. Participants:,Rural GPs and nurses working in rural communities. Results:,This paper reports on the issues highlighted by clinicians in providing after-hours primary medical care in rural and remote communities. These included community expectations, systems of care, scope of practice, private practice/public hospital interface, and medico legal issues. Conclusion:,The issues facing after-hours health services in rural communities are not new. There are many opportunities for improvement of systems. A formal program including workshops and training has provided a useful forum to commence service improvements. [source]

Palliative care by nurses in rural and remote practice

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 4 2004
John P. Rosenberg
Abstract Objective:,To evaluate the experiences of a group of rural and remote nurses in providing palliative care and to discuss the implications of this evaluation for the development and implementation of professional support strategies. Design:,Semi-structured survey comprising 23 items measuring perceptions of the nature of rural and remote practice, the provision of palliative care in these settings and the appropriateness of various professional development strategies; as well as 12 open-ended questions to obtain qualitative descriptions relating to key concepts in rural and remote practice. Setting:,Rural and remote communities in the Southern zone of Queensland Health. Subjects:,Thirty-one registered and enrolled nurses, all female, who attended a two-day professional development workshop. Main outcome measures:,Identification of characteristics of, barriers against and strategies to support the practice of palliative care in rural and remote communities. Results:,High levels of agreement with key statements relating to issues evident in contemporary literature regarding rural and remote nursing practice; qualitative descriptions show congruence with key statements. Conclusions:,This evaluation demonstrated congruence between the challenges faced by this group of nurses and those reported in the literature. These nurses identified the importance of peer networking as an integral part of their work, which enhanced their potential as rural and remote palliative care providers. What is already known:,The issues faced by nurses in rural and remote communities have been described in previous studies. For the most part, these had not specifically targeted the practice of palliative care in this setting. It was not clear whether the practice of palliative care brought distinct challenges to nurses. What this paper adds:,This paper adds to the growing body of knowledge about the professional development needs of nurses in rural and remote communities in relation to the practice of palliative care. It suggests that the nurses surveyed in this study share many challenges in common with nurses practising rural and remote settings. Palliative care is understood to be an integral part of practice, despite the infrequency of palliative care clients and the diverse roles they carry out. Barriers to professional development related to geographical and professional isolation are shared in common. An imperative emerges to identify professional development strategies that are directly relevant to rural and remote settings, to improve access to professional development resources and to promote sustainable peer support networks. [source]

ISSUES AFFECTING AUSTRALIA'S RURAL OCCUPATIONAL THERAPY WORKFORCE

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2000
Jeannine Millsteed
ABSTRACT The unequal distribution of health workers across Australia in favour of urban areas affects the provision of effective health services to rural and remote communities. Additional pressures on the current and future supply of occupational therapists may arise from a restructuring of the health labour force and demographic changes in the age structure of the population. Projections made on the basis of these data indicate that employment growth for occupational therapists will create a demand for 9600 therapists in 2005, or 79.9% more than the number of occupational therapists employed in 1994. Factors such as reductions in the level of immigration and the number of people of working age, and a diminishing population of school leavers to fill student places in universities will make it difficult to meet the projected demand for occupational therapists. Occupational therapy labour force planning suffers from a lack of detailed data on under-serviced areas. Such data are critical for clarifying the magnitude of the projected discrepancy between future demand and supply needs for occupational therapists in rural and urban areas in Australia. [source]

Prevalence and associations of cataract in indigenous Australians within central Australia: the Central Australian Ocular Health Study

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 4 2010
John Landers MBBS MPH PhD
Abstract Purpose:, To determine the prevalence and associations of cataract within the indigenous Australian population living in central Australia. Methods:, 1884 individuals aged ,20 years, living in one of 30 remote communities within the statistical local area of ,central Australia' were recruited for this study. This equated to 36% of those aged ,20 years and 67% of those aged ,40 years within this district. Slit-lamp examination was performed. The degree and subtype of cataract was graded using the Lens Opacities Classification System III criteria. A cataract was defined as a nuclear opalescence ,4.0, a cortical opacity ,3.0, a posterior subcapsular opacity ,2.0, a visual acuity worse than 6/12 or a visual acuity worse than 6/60 due to cataract. The prevalence of cataract in one or both eyes was presented for each of the definitions. Results:, Nuclear opalescence cataract was present in 13.5% (18.5% of those ,40 years); cortical opacity cataract was present in 13.1% (17.7% of those ,40 years); and posterior subcapsular cataract was present in 15.8% (21.0% of those ,40 years). 12.6% of patients (17.3% of those ,40 years) and 4.4% of patients (5.9% of those ,40 years) had a cataract that resulted in a visual acuity of worse than 6/12 and worse than 6/60, respectively. All cataracts were associated with advancing age. Posterior subcapsular cataract was associated with self-reported diabetes. Conclusion:, There is a higher prevalence of cataract among indigenous Australians living within remote central Australia compared with the non-indigenous population. Services for this population need to be designed with this in mind when planning resource allocation. [source]

Prevalence and associations of diabetic retinopathy in indigenous Australians within central Australia: the Central Australian Ocular Health Study

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 4 2010
John Landers MBBS MPH PhD
Abstract Purpose:, To determine the prevalence and associations of diabetic retinopathy (DR) within the indigenous Australian population living in central Australia. Methods:, 1884 individuals aged 20 years or older, living in one of 30 remote communities within the statistical local area of ,central Australia' were recruited for this study. This equated to 36% of those aged 20 years or older and 67% of those aged 40 years or older within this district. Participants were recruited as they presented to the eye clinic at each remote community. Following dilated slit-lamp fundoscopy, the amount of DR in participants with diabetes mellitus (DM) was quantified using the Early Treatment of Diabetic Retinopathy Study criteria. The presence of any DR and vision-threatening DR (clinically significant macular oedema and/or proliferative DR) in one or both eyes was presented. Results:, Of those with diabetes, 22.2% (25.4% of those aged 40 years or older) had any DR and 7.0% (8.4% of those aged 40 years or older) had vision-threatening DR. Both the presence of any DR and vision-threatening DR were associated with advancing age and HbA1c level, but neither subcategory was associated with sex or self-reported hypertension. Conclusion:, Our study has shown similar prevalence rates for DR in indigenous Australians compared with non-indigenous Australians. However, as DM is far more prevalent among indigenous Australians, the proportion of those affected by DR across the population should be considerably higher when compared with non-indigenous Australians. [source]

The Efficacy of a Community-Based Project in a Chinese Context

ASIAN SOCIAL WORK AND POLICY REVIEW, Issue 1 2009
Joyce L. C. Ma
In this paper, the authors report the results of an exploratory study which assessed the service efficacy of a collaborative service initiative developed by a university academic department and a community-based social service agency in a socially deprived and remote community in Hong Kong. The project aimed to foster mutual help and self-help of low-income families and deepen their social connection with the community. Service efficacy was assessed using a structured questionnaire and a focus group interview. After participating in the service project, the well-being of the participants has become better and their family relationships have improved. They have developed a stronger sense of belonging toward the community. The preliminary findings support the importance of creating social network in social work practice for low-income families residing in a deprived and remote neighborhood. [source]