Evidence-based nutrition and cardiovascular disease in the Asia-Pacific region

The Asia-Pacific region is undergoing a major change in both food and health patterns, with a connection between the two more than likely. Evidence for certain traditional Asia-Pacific foods as protective agents against chronic non-communicable disease and cardiovascular disease (CVD), in particular, is growing at a time when their usage diminishes. The nature of the evidence to establish relevant Asia-Pacific food-health linkages will include randomised placebo-controlled clinical trials, but is much more extensive and meaningful. Okinawans have probably achieved one of the most successful food cultures from a health point of view and serve as a reference point for the Asia-Pacific region. The expert working party has produced, in November 2000, the 'Okinawan Recommendations on Nutrition and CVD in the Asia-Pacific region'.

Investigating health, economic and socio-political factors that need consideration when establishing Victorian Aboriginal land management projects

This article focuses on three Victorian Aboriginal¹ groups (Bangerang, Boonwurrung and Yorta Yorta) to explore elements that provide or discourage development of land management projects. Results from this small qualitative study show that a number of distinct health, socio-political and economic factors need to be considered when developing Aboriginal land management projects. This study indicates that a greater involvement in Aboriginal land management projects -- critical to Aboriginal peoples' health, economic and social structures - will only occur through increased community consultation, respect, training, consistency between all stakeholders involved, resources and the provision of employment opportunities. Further research is required to strengthen this evidence, allowing policy-makers to be progressive when developing land management projects for Aboriginal Victorian people as a health promoting tool.

Culture, identity, health : Australian South Sea Islanders in Mackay

This research concerns the descendants of 19th century Kanaka labourers. Through innovative methodology, it examines their culture, identity and health. It has contributed to the official recognition of Australian South Sea Islanders, with significant implications for policies and services provided by State and Federal Governments, especially in health care.

Fuzzy well-being in Pacific Asia

This paper develops a framework that uses fuzzy-set theory to measure human well-being. Fuzzy sets allow for gradual transition from one state to another while also allowing one to incorporate rules and goals, and hence are more appropriate for measuring outcomes that are ambiguous. Such ambiguity is an inherent characteristic of cross-country achieved well-being assessments. This framework is used to provide a fuzzy representation of the well known Human Development Index (HDI) and its three components. Fuzzy HDI estimates for 14 Pacific Asian countries are provided and compared with non-fuzzy estimates. Quite large differences in rankings emerge. The paper concludes by suggesting that fuzzy measures should be used more widely to measure achieved well-being outcomes.

Guiding policy change to reduce diet-related disease in the Pacific

Research was undertaken in Fiji and Tonga to identify the most promising policy interventions to improve diets and non-communicable diseases. The participatory approach combined with modelling enabled evidence-informed decision-making by stakeholders. The framework developed is practical and systematic and is recommended for use in other countries in the region.

Contributing to health reform : urban Aboriginal women speak out

In this thesis, the researcher shares their own personal journey as an Aboriginal researcher walking the borderlands between academic and Indigenous worldviews.  Indigenous Methodologies and Talking Circles provided a culturally safe environment for urban Aboriginal women to collectively develop and share their strategies to enable health care providers, educators, and policy makers to provide respectful non-racist, non-disciminatory health care.

Developing an exploratory framework linking Australian Aboriginal peoples' connection to country and concepts of wellbeing

Aboriginal people across Australia suffer significant health inequalities compared with the non-Indigenous population. Evidence indicates that inroads can be made to reduce these inequalities by better understanding social and cultural determinants of health, applying holistic notions of health and developing less rigid definitions of wellbeing. The following article draws on qualitative research on Victorian Aboriginal peoples' relationship to their traditional land (known as Country) and its link to wellbeing, in an attempt to tackle this. Concepts of wellbeing, Country and nature have also been reviewed to gain an understanding of this relationship. An exploratory framework has been developed to understand this phenomenon focusing on positive (e.g., ancestry and partnerships) and negative (e.g., destruction of Country and racism) factors contributing to Aboriginal peoples' health. The outcome is an explanation of how Country is a fundamental component of Aboriginal Victorian peoples' wellbeing and the framework articulates the forces that impact positively and negatively on this duality. This review is critical to improving not only Aboriginal peoples' health but also the capacity of all humanity to deal with environmental issues like disconnection from nature and urbanisation.

Comparison of two modes of delivery of an exercise prescription scheme

AIM: Green Prescription (GRx) referrals from health professionals have been shown to be effective for increasing the physical activity levels of patients. Little is known about which methods of delivering the programme represents the best value for money. The purpose of this paper was to compare the cost and outcomes of two modes of delivery of a GRx programme. One mode offered phone support involving monthly telephone calls over a 3-4 month period to encourage physical activity participation. A second mode offered community support via weekly face-to-face support group meetings in which physical activities were offered. METHODS: The evaluation involved staff interviews, patient interviews and analysis of GRx records for the 2007 calendar year. RESULTS: There was a large rate of drop-out (68%) from GRx referral to registration. For those who registered, there was a clear preference for community support, and engagement of Maori and Pacific peoples was higher in this mode of delivery. The proportion (but not absolute number) of people who successfully completed their mode of delivery was higher with phone support. However, participants in community support self-reported a significantly greater number of days of exercise per week than those in phone support. The total expected cost per person for phone support was $102.07 and $108.15 for community support. A greater proportion of participants in community support were very satisfied overall with their mode of delivery. CONCLUSION: The two modes were comparable in cost and outcomes, though there was greater penetration of target ethnic populations in community support. Providing a choice of GRx mode of delivery allows participants to choose based on their personal and cultural needs.

Comparison of two modes of delivery of an exercise prescription scheme

SummaryGreen Prescription (GRx) is a referral from a health professional for a patient to become more physically active. In Auckland, GRx is delivered either on the telephone or face-to-face. A comparison of the two modes of delivery (telephone vs. face-to-face) was conducted. This evaluation involved staff interviews, patient interviews and analysis of GRx records for the 2007 calendar year. Results indicated that the modes of delivery were similar in terms of costs as well as outcomes. However, the face-to-face mode of delivery was more popular with Maori and Pacific peoples. Providing a choice of GRx mode of delivery allows participants to choose based on their personal and cultural needs.AbstractAimGreen Prescription (GRx) referrals from health professionals have been shown to be effective for increasing the physical activity levels of patients. Little is known about which methods of delivering the programme represents the best value for money. The purpose of this paper was to compare the cost and outcomes of two modes of delivery of a GRx programme. One mode offered phone support involving monthly telephone calls over a 3-4 month period to encourage physical activity participation. A second mode offered community support via weekly face-to-face support group meetings in which physical activities were offered.MethodThe evaluation involved staff interviews, patient interviews and analysis of GRx records for the 2007 calendar year.ResultsThere was a large rate of drop-out (68%) from GRx referral to registration. For those who registered, there was a clear preference for community support, and engagement of Māori and Pacific peoples was higher in this mode of delivery. The proportion (but not absolute number) of people who successfully completed their mode of delivery was higher with phone support. However, participants in community support self-reported a significantly greater number of days of exercise per week than those in phone support. The total expected cost per person for phone support was $102.07 and $108.15 for community support. A greater proportion of participants in community support were very satisfied overall with their mode of delivery.ConclusionThe two modes were comparable in cost and outcomes, though there was greater penetration of target ethnic populations in community support. Providing a choice of GRx mode of delivery allows participants to choose based on their personal and cultural needs.

Gathering for God : George Brown in Oceania

Combining 'the gathering of artefacts with the gathering of souls', George Brown was a key figure in the Christian, and especially the Wesleyan Methodist, history of nineteenth-century Oceania. Using his life as a case study, Helen Bethea Gardner examines the role of Christian missionaries in the Pacific Islands. Brown's career (1860-1908) spanned one of the most tumultuous political periods in the South Pacific, as one by one islands were colonised by imperial nations. He was one of the most politically engaged of all missionaries, encouraging colonial rule in the Pacific by America, Britain, Germany and, eventually, Australia and New Zealand. Originally from the north of England, he worked as a missionary in Samoa from 1860, moving to the Bismarck Archipelago (now Papua New Guinea) in 1875. From the 1880s until his retirement in 1907, he worked in Sydney as the general secretary of the Australasian Methodist Overseas Mission. Gathering for God examines Brown's missionary letters, journals and journalism, exploring how he attracted Pacific Islanders to Christian teachings, analysing his leadership during an armed attack on New Britain villages accused of cannibalism, and looking at his work in the new discipline of anthropology. He was a major collector of artefacts (his collection is now in the Osaka Museum) and photographer of Pacific peoples (his collection is in the Australian Museum).

Education and training as a social science : some empirical evidence in the Rosebank Business Precinct of Auckland New Zealand

Tertiary institutions should seek continuous feedback from industries to keep track of the needs of businesses to provide education and training. Academics should stay in touch with businesses by networking and consulting. Holland and De Cieri (2006) refer to theories of child learning (pedagogy) to inform their understanding of andragogy, the study of adult learning. Adult learners would be continuous learners and would move in and out of formal education according to individual needs or life circumstances, job requirements or career development. In designing programmes and up-grading curricula, these are important factors to bear in mind so that programmes “cater” for these learners as well.

This study was financed by Auckland City Council focussing on Auckland’s Rosebank Business Precinct (ARBP). The surrounding communities, particularly Mäori, Pacific peoples and recent migrants, experience disparities in employment. Our research questions were:
• Is there a skills match between the present-day workforce and actual business needs over the medium term?
• What can these data tell us about Rosebank’s trajectory as a skilled business cluster and about its future workforce requirements?
• What education and training will be necessary for these organisations to maintain their competitive advantage and profit margins?

The target population were the 500-600 businesses operating on Rosebank Road. A total of 529 businesses were identified. Interviews with 102 companies with a 36-question questionnaire were conducted. The sampling frame was owner-managers (senior, non-shareholding managers). Of the respondent firms, 68.75% had vacancies for up to 3 months and 31.24% vacancies for 6 months.

This paper highlights areas identified in the ARBP for developing programmes and curricula for tertiary institutions to provide employable students with the right knowledge, skills and attributes (KSAs) to grow existing ventures. A fine balance must be struck between human and organisational needs. In the analysis and discussion we point out what education or training is necessary for the ARBP to provide greater efficiencies and subsequent improvement to their profit levels by current and future employees entering the workforce; well “equipped” employees with knowledge and skills to add value in their organisations. Recommendations, future perspectives and conclusions form the last part of this paper

Epidemiology of acute rheumatic fever in New Zealand 1996-2005

Aim: Acute rheumatic fever (ARF) and its sequela chronic rheumatic heart disease remain significant causes of morbidity and mortality in New Zealand, particularly among Māori and Pacific peoples. Despite its importance, ARF epidemiology has not been reviewed recently. The aims of this study were to assess trends in ARF incidence rates between 1996 and 2005 and the extent to which ARF is concentrated in certain populations based on age, sex, ethnicity and geographical location.

Methods: This descriptive epidemiological study examined ARF incidence rates using hospitalisation data (1996–2005) and population data from the 1996 and 2001 censuses. Rates were compared by using rate ratios and 95% confidence intervals.

Results: New Zealand's annual ARF rate was 3.4 per 100 000. ARF was concentrated in certain populations: 5- to 14-year-olds, Māori and Pacific peoples and upper North Island areas. From 1996 to 2005, the New Zealand European and Others ARF rate decreased significantly while Māori and Pacific peoples’ rates increased. Compared with New Zealand European and Others, rate ratios were 10.0 for Māori and 20.7 for Pacific peoples. Of all cases, 59.5% were Māori or Pacific children aged 5–14 years, yet this group comprised only 4.7% of the New Zealand population.

Conclusion: ARF rates in New Zealand have failed to decrease since the 1980s and remain some of the highest reported in a developed country. There are large, and now widening, ethnic disparities in ARF incidence. ARF is so concentrated by age group, ethnicity and geographical area that highly targeted interventions could be considered, based on these characteristics.

Education and training deficits in industrial clusters : empirical evidence that managers can use to rectify the skills gap in Auckland precinct

Tertiary institutions should seek continuous feedback from industries to keep track of the needs of businesses to provide education and training. In designing programmes and upgrading curricula, there are important factors to bear in mind so that programmes "cater" for all levels of learners. The Auckland City Council financed this study, focussing on Auckland's Rosebank Business Precinct (ARBP). Surrounding communities, particularly Maori, Pacific peoples and recent migrants, experience disparities in employment. The target population were 500+ businesses operating on Rosebank Road. A total of 529 businesses were identified. Interviews with 102 companies with a 36-question questionnaire were conducted. Areas were identified and covered in this paper in the ARBP for developing programmes and curricula for tertiary institutions to provide employable students with the right knowledge, skills and attributes to grow and manage existing ventures. In the analysis we point out what education or training is necessary for ARBP to provide greater efficiencies and improvement in profit levels. Recommendations and conclusions are provided.