Telemedicine for rural and remote child and youth mental health services

The E-Child and Youth Mental Health Service was designed to provide children and adolescents in Queensland with access to specialist mental health consultations using telemedicine. A project officer provided a single point of contact for referral management and clinic coordination, thereby reducing barriers of access to the service. Over a six-month period from November 2004, 42 point-to-point videoconferences were conducted to nine sites in Queensland. Three multipoint conferences were also conducted. Eleven videoconferences (24%) were arranged for administrative purposes, and 34 (76%) were conducted for the delivery of clinical services (30 patients). The referral and consultation activity suggests an improvement in the capacity of rural and remote mental health service providers to deliver specialist services for children and adolescents.

Kidney and related chronic disease profiles and risk factors in three remote Australian Aboriginal communities

Morbidities and deaths from noncommunicable chronic diseases are greatly increased in remote Australian Aboriginal communities, but little is known of the underlying community-based health profiles. We describe chronic-disease profiles and their risk factors in 3 remote communities in the Northern Territory. Consenting adults (18+ years of age) in 3 communities participated in a brief history and examination between 2000 and mid-2003 as part of a systematic program to improve chronic-disease awareness and management. Participation was 67%,128%, and 62% in communities A, B, and C, respectively with a total of 1070 people examined. Current smokers included 41% of females and 72% of males. Most men were current drinkers, but most women were not. Parameters of body weight differed markedly by community, with mean body mass index (BMC) varying from 21.4 to 27.9 kg/m(2). Rates of chronic diseases were excessive but differed markedly; an almost threefold difference in the likelihood of any morbidity existed between communities A and C. Rates increased with age, but the greatest numbers of people with morbidities were in the middle-aged group. Most people had multiple morbidities with tremendous overlap. Hypertension and kidney disease appear to be early manifestations of the integrated chronic-disease syndrome, while diabetes is a late manifestation or complication. Substantial numbers of new cases of disease were identified by testing, and blood pressure improved in treated people with hypertension. Wide variations occur in body habitus, risk factors, and chronic-disease rates among communities, but an overwhelming need for effective smoking interventions exists in all. Systematic screening is useful in identifying high-risk individuals, most at early treatable stages there. Findings are very important for estimating current treatment needs, future burdens of disease, and for needs-based health services planning. Resources required will vary according to the burden of disease. (C) 2005 by the National Kidney Foundation, Inc.

Analysis of plant microfossils in archaeological deposits from two remote archipelagos: The Marshall Islands, Eastern Micronesia, and the Pitcairn Group, Southeast Polynesia

Pollen and starch residue analyses were conducted on 24 sediment samples from archaeological sites on Maloelap and Ebon Atolls in the Marshall Islands, eastern Micronesia, and Henderson and Pitcairn Islands in the Pitcairn Group, Southeast Polynesia. The sampled islands, two of which are mystery islands (Henderson and Pitcairn), previously occupied and abandoned before European contact, comprise three types of Pacific islands: low coral atolls, raised atolls, and volcanic islands. Pollen, starch grains, calcium oxylate crystals, and xylem cells of introduced non-Colocasia Araceae (aroids) were identified in the Marshalls and Henderson (ca. 1,900 yr B.P. and 1,200 yr B.P. at the earliest, respectively). The data provide direct evidence of prehistoric horticulture in those islands and initial fossil pollen sequences from Pitcairn Island. Combined with previous studies, the data also indicate a horticultural system on Henderson comprising both field and tree crops, with seven different cultigens, including at least two species of the Araceae. Starch grains and xylem cells of Ipomoea sp., possibly introduced 1. batatas, were identified in Pitcairn Island deposits dated to the last few centuries before European contact in 1790.