Aboriginal and Torres Strait Islander health research and the conduct of longitudinal studies: issues for debate

The National Health and Medical Research Council, Research Agenda Working Group (RAWG), and the literature on Indigenous health have identified the need to fill gaps in descriptive data on Aboriginal and Torres Strait Islander health and noted both the lack of research with urban populations and the need for longitudinal studies. This paper presents some of the broad ethical and methodological challenges associated with longitudinal research in Indigenous health and focuses particularly on national studies and studies in urban areas. Our goal is to advance debate in the public health arena about the application of ethical guidelines and the conduct of longitudinal studies in Aboriginal and Torres Strait Islander communities. We encourage others to offer their experiences in this field.

Epizootic activity of Murray Valley encephalitis and Kunjin viruses in an aboriginal community in the Southeast Kimberley region of Western Australia: Results of mosquito fauna and virus isolation studies

We undertook annual surveys of flavivirus virus activity in the community of Billiluna of Western Australia in the southeast Kimberley region between 1989 and 2001. Culex annulirostris was the dominant mosquito species, particularly in years of above average rains and flooding. Murray Valley encephalitis (MVE) virus was isolated in 8 of the 13 years of the study from seven mosquito species, but more than 90% of the isolates were from Cx. annulirostris. The results suggest that MVE virus is epizootic in the region, with activity only apparent in years with average or above average rainfall and increased numbers of Cx. annulirostris. High levels of MVE virus activity and associated human cases were detected only once (in 1993) during the survey period. Activity of MVE virus could only be partially correlated with wet season rainfall and flooding, suggesting that a number of other factors must also be considered to accurately predict MVE virus activity at such communities.

Historical and dialectical perspectives on the teaching of Aboriginal and Torres Strait Islander musics in the Australian education system

Indigenous studies (also referred to as Aboriginal and Torres Strait Islander studies) has a double identity in the Australian education system, consisting of the education of Indigenous students and education of all students about Aboriginal and Torres Strait Islander cultures and histories. Through explanations of the history of the inclusion of Aboriginal and Torres Strait Islander musics in Australian music education, this article critiques ways in which these musics have been positioned in relation to a number of agendas. These include definitions of Aboriginal and Torres Strait Islander musics as types of Australian music, as ethnomusicological objects, as examples of postcolonial discourse, and as empowerment for Indigenous students. The site of discussion is the work of the Australian Society for Music Education, as representative of trends in Australian school-based music education, and the Centre for Aboriginal Studies in Music at the University of Adelaide, as an example of a tertiary music program for Indigenous students.

Editorial

The year 2003 marks the 30th anniversary of The Australian Journal of Indigenous Education (AJIE) and coincides with the re-launching of the journal as a peer reviewed research journal.Beginning life in 1973 as The Aboriginal Child at School, AJIE has played a vital role in raising awareness of educational issues for Aboriginal and Torres Strait Islander peoples; fostering debate amongst researchers, government representatives and community groups; and sharing stories of success between both Indigenous and non- Indigenous practitioners positioned in the broad area of Aboriginal and Torres Strait Islander education. The dialogue which has taken place in AJIE over the past 30 years maps out the social, political and cultural history of Indigenous education in Australia, and draws attention to the shifting paradigms,problems and practical outcomes.

Cherbourg revisited: hearing health changes in an Aboriginal community, 1972 to 2000

The aim of this study was to investigate current audiological outcomes of Cherbourg schoolchildren and compare these outcomes to those obtained in a 1972 study of hearing health in the same community. Seventy-eight primary school children of Cherbourg State School participated in the study. Their peripheral hearing and middle ear function were tested using pure-tone air conduction audiometry and tympanometry respectively. A significant improvement in the hearing status of this population was noted compared to that reported in 1972. The improvements in the hearing status of Indigenous schoolchildren at Cherbourg can be attributed to a number of factors, including increased awareness of both ear health and general health, as well as the introduction of hearing health care services, over the past three decades.

Cherbourg's Chinatown: creating an identity of place on an Australian Aboriginal settlement

This is the story of an extraordinary Aboriginal woman, Princy Carlo, and the identity of place she and her descendants fashioned within the confines of the Aboriginal settlement of Cherbourg (formerly Barambah), during the early twentieth century. The patch of Cherbourg that came to be known as 'Chinatown' has to date attracted cursory reference in historical commentary on the south-eastern Queensland Aboriginal settlement. Yet, hidden beneath what may appear as an inconsequential historical detail lies a fascinating illustration of the negotiation of place identity within a frame of triangulated group relations (Aboriginal-Chinese-White) in what remained, in essence, a colonial society. Incorporating primary written sources and oral accounts from descendants the study analyses the forging of the Chinatown identity of place through a process of 'spatial othering', eliciting features unique to this indigenous identity-construct. The study provides an insight into Aboriginal connection and kinship with land following forced removal to a government settlement, and contributes to the historical records of the Cherbourg Aboriginal community and the Eidsvold district in Queensland, Australia. (C) 2003 Elsevier Science Ltd. All rights reserved.

Whitegoods (Aboriginal Affairs)

Despite all the rhetopic there has been little recognition of the way in which different cultural frameworks should set political goals and aspirations.

Hypertension, dyslipidemia, body mass index, Diabetes and smoking status in aboriginal australians in a remote community

Objectives: Study objectives were: 1) to describe the differences in the prevalence of CHID risk factors between Aboriginal people in a remote community and the general Australian population; and 2) to compare the predicted risks of CHD events between Aboriginal and non-Aboriginal Australians. Design: A cross-sectional study. Participants: 681 Aboriginal adults aged 25 to 74 years. Results: Aboriginal young adults had substantially higher prevalence of diabetes compared to non-Aboriginal Australians. The prevalence ratios for diabetes were 12.5, 5.6, 3.2, 1.3, and 0.73 for 25-, 35-, 45-, 55-, and 65- to 74-year-old females, respectively, The corresponding values for males were 12.1, 2.7, 2.9, 0.69, and 0.42. Young females had a higher prevalence of obesity, overweight, and abnormal waist circumference, while males and females 45 years and older tended to have a lower prevalence of overweight and ab. normal waist circumference. Compared to the general population, Aboriginal adults had a lower prevalence of abnormal total cholesterol but a higher prevalence of abnormal HDL, triglycerides, hypertension, and smoking. The risk ratios of abnormal total cholesterol for females ages 2534, 35-44, 45-54, 55-64, and 65-75 years were 0.38, 0.53, 0.48, 0.48, and 0.41, respectively. Conclusions: Aboriginal people in the remote community experienced different levels of CHD risk predictors from the general Australian population. They had a lower prevalence of abnormal total cholesterol and a higher prevalence of abnormal HDL, smoking, diabetes, and hypertension.

Secondary prevention of renal and cardiovascular disease: Results of a renal and cardiovascular treatment program in an Australian aboriginal community

Australian Aborigines are experiencing an epidemic of renal and cardiovascular disease. In late 1995 we introduced a treatment program into the Tiwi community, which has a three- to fivefold increase in death rates and a recent annual incidence of treated ESRD of 2760 per million. Eligible for treatment were people with hypertension, diabetics with micro or overt albuminuria, and all people with overt albuminuria. Treatment centered around use of perindopril (Coversyl, Servier), with other agents added to reach BP goals; attempts to control glucose and lipid levels; and health education. Thirty percent of the adult population, or 267 people, were enrolled, with a mean follow up of 3.39 yr. Clinical parameters were followed every 6 mo, and rates of terminal endpoints were compared with those of 327 historical controls matched for baseline disease severity, followed in the pretreatment program era. There was a dramatic reduction in BP in the treatment group, which was sustained through 3 yr of treatment. Albuminuria and GFR stabilized or improved. Rates of natural deaths were reduced by an estimated 50% (P = 0.012); renal deaths were reduced by 57% (P = 0.038); and nonrenal deaths by 46% (P = 0.085). Survival benefit was suggested at all levels of overt albuminuria, and regardless of diabetes status, baseline BP, or prior administration of angiotensin converting enzyme inhibitors (ACEI). No significant benefit was apparent among people without overt albuminuria, nor among those with GFR less than 60 ml/min. An estimated 13 renal deaths and 10 nonrenal deaths were prevented, with the number-needed-to-treat to avoid one terminal event of only 11.6. Falling deaths and renal failure in the whole community support these estimates. The program was extremely cost-effective. Programs like this should be introduced to all high-risk communities as a matter of urgency.

Validation of self-reported cigarette smoking in a remote Australian Aboriginal community

Objective: To examine the relationship between self-reported tobacco smoking and urinary cotinine concentrations in the setting of a remote Aboriginal community. Methods: In a remote Northern Territory (NT) Aboriginal community the relationship between self-reported tobacco smoking and urinary cotinine concentrations was examined as part of a cross-sectional survey of cardiovascular risk factors. Current tobacco smoking was assessed as part of a questionnaire. The concentration of cotinine and cotinine/creatinine ratio (CCR) in a spot urine sample were used as a biochemical marker of nicotine exposure. Results: A total of 237 people took part in the survey, although completed questionnaires and urine results were available for 184 people. Current tobacco smoking was reported by 161 (69 [95% Cl 63 to 75]%) people, with higher rates among males (84/104, 81 [95% Cl 72 to 88]%) than females (77/129, 60 [95% Cl 51 to 68]%, p