General practitioner utilisation amongst urban Aboriginal and Torres Strait Islander children aged less than 5 years

Aim There are limited studies documenting the frequency and reason for attendance to primary health care services in Australian children, particularly for urban Aboriginal and Torres Strait Islander children. This study describes health service utilisation in this population in an urban setting. Methods An ongoing prospective cohort study of Aboriginal and Torres Strait Islander children aged <5 years registered with an urban Aboriginal and Torres Strait Islander primary health care centre in Brisbane, Australia. Detailed demographic, clinical, health service utilisation and risk factor data are collected by Aboriginal researchers at enrolment and monthly for a period of 12 months on each child. The incidence of health service utilisation was calculated according to the Poisson distribution. Results Between 14 February 2013 and 31 October 2014, 118 children were recruited, providing data for 535 child-months of observation. Ninety-one percent of children were Aboriginal, 4% Torres Strait Islander and 5% were both Aboriginal and Torres Strait Islander. The incidence of presentations to see a doctor for any reason was 43.9 episodes/100 child months (95%CI 38.4 – 49.9) The most common reasons for presentation were for immunisations (23%), respiratory illnesses (19%) and for Australian Government funded Indigenous child health check (16%). The primary health services used, for majority of these visits were Aboriginal and Torres Strait Islander specific medical services (61%). Conclusions Within a cultural-specific service for an urban Aboriginal and Torres Strait Islander people, there is a high frequency of childhood attendance at for primary health care services. Well-health checks and respiratory illnesses were the most common reasons. The high proportion of visits for well child services suggests a potential for opportunistic health promotion, education and early interventions across a range of child health issues.

'Work it out': Evaluation of a chronic condition self-management program for urban Aboriginal and Torres Strait Islander people with or at risk of cardiovascular disease

This thesis evaluates a chronic condition self-management program for Aboriginal and Torres Strait Islander people in urban south-east Queensland who have or are at risk of cardiovascular disease. Outcomes showed short-term improvements for some anthropometry measures which could be a trend for improvement in other anthropometry indicators over the longer term. The program was of particular benefit for participants who had several social and emotional wellbeing conditions. The use of an Aboriginal and Torres Strait Islander conceptual framework was critical in undertaking culturally competent quantitative research in this project.

"We don't tell people what to do": An ethnography of health promotion with Indigenous Australians in South East Queensland

This thesis contributes to the decolonisation of health promotion by examining Indigenous-led health promotion practice in an urban setting. Using critical ethnography, the study revealed dialogical, identity-based approaches that centred relationship, community control and choice. Based on the findings, the thesis proposes four interrelated principles for decolonising health promotion and argues that Indigenous-led health promotion presents a way to bridge the rhetoric and practice of empowerment in Australian mainstream health promotion practice.

Retinal photography screening programs to prevent vision loss from diabetic retinopathy in rural and urban Australia: A review

Purpose This review assessed the effectiveness of diabetic retinopathy (DR) screening programs, using retinal photography in Australian urban and rural settings, and considered implications for public health strategy and policy. Methods An electronic search of MEDLINE, PubMed, and Embase for studies published between 1 January 1996 and the 30 June 2013 was undertaken. Key search terms were “diabetic retinopathy,” “screening,” “retinal photography” and “Australia.” Results Twelve peer-reviewed publications were identified. The 14 DR screening programs identified from the 12 publications were successfully undertaken in urban, rural and remote communities across Australia. Locations included a pathology collection center, and Indigenous primary health care and Aboriginal community controlled organizations. Each intervention using retinal photography was highly effective at increasing the number of people who underwent screening for DR. The review identified that prior to commencement of the screening programs a median of 48% (range 16–85%) of those screened had not undergone a retinal examination within the recommended time frame (every year for Indigenous people and every 2 years for non-Indigenous people in Australia). A median of 16% (range 0–45%) of study participants had evidence of DR. Conclusions This review has shown there have been many pilot and demonstration projects in rural and urban Australia that confirm the effectiveness of retinal photography-based screening for DR

Enabling Indigenous education success beyond regional borders

Higher education is a powerful tool for reducing social and economic disadvantage. But access to higher education can be difficult, particularly for Indigenous Australians who face multiple levels of social, economic and geographical isolation. While enabling programs can support Indigenous students to gain university entry, the experience at Central Queensland University (CQUniversity) suggests that their past success has been limited. In this paper, the authors describe the enabling program available to Indigenous students at CQUniversity. They suggest that the newly developed, flexible, online version of the program is helping to address geographical and social isolation and improve successful outcomes for Indigenous Australians.

A multi-centre open-label randomised non-inferiority trial comparing watchful waiting to antibiotic treatment for acute otitis media without perforation in low-risk urban Aboriginal and Torres Strait Islander children (the WATCH trial): study protocol for a randomised controlled trial

Background Treatment guidelines recommend watchful waiting for children older than 2 years with acute otitis media (AOM) without perforation, unless they are at high risk of complications. The high prevalence of chronic suppurative otitis media (CSOM) in remote Aboriginal and Torres Strait Islander communities leads these children to be classified as high risk. Urban Aboriginal and Torres Strait Islander children are at lower risk of complications, but evidence to support the subsequent recommendation for watchful waiting in this population is lacking. Methods/Design This non-inferiority multi-centre randomised controlled trial will determine whether watchful waiting is non-inferior to immediate antibiotics for urban Aboriginal and Torres Strait Islander children with AOM without perforation. Children aged 2 − 16 years with AOM who are considered at low risk for complications will be recruited from six participating urban primary health care services across Australia. We will obtain informed consent from each participant or their guardian. The primary outcome is clinical resolution on day 7 (no pain, no fever of at least 38 °C, no bulging eardrum and no complications of AOM such as perforation or mastoiditis) as assessed by general practitioners or nurse practitioners. Participants and outcome assessors will not be blinded to treatment. With a sample size of 198 children in each arm, we have 80 % power to detect a non-inferiority margin of up to 10 % at a significance level of 5 %, assuming clinical improvement of at least 80 % in both groups. Allowing for a 20 % dropout rate, we aim to recruit 495 children. We will analyse both by intention-to-treat and per protocol. We will assess the cost- effectiveness of watchful waiting compared to immediate antibiotic prescription. We will also report on the implementation of the trial from the perspectives of parents/carers, health professionals and researchers. Discussion The trial will provide evidence for the safety and effectiveness of watchful waiting for the management of AOM in Aboriginal and Torres Strait Islander children living in urban settings who are considered to be at low risk of complications.

Two worlds apart: Indigenous community perspectives and Non-Indigenous teacher perspectives on Australian schools

Our evaluation studies of Indigenous school reform begin from a different starting point: listening to, hearing and engaging with the commentaries, voices, narratives and analyses of Indigenous community as they discuss and recount their experiences and current encounters with Australian state schools. Here we undertake a contrastive documentation of the views of Indigenous community members, Elders, parents, education workers, and young people and, indeed, of the views of their non-Indigenous teachers and school principals. This is a dramatic picture of two distinctive cultural lifeworlds, communities and worldviews in contact, of two very different ‘constructions’ by participants of a shared, mutual experience: everyday interaction in the social field of the Australian school. Taken together, our Indigenous and non-Indigenous participants repeatedly confirmed and corroborated a key theme: that Indigenous peoples continue to be viewed and ‘treated’ through the lens and language of cultural, intellectual and moral ‘deficit’.

Marketing of small indigenous species of fish (SIS) in three selected fish markets of Mymensingh

A socio-economic survey was conducted round the year in three fish markets at Mymensingh, Bangladesh. The selected markets were categorized as rural market (Sutiakhali market), a peri-urban market (Kamal Ranjeet market, BAU) and an urban market (Notun Bazar market, Mymensingh town). It was learnt from the survey that the availability of Small Indigenous Fish Species (SIS) declined to a great extent over the last few years and at presently many of such fish species are either threatened or at the edge of extinction. The supply of SIS was highest in KR market (37% of total) and more or less similar in Notun Bazar and Sutiakhali fish market (25 and 27% respectively). The total supply of SIS fluctuated from 25% to 35% throughout the year in these markets. About 48 SIS were found in the sampled markets over the survey period. The highest number of species (45) was found in KR market followed by Notun Bazar (42) and Sutiakhali (37) fish markets. During the survey, three critically endangered species namely, schilbid catfish, garua catfish and rita were found in these markets. Beside these, other 11 and 10 species were listed to be endangered and vulnerable respectively. The biodiversity of 21 SIS found in three markets were no threat at all. Three species (guntea loach, Indian glass barb and flying barb) were 'data deficient' as reported by the IUCN Red Book (IUCN-Bangladesh 2000). From the supply point of view small prawn, spotted snakehead, stinging catfish, pool barb, striped dwarf catfish, Gangetic mystus, walking catfish and tank goby were the prominent fish. The least available species found in this survey were lesser spiny eel, barred spiny eel, Gangetic ailia, freshwater garfish, zig-zag eel, flying barb, Ganges river sprat, freshwater river shad and dwarf gourami. The weight of SIS available in Notun bazar was highest and nearly double than other two markets. There was no significant difference recorded in the supply of SIS in Sutiakhali and KR markets. The average monthly SIS supply was 185, 192 and 467 kg in KR, Sutiakhali and Notun Bazar, respectively; therefore, the cumulative average supply was 844 kg per month in three markets. The price of SIS ranged widely from taka 50-450/kg depending on species, location of market, time of purchase and the condition of fish. In general small prawn, ticto barb, dwarf gourami, Gangetic leaffish, and Annandale loach were sold at a lower price (ranged taka 50-100/kg) and these species could be considered at the bottom of the market-price list. Other SIS like walking catfish, climbing parch, butter catfish, cotio and schilbid catfish valued as highest price (ranged taka 150-450/kg). There was no specific marketing chain for SIS in Mymensingh region. The components of marketing channels and their expansion varied with seasons and locations. The general pattern, however, was as this - after buying fish from fish farmer/fishermen, middlemen (locally known as Foria) used to buy fish to wholesale market and sell to the wholesalers. The retailers used to buy fish from wholesaler through auction to the highest bidders. The retailers then send the fish to particular market where the fish reached the consumers. The livelihood strategy of SIS retailers in three fish markets showed that socio-economic constraints such as low income, poor educational background, low economic status and lack of capital are the main constrains [sic]. Most of the retailers proposed that government should control the fish price throughout the year, so that the producers can get reasonable and stable price. Construction of cold storage and preservation facilities at market sites, improvement of road and communication, improvement of physical market facilities and reduction of market chain is essential. Credit facilities, improvement of their standard of living, health and sanitary condition, housing condition, children education and access to drinking water facilities were identified as additional aspects to improve socio-economic condition of SIS retailers.

Response of macrozoobenthos communities to ecological engineering remediation in a hypertrophic urban lake

The relationship of macrozoobenthos communities with some environmental variables, and their response to the ongoing restoration measures were studied in a small hypertrophic urban lake near the Yangzte River, China. Twenty taxa including 9 oligochaetes, 7 insects, 2 mollusks and two other animals were found during March 2005 to May 2006. The reappearance of some indigenous macrozoobenthos species showed that the ecological engineering remediation carried out was helpful for the recovery of the macrozoobenthos communities. Through canonical correspondence analysis (CCA), it was detected that temperature (T), conductivity (COND), Secchi depth/deep (SD/Deep), TN, total suspended solids (SS) and chemical oxygen demand (CODcr) were significant environmental factors that influenced the pattern of macrozoobenthos. Limnodrilus hoffmeisteri, Tanypus sp. and Alocinma longicornis could be used as potential bio-indicators in monitoring the development of ecological restoration.

Instituting order: the limitations of Nasser’s post-colonial planning visions for Cairo in the case of the indigenous quarter of Bulaq (1952–1970)

This paper investigates the limitations of postcolonial planning practices that aimed to modernise Cairo’s urban spaces during Gamal Abdel Nasser rule (1952–70). Following the Free Officers revolution of 1952, ambition to display urban order through forceful change in the city’s built environment was in action. Nasser’s visions of modernity were explicit in a series of attempts to reshape several prime locations in central Cairo, which included the old traditional waterfront quarter, in Bulaq Abul Ela. An analysis of the Bulaq planning scheme drafted in 1966 reveals insights into how notions of order were spatialised to integrate with Cairo’s complex urban fabric. The official plans to regularise Bulaq also strongly demonstrates how this was a top-down, centralised process in terms of governance, with full utilisation of state resources, namely the military and the media. From a wider perspective, planning practices under Nasser demonstrated an evident break with the past to eliminate memories of colonisation and disorder. Drawing on original resources, archival material, meeting minutes and maps of this historical but dilapidated quarter of Cairo, this paper gives an insight into how Nasser’s government attempted to convey a sense of order in a revolutionary country without, however, having an understanding of order as a coherent, multilayered and sequential process of change.

Dairy farms typology and management of animal genetic resources in the peri-urban zone of Bamako (Mali)

Facing growth in demand, dairy production in peri-urban areas of developing countries is changing rapidly. To characterise this development around Bamako (Mali), this study establishes a typology of dairy production systems with a special focus on animal genetic resources. The survey included 52 dairy cattle farms from six peri-urban sites. It was conducted in 2011 through two visits, in the dry and harvest seasons. The median cattle number per farm was 17 (range 5-118) and 42% of farmers owned cropland (8.3 +/- 7.3 ha, minimum 1 ha, maximum 25 ha). Feeding strategy was a crucial variable in farm characterisation, accounting for about 85% of total expenses. The use of artificial insemination and a regular veterinary follow-up were other important parameters. According to breeders’ answers, thirty genetic profiles were identified, from local purebreds to different levels of crossbreds. Purebred animals raised were Fulani Zebu (45.8%), Maure Zebu (9.2%), Holstein (3.0%), Azawak Zebu (1.3%), Mere Zebu (0.5%) and Kuri taurine (0.1%). Holstein crossbred represented 30.5% of the total number of animals (19.0% Fulani-Holstein, 11.2% Maure-Holstein and 0.3% Kuri-Holstein). Montbéliarde, Normande and Limousin crossbreds were also found (6.6%, 0.7% and 0.3%, respectively). A multivariate analysis helped disaggregate the diversity of management practices. The high diversity of situations shows the need for consideration of typological characteristics for an appropriate intervention. Although strongly anchored on local breeds, the peri-urban dairy systems included a diversity of exotic cattle, showing an uncoordinated quest of breeders for innovation. Without a public intervention, this dynamic will result in an irremediable erosion of indigenous animal genetic resources.

Adding value to the urban lawnscape: insect abundance and diversity in grass-free lawns

Insect diversity may be declining even more rapidly than in plants and vertebrates, particularly in areas where indigenous habitats are replaced by an anthropogenic one. The most common component of anthropogenic greenspace is the ornamental lawn. Intensively managed and offering limited habitat opportunities for both plants and insects, lawns are biodiversity poor and ecologically insensitive. An alternative lawn format that positively influences biodiversity and reduces management requirements would be a useful tool in eco-friendly urban greenspace management. In investigating the potential for a forb-only alternative to the grass lawn we sampled both trial grass-free lawn formats and turf lawns to identify any influence that lawn composition and grass-free lawn specific mowing regimes might have on the abundance and diversity of insect families. In addition to the mowing regimes, both the composition and origin of lawn flora were found to significantly influence insect abundance and diversity and these factors rarely interacted. Native-only and mixed origin grass-free lawns hosted greater numbers of adult insects than found in turf and an equivalent diversity of insect families, however the mowing regime applied was distinct from traditional turf lawn management by being substantially less intensive and our results suggest that there is the potential for even greater abundance and diversity via the grass-free format that may offer additional resources to insectivorous garden species such as birds. When the composition of grass-free lawns included native forbs the diversity of insect families was found be sufficiently different from turf lawns to form distinct assemblages and in so doing contribute to beta diversity within urban greenspace. In sum, grass-free lawns may be a useful and aesthetically appropriate tool for adding value to the generally biodiversity poor urban lawnscape.

Animal cysticercosis in indigenous Brazilian villages

A inspeção sanitária da carne bovina e suína tem sido a principal forma diagnóstica da cisticercose animal e da prevenção da teníase no Brasil. As aldeias indígenas Jaguapirú e Bororó estão localizadas próximo à área urbana do município de Dourados-MS, com condições precárias de saneamento básico, onde bovinos e suínos são criados como fonte de alimento para consumo próprio, bem como para comercialização externa, geralmente sem inspeção sanitária oficial. Neste estudo, 96 carcaças bovinas e 117 amostras de soro de suínos, criados nas aldeias indígenas, foram avaliadas para a presença de formas metacestóides à inspeção sanitária e de anticorpos anti-Taenia sp. ao teste ELISA, respectivamente. Observaram-se 18,75% de positividade para cisticercose bovina e 9,4% para cisticercose suína. A ocorrência do complexo teníase-cisticercose nas aldeias pode favorecer a ocorrência desta zoonose na população indígena. Condições adequadas de abate e inspeção sanitária dos animais destas aldeias se fazem urgente para o controle do complexo teníase-cisticercose na população indígena.

Air pollution levels measured at traffic hot spots : Brisbane urban corridor study

Air pollution levels were monitored continuously over a period of 4 weeks at four sampling sites along a busy urban corridor in Brisbane. The selected sites were representative of industrial and residential types of urban environment affected by vehicular traffic emissions. The concentration levels of submicrometer particle number, PM2.5, PM10, CO, and NOx were measured 5-10 meters from the road. Meteorological parameters and traffic flow rates were also monitored. The data were analysed in terms of the relationship between monitored pollutants and existing ambient air quality standards. The results indicate that the concentration levels of all pollutants exceeded the ambient air background levels, in certain cases by up to an order of magnitude. While the 24-hr average concentration levels did not exceed the standard, estimates for the annual averages were close to, or even higher than the annual standard levels.