Diabetes in Australian aboriginal and Torres Strait Islander peoples

Type 2 diabetes arises from a complex and multifactorial set of factors, including genetic susceptibility, behaviour (including diet and exercise), early nutrition, obesity and psychosocial stress, leading to insulin resistance and pancreatic failure. These factors in turn are influenced by social and physical environmental factors. Each of these may be important determinants of the high prevalence and incidence of type 2 diabetes in Australian Aboriginal and Torres Strait Islander people. Public health interventions for primary and secondary prevention need to recognize this complexity. Although a reduction in the prevalence of obesity or diabetes in the short-medium term is rarely if ever achieved, there are documented examples of community-based programs which have been effective in reducing the risk of developing type 2 diabetes and its cardiovascular complications. Such interventions need to be community-directed and appropriate to local circumstances in order to be effective.     

The tobacco industry and Aboriginal and Torres Strait Islander people

Three features are essential in designing the flexible funding payments and pay-for-performance elements.     

General practice training in Aboriginal and Torres Strait Islander health

This article reviews the history of general practice vocational training in Aboriginal and Torres Strait Islander health, identifies current initiatives and recommends future approaches based on recent evidence. General practice vocational training in Aboriginal and Torres Strait Islander health requires ongoing support and investment from governments and training and general practice organisations if the gains made to date are to be consolidated and health outcomes are to improve. In particular, investment in sustained and respectful partnerships with Aboriginal and Torres Strait Islander peoples and organisations will continue to provide the groundwork for effective training of general practitioners in this critical health area, and will also play an important role in capacity-building in Aboriginal and Torres Strait Islander communities.     

Overseas-trained doctors in Aboriginal and Torres Strait Islander health services: many unanswered questions

Aboriginal and Torres Strait Islander health services are heavily dependent on overseas-trained doctors (OTDs). These OTDs are increasingly from countries with variable English language and educational equivalency compared with locally trained doctors. Aboriginal and Torres Strait Islander health services create particular demands for all doctors, such as negotiating "cultural domains" and acknowledging the contribution of Aboriginal health workers. Little is known about the roles and experience of OTDs in health service provision in Indigenous communities. Barriers to effective research into the experience of OTDs include privacy legislation and a lack of standardised data. Researching the narratives of OTDs in Indigenous health services offers an opportunity to explore the diversity and complexity of the cultural interfaces in health service provision.     

The National Health and Medical Research Council Road Map: a strategic framework for improving Aboriginal and Torres Strait Islander health through research

What impact has the NHMRC Road Map had on Aboriginal and Torres Strait Islander health? A review process now underway aims to find out.     

Reducing the burden of cancer for Aboriginal and Torres Strait Islander Australians: time for a coordinated, collaborative, priority-driven, Indigenous-led research program

Australia's efforts to prevent, diagnose and treat cancer are not as successful for Aboriginal and Torres Strait Islander people as they are for other Australians. There is a need for a nationally coordinated, collaborative, priority-driven research effort to better understand what works, and we need to implement that knowledge. All aspects of the process must involve genuine Indigenous leadership and participation.     

The Lowitja Institute: building a national strategic research agenda to improve the health of Aboriginal and Torres Strait Islander peoples

With community involvement, research can be a powerful tool for closing the gap in Indigenous health disparity.     

Health of Aboriginal and Torres Strait Islander children in remote Far North Queensland: findings of the Paediatric Outreach Service

AIM: To describe the pattern of disease and other health problems in children living in remote Far North Queensland (FNQ). DESIGN, SETTING AND PARTICIPANTS: Retrospective review of the FNQ Paediatric Outreach Service's Medical Director database for the period June 2001 to February 2006. Three subpopulations were compared: children from predominantly Aboriginal communities, predominantly Torres Strait Islander communities, and other communities. All children referred to the service during the study period were reviewed. MAIN OUTCOME MEASURES: Number of children seen and common diagnoses. RESULTS: 3562 children were referred during the study period, and a total of 3932 diagnoses were made; 56% of the paediatric population of the Aboriginal communities and 23% of the paediatric population of Torres Strait Islander communities were seen. Of 40 separate diseases/health problems reviewed, the three most common reasons for presentation were chronic suppurative otitis media, suspected child abuse and neglect, and failure to thrive. In the paediatric population of Aboriginal communities, the prevalence of fetal alcohol spectrum disorder was at least 15/1000 (1.5%), and in Torres Strait Islander children, rheumatic heart disease prevalence was at least 6/1000 (0.6%). Rheumatic fever rates were among the highest in Australia. CONCLUSION: Rates of preventable complex and chronic health problems in Aboriginal and Torres Strait Islander children in remote FNQ are alarmingly high. Areas requiring urgent public health intervention include alcohol-related conditions and rheumatic fever.     

山东省潍坊市1992～2003年艾滋病监测资料分析

目的 :了解潍坊市AIDS/HIV感染者流行病特征 ,分析其流行趋势 ,为相关部门采取措施提供科学依据。方法 :对潍坊市 1992～ 2 0 0 3年艾滋病重点人群血清学监测结果归纳整理 ,进行流行病学分析。结果 :十二年来全市共检测血清 1195 77人份 ,发现HIV阳性者 11例 ,检出率为 9.19/ 10万 ,其中AIDS病人 4例 (死 3例 )。男女比例 7∶4 ,2 2岁～ 38岁 10例 ,6月龄幼儿 1例。职业以农民为主 (9例 )。外地传入 7例 ,本地感染 4例。血液、性接触及母—婴三种传播途径均有。 2 0 0 3年HIV检出人数明显增加 ,1992～ 1997年仅检出 1例 ,1998～ 2 0 0 2年检出 3例 ,2 0 0 3年检出 7例。结论　潍坊市属艾滋病低流行区 ,12年期间 ,感染率 1.2 8/ 10万 ,但有向快速增长发展的趋势。今后应加大监测力度 ,加强医务人员专业知识培训和人民群众的宣传教育。     

2010-2011年贵阳市吸毒人员艾滋病国家级哨点监测情况分析

目的:了解本地区吸毒人群一般人口学情况、艾滋病防治知识知晓情况、行为学情况以及HIV感染情况,为行为干预工作提供针对性措施。方法:按照《全国艾滋病哨点监测实施方案》对一般人口学信息、血清学信息、行为学信息、艾滋病防治有关信息进行监测。结果:2011年女性在吸毒人群中的比例有所上升,同居比例上升。2010年HIV阳性率为1.5%,2011年HIV检出率为1.0%。结论:2011年吸毒人群中女性所占比例上升,在强制戒毒所期间发生性行为的比例上升。提示以后工作中应加强对女性和安全性行为的健康教育。