Evaluating the petrol-sniffing prevention programs of the Healthy Aboriginal Life Team (HALT)

Abstract: The evaluation of the Healthy Aboriginal Life Team's (HALT) petrol-sniffing prevention programs at Yuendumu, Kintore and the Pitjantjatjara Lands first required a specification of program outcome—which was not changes in the enumerated prevalence of petrol sniffing, but alteration in parental perceptions of the relevance and effectiveness of families' nurturant authority over recalcitrant youngsters. The evaluation then proceeded by a series of interviews with resident or ex-resident adults (Aboriginal and non-Aboriginal) of Yuendumu, Kintore, Kiwirrkurra, Ernabella, Indulkana and Fregon. Adults articulated their efficacy in different ways in each place. Some favoured the conclusion that HALT had helped them, others clearly identified HALT as an obstacle to or a distraction from the implementation of other preventive and curative community-based action. We discerned a ferment of cultural adjustment in the distribution of authority over children among parents and welfare agencies. We caution against finding in HALT'S successes a model procedure for benign interventions into such cultural adjustment.     

Balance of prostacyclin and thromboxane in offspring of parents with premature coronary arterial disease.

6-keto-prostaglandin F1a and thromboxane B2 were determined in order to obtain more information about the prostacyclin synthesis and thromboxane A2 release in 3- to 18-year-old healthy children and in offspring of parents who have had an acute myocardial infarction before the age of 45. The authors demonstrated a reduction of plasma prostacyclin synthesis in children with a positive family history of premature coronary arterial disease. Thromboxane levels in the affected adolescent boys were significantly lower compared with the controls. The ratio of thromboxane:prostacyclin in endangered children did not show a significant difference from that of healthy controls. These data indicate that prostaglandins are a definitive marker for identifying cardiovascular risk children. It must be supposed that in adolescence, only in boys, with a positive family history of premature coronary arterial disease, a compensatory mechanism exists to protect them from developing an imbalance in the regulation of prostaglandins.     

Immunology

A selection of interesting papers that were published in the two months before our press date in major journals most likely to report significant results in immunology.     

Access to primary health care for Australian young people: service provider perspectives.

BACKGROUND: To adequately address the complex health needs of young people, their access to services, and the quality of services received, must be improved. AIMS: To explore the barriers to service provision for young people and to identify the training needs of primary healthcare service providers in New South Wales (NSW), Australia. DESIGN OF STUDY: A cross-sectional, qualitative study of the perspectives of a range of health service providers. SETTING: A range of primary healthcare organisations across NSW. METHODS: Samples of general practitioners (GPs), youth health workers, youth health coordinators, and community health centre staff were drawn from urban and rural clusters across NSW. Focus groups and interviews were used to identify barriers to service provision and the training needs of service providers. Data were tape recorded, transcribed, and analysed. RESULTS: Barriers to service provision among GPs and community health centre staff included inadequate time, flexibility, skills, and confidence in working with young people, and poor linkages with other relevant services. Training needs included better knowledge of and skills in adolescent health requirements, working with adolescents, and working with other services. Barriers to service provision for youth health workers and coordinators included lack of financial resources and infrastructure. There were few linkages between groups of service providers. CONCLUSION: Models of service provision that allow stronger linkages between service providers, sufficient time for consultation with young people, adequate training and support of health professionals, and flexibility of service provision, including outreach, should be explored and evaluated.