Exploring factors impacting early childhood health among Aboriginal and Torres Strait Islander families and communities: protocol for a population-based cohort study using data linkage (the ‘Defying the Odds’ study)

PubMed Central

Gubhaju, Lina; Jorm, Louisa; Preen, David; Jones, Jocelyn; Joshy, Grace; Shepherd, Carrington; McAullay, Daniel; Eades, Sandra; Ball, Stephen

2018-01-01

Introduction Empirical evidence on family and community risk and protective factors influencing the comparatively high rates of potentially preventable hospitalisations and deaths among Aboriginal and Torres Strait Islander infants and children is limited. As is evidence on geographical variation in these risks. The ‘Defying the Odds’ study aims to explore the impact of perinatal outcomes, maternal social and health outcomes and level of culturally secure service availability on the health outcomes of Western Australian (WA) Aboriginal infants and children aged 0–5 years. Methods and analysis The study combines a retrospective cohort study that uses state-wide linked health and administrative data from 12 data sources for multiple generations within Aboriginal families in WA, with specifically collected survey data from health and social services supporting Aboriginal families in regions of WA. Data sources include perinatal/birth registration, hospital, emergency department, mental health services, drug and alcohol service use, mortality, infectious disease notifications, and child protection and family services. Multilevel regression models will be used to examine the intensity of admissions and presentations, mortality, intensity of long stays and morbidity-free survival (no admissions) for Aboriginal children born in WA in 2000–2013. Relationships between maternal (and grand-maternal) health and social factors and child health outcomes will be quantified. Community-level variation in outcomes for Aboriginal children and factors contributing to this variation will be examined, including the availability of culturally secure services. Online surveys were sent to staff members at relevant services to explore the scope, reach and cultural security of services available to support Aboriginal families across selected regions of WA. Ethics and dissemination Ethics approvals have been granted for the study. Interpretation and dissemination are guided by the study team’s Aboriginal leadership and reference groups. Dissemination will be through direct feedback and reports to health services in the study and via scientific publications and policy recommendations. PMID:29599395

What factors contribute to positive early childhood health and development in Australian Aboriginal children? Protocol for a population-based cohort study using linked administrative data (The Seeding Success Study).

PubMed

Falster, Kathleen; Jorm, Louisa; Eades, Sandra; Lynch, John; Banks, Emily; Brownell, Marni; Craven, Rhonda; Einarsdóttir, Kristjana; Randall, Deborah

2015-05-18

Australian Aboriginal children are more likely than non-Aboriginal children to have developmental vulnerability at school entry that tracks through to poorer literacy and numeracy outcomes and multiple social and health disadvantages in later life. Empirical evidence identifying the key drivers of positive early childhood development in Aboriginal children, and supportive features of local communities and early childhood service provision, are lacking. The study population will be identified via linkage of Australian Early Development Census data to perinatal and birth registration data sets. It will include an almost complete population of children who started their first year of full-time school in New South Wales (NSW), Australia, in 2009 and 2012. Early childhood health and development trajectories for these children will be constructed via linkage to a range of administrative data sets relating to birth outcomes, congenital conditions, hospital admissions, emergency department presentations, receipt of ambulatory mental healthcare services, use of general practitioner services, contact with child protection and out-of-home care services, receipt of income assistance and fact of death. Using multilevel modelling techniques, we will quantify the contributions of individual-level and area-level factors to variation in early childhood development outcomes in Aboriginal and non-Aboriginal children. Additionally, we will evaluate the impact of two government programmes that aim to address early childhood disadvantage, the NSW Aboriginal Maternal and Infant Health Service and the Brighter Futures Program. These evaluations will use propensity score matching methods and multilevel modelling. Ethical approval has been obtained for this study. Dissemination mechanisms include engagement of stakeholders (including representatives from Aboriginal community controlled organisations, policy agencies, service providers) through a reference group, and writing of summary reports for policy and community audiences in parallel with scientific papers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Does Child Abuse and Neglect Explain the Overrepresentation of Aboriginal and Torres Strait Islander Young People in Youth Detention? Findings from a Birth Cohort Study

ERIC Educational Resources Information Center

Doolan, Ivan; Najman, Jake M.; Mills, Ryan; Cherney, Adrian; Strathearn, Lane

2013-01-01

Objective: Determine whether a history of family social disadvantage and/or child abuse and neglect explain the overrepresentation of Indigenous Australian young people in youth detention. Methods: Maternal survey data from the Mater University Study of Pregnancy was linked with child abuse and neglect and youth justice data from the Queensland…

The oral health behaviours and fluid consumption practices of young urban Aboriginal preschool children in south-western Sydney, New South Wales, Australia.

PubMed

George, Ajesh; Grace, Rebekah; Elcombe, Emma; Villarosa, Amy R; Mack, Holly A; Kemp, Lynn; Ajwani, Shilpi; Wright, Darryl C; Anderson, Cheryl; Bucknall, Natasha; Comino, Elizabeth

2018-04-01

Australian Aboriginal children have a higher risk of dental caries yet there is limited focus on oral health risk factors for urban Aboriginal preschool children. This study examined the oral health behaviours and fluid consumption practices of young children from an urban Aboriginal community in south-western Sydney, Australia. In total, 157 Aboriginal children who were recruited to the "Gudaga" longitudinal birth cohort participated in this study. A survey design was employed and parents responded to the oral health questions when their child was between 18 and 60 months. Few parents (20%) were concerned about their child's oral health across the time period. By 60 months, only 20% of children had seen a dentist while 80% were brushing their teeth at least once daily. High levels of bottle use were seen up to 30 months. Consumption of sugary drinks was also very high in the early years, although this was replaced by water by 36 months. While there are some encouraging findings, such as the rates of tooth brushing and increasing rates of water consumption, the findings do highlight the poor uptake of dental services and high levels of bottle usage among urban aboriginal children during their early years. SO WHAT?: Targeted oral health promotional programs are needed in the urban Aboriginal community to better support parents understanding of good oral health practices in the early years and engagement with dental health services. © 2017 Australian Health Promotion Association.

Dental caries risk indicators among Australian Aboriginal young adults.

PubMed

Jamieson, Lisa M; Roberts-Thomson, K F; Sayers, S M

2010-06-01

To determine dental caries risk indicators among a birth cohort of Australian Aboriginal young adults (n=442). Data were from the Aboriginal Birth Cohort study, a prospective longitudinal investigation of Aboriginal individuals born 1987-1990 at an Australian regional hospital. Models representing demographic, socioeconomic, behavioural, dental service utilization and clinical oral health variables were tested using multivariate regression. The percent DT>0 was 72.9 (95% CI 68.7-77.1), mean DT was 4.19 (95% CI 3.8-4.6), percent DMFT>0 was 77.4 (95% CI 73.5-81.3) and mean DMFT was 4.84 (95% CI 4.4-5.3). After controlling for other covariates, risk indicators for percent DT>0 included soft drink consumption every day or a few times a week (PR 1.25, 95% CI 1.08-1.45), not consuming milk every day or a few times a week (PR 1.16, 95% CI 1.04-1.30) and sweet consumption every day or a few times a week (PR 1.18, 95% CI 1.04-1.33). Risk indicators for mean DT included sweet consumption every day or a few times a week (B=1.14, 95% CI 0.27-2.02), nonownership of a toothbrush (B=0.91, 95% CI 0.10-1.87) and presence of plaque (B=2.46, 95% CI 0.96-3.96). Those with 4 +  occupants in their house the previous night had 1.2 times the prevalence of having DMFT>0 than their counterparts with less household occupants (95% CI 1.01-1.49). Percent DMFT>0 was also associated with consumption of soft drink every day or a few times a week (PR 1.18, 95% CI 1.04-1.34) and consumption of sweets every day or a few times a week (PR 1.23, 95% CI 1.10-1.37). Mean DMFT was higher among those who consumed sweets every day or a few times a week (B = 0.13, 95% CI 0.05-0.22) and who had dental anxiety (B=0.10, 95% CI 0.01-0.19). In an Australian Aboriginal young adult cohort, risk indicators for dental caries included social determinants such as household size, dietary behaviours such as regular consumption of soft drink and sweets, dental behaviour such as nonownership of a toothbrush and dental anxiety. © 2009 John Wiley & Sons A/S.

Help bring back the celebration of life: A community-based participatory study of rural Aboriginal women’s maternity experiences and outcomes

PubMed Central

2013-01-01

Background Despite clear evidence regarding how social determinants of health and structural inequities shape health, Aboriginal women’s birth outcomes are not adequately understood as arising from the historical, economic and social circumstances of their lives. The purpose of this study was to understand rural Aboriginal women’s experiences of maternity care and factors shaping those experiences. Methods Aboriginal women from the Nuxalk, Haida and 'Namgis First Nations and academics from the University of British Columbia in nursing, medicine and counselling psychology used ethnographic methods within a participatory action research framework. We interviewed over 100 women, and involved additional community members through interviews and community meetings. Data were analyzed within each community and across communities. Results Most participants described distressing experiences during pregnancy and birthing as they grappled with diminishing local maternity care choices, racism and challenging economic circumstances. Rural Aboriginal women’s birthing experiences are shaped by the intersections among rural circumstances, the effects of historical and ongoing colonization, and concurrent efforts toward self-determination and more vibrant cultures and communities. Conclusion Women’s experiences and birth outcomes could be significantly improved if health care providers learned about and accounted for Aboriginal people’s varied encounters with historical and ongoing colonization that unequivocally shapes health and health care. Practitioners who better understand Aboriginal women’s birth outcomes in context can better care in every interaction, particularly by enhancing women’s power, choice, and control over their experiences. Efforts to improve maternity care that account for the social and historical production of health inequities are crucial. PMID:23360168

Inequalities in pediatric avoidable hospitalizations between Aboriginal and non-Aboriginal children in Australia: a population data linkage study.

PubMed

Falster, Kathleen; Banks, Emily; Lujic, Sanja; Falster, Michael; Lynch, John; Zwi, Karen; Eades, Sandra; Leyland, Alastair H; Jorm, Louisa

2016-10-21

Australian Aboriginal children experience a disproportionate burden of social and health disadvantage. Avoidable hospitalizations present a potentially modifiable health gap that can be targeted and monitored using population data. This study quantifies inequalities in pediatric avoidable hospitalizations between Australian Aboriginal and non-Aboriginal children. This statewide population-based cohort study included 1 121 440 children born in New South Wales, Australia, between 1 July 2000 and 31 December 2012, including 35 609 Aboriginal children. Using linked hospital data from 1 July 2000 to 31 December 2013, we identified pediatric avoidable, ambulatory care sensitive and non-avoidable hospitalization rates for Aboriginal and non-Aboriginal children. Absolute and relative inequalities between Aboriginal and non-Aboriginal children were measured as rate differences and rate ratios, respectively. Individual-level covariates included age, sex, low birth weight and/or prematurity, and private health insurance/patient status. Area-level covariates included remoteness of residence and area socioeconomic disadvantage. There were 365 386 potentially avoidable hospitalizations observed over the study period, most commonly for respiratory and infectious conditions; Aboriginal children were admitted more frequently for all conditions. Avoidable hospitalization rates were 90.1/1000 person-years (95 % CI, 88.9-91.4) in Aboriginal children and 44.9/1000 person-years (44.8-45.1) in non-Aboriginal children (age and sex adjusted rate ratio = 1.7 (1.7-1.7)). Rate differences and rate ratios declined with age from 94/1000 person-years and 1.9, respectively, for children aged <2 years to 5/1000 person-years and 1.8, respectively, for ages 12- < 14 years. Findings were similar for the subset of ambulatory care sensitive hospitalizations, but in contrast, non-avoidable hospitalization rates were almost identical in Aboriginal (10.1/1000 person-years, (9.6-10.5)) and non-Aboriginal children (9.6/1000 person-years (9.6-9.7)). We observed substantial inequalities in avoidable hospitalizations between Aboriginal and non-Aboriginal children regardless of where they lived, particularly among young children. Policy measures that reduce inequities in the circumstances in which children grow and develop, and improved access to early intervention in primary care, have potential to narrow this gap.

Aboriginal Families Study: a population-based study keeping community and policy goals in mind right from the start

PubMed Central

2013-01-01

Background Australian Aboriginal and Torres Strait Islander women are between two to five times more likely to die in childbirth than non-Aboriginal women, and two to three times more likely to have a low birthweight infant. Babies with a low birthweight are more likely to have chronic health problems in adult life. Currently, there is limited research evidence regarding effective interventions to inform new initiatives to strengthen antenatal care for Aboriginal families. Method/Design The Aboriginal Families Study is a cross sectional population-based study investigating the views and experiences of Aboriginal and non-Aboriginal women having an Aboriginal baby in the state of South Australia over a 2-year period. The primary aims are to compare the experiences and views of women attending standard models of antenatal care with those accessing care via Aboriginal Family Birthing Program services which include Aboriginal Maternal Infant Care (AMIC) Workers as members of the clinical team; to assess factors associated with early and continuing engagement with antenatal care; and to use the information to inform strengthening of services for Aboriginal families. Women living in urban, regional and remote areas of South Australia have been invited to take part in the study by completing a structured interview or, if preferred, a self-administered questionnaire, when their baby is between 4–12 months old. Discussion Having a baby is an important life event in all families and in all cultures. How supported women feel during pregnancy, how women and families are welcomed by services, how safe they feel coming in to hospitals to give birth, and what happens to families during a hospital stay and in the early months after the birth of a new baby are important social determinants of maternal, newborn and child health outcomes. The Aboriginal Families Study builds on consultation with Aboriginal communities across South Australia. The project has been implemented with guidance from an Aboriginal Advisory Group keeping community and policy goals in mind right from the start. The results of the study will provide a unique resource to inform quality improvement and strengthening of services for Aboriginal families. PMID:23767813

Recent fertility and mortality trends among aboriginal and nonaboriginal populations of central Siberia.

PubMed

Leonard, W R; Keenleyside, A; Ivakine, E

1997-06-01

We examine mortality and fertility patterns of aboriginal (primarily Evenki and Keto) and Russian (i.e., nonaboriginal) populations from the Baykit District of Central Siberia for the period 1982-1994. Mortality rates in the aboriginal population of Baykit are substantially greater than those observed in the Russians and are comparable to levels recently reported for other indigenous Siberian groups. Infant mortality rates average 48 per 1000 live births among Baykit aboriginals, three times greater than the Russians of the district (15 per 1000 births) and more than double the rates for Inuit and Indian populations of Canada. Similarly, crude death rates of the Baykit aboriginals are twice as high as those observed in either the Baykit Russians or the Canadian aboriginal populations (13 vs 6-7 deaths per 1000 individuals). Birth rates of the indigenous population of Baykit are higher than those of the Russians (33 vs. 15 births per 1000 individuals) but are comparable to those of Canadian aboriginal groups. Violence and accidents are the leading causes of adult male mortality in both ethnic groups, whereas circulatory diseases have emerged as the prime cause of death in women. The greater male mortality resulting from violence and accidents is a widely observed cross-cultural phenomenon. The emergence of circulatory diseases as a major mortality risk for women, however, appears to be linked to specific lifestyle changes associated with Soviet reorganization of indigenous Siberian societies. Marked declines in mortality and increases in fertility were observed in the Baykit aboriginal population during the mid to late 1980s with the government's implementation of anti-alcohol policies. The decline in mortality, however, was largely erased during the early 1990s, as the region became increasingly isolated and marginalized following the collapse of the Soviet Union. Demographic trends in the Baykit District suggest that because the indigenous groups have become more isolated, many are returning to a more traditional subsistence lifestyle.

Aboriginal Street-involved Youth Experience Elevated Risk of Incarceration

PubMed Central

Barker, Brittany; Alfred, Gerald Taiaiake; Fleming, Kim; Nguyen, Paul; Wood, Evan; Kerr, Thomas; DeBeck, Kora

2015-01-01

Objectives Past research has identified risk factors associated with incarceration among adult Aboriginal populations; however, less is known about incarceration among street-involved Aboriginal youth. Therefore, we undertook this study to longitudinally investigate recent reports of incarceration among a prospective cohort of street-involved youth in Vancouver, Canada. Study Design Prospective cohort study. Methods Data were collected from a cohort of street-involved, drug-using youth from September 2005 to May 2013. Multivariate generalized estimating equation analyses were employed to examine the potential relationship between Aboriginal ancestry and recent incarceration. Results Among our sample of 1050 youth, 248 (24%) reported being of aboriginal ancestry, and 378 (36%) reported being incarcerated in the previous six months at some point during the study period. In multivariate analysis controlling for a range of potential confounders including drug use patterns and other risk factors, Aboriginal ancestry remained significantly associated with recent incarceration (adjusted odds ratio [AOR]=1.44; 95% confidence interval [CI]: 1.12–1.86). Conclusions Even after adjusting for drug use patterns and other risk factors associated with incarceration, this study found that Aboriginal street-involved youth were still significantly more likely to be incarcerated than their non-Aboriginal peers. Given the established harms associated with incarceration these findings underscore the pressing need for systematic reform including culturally appropriate interventions to prevent Aboriginal youth from becoming involved with the criminal justice system. PMID:26390949

The effect of maternal betel quid exposure during pregnancy on adverse birth outcomes among aborigines in Taiwan.

PubMed

Yang, Mei-Sang; Lee, Chien-Hung; Chang, Shun-Jen; Chung, Tieh-Chi; Tsai, Eing-Mei; Ko, Allen Min-Jen; Ko, Ying-Chin

2008-05-01

In considering documented developmental toxicity and teratogenicity found in earlier research, maternal betel quid chewing may very well be linked to a higher risk of adverse birth outcomes. The aim of this study was to investigate the significance of betel quid chewing, together with the use of cigarettes or alcohol, either independently or combined, on birth-related outcomes. A total of 1264 aboriginal women who had just given birth in 10 hospitals in Southern and Eastern Taiwan were recruited. Information on their maternal and newborn characteristics was obtained from medical charts and by performing personal interviews using a validated questionnaire. Maternal areca nut chewing during pregnancy was found to be significantly associated with both birth weight loss (-89.54 g) and birth length reduction (-0.43 cm). A significantly lower male newborn rate (aOR=0.62) was observed among aboriginal women with a habit of betel quid chewing during pregnancy. The use of this substance conveyed a 2.40- and 3.67-fold independent risk of low birth weight and full-term low birth weight, respectively. An enhanced risk (aOR=3.26-5.99) of low birth weight was observed among women concomitantly using betel quid, cigarette and alcohol during gestation. Our findings suggest that betel quid chewing during pregnancy has a substantial effect on a number of birth outcomes, including sex ratio at birth, lower birth weight and reduced birth length.

Relation of child, caregiver, and environmental characteristics to childhood injury in an urban Aboriginal cohort in New South Wales, Australia.

PubMed

Thurber, Katherine; Burgess, Leonie; Falster, Kathleen; Banks, Emily; Möller, Holger; Ivers, Rebecca; Cowell, Chris; Isaac, Vivian; Kalucy, Deanna; Fernando, Peter; Woodall, Cheryl; Clapham, Kathleen

2018-04-01

Despite being disproportionately affected by injury, little is known about factors associated with injury in Aboriginal children. We investigated factors associated with injury among urban Aboriginal children attending four Aboriginal Community Controlled Health Services in New South Wales, Australia. We examined characteristics of caregiver-reported child injury, and calculated prevalence ratios of 'ever-injury' by child, family, and environmental factors. Among children in the cohort, 29% (n=373/1,303) had ever broken a bone, been knocked out, required stitches or been hospitalised for a burn or poisoning; 40-78% of first injuries occurred at home and 60-91% were treated in hospital. Reported ever-injury was significantly lower (prevalence ratio ≤0.80) among children who were female, younger, whose caregiver had low psychological distress and had not been imprisoned, whose family experienced few major life events, and who hadn't experienced alcohol misuse in the household or theft in the community, compared to other cohort members. In this urban Aboriginal child cohort, injury was common and associated with measures of family and community vulnerability. Implications for public health: Prevention efforts targeting upstream injury determinants and Aboriginal children living in vulnerable families may reduce child injury. Existing broad-based intervention programs for vulnerable families may present opportunities to deliver targeted injury prevention. © 2017 The Authors.

Exploring undergraduate midwifery students' readiness to deliver culturally secure care for pregnant and birthing Aboriginal women.

PubMed

Thackrah, Rosalie D; Thompson, Sandra C; Durey, Angela

2015-04-16

Culturally secure health care settings enhance accessibility by Aboriginal Australians and improve their satisfaction with service delivery. A culturally secure health service recognises and responds to the legitimate cultural rights of the recipients of care. Focus is upon the health care system as well as the practice and behaviours of the individuals within it. In an attempt to produce culturally secure practitioners, the inclusion of Aboriginal content in health professional programs at Australian universities is now widespread. Studies of medical students have identified the positive impact of this content on knowledge and attitudes towards Aboriginal people but relatively little is known about the responses of students in other health professional education programs. This study explored undergraduate midwifery students' knowledge and attitudes towards Aboriginal people, and the impact of Aboriginal content in their program. The study surveyed 44 students who were in their first, second and third years of a direct entry, undergraduate midwifery program at a Western Australian (WA) university. The first year students were surveyed before and after completion of a compulsory Aboriginal health unit. Second and third year students who had already completed the unit were surveyed at the end of their academic year. Pre- and post-unit responses revealed a positive shift in first year students' knowledge and attitudes towards Aboriginal people and evidence that teaching in the unit was largely responsible for this shift. A comparison of post-unit responses with those from students in subsequent years of their program revealed a significant decline in knowledge about Aboriginal issues, attitudes towards Aboriginal people and the influence of the unit on their views. Despite this, all students indicated a strong interest in more clinical exposure to Aboriginal settings. The inclusion of a unit on Aboriginal health in an undergraduate midwifery program has been shown to enhance knowledge and shift attitudes towards Aboriginal people in a positive direction. These gains may not be sustained, however, without vertical integration of content and reinforcement throughout the program. Additional midwifery-specific Aboriginal content related to pregnancy and birthing, and recognition of strong student interest in clinical placements in Aboriginal settings provide opportunities for future curriculum development.

A review of life expectancy and infant mortality estimations for Australian Aboriginal people

PubMed Central

2014-01-01

Background Significant variation exists in published Aboriginal mortality and life expectancy (LE) estimates due to differing and evolving methodologies required to correct for inadequate recording of Aboriginality in death data, under-counting of Aboriginal people in population censuses, and unexplained growth in the Aboriginal population attributed to changes in the propensity of individuals to identify as Aboriginal at population censuses. The objective of this paper is to analyse variation in reported Australian Aboriginal mortality in terms of LE and infant mortality rates (IMR), compared with all Australians. Methods Published data for Aboriginal LE and IMR were obtained and analysed for data quality and method of estimation. Trends in reported LE and IMR estimates were assessed and compared with those in the entire Australian population. Results LE estimates derived from different methodologies vary by as much as 7.2 years for the same comparison period. Indirect methods for estimating Aboriginal LE have produced LE estimates sensitive to small changes in underlying assumptions, some of which are subject to circular reasoning. Most indirect methods appear to under-estimate Aboriginal LE. Estimated LE gaps between Aboriginal people and the overall Australian population have varied between 11 and 20 years. Latest mortality estimates, based on linking census and death data, are likely to over-estimate Aboriginal LE. Temporal LE changes by each methodology indicate that Aboriginal LE has improved at rates similar to the Australian population overall. Consequently the gap in LE between Aboriginal people and the total Australian population appears to be unchanged since the early 1980s, and at the end of the first decade of the 21st century remains at least 11–12 years. In contrast, focussing on the 1990–2010 period Aboriginal IMR declined steeply over 2001–08, from more than 12 to around 8 deaths per 1,000 live births, the same level as Australia overall in 1993–95. The IMR gap between Aboriginal people and the total Australian population, while still unacceptable, has declined considerably, from over 8 before 2000 to around 4 per 1,000 live births by 2008. Conclusions Regardless of estimation method used, mortality and LE gaps between Aboriginal and non-Aboriginal people are substantial, but remain difficult to estimate accurately. PMID:24383435

The 'stolen generations' of mothers and daughters: child apprehension and enhanced HIV vulnerabilities for sex workers of Aboriginal ancestry.

PubMed

Duff, Putu; Bingham, Brittany; Simo, Annick; Jury, Delores; Reading, Charlotte; Shannon, Kate

2014-01-01

The number of children in care of the state continues to grow in BC, Canada with a historical legacy of child apprehension among criminalized and marginalized populations, particularly women of Aboriginal ancestry and sex workers. However, there is a paucity of research investigating child apprehension experiences among marginalized mothers. The objective of the current analysis is to examine the prevalence and correlates of child apprehensions among female sex workers in Vancouver, Canada. Analyses were drawn from the AESHA (An Evaluation of Sex Workers Health Access, 2010-present), a prospective cohort of street and off-street SWs, through outreach and semi-annual visits to the research office. Bivariate and multivariate logistic regression were used to examine correlates of child apprehension. Of a total of 510 SWs, 350 women who had given birth to at least one child were included in the analyses (median age = 37 yrs: IQR: 31-44 yrs). The prevalence of child apprehension among mothers was 38.3%, with 37.4% reporting having been apprehended themselves by child welfare services. In multivariable analysis, servicing clients in outdoor public spaces (versus formal sex work establishments or informal indoor settings) (adjusted odds ratio, (aOR) = 2.73; 95%CI 1.27-5.90), history of injecting drugs (aOR  = 2.53; 95%CI 1.42-4.49), Aboriginal ancestry (aOR = 1.66; 95%CI 1.01-2.74) were associated with increased odds of child apprehension. Child apprehension rates are high, particularly among the most marginalized sex workers, including sex workers who use drugs and sex workers of Aboriginal ancestry. Structural reforms to child protection are urgently needed, that support family-based care address the historical legacy of colonization affecting Aboriginal peoples.

Coronary heart disease events in Aboriginal Australians: incidence in an urban population.

PubMed

Bradshaw, Pamela J; Alfonso, Helman S; Finn, Judith C; Owen, Julie; Thompson, Peter L

2009-05-18

To determine the incidence of coronary heart disease (CHD) events in an urban Aboriginal population. Cohort study of 906 Aboriginal people without CHD from 998 who had undergone risk-factor assessment in the Perth Aboriginal Atherosclerosis Risk Study (PAARS) in 1998-1999. PAARS cohort data were electronically linked to a range of databases that included Western Australian hospital morbidity data and death registry data. We analysed data from January 1980 to December 2006 to identify previous admissions for CHD from 1980 to baseline (1998-1999) and new events from baseline to 2006. First CHD event (hospital admission or death). There were 891 linked records for the 906 participants without previous CHD. The event rate was 12.6/1000 person-years (95% CI, 10.2-15.6/1000 person-years). Annual CHD event rates ranged from 8 to 18/1000 person-years. After adjustment for age (sex was not associated with the risk factors assessed), factors associated with risk of a CHD event in the PAARS cohort were a history of diabetes, overweight or obesity (indicated by body mass index), smoking, and hypertension, but not waist circumference. People with these risk factors were 1.9-2.7 times more likely to experience a CHD event. Compared with previously published information from a remote Aboriginal community in the Northern Territory, the incidence of CHD events among urban-dwelling Aboriginal people was not significantly different (P > 0.05 overall and for subgroups defined by age and sex). City-dwelling Aboriginal Australians have an incidence of CHD events comparable to that of Aboriginal people living in remote northern Australia.

Oral health and social and emotional well-being in a birth cohort of Aboriginal Australian young adults.

PubMed

Jamieson, Lisa M; Paradies, Yin C; Gunthorpe, Wendy; Cairney, Sheree J; Sayers, Susan M

2011-08-19

Social and emotional well-being is an important component of overall health. In the Indigenous Australian context, risk indicators of poor social and emotional well-being include social determinants such as poor education, employment, income and housing as well as substance use, racial discrimination and cultural knowledge. This study sought to investigate associations between oral health-related factors and social and emotional well-being in a birth cohort of young Aboriginal adults residing in the northern region of Australia's Northern Territory. Data were collected on five validated domains of social and emotional well-being: anxiety, resilience, depression, suicide and overall mental health. Independent variables included socio-demographics, dental health behaviour, dental disease experience, oral health-related quality of life, substance use, racial discrimination and cultural knowledge. After adjusting for other covariates, poor oral health-related items were associated with each of the social and emotional well-being domains. Specifically, anxiety was associated with being female, having one or more decayed teeth and racial discrimination. Resilience was associated with being male, having a job, owning a toothbrush, having one or more filled teeth and knowing a lot about Indigenous culture; while being female, having experienced dental pain in the past year, use of alcohol, use of marijuana and racial discrimination were associated with depression. Suicide was associated with being female, having experience of untreated dental decay and racial discrimination; while being female, having experience of dental disease in one or more teeth, being dissatisfied about dental appearance and racial discrimination were associated with poor mental health. The results suggest there may be value in including oral health-related initiatives when exploring the role of physical conditions on Indigenous social and emotional well-being.

Paperbark and pinard: A historical account of maternity care in one remote Australian Aboriginal town.

PubMed

Ireland, Sarah; Belton, Suzanne; McGrath, Ann; Saggers, Sherry; Narjic, Concepta Wulili

2015-12-01

Maternity care in remote areas of the Australian Northern Territory is restricted to antenatal and postnatal care only, with women routinely evacuated to give birth in hospital. Using one remote Aboriginal community as a case study, our aim with this research was to document and explore the major changes to the provision of remote maternity care over the period spanning pre-European colonisation to 1996. Our research methods included historical ethnographic fieldwork (2007-2013); interviews with Aboriginal women, Aboriginal health workers, religious and non-religious non-Aboriginal health workers and past residents; and archival review of historical documents. We identified four distinct eras of maternity care. Maternity care staffed by nuns who were trained in nursing and midwifery serviced childbirth in the local community. Support for community childbirth was incrementally withdrawn over a period, until the government eventually assumed responsibility for all health care. The introduction of Western maternity care colonised Aboriginal birth practices and midwifery practice. Historical population statistics suggest that access to local Western maternity care may have contributed to a significant population increase. Despite population growth and higher demand for maternity services, local maternity services declined significantly. The rationale for removing childbirth services from the community was never explicitly addressed in any known written policy directive. Declining maternity services led to the de-skilling of many Aboriginal health workers and the significant community loss of future career pathways for Aboriginal midwives. This has contributed to the current status quo, with very few female Aboriginal health workers actively providing remote maternity care. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Lifetime risk of developing coronary heart disease in Aboriginal Australians: a cohort study.

PubMed

Wang, Zhiqiang; Hoy, Wendy E

2013-01-30

Lifetime risk of coronary heart disease (CHD) is an important yardstick by which policy makers, clinicians and the general public can assess and promote the awareness and prevention of CHD. The lifetime risk in Aboriginal people is not known. Using a cohort with up to 20 years of follow-up, we estimated the lifetime risk of CHD in Aboriginal people. A cohort study. A remote Aboriginal region. 1115 Aboriginal people from one remote tribal group who were free from CHD at baseline were followed for up to 20 years. During the follow-up period, new CHD incident cases were identified through hospital and death records. We estimated the lifetime risks of CHD with and without adjusting for the presence of competing risk of death from non-CHD causes. Participants were followed up for 17 126 person-years, during which 185 developed CHD and 144 died from non-CHD causes. The average age at which the first CHD event occurred was 48 years for men and 49 years for women. The risk of developing CHD increased with age until 60 years and then decreased with age. Lifetime cumulative risk without adjusting for competing risk was 70.7% for men and 63.8% for women. Adjusting for the presence of competing risk of death from non-CHD causes, the lifetime risk of CHD was 52.6% for men and 49.2% for women. Lifetime risk of CHD is as high as one in two in both Aboriginal men and women. The average age of having first CHD events was under 50 years, much younger than that reported in non-Aboriginal populations. Our data provide useful knowledge for health education, screening and prevention of CHD in Aboriginal people.

Nutritional status of haemodialysis patients: comparison of Australian cohorts of Aboriginal and European descent.

PubMed

Todd, Alwyn; Carroll, Robert; Gallagher, Meghan; Meade, Anthony

2013-12-01

It is not known whether nutritional status differs between Australian Aboriginal and non Aboriginal haemodialysis subjects. The aim of this study was to investigate the nutritional status of Australian Aboriginal and non-Aboriginal haemodialysis subjects at satellite dialysis centres. Seventy-six (25 Aboriginal, 51 non-Aboriginal) prevalent haemodialysis patients were enrolled in a 3-month cross-sectional study. Each month anthropometric and biochemical measurements were collected. Nutritional status (diet history, patient-generated subjective global assessment (PG-SGA), handgrip strength) was assessed by a dietitian. PG-SGA detected mild to moderate malnutrition in 35% of Aboriginal patients and 25% of non-Aboriginal patients. The overall physical rating on the PG-SGA was significantly higher in Aboriginal patients, indicating the presence of a greater deficit in muscle mass in this population. Inter-dialytic weight gain was significantly greater in Aboriginal subjects (median [range] 3.0 [2.1-5.7] vs 2.5 [-0.3-5.0] kg, P<0.001). Glucose and HbA1c were significantly higher in Aboriginal subjects with diabetes than in non-Aboriginal patients with diabetes (median [range] 9.4 [4.9-23.4] vs 5.7 [3.1-12.9], P=0.002; 7.0 [5.2-11.0] vs 5.8 [4.6-9.0], P<0.000; respectively). These findings occurred in the setting of each cohort having adequate dialysis parameters (median Kt/V of >1.6 and median normalized protein catabolic rate 1.5). Difficulties were encountered in obtaining dietary information from Aboriginal subjects using the diet history method. Subjects had acceptable parameters of dialysis adequacy; however, 35% had evidence of malnutrition. Further research should focus on establishing a knowledge base for the nutritional management for Aboriginal dialysis subjects, and the development of a validated individual dietary assessment method for use in this population group. © 2013 Asian Pacific Society of Nephrology.

Cancer Data and Aboriginal Disparities (CanDAD)-developing an Advanced Cancer Data System for Aboriginal people in South Australia: a mixed methods research protocol.

PubMed

Yerrell, Paul Henry; Roder, David; Cargo, Margaret; Reilly, Rachel; Banham, David; Micklem, Jasmine May; Morey, Kim; Stewart, Harold Bundamurra; Stajic, Janet; Norris, Michael; Brown, Alex

2016-12-23

In Australia, Aboriginal and Torres Strait Islander People carry a greater burden of cancer-related mortality than non-Aboriginal Australians. The Cancer Data and Aboriginal Disparities Project aims to develop and test an integrated, comprehensive cancer monitoring and surveillance system capable of incorporating epidemiological and narrative data to address disparities and advocate for clinical system change. The Advanced Cancer Data System will integrate routinely collected unit record data from the South Australian Population Cancer Registry and a range of other data sources for a retrospective cohort of indigenous people with cancers diagnosed from 1990 to 2010. A randomly drawn non-Aboriginal cohort will be matched by primary cancer site, sex, age and year at diagnosis. Cross-tabulations and regression analyses will examine the extent to which demographic attributes, cancer stage and survival vary between the cohorts. Narratives from Aboriginal people with cancer, their families, carers and service providers will be collected and analysed using patient pathway mapping and thematic analysis. Statements from the narratives will structure both a concept mapping process of rating, sorting and prioritising issues, focusing on issues of importance and feasibility, and the development of a real-time Aboriginal Cancer Measure of Experience for ongoing linkage with epidemiological data in the Advanced Cancer Data System. Aboriginal Community engagement underpins this Project. The research has been approved by relevant local and national ethics committees. Findings will be disseminated in local and international peer-reviewed journals and conference presentations. In addition, the research will provide data for knowledge translation activities across the partner organisations and feed directly into the Statewide Cancer Control Plan. It will provide a mechanism for monitoring and evaluating the implementation of the recommendations in these documents. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Cancer Data and Aboriginal Disparities (CanDAD)—developing an Advanced Cancer Data System for Aboriginal people in South Australia: a mixed methods research protocol

PubMed Central

Yerrell, Paul Henry; Roder, David; Cargo, Margaret; Reilly, Rachel; Banham, David; Micklem, Jasmine May; Morey, Kim; Stewart, Harold Bundamurra; Stajic, Janet; Norris, Michael; Brown, Alex

2016-01-01

Introduction In Australia, Aboriginal and Torres Strait Islander People carry a greater burden of cancer-related mortality than non-Aboriginal Australians. The Cancer Data and Aboriginal Disparities Project aims to develop and test an integrated, comprehensive cancer monitoring and surveillance system capable of incorporating epidemiological and narrative data to address disparities and advocate for clinical system change. Methods and analysis The Advanced Cancer Data System will integrate routinely collected unit record data from the South Australian Population Cancer Registry and a range of other data sources for a retrospective cohort of indigenous people with cancers diagnosed from 1990 to 2010. A randomly drawn non-Aboriginal cohort will be matched by primary cancer site, sex, age and year at diagnosis. Cross-tabulations and regression analyses will examine the extent to which demographic attributes, cancer stage and survival vary between the cohorts. Narratives from Aboriginal people with cancer, their families, carers and service providers will be collected and analysed using patient pathway mapping and thematic analysis. Statements from the narratives will structure both a concept mapping process of rating, sorting and prioritising issues, focusing on issues of importance and feasibility, and the development of a real-time Aboriginal Cancer Measure of Experience for ongoing linkage with epidemiological data in the Advanced Cancer Data System. Aboriginal Community engagement underpins this Project. Ethics and dissemination The research has been approved by relevant local and national ethics committees. Findings will be disseminated in local and international peer-reviewed journals and conference presentations. In addition, the research will provide data for knowledge translation activities across the partner organisations and feed directly into the Statewide Cancer Control Plan. It will provide a mechanism for monitoring and evaluating the implementation of the recommendations in these documents. PMID:28011808

Early Childhood Development over Time for a Cohort of Australian Aboriginal Children Living in an Urban Environment

ERIC Educational Resources Information Center

Grace, Rebekah; Elcombe, Emma; Knight, Jennifer; McMahon, Catherine; McDonald, Jenny; Comino, Elizabeth

2017-01-01

Child development for a cohort of urban Aboriginal children was assessed at three time points: 12 months, 3 years and 4.5 years. This paper reports developmental findings and explores the impact of child, family, home and community variables over time. Overall, child development at 4.5 years was significantly below the standardised mean. Female…

Disparities in cancer stage at diagnosis and survival of Aboriginal and non-Aboriginal South Australians.

PubMed

Banham, David; Roder, David; Keefe, Dorothy; Farshid, Gelareh; Eckert, Marion; Cargo, Margaret; Brown, Alex

2017-06-01

This study tested the utility of retrospectively staging cancer registry data for comparing stage and stage-specific survivals of Aboriginal and non-Aboriginal people. Differences by area level factors were also explored. This test dataset comprised 950 Aboriginal cases and all other cases recorded on the South Australian cancer registry with a 1977-2010 diagnosis. A sub-set of 777 Aboriginal cases diagnosed in 1990-2010 were matched with randomly selected non-Aboriginal cases by year of birth, diagnostic year, sex, and primary site of cancer. Competing risk regression summarised associations of Aboriginal status, stage, and geographic attributes with risk of cancer death. Aboriginal cases were 10 years younger at diagnosis, more likely to present in recent diagnostic years, to be resident of remote areas, and have primary cancer sites of head & neck, lung, liver and cervix. Risk of cancer death was associated in the matched analysis with more advanced stage at diagnosis. More Aboriginal than non-Aboriginal cases had distant metastases at diagnosis (31.3% vs 22.0, p<0.001). After adjusting for stage, remote-living Aboriginal residents had higher risks of cancer death than Aboriginal residents of metropolitan areas. Non-Aboriginal cases had the lowest risk of cancer death. Retrospective staging proved to be feasible using registry data. Results indicated more advanced stages for Aboriginal than matched non-Aboriginal cases. Aboriginal people had higher risks of cancer death, which persisted after adjusting for stage, and applied irrespective of remoteness of residence, with highest risk of death occurring among Aboriginal people from remote areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mortality in a cohort of remote-living Aboriginal Australians and associated factors.

PubMed

Hyde, Zoë; Smith, Kate; Flicker, Leon; Atkinson, David; Almeida, Osvaldo P; Lautenschlager, Nicola T; Dwyer, Anna; LoGiudice, Dina

2018-01-01

We aimed to describe mortality in a cohort of remote-living Aboriginal Australians using electronic record linkage. Between 2004 and 2006, 363 Aboriginal people living in remote Western Australia (WA) completed a questionnaire assessing medical history and behavioural risk factors. We obtained mortality records for the cohort from the WA Data Linkage System and compared them to data for the general population. We used Cox proportional hazards regression to identify predictors of mortality over a 9-year follow-up period. The leading causes of mortality were diabetes, renal failure, and ischaemic heart disease. Diabetes and renal failure accounted for 28% of all deaths. This differed from both the Australian population as a whole, and the general Indigenous Australian population. The presence of chronic disease did not predict mortality, nor did behaviours such as smoking. Only age, male sex, poor mobility, and cognitive impairment were risk factors. To reduce premature mortality, public health practitioners should prioritise the prevention and treatment of diabetes and renal disease in Aboriginal people in remote WA. This will require a sustained and holistic approach.

Mortality in a cohort of remote-living Aboriginal Australians and associated factors

PubMed Central

Hyde, Zoë; Smith, Kate; Flicker, Leon; Atkinson, David; Almeida, Osvaldo P.; Lautenschlager, Nicola T.; Dwyer, Anna

2018-01-01

Objectives We aimed to describe mortality in a cohort of remote-living Aboriginal Australians using electronic record linkage. Methods Between 2004 and 2006, 363 Aboriginal people living in remote Western Australia (WA) completed a questionnaire assessing medical history and behavioural risk factors. We obtained mortality records for the cohort from the WA Data Linkage System and compared them to data for the general population. We used Cox proportional hazards regression to identify predictors of mortality over a 9-year follow-up period. Results The leading causes of mortality were diabetes, renal failure, and ischaemic heart disease. Diabetes and renal failure accounted for 28% of all deaths. This differed from both the Australian population as a whole, and the general Indigenous Australian population. The presence of chronic disease did not predict mortality, nor did behaviours such as smoking. Only age, male sex, poor mobility, and cognitive impairment were risk factors. Conclusions To reduce premature mortality, public health practitioners should prioritise the prevention and treatment of diabetes and renal disease in Aboriginal people in remote WA. This will require a sustained and holistic approach. PMID:29621272

Growing up our way: the first year of life in remote Aboriginal Australia.

PubMed

Kruske, Sue; Belton, Suzanne; Wardaguga, Molly; Narjic, Concepta

2012-06-01

In this study, we attempted to explore the experiences and beliefs of Aboriginal families as they cared for their children in the first year of life. We collected family stories concerning child rearing, development, behavior, health, and well-being between each infant's birth and first birthday. We found significant differences in parenting behaviors and child-rearing practices between Aboriginal groups and mainstream Australians. Aboriginal parents perceived their children to be autonomous individuals with responsibilities toward a large family group. The children were active agents in determining their own needs, highly prized, and included in all aspects of community life. Concurrent with poverty, neocolonialism, and medical hegemony, child-led parenting styles hamper the effectiveness of health services. Hence, until the planners of Australia's health systems better understand Aboriginal knowledge systems and incorporate them into their planning, we can continue to expect the failure of government and health services among Aboriginal communities.

The ‘Stolen Generations' of Mothers and Daughters: Child Apprehension and Enhanced HIV Vulnerabilities for Sex Workers of Aboriginal Ancestry

PubMed Central

Duff, Putu; Bingham, Brittany; Simo, Annick; Jury, Delores; Reading, Charlotte; Shannon, Kate

2014-01-01

Objectives The number of children in care of the state continues to grow in BC, Canada with a historical legacy of child apprehension among criminalized and marginalized populations, particularly women of Aboriginal ancestry and sex workers. However, there is a paucity of research investigating child apprehension experiences among marginalized mothers. The objective of the current analysis is to examine the prevalence and correlates of child apprehensions among female sex workers in Vancouver, Canada. Methods Analyses were drawn from the AESHA (An Evaluation of Sex Workers Health Access, 2010-present), a prospective cohort of street and off-street SWs, through outreach and semi-annual visits to the research office. Bivariate and multivariate logistic regression were used to examine correlates of child apprehension. Results Of a total of 510 SWs, 350 women who had given birth to at least one child were included in the analyses (median age = 37 yrs: IQR: 31–44 yrs). The prevalence of child apprehension among mothers was 38.3%, with 37.4% reporting having been apprehended themselves by child welfare services. In multivariable analysis, servicing clients in outdoor public spaces (versus formal sex work establishments or informal indoor settings) (adjusted odds ratio, (aOR) = 2.73; 95%CI 1.27–5.90), history of injecting drugs (aOR = 2.53; 95%CI 1.42–4.49), Aboriginal ancestry (aOR = 1.66; 95%CI 1.01–2.74) were associated with increased odds of child apprehension. Discussion/Conclusions Child apprehension rates are high, particularly among the most marginalized sex workers, including sex workers who use drugs and sex workers of Aboriginal ancestry. Structural reforms to child protection are urgently needed, that support family-based care address the historical legacy of colonization affecting Aboriginal peoples. PMID:24927324

Australian engineering educators' attitudes towards Aboriginal cultures and perspectives

NASA Astrophysics Data System (ADS)

Goldfinch, Thomas; Prpic, Juliana Kaya; Jolly, Lesley; Leigh, Elyssebeth; Kennedy, Jade

2017-07-01

In Australia, representation of Aboriginal populations within the engineering profession is very low despite participation targets set by Government departments, professional bodies and Universities. Progressing the Aboriginal inclusion agenda within Australian Engineering Education requires a clearer understanding of engineering educators' preparedness for increased numbers of students from this non-traditional cohort. This research stems from a recently completed project that explored Aboriginal perspectives in engineering education and proposed a model for embedding perspectives in curricula. Nine engineering academics were interviewed to explore attitudes towards Aboriginal perspectives in engineering and the viability of the proposed model. Results of the interviews indicate efforts to embed Aboriginal perspectives are starting from a small base of knowledge and experience. Individuals' motivations and values indicate that there is significant support for improving this, but that efforts can be hampered by conceptions of Aboriginal perspectives that do not consider how Aboriginal knowledges may change engineering itself.

Oral cavity squamous cell carcinoma - characteristics and survival in aboriginal and non-aboriginal Western australians.

PubMed

Frydrych, A M; Slack-Smith, L M; Parsons, R; Threlfall, T

2014-01-01

Squamous cell carcinoma (SCC) is the most common type of malignancy affecting the oral cavity. While exposures to main risk factors for oral SCC such as smoking and alcohol use are higher amongst the Aboriginal people, little is known about oral cancer in this population. This study aimed to describe characteristics and survival of oral SCC in Aboriginal and non-Aboriginal Western Australians. All primary oral SCC cases reported to the Western Australian Cancer Registry (WACR) between 1990 and 1999 were analysed with respect to person characteristics including: date of birth, sex and indigenous status; and disease characteristics including: date of biopsy, disease stage and site as well as date of recurrence and date of death. Exclusion criteria included diagnosis not based on incisional or excisional biopsy, diagnosis other than oral SCC or a history of another malignant neoplasm. Aboriginal individuals were more likely to reside in rural areas. No statistically significant differences in oral SCC characteristics and survival were noted between Aboriginal and non-Aboriginal Western Australians. This study provides new information on person and disease characteristics of Aboriginal Western Australians diagnosed with oral SCC.

Antenatal emotional wellbeing screening in Aboriginal and Torres Strait Islander primary health care services in Australia.

PubMed

Gausia, Kaniz; Thompson, Sandra; Nagel, Tricia; Rumbold, Alice; Connors, Christine; Matthews, Veronica; Boyle, Jacqueline; Schierhout, Gill; Bailie, Ross

2013-12-01

The aim of this study was to examine the extent to which antenatal emotional wellbeing (EW) assessments are undertaken in primary health care (PHC) centres and factors associated with completion of EW screening. Medical records of 797 pregnant women from 36 PHC centres in five states (NSW, QLD, SA, WA and NT) were audited. Overall, 85% of the women were Aboriginal. The proportion of women with documented screening for EW varied from 5 to 38% between states (mean 17%). Aboriginal women were four times more likely (adjusted Odds Ratio (OR = 4.13, 95% CI = 2.46-6.92) to not be screened for antenatal EW than non-Aboriginal women. Aboriginality, <4 antenatal visits, absence of an antenatal and birth care plan, and lack of counselling on financial support were independently linked with no screening of EW. Provision of training for health service providers and further research on appropriate screening tools for Aboriginal women are needed to help redress this gap.

The Cedar Project: correlates of attempted suicide among young Aboriginal people who use injection and non-injection drugs in two Canadian cities.

PubMed

Moniruzzaman, Akm; Pearce, Margo E; Patel, Sheetal H; Chavoshi, Negar; Teegee, Mary; Adam, Warner; Christian, Wayne M; Henderson, Earl; Craib, Kevin J P; Schechter, Martin T; Spittal, Patricia M

2009-06-01

Aboriginal leadership and families are deeply concerned about the rate of suicide attempt among their young people. The objectives of this study were to (a) describe the prevalence of suicide attempt and (b) to describe correlates of vulnerability to suicide attempts within a cohort of young Aboriginal people who use drugs in 2 Canadian cities. We aimed to situate the findings within the context of historical and lifetime trauma. Study design. The Cedar Project is a prospective cohort study involving 605 young Aboriginal people aged 14-30 who use drugs in Vancouver and Prince George, British Columbia, Canada. Multivariable logistic regression modelling identified independent predictors of suicide attempts. Estimates of adjusted odds ratios and 95% confidence intervals were calculated. In multivariable analysis, residing in Prince George (Adjusted Odds Ratio [AOR]: 1.80, 95% CI: 1.23, 2.64), ever having been sexually abused (AOR: 2.07, 95% CI: 1.39, 3.08), and ever having overdosed (AOR: 2.29, 95% CI: 1.53, 3.42) independently predicted lifetime attempted suicide. Suicide prevention and intervention programs must address historical and lifetime trauma among Aboriginal young people who struggle with substance dependence.

The impact of monetary incentives on general fertility rates in Western Australia.

PubMed

Langridge, Amanda T; Nassar, Natasha; Li, Jianghong; Jacoby, Peter; Stanley, Fiona J

2012-04-01

There has been widespread international concern about declining fertility rates and the long-term negative consequences particularly for industrialised countries with ageing populations. In an attempt to boost fertility rates, the Australian Government introduced a maternity payment known as the Baby Bonus. However, major concerns have been raised that such monetary incentives would attract teenagers and socially disadvantaged groups. Population-level data and generalised linear models were used to examine general fertility rates between 1995 and 2006 by socioeconomic group, maternal age group, Aboriginality and location in Western Australia prior to and following the introduction of the Baby Bonus in July 2004. After a steady decline in general fertility rates between 1995 and 2004, rates increased significantly from 52.2 births per 1000 women, aged between 15 and 49 years, in 2004 to 58.6 births per 1000 women in 2006. While there was an overall increase in general fertility rates after adjusting for maternal socio-demographic characteristics, there were no significant differences among maternal age groups (p=0.98), between Aboriginal and non-Aboriginal women(p=0.80), maternal residential locations (p=0.98) or socioeconomic groups (p=0.68). The greatest increase in births were among women residing in the highest socioeconomic areas who had the lowest general fertility rate in 2004 (21.5 births per 1000 women) but the highest in 2006 (38.1 births per 1000 women). Findings suggest that for countries with similar social, economic and political climates to Australia, a monetary incentive may provide a satisfactory solution to declining general fertility rates.

After accounting for competing causes of death and more advanced stage, do Aboriginal and Torres Strait Islander peoples with cancer still have worse survival? A population-based cohort study in New South Wales.

PubMed

Tervonen, Hanna E; Walton, Richard; You, Hui; Baker, Deborah; Roder, David; Currow, David; Aranda, Sanchia

2017-06-02

Aboriginal and Torres Strait Islander peoples in Australia have been found to have poorer cancer survival than non-Aboriginal people. However, use of conventional relative survival analyses is limited due to a lack of life tables. This cohort study examined whether poorer survival persist after accounting for competing risks of death from other causes and disparities in cancer stage at diagnosis, for all cancers collectively and by cancer site. People diagnosed in 2000-2008 were extracted from the population-based New South Wales Cancer Registry. Aboriginal status was multiply imputed for people with missing information (12.9%). Logistic regression models were used to compute odds ratios (ORs) with 95% confidence intervals (CIs) for 'advanced stage' at diagnosis (separately for distant and distant/regional stage). Survival was examined using competing risk regression to compute subhazard ratios (SHRs) with 95%CIs. Of the 301,356 cases, 2517 (0.84%) identified as Aboriginal (0.94% after imputation). After adjusting for age, sex, year of diagnosis, socio-economic status, remoteness, and cancer site Aboriginal peoples were more likely to be diagnosed with distant (OR 1.30, 95%CI 1.17-1.44) or distant/regional stage (OR 1.29, 95%CI 1.18-1.40) for all cancers collectively. This applied to cancers of the female breast, uterus, prostate, kidney, others (those not included in other categories) and cervix (when analyses were restricted to cases with known stages/known Aboriginal status). Aboriginal peoples had a higher hazard of death than non-Aboriginal people after accounting for competing risks from other causes of death, socio-demographic factors, stage and cancer site (SHR 1.40, 95%CI 1.31-1.50 for all cancers collectively). Consistent results applied to colorectal, lung, breast, prostate and other cancers. Aboriginal peoples with cancer have an elevated hazard of cancer death compared with non-Aboriginal people, after accounting for more advanced stage and competing causes of death. Further research is needed to determine reasons, including any contribution of co-morbidity, lifestyle factors and differentials in service access to help explain disparities.

Generational Sex And HIV Risk Among Indigenous Women In A Street-Based Urban Canadian Setting

PubMed Central

Bingham, Brittany; Leo, Diane; Zhang, Ruth; Montaner, Julio

2014-01-01

In Canada, indigenous women are overrepresented among new HIV infections and street-based sex workers. Scholars suggest that Aboriginal women’s HIV risk stems from intergenerational effects of colonisation and racial policies. This research examined generational sex work involvement among Aboriginal and non-Aboriginal women and the effect on risk for HIV acquisition. The sample included 225 women in street-based sex work and enrolled in a community-based prospective cohort, in partnership with local sex work and Aboriginal community partners. Bivariate and multivariate logistic regression modeled an independent relationship between Aboriginal ancestry and generational sex work; and the impact of generational sex work on HIV infection among Aboriginal sex workers. Aboriginal women (48%) were more likely to be HIV-positive, with 34% living with HIV compared to 24% non-Aboriginal. In multivariate logistic regression model, Aboriginal women remained 3 times more likely to experience generational sex work (aOR:2.97; 95%CI:1.5,5.8). Generational sex work was significantly associated with HIV (aOR=3.01, 95%CI: 1.67–4.58) in a confounder model restricted to Aboriginal women. High prevalence of generational sex work among Aboriginal women and 3-fold increased risk for HIV infection are concerning. Policy reforms and community-based, culturally safe and trauma informed HIV prevention initiatives are required for Indigenous sex workers. PMID:24654881

Generational sex work and HIV risk among Indigenous women in a street-based urban Canadian setting.

PubMed

Bingham, Brittany; Leo, Diane; Zhang, Ruth; Montaner, Julio; Shannon, Kate

2014-01-01

In Canada, Indigenous women are over-represented among new HIV infections and street-based sex workers. Scholars suggest that Aboriginal women's HIV risk stems from intergenerational effects of colonisation and racial policies. This research examined generational sex work involvement among Aboriginal and non-Aboriginal women and the effect on risk for HIV acquisition. The sample included 225 women in street-based sex work and enrolled in a community-based prospective cohort, in partnership with local sex work and Aboriginal community partners. Bivariate and multivariate logistic regression modeled an independent relationship between Aboriginal ancestry and generational sex work and the impact of generational sex work on HIV infection among Aboriginal sex workers. Aboriginal women (48%) were more likely to be HIV-positive, with 34% living with HIV compared to 24% non-Aboriginal women. In multivariate logistic regression model, Aboriginal women remained three times more likely to experience generational sex work (AOR:2.97; 95%CI:1.5,5.8). Generational sex work was significantly associated with HIV (AOR = 3.01, 95%CI: 1.67-4.58) in a confounder model restricted to Aboriginal women. High prevalence of generational sex work among Aboriginal women and three-fold increased risk for HIV infection are concerning. Policy reforms and community-based, culturally safe and trauma informed HIV-prevention initiatives are required for Indigenous sex workers.

‘Choice, culture and confidence’: key findings from the 2012 having a baby in Queensland Aboriginal and Torres Strait Islander survey

PubMed Central

2014-01-01

Background To describe the maternity care experiences of Aboriginal and/or Torres Strait Islander women in Queensland, Australia and to identify areas for policy and practice improvements. Methods A culturally-tailored survey requesting both quantitative and qualitative information was completed by respondents either independently (online or in hard copy) or with the assistance of a trained peer-interviewer. Data were analysed using descriptive statistics and thematic analysis. Eligible women were over 16 years of age, identified as Aboriginal and/or Torres Strait Islander, resided in Queensland, and had a live, singleton birth between the first of July 2011 and the first of July 2012. Results 187 women of 207 respondents were included in analyses. Women reported high rates of stressful life events in pregnancy, low levels of choice in place of birth and model of care and limited options to carry out cultural practices. High levels of confidence in parenting were also reported. Women were less likely to report being treated with kindness, understanding and respect by maternity care staff than women answering a similar mainstream survey. Conclusions Aboriginal and Torres Strait Islander women have additional needs to mainstream Australian women. This study identified a number of recommendations to improve services including the need to enhance the cultural competence of maternity services; increase access to continuity of midwifery care models, facilitate more choices in care, work with the strengths of Aboriginal and Torres Strait Islander women, families and communities, and engage women in the design and delivery of care. PMID:24884930

Digital assessment of the fetal alcohol syndrome facial phenotype: reliability and agreement study.

PubMed

Tsang, Tracey W; Laing-Aiken, Zoe; Latimer, Jane; Fitzpatrick, James; Oscar, June; Carter, Maureen; Elliott, Elizabeth J

2017-01-01

To examine the three facial features of fetal alcohol syndrome (FAS) in a cohort of Australian Aboriginal children from two-dimensional digital facial photographs to: (1) assess intrarater and inter-rater reliability; (2) identify the racial norms with the best fit for this population; and (3) assess agreement with clinician direct measures. Photographs and clinical data for 106 Aboriginal children (aged 7.4-9.6 years) were sourced from the Lililwan Project . Fifty-eight per cent had a confirmed prenatal alcohol exposure and 13 (12%) met the Canadian 2005 criteria for FAS/partial FAS. Photographs were analysed using the FAS Facial Photographic Analysis Software to generate the mean PFL three-point ABC-Score, five-point lip and philtrum ranks and four-point face rank in accordance with the 4-Digit Diagnostic Code. Intrarater and inter-rater reliability of digital ratings was examined in two assessors. Caucasian or African American racial norms for PFL and lip thickness were assessed for best fit; and agreement between digital and direct measurement methods was assessed. Reliability of digital measures was substantial within (kappa: 0.70-1.00) and between assessors (kappa: 0.64-0.89). Clinician and digital ratings showed moderate agreement (kappa: 0.47-0.58). Caucasian PFL norms and the African American Lip-Philtrum Guide 2 provided the best fit for this cohort. In an Aboriginal cohort with a high rate of FAS, assessment of facial dysmorphology using digital methods showed substantial inter- and intrarater reliability. Digital measurement of features has high reliability and until data are available from a larger population of Aboriginal children, the African American Lip-Philtrum Guide 2 and Caucasian (Strömland) PFL norms provide the best fit for Australian Aboriginal children.

Re-Presenting Urban Aboriginal Identities: Self-Representation in "Children of the Sun"

ERIC Educational Resources Information Center

Lumby, Bronwyn; McGloin, Colleen

2009-01-01

Teaching Aboriginal studies to a diverse student cohort presents challenges in the pursuit of developing a critical pedagogy. In this paper, we present "Children of the Sun" (2006), a local film made by Indigenous youth in the Illawarra region south of Sydney, New South Wales. We outline the film's genesis and its utilisation in our…

A cohort study: temporal trends in prevalence of antecedents, comorbidities and mortality in Aboriginal and non-Aboriginal Australians with first heart failure hospitalization, 2000-2009.

PubMed

Teng, Tiew-Hwa Katherine; Katzenellenbogen, Judith M; Hung, Joseph; Knuiman, Matthew; Sanfilippo, Frank M; Geelhoed, Elizabeth; Bessarab, Dawn; Hobbs, Michael; Thompson, Sandra C

2015-08-12

Little is known about trends in risk factors and mortality for Aboriginal Australians with heart failure (HF). This population-based study evaluated trends in prevalence of risk factors, 30-day and 1-year all-cause mortality following first HF hospitalization among Aboriginal and non-Aboriginal Western Australians in the decade 2000-2009. Linked-health data were used to identify patients (20-84 years), with a first-ever HF hospitalization. Trends in demographics, comorbidities, interventions and risk factors were evaluated. Logistic and Cox regression models were fitted to test and compare trends over time in 30-day and 1-year mortality. Of 17,379 HF patients, 1,013 (5.8%) were Aboriginal. Compared with 2000-2002, the prevalence (as history) of myocardial infarction and hypertension increased more markedly in 2006-2009 in Aboriginal (versus non-Aboriginal) patients, while diabetes and chronic kidney disease remained disproportionately higher in Aboriginal patients. Risk factor trends, including the Charlson comorbidity index, increased over time in younger Aboriginal patients. Risk-adjusted 30-day mortality did not change over the decade in either group. Risk-adjusted 1-year mortality (in 30-day survivors) was non-significantly higher in Aboriginal patients in 2006-2008 compared with 2000-2002 (hazard ratio (HR) 1.44; 95% CI 0.85-2.41; p-trend = 0.47) whereas it decreased in non-Aboriginal patients (HR 0.87; 95% CI 0.78-0.97; p-trend = 0.01). Between 2000 and 2009, the prevalence of HF antecedents increased and remained disproportionately higher in Aboriginal (versus non-Aboriginal) HF patients. Risk-adjusted 1-year mortality did not improve in Aboriginal patients over the period in contrast with non-Aboriginal patients. These findings highlight the need for better prevention and post-HF care in Aboriginal Australians.

Defining the gap: a systematic review of the difference in rates of diabetes-related foot complications in Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians.

PubMed

West, Matthew; Chuter, Vivienne; Munteanu, Shannon; Hawke, Fiona

2017-01-01

The Aboriginal and Torres Strait Islander community has an increased risk of developing chronic illnesses including diabetes. Among people with diabetes, foot complications are common and make a significant contribution to the morbidity and mortality associated with this disease. The aim of this review was to systematically evaluate the literature comparing the rates of diabetes related foot complications in Aboriginal and Torres Strait Islander Australians to non-Indigenous Australians. MEDLINE, EMBASE, The Cochrane Library; PUBMED and CINAHL were searched from inception until August 2016. Inclusion criteria were: published cross-sectional or longitudinal studies reporting the prevalence of diabetes related foot complications in both a cohort of Aboriginal and Torres Strait Islander Australians and a cohort of one other Australian population of any age with diabetes. Risk of bias was assessed using the STROBE tool. Eleven studies including a total of 157,892 participants were included. Studies were set in Queensland, the Northern Territory and Western Australia, primarily in rural and remote areas. Aboriginal and Torres Strait Islander Australians experienced substantially more diabetes related foot complications with the mean age up to 14 years younger than non-Indigenous Australians. Aboriginality was associated with increased risk of peripheral neuropathy, foot ulceration and amputation. In several studies, Aboriginal and Torres Strait Islander Australians accounted for the vast majority of diabetes related foot complications (up to 91%) while comprising only a small proportion of the regional population. Reporting quality as assessed with the STROBE tool showed underreporting of: methods, sample description and potential sources of bias. There are no data available for some Australian states and for specific types of diabetes related foot complications. Aboriginal and Torres Strait Islander Australians have a 3-6 fold increased likelihood of experiencing a diabetes related foot complication compared to non-Indigenous Australians. Evidence-based, culturally appropriate screening and intervention programs and improved access to effective health care services are required to prevent a widening of the gap in diabetes related foot complications between Aboriginal and Torres Strait Islander and non-Indigenous Australians.

Health Service Use and Costs Associated with Low Birth Weight--A Population Level Analysis.

PubMed

Thanh, Nguyen Xuan; Toye, Jennifer; Savu, Anamaria; Kumar, Manoj; Kaul, Padma

2015-09-01

To examine differences in health services utilization (HSU) costs in the first year of life between low birth weight (LBW) and normal birth weight (NBW) infants, identify maternal and child characteristics associated with HSU costs, and estimate annual HSU cost of LBW infants for the province of Alberta, Canada. A retrospective cohort study including all live births between 2004 and 2010. Data from the Alberta Perinatal Health Program database were linked to health care administrative data including inpatient, outpatient, and practitioner claims to identify HSU within the first year of life. One-year HSU costs among LBW infants (n = 16,209) were $33,096 compared with $3942 among NBW infants (n = 189,586). There was a strong negative correlation between HSU costs and increasing birth weight, with health care costs among extreme LBW (<1000 g), very LBW (1000 and 1499 g), and moderate LBW (1500 and 2499 g) of $117,000, $84,000, and, $20,000, respectively. Maternal characteristics such as high prepregnancy weight, aboriginal status, and lower socioeconomic status were associated with higher HSU costs among the infants. LBW accounted for 7% of all infants but 37% of the total costs, amounting to $108 million annually. Compared with NBW infants, LBW infants consume more health resources not only in terms of initial hospitalization but also of re-hospitalizations, outpatient, and physician visits during the first year of their life. Interventions targeting social determinants of health are required to improve birth weight outcomes in Alberta. Copyright © 2015 Elsevier Inc. All rights reserved.

Enhanced reporting of deaths among Aboriginal and Torres Strait Islander peoples using linked administrative health datasets.

PubMed

Taylor, Lee K; Bentley, Jason; Hunt, Jennifer; Madden, Richard; McKeown, Sybille; Brandt, Peter; Baker, Deborah

2012-07-02

Aboriginal and Torres Strait Islander peoples are under-reported in administrative health datasets in NSW, Australia. Correct reporting of Aboriginal and Torres Strait Islander peoples is essential to measure the effectiveness of policies and programmes aimed at reducing the health disadvantage experienced by Aboriginal and Torres Strait Islander peoples. This study investigates the potential of record linkage to enhance reporting of deaths among Aboriginal and Torres Strait Islander peoples in NSW, Australia. Australian Bureau of Statistics death registration data for 2007 were linked with four population health datasets relating to hospitalisations, emergency department attendances and births. Reporting of deaths was enhanced from linked records using two methods, and effects on patterns of demographic characteristics and mortality indicators were examined. Reporting of deaths increased by 34.5% using an algorithm based on a weight of evidence of a person being Aboriginal or Torres Strait Islander, and by 56.6% using an approach based on 'at least one report' of a person being Aboriginal or Torres Strait Islander. The increase was relatively greater in older persons and those living in less geographically remote areas. Enhancement resulted in a reduction in the urban-remote differential in median age at death and increases in standardised mortality ratios particularly for chronic conditions. Record linkage creates a statistical construct that helps to correct under-reporting of deaths and potential bias in mortality statistics for Aboriginal and Torres Strait Islander peoples.

Population-Based Prevalence of Intellectual Disability and Autism Spectrum Disorders in Western Australia

PubMed Central

Bourke, Jenny; de Klerk, Nick; Smith, Timothy; Leonard, Helen

2016-01-01

Abstract To investigate the prevalence of intellectual disability (ID) and/or autism spectrum disorders (ASDs) in Western Australia (WA). A cohort of children born from 1983 to 2010 in WA with an ID and/or ASD were identified using the population-based IDEA (Intellectual Disability Exploring Answers) database, which ascertains cases through the Disability Services Commission (DSC) as well as education sources. Information on race, gender, mother's residence at birth and deaths was obtained through linkage to the Midwives Notification System and the Mortality Register. Diagnostic information on the cause of ID was obtained through review of medical records where available and children were classified as biomedical cause, ASD, or unknown cause. An overall prevalence of ID of 17.0/1000 livebirths (95% CI: 16.7, 17.4) showed an increase from the 10-year previous prevalence of 14.3/1000. The prevalence for mild or moderate ID was 15.0 (95% CI: 14.6, 15.3), severe ID was 1.2 (95% CI: 1.1, 1.3), and unknown level of ID was 0.9 (95% CI: 0.8, 1.0)/1000 livebirths. The prevalence for Aboriginal children was 39.0/1000 compared with 15.7/1000 for non-Aboriginal children, giving a prevalence ratio of 2.5 (95% CI: 2.4, 2.6). Prevalence of all ASD was 5.1/1000 of which 3.8/1000 had ASD and ID. The prevalence of ID has risen in WA over the last 10 years with most of this increase due to mild or moderate ID. Whilst the prevalence of ASD has also increased over this time this does not fully explain the observed increase. Aboriginal children are at a 2.5-fold risk of ID but are less likely to be accessing disability services. PMID:27227936

Long-term medical outcomes among Aboriginal living kidney donors.

PubMed

Storsley, Leroy J; Young, Ann; Rush, David N; Nickerson, Peter W; Ho, Julie; Suon, Vuthana; Karpinski, Martin

2010-08-27

It is unknown whether favorable long-term data on the safety of living kidney donation can be extrapolated to populations at higher risk of chronic kidney disease. Indigenous people (i.e., Aboriginals) have a high prevalence of risk factors for chronic kidney disease and Aboriginal living donor outcomes need to be defined. We performed a retrospective cohort study of all 38 Aboriginal donors donating at our center since 1970 and 76 randomly selected white donor controls to determine the long-term rates of hypertension, diabetes, and renal function postdonation. Follow-up was obtained for 91% of both Aboriginal and white donors (mean follow-up approximately 14 years). Hypertension has been diagnosed more frequently among Aboriginal donors (Ab 42% vs. white 19%, P=0.02). Notably, all 11 Aboriginal donors more than 20 years postdonation have developed hypertension. Diabetes has also been diagnosed more frequently among Aboriginal donors (Ab 19% vs. white 2%, P=0.005), including 5 of 11 (45%) more than 20 years postdonation. Follow-up estimated glomerular filtration rate was higher in Aboriginal donors (Ab 77+/-17 vs. white 67+/-13 mL/min/1.73 m, P=0.002) but not significantly different in adjusted analyses. One Aboriginal donor developed end-stage renal disease 14 years postdonation. Aboriginal living kidney donors at our center have high rates of hypertension and diabetes on long-term follow-up, although renal function is preserved to date. This profile is similar to that of the general unselected Aboriginal population despite detailed medical evaluation before donation. These findings have important implications for donor counseling and may have implications for other high-risk donor populations.

Rates of Initial Virological Suppression and Subsequent Virological Failure After Initiating Highly Active Antiretroviral Therapy: The Impact of Aboriginal Ethnicity and Injection Drug Use

PubMed Central

Martin, L.J.; Houston, S.; Yasui, Y.; Wild, T.C.; Saunders, L.D.

2010-01-01

Objectives: To compare rates of initial virological suppression and subsequent virological failure by Aboriginal ethnicity after starting highly active antiretroviral therapy (HAART). Methods: We conducted a retrospective cohort study of antiretroviral-naïve HIV-patients starting HAART in January 1999-June 2005 (baseline), followed until December 31, 2005 in Alberta, Canada. We compared the odds of achieving initial virological suppression (viral load <500 copies/mL) by Aboriginal ethnicity using logistic regression and, among those achieving suppression, rates of virological failure (the first of two consecutive viral loads > 1000 copies/mL) by Aboriginal ethnicity using cumulative incidence curves and Cox proportional hazards models. Sex, injection drug use as an HIV exposure category (IDU), baseline age, CD4 cell count, viral load, calendar year, and HAART regimen were considered as potential confounders. Results: Of 461 study patients, 37% were Aboriginal and 48% were IDUs; 71% achieved initial virological suppression and were followed for 730.4 person-years. After adjusting for confounding variables, compared to non-Aboriginals with other exposures, the odds of achieving initial virological suppression were lower for Aboriginal IDUs (odds ratio (OR)=0.33, 95% CI=0.19-0.60, p=0.0002), non-Aboriginal IDUs (OR=0.30, 95% CI=0.15-0.60, p=0.0006), and Aboriginals with other exposures (OR=0.38, 95% CI=0.21-0.67, p=0.0009). Among those achieving suppression, Aboriginals experienced higher virological failure rates ≥1 year after suppression (hazard ratio=3.35, 95% CI=1.68-6.65, p=0.0006). Conclusions: Future research should investigate adherence among Aboriginals and IDUs treated with HAART and explore their treatment experiences to assess ways to improve outcomes. PMID:21187007

Developmental milestones among Aboriginal children in Canada

PubMed Central

Findlay, Leanne; Kohen, Dafna; Miller, Anton

2014-01-01

BACKGROUND: Windows of achievement provide age ranges for the attainment of early developmental skills. Group-specific research is warranted given that development may be influenced by social or cultural factors. OBJECTIVES: To examine developmental milestones for Inuit, Métis and off-reserve First Nation children in Canada, based on developmental domains collected from the 2006 Aboriginal Children’s Survey. Sociodemographic and health predictors of risk for developmental delay were also examined. RESULTS: The ranges in which children achieve certain developmental milestones are presented. Gross motor and self-help skills were found to be achieved earlier (across the three Aboriginal groups), whereas language skills were achieved slightly later than in Canadian children in general. Furthermore, health factors (eg, low birth weight, chronic health conditions) were associated with late achievement of developmental outcomes even when sociodemographic characteristics were considered. CONCLUSIONS: Findings suggest that the timing of milestone achievement may differ for Aboriginal children, highlighting the importance of establishing culturally specific norms and standards rather than relying on those derived from general populations. This information may be useful for practitioners and parents interested in identifying the age ranges for development, as well as age ranges indicating potential for developmental risk and opportunities for early intervention among Aboriginal children. PMID:24855426

Aboriginal parent support: A partnership approach.

PubMed

Munns, Ailsa; Toye, Christine; Hegney, Desley; Kickett, Marion; Marriott, Rhonda; Walker, Roz

2018-02-01

This study was positioned within a larger action research study relating to a peer-led Aboriginal home visiting parent support program in an urban Western Australian setting. The aims for this study component were to identify program elements, exploring participants' perceptions of the program's suitability, feasibility, acceptability and effectiveness to inform program model recommendations and add to the body of knowledge on effective Aboriginal peer-led program models. The ability of Aboriginal parents to develop positive family environments is crucial, with parent support needing to be reflexive to local needs and sociocultural influences. Culturally appropriate service provision needs meaningful and acceptable strategies. This study was situated within a critical paradigm supporting Participatory Action Research methodology, using Action Learning Sets as the participant engagement and data collection setting. Within ten Action Learning Sets, focus group interviews were carried out with Aboriginal peer support workers, a non-Aboriginal parent support worker, an Aboriginal program coordinator, an Aboriginal education support officer and non-Aboriginal program managers (n = 8), and individual interviews with parents (n = 2) and community agencies (n = 4). Data were analysed using thematic analysis. Five themes were derived from peer support worker and community agency cohorts: peer support worker home visiting skills; responding to impacts of social determinants of health; client support and engagement; interagency collaboration; and issues addressing program sustainability. Parent responses augmented these themes. Participants identified five key elements relating to peer-led home visiting support for Aboriginal parents. These are uniquely placed to inform ongoing program development as there is little additional evidence in wider national and international contexts. Engagement with communities and peer support workers to develop culturally relevant partnerships with Aboriginal families is integral to contemporary child health practice. Ongoing nurse support is needed for peer support worker role development. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal. © 2017 John Wiley & Sons Ltd.

Injury hospitalizations due to unintentional falls among the Aboriginal population of British Columbia, Canada: incidence, changes over time, and ecological analysis of risk markers, 1991-2010.

PubMed

Jin, Andrew; Lalonde, Christopher E; Brussoni, Mariana; McCormick, Rod; George, M Anne

2015-01-01

Aboriginal people in British Columbia (BC) have higher injury incidence than the general population. Our project describes variability among injury categories, time periods, and geographic, demographic and socio-economic groups. This report focuses on unintentional falls. We used BC's universal health care insurance plan as a population registry, linked to hospital separation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence and Standardized Relative Risk (SRR) of hospitalization for unintentional fall injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics with community SRR of injury by linear regression. During 1991 through 2010, the crude rate of hospitalization for unintentional fall injury in BC was 33.6 per 10,000 person-years. The Aboriginal rate was 49.9 per 10,000 and SRR was 1.89 (95% confidence interval 1.85-1.94). Among those living on reserves SRR was 2.00 (95% CI 1.93-2.07). Northern and non-urban HSDAs had higher SRRs, within both total and Aboriginal populations. In every age and gender category, the HSDA-standardized SRR was higher among the Aboriginal than among the total population. Between 1991 and 2010, crude rates and SRRs declined substantially, but proportionally more among the Aboriginal population, so the gap between the Aboriginal and total population is narrowing, particularly among females and older adults. These community characteristics were associated with higher risk: lower income, lower educational level, worse housing conditions, and more hazardous types of employment. Over the years, as socio-economic conditions improve, risk of hospitalization due to unintentional fall injury has declined among the Aboriginal population. Women and older adults have benefited more.

Injury Hospitalizations Due to Unintentional Falls among the Aboriginal Population of British Columbia, Canada: Incidence, Changes over Time, and Ecological Analysis of Risk Markers, 1991-2010

PubMed Central

2015-01-01

Background Aboriginal people in British Columbia (BC) have higher injury incidence than the general population. Our project describes variability among injury categories, time periods, and geographic, demographic and socio-economic groups. This report focuses on unintentional falls. Methods We used BC’s universal health care insurance plan as a population registry, linked to hospital separation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence and Standardized Relative Risk (SRR) of hospitalization for unintentional fall injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics with community SRR of injury by linear regression. Results During 1991 through 2010, the crude rate of hospitalization for unintentional fall injury in BC was 33.6 per 10,000 person-years. The Aboriginal rate was 49.9 per 10,000 and SRR was 1.89 (95% confidence interval 1.85-1.94). Among those living on reserves SRR was 2.00 (95% CI 1.93-2.07). Northern and non-urban HSDAs had higher SRRs, within both total and Aboriginal populations. In every age and gender category, the HSDA-standardized SRR was higher among the Aboriginal than among the total population. Between 1991 and 2010, crude rates and SRRs declined substantially, but proportionally more among the Aboriginal population, so the gap between the Aboriginal and total population is narrowing, particularly among females and older adults. These community characteristics were associated with higher risk: lower income, lower educational level, worse housing conditions, and more hazardous types of employment. Conclusions Over the years, as socio-economic conditions improve, risk of hospitalization due to unintentional fall injury has declined among the Aboriginal population. Women and older adults have benefited more. PMID:25793298

Hospitalizations due to unintentional transport injuries among Aboriginal population of British Columbia, Canada: Incidence, changes over time and ecological analysis of risk markers

PubMed Central

George, M. Anne; Jin, Andrew; Amram, Ofer; McCormick, Rod; Lalonde, Christopher E.

2018-01-01

Background Worldwide, Indigenous people have disproportionately higher rates of transport injuries. We examined disparities in injury-related hospitalizations resulting from transport incidents for three population groups in British Columbia (BC): total population, Aboriginal off-reserve, and Aboriginal on-reserve populations. We also examined sociodemographic, geographic and ethnic risk markers for disparities. Methods We identified Aboriginal people through BC’s universal health care insurance plan insurance premium group and birth and death record notations. We calculated crude incidence rate and Standardized Relative Risk (SRR) of hospitalization for unintentional transport injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with SRR of transport injury by multivariable linear regression. Results During the period 1991–2010, the SRR for the off-reserve Aboriginal population was 1.77 (95% CI: 1.71 to 1.83); and 2.00 (95% CI: 1.93 to 2.07) among those living on-reserve. Decline in crude rate and SRRs was observed over this period among both the Aboriginal and total populations of BC, but was proportionally greater among the Aboriginal population. The best-fitting multivariable risk marker model was an excellent fit (R2 = 0.912, p<0.001), predicted SRRs very close to observed values, and retained the following terms: urban residence, population per room, proportion of the population with a high school certificate, proportion of the population employed; and multiplicative interactions of Aboriginal ethnicity with population per room and proportion of the population employed. Conclusions Disparities in risk of hospitalization due to unintentional transport injury have narrowed. Aboriginal ethnicity modifies the effects of socioeconomic risk factors. Continued improvement of socioeconomic conditions and implementation of culturally relevant injury prevention interventions are needed. PMID:29373595

Hospitalizations due to unintentional transport injuries among Aboriginal population of British Columbia, Canada: Incidence, changes over time and ecological analysis of risk markers.

PubMed

Brussoni, Mariana; George, M Anne; Jin, Andrew; Amram, Ofer; McCormick, Rod; Lalonde, Christopher E

2018-01-01

Worldwide, Indigenous people have disproportionately higher rates of transport injuries. We examined disparities in injury-related hospitalizations resulting from transport incidents for three population groups in British Columbia (BC): total population, Aboriginal off-reserve, and Aboriginal on-reserve populations. We also examined sociodemographic, geographic and ethnic risk markers for disparities. We identified Aboriginal people through BC's universal health care insurance plan insurance premium group and birth and death record notations. We calculated crude incidence rate and Standardized Relative Risk (SRR) of hospitalization for unintentional transport injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with SRR of transport injury by multivariable linear regression. During the period 1991-2010, the SRR for the off-reserve Aboriginal population was 1.77 (95% CI: 1.71 to 1.83); and 2.00 (95% CI: 1.93 to 2.07) among those living on-reserve. Decline in crude rate and SRRs was observed over this period among both the Aboriginal and total populations of BC, but was proportionally greater among the Aboriginal population. The best-fitting multivariable risk marker model was an excellent fit (R2 = 0.912, p<0.001), predicted SRRs very close to observed values, and retained the following terms: urban residence, population per room, proportion of the population with a high school certificate, proportion of the population employed; and multiplicative interactions of Aboriginal ethnicity with population per room and proportion of the population employed. Disparities in risk of hospitalization due to unintentional transport injury have narrowed. Aboriginal ethnicity modifies the effects of socioeconomic risk factors. Continued improvement of socioeconomic conditions and implementation of culturally relevant injury prevention interventions are needed.

Improving Aboriginal maternal and infant health services in the 'Top End' of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change.

PubMed

Barclay, Lesley; Kruske, Sue; Bar-Zeev, Sarah; Steenkamp, Malinda; Josif, Cathryn; Narjic, Concepta Wulili; Wardaguga, Molly; Belton, Suzanne; Gao, Yu; Dunbar, Terry; Kildea, Sue

2014-06-02

Health services research is a well-articulated research methodology and can be a powerful vehicle to implement sustainable health service reform. This paper presents a summary of a five-year collaborative program between stakeholders and researchers that led to sustainable improvements in the maternity services for remote-dwelling Aboriginal women and their infants in the Top End (TE) of Australia. A mixed-methods health services research program of work was designed, using a participatory approach. The study area consisted of two large remote Aboriginal communities in the Top End of Australia and the hospital in the regional centre (RC) that provided birth and tertiary care for these communities. The stakeholders included consumers, midwives, doctors, nurses, Aboriginal Health Workers (AHW), managers, policy makers and support staff. Data were sourced from: hospital and health centre records; perinatal data sets and costing data sets; observations of maternal and infant health service delivery and parenting styles; formal and informal interviews with providers and women and focus groups. Studies examined: indicator sets that identify best care, the impact of quality of care and remoteness on health outcomes, discrepancies in the birth counts in a range of different data sets and ethnographic studies of 'out of hospital' or health centre birth and parenting. A new model of maternity care was introduced by the health service aiming to improve care following the findings of our research. Some of these improvements introduced during the five-year research program of research were evaluated. Cost effective improvements were made to the acceptability, quality and outcomes of maternity care. However, our synthesis identified system-wide problems that still account for poor quality of infant services, specifically, unacceptable standards of infant care and parent support, no apparent relationship between volume and acuity of presentations and staff numbers with the required skills for providing care for infants, and an 'outpatient' model of care. Services were also characterised by absent Aboriginal leadership and inadequate coordination between remote and tertiary services that is essential to improve quality of care and reduce 'system-introduced' risk. Evidence-informed redesign of maternity services and delivery of care has improved clinical effectiveness and quality for women. However, more work is needed to address substandard care provided for infants and their parents.

Worker compensation injuries among the Aboriginal population of British Columbia, Canada: incidence, annual trends, and ecological analysis of risk markers, 1987-2010.

PubMed

Jin, Andrew; George, M Anne; Brussoni, Mariana; Lalonde, Christopher E

2014-07-10

Aboriginal people in British Columbia (BC) have higher injury incidence than the general population, but information is scarce regarding variability among injury categories, time periods, and geographic, demographic and socio-economic groups. Our project helps fill these gaps. This report focuses on workplace injuries. We used BC's universal health care insurance plan as a population registry, linked to worker compensation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence rate and Standardized Relative Risk (SRR) of worker compensation injury, adjusted for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We assessed annual trend by regressing SRR as a linear function of year. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with community SRR of injury by multivariable linear regression. During the period 1987-2010, the crude rate of worker compensation injury in BC was 146.6 per 10,000 person-years (95% confidence interval: 146.4 to 146.9 per 10,000). The Aboriginal rate was 115.6 per 10,000 (95% CI: 114.4 to 116.8 per 10,000) and SRR was 0.88 (95% CI: 0.87 to 0.89). Among those living on reserves SRR was 0.79 (95% CI: 0.78 to 0.80). HSDA SRRs were highly variable, within both total and Aboriginal populations. Aboriginal males under 35 and females under 40 years of age had lower SRRs, but older Aboriginal females had higher SRRs. SRRs are declining, but more slowly for the Aboriginal population. The Aboriginal population was initially at lower risk than the total population, but parity was reached in 2006. These community characteristics independently predicted injury risk: crowded housing, proportion of population who identified as Aboriginal, and interactions between employment rate and income, occupational risk, proportion of university-educated persons, and year. As employment rates rise, so has risk of workplace injury among the Aboriginal population. We need culturally sensitive prevention programs, targeting regions and industries where Aboriginal workers are concentrated and demographic groups that are at higher risk.

Worker compensation injuries among the Aboriginal population of British Columbia, Canada: incidence, annual trends, and ecological analysis of risk markers, 1987–2010

PubMed Central

2014-01-01

Background Aboriginal people in British Columbia (BC) have higher injury incidence than the general population, but information is scarce regarding variability among injury categories, time periods, and geographic, demographic and socio-economic groups. Our project helps fill these gaps. This report focuses on workplace injuries. Methods We used BC’s universal health care insurance plan as a population registry, linked to worker compensation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence rate and Standardized Relative Risk (SRR) of worker compensation injury, adjusted for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We assessed annual trend by regressing SRR as a linear function of year. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with community SRR of injury by multivariable linear regression. Results During the period 1987–2010, the crude rate of worker compensation injury in BC was 146.6 per 10,000 person-years (95% confidence interval: 146.4 to 146.9 per 10,000). The Aboriginal rate was 115.6 per 10,000 (95% CI: 114.4 to 116.8 per 10,000) and SRR was 0.88 (95% CI: 0.87 to 0.89). Among those living on reserves SRR was 0.79 (95% CI: 0.78 to 0.80). HSDA SRRs were highly variable, within both total and Aboriginal populations. Aboriginal males under 35 and females under 40 years of age had lower SRRs, but older Aboriginal females had higher SRRs. SRRs are declining, but more slowly for the Aboriginal population. The Aboriginal population was initially at lower risk than the total population, but parity was reached in 2006. These community characteristics independently predicted injury risk: crowded housing, proportion of population who identified as Aboriginal, and interactions between employment rate and income, occupational risk, proportion of university-educated persons, and year. Conclusions As employment rates rise, so has risk of workplace injury among the Aboriginal population. We need culturally sensitive prevention programs, targeting regions and industries where Aboriginal workers are concentrated and demographic groups that are at higher risk. PMID:25012161

Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study.

PubMed

Wang, Zhiqiang; Hoy, Wendy E; Si, Damin

2010-08-17

Diabetes is an important contributor to the health inequity between Aboriginal and non-Aboriginal Australians. This study aims to estimate incidence rates of diabetes and to assess its associations with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) among Aboriginal participants in a remote community. Six hundred and eighty six (686) Aboriginal Australians aged 20 to 74 years free from diabetes at baseline were followed for a median of 11 years. During the follow-up period, new diabetes cases were identified through hospital records. Cox proportional hazards models were used to assess relationships of the incidence rates of diabetes with IFG, IGT and body mass index (BMI). One hundred and twenty four (124) new diabetes cases were diagnosed during the follow up period. Incidence rates increased with increasing age, from 2.2 per 1000 person-years for those younger than 25 years to 39.9 per 1000 person-years for those 45-54 years. By age of 60 years, cumulative incidence rates were 49% for Aboriginal men and 70% for Aboriginal women. The rate ratio for developing diabetes in the presence of either IFG or IGT at baseline was 2.2 (95% CI: 1.5, 3.3), adjusting for age, sex and BMI. Rate ratios for developing diabetes were 2.2 (95% CI: 1.4, 3.5) for people who were overweight and 4.7 (95% CI: 3.0, 7.4) for people who were obese at baseline, with adjustment of age, sex and the presence of IFG/IGT. Diabetes incidence rates are high in Aboriginal people. The lifetime risk of developing diabetes among Aboriginal men is one in two, and among Aboriginal women is two in three. Baseline IFG, IGT and obesity are important predictors of diabetes.

Confronting uncomfortable truths: receptivity and resistance to Aboriginal content in midwifery education.

PubMed

Thackrah, Rosalie D; Thompson, Sandra C

2013-12-01

The emotional responses of students undertaking a new, compulsory unit on Indigenous cultures and health were investigated as part of a broader study looking at culturally secure practice in midwifery education and service provision for Aboriginal women. Classroom observations were conducted on a first year midwifery cohort from July to October 2012 and students completed 'before and after' questionnaires. A spectrum of emotional responses was identified and found to be consistent with studies of medical student exposure to Aboriginal content. While stereotypes were challenged and perceptions altered as a result of the content, issues surrounding racism remained unresolved, with some students expressing dismay at the attitudes of their peers. This study confirmed the need for content on Aboriginal health and cultures to extend beyond one unit in a course. Learning and knowledge must be carefully integrated and developed to maximise understanding and ensure that unresolved issues are addressed.

Diagnosed alcohol dependence and criminal sentencing among British Columbian Aboriginal offenders.

PubMed

Rempel, Emily S; Somers, Julian M; Calvert, John R; McCandless, Lawrence C

2015-09-01

Alcohol use is commonly reported as a short-term criminal risk factor; however there is minimal research on the effects of alcohol dependence on crime. Canadian Aboriginal offenders exhibit both disproportionate crime and alcohol disorder prevalence. This study aims to examine the impact of diagnosed alcohol dependence on Aboriginal ethnicity and criminal sentencing in British Columbia. We used an administrative linkage database of social, health and justice system variables to develop a retrospective cohort of 70,035 offenders sentenced through courts in British Columbia from 2001-2010. We used a coefficient difference mediation analysis to evaluate the mediating effect of alcohol dependence on the association between self-reported Aboriginal status and sentencing rate. Aboriginal offenders had 1.92 (95% C.I.: 1.79,2.06) times higher odds of alcohol dependence than Caucasian offenders. Adjustment for health, social and demographic factors resulted in a 27% (95% Confidence Interval (CI): 15%, 33%) reduction in the association of Aboriginal ethnicity on sentencing. Adjustment for alcohol dependence resulted in only a further reduction of 2% (95% CI: -12%, 15%). Although alcohol dependence was associated both with Aboriginal ethnicity and sentencing, it did not have a significant mediating impact on sentencing rate. Alcohol dependence was not a mediator for the relationship between sentencing rate and Aboriginal ethnicity. However, due to the proportion of offenders diagnosed with alcohol dependence, these results support alcohol misuse as an important public health policy target in this population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Canada's evacuation policy for pregnant First Nations women: Resignation, resilience, and resistance.

PubMed

Lawford, Karen M; Giles, Audrey R; Bourgeault, Ivy L

2018-02-10

Aboriginal peoples in Canada are comprised of First Nations, Métis, and Inuit. Health care services for First Nations who live on rural and remote reserves are mostly provided by the Government of Canada through the federal department, Health Canada. One Health Canada policy, the evacuation policy, requires all First Nations women living on rural and remote reserves to leave their communities between 36 and 38 weeks gestational age and travel to urban centres to await labour and birth. Although there are a few First Nations communities in Canada that have re-established community birthing and Aboriginal midwifery is growing, most First Nations communities are still reliant on the evacuation policy for labour and birthing services. In one Canadian province, Manitoba, First Nations women are evacuated to The Pas, Thompson, or Winnipeg but most - including all women with high-risk pregnancies - go to Winnipeg. To contribute scholarship that describes First Nations women's and community members' experiences and perspectives of Health Canada's evacuation policy in Manitoba. Applying intersectional theory to data collected through 12 semi-structured interviews with seven women and five community members (four females, one male) in Manitoba who had experienced the evacuation policy. The data were analyzed thematically, which revealed three themes: resignation, resilience, and resistance. The theme of resignation was epitomized by the quote, "Nobody has a choice." The ability to withstand and endure the evacuation policy despite poor or absent communication and loneliness informed of resilience. Resistance was demonstrated by women who questioned the necessity and requirement of evacuation for labour and birth. In one instance, resistance took the form of a planned homebirth with Aboriginal registered midwives. There is a pressing need to improve the maternity care services that First Nations women receive when they are evacuated out of their communities, particularly when understood from the specific legal and constitutional position of First Nations women in Manitoba. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Factors associated with non-attendance in a general practice super clinic population in regional Australia: A retrospective cohort study.

PubMed

Nancarrow, Susan; Bradbury, Joanne; Avila, Catherine

2014-01-01

Non-attendance at medical appointments is associated with increased patient morbidity and is a significant drain on health service resources. Australian studies have focused on secondary healthcare settings, screening, and interventions to reduce non-attendance. To explore factors associated with non-attendance in a regional primary care setting. A retrospective cohort of all patients with a scheduled appointment between October 2011 and October 2013 at a regional, primary care clinic providing medical and allied health services in a region of New South Wales (NSW) serving a large Aboriginal population (10.7 per cent). Using multivariate logistic regression, non-attendance was regressed on a range of covariates, including number of appointments per person, gender and ethnicity, and day of the week. The overall proportion of missed appointments was 7.6 per cent. Risk factors for non-attendance were day of the week [Mondays (8.1 per cent), Fridays (8.0 per cent), and Thursdays (7.9 per cent), (χ2(4)= 20.208, p<0.0005], having fewer scheduled appointments [≤5 appointments resulted in 19.1 per cent greater risk of failure to attend (FTA) (95% CI: 11-28%)]; Aboriginality (OR=4.022, 95% CI: 3.263, 4.956), and female gender (OR=1.077; 95% CI 1.024, 1.132). There was a trend toward an interaction between gender and Aboriginality, with Aboriginal females being the group most likely to miss appointments (OR=1.272, 95% CI: 0.949, 1.705). This is the largest study of non-attendance in an Australian primary healthcare setting. While not a typical setting, the study had the advantage of a large, mixed population. The suggested high rates of non-attendance by Aboriginal females have potentially important policy implications.

Seroprevalence of Coxiella burnetii in Australian dogs.

PubMed

Shapiro, A J; Norris, J M; Heller, J; Brown, G; Malik, R; Bosward, K L

2016-09-01

The role of dogs in the transmission of Coxiella burnetii to humans is uncertain, and extensive seroprevalence studies of dogs have not been previously conducted in Australia. This study determined C. burnetii exposure in four diverse canine subpopulations by adapting, verifying and comparing an indirect immunofluoresence assay (IFA) and an enzyme-linked immunosorbent assay (ELISA) used to detect anti-C. burnetii antibodies in humans. Canine serum samples (n = 1223) were tested with IFA from four subpopulations [breeding establishments; household pets; free-roaming dogs in Aboriginal communities; shelter dogs]. The proportions of seropositive dogs were as follows: breeding (7/309, 2.3%), household pets (10/328, 3%), Aboriginal communities (21/321, 6.5%) and shelters (5/265, 1.9%). Dogs from Aboriginal communities were 2.8 times (CI 1.5-5.1; P < 0.001) more likely to be seropositive than dogs from other populations. The ELISA was used on 86 of 1223 sera tested with IFA, and a Cohen's Kappa coefficient of 0.60 (CI 0.43-0.78) indicated good agreement between the two assays. This study has established that Australian dogs within all four subpopulations have been exposed to C. burnetii and that a higher seroprevalence was observed amongst free-roaming dogs associated with Aboriginal communities. As C. burnetii recrudesces during pregnancy and birth products contain the highest concentration of organism, individuals assisting at the time of parturition, those handling pups shortly after birth as well as those residing in the vicinity of whelping dogs are potentially at risk of developing Q fever. However, the identification of active antigen shed in excreta from seropositive dogs is required in order to accurately define and quantify the public health risk. © 2016 Blackwell Verlag GmbH.

Improving Aboriginal maternal and infant health services in the ‘Top End’ of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change

PubMed Central

2014-01-01

Background Health services research is a well-articulated research methodology and can be a powerful vehicle to implement sustainable health service reform. This paper presents a summary of a five-year collaborative program between stakeholders and researchers that led to sustainable improvements in the maternity services for remote-dwelling Aboriginal women and their infants in the Top End (TE) of Australia. Methods A mixed-methods health services research program of work was designed, using a participatory approach. The study area consisted of two large remote Aboriginal communities in the Top End of Australia and the hospital in the regional centre (RC) that provided birth and tertiary care for these communities. The stakeholders included consumers, midwives, doctors, nurses, Aboriginal Health Workers (AHW), managers, policy makers and support staff. Data were sourced from: hospital and health centre records; perinatal data sets and costing data sets; observations of maternal and infant health service delivery and parenting styles; formal and informal interviews with providers and women and focus groups. Studies examined: indicator sets that identify best care, the impact of quality of care and remoteness on health outcomes, discrepancies in the birth counts in a range of different data sets and ethnographic studies of ‘out of hospital’ or health centre birth and parenting. A new model of maternity care was introduced by the health service aiming to improve care following the findings of our research. Some of these improvements introduced during the five-year research program of research were evaluated. Results Cost effective improvements were made to the acceptability, quality and outcomes of maternity care. However, our synthesis identified system-wide problems that still account for poor quality of infant services, specifically, unacceptable standards of infant care and parent support, no apparent relationship between volume and acuity of presentations and staff numbers with the required skills for providing care for infants, and an ‘outpatient’ model of care. Services were also characterised by absent Aboriginal leadership and inadequate coordination between remote and tertiary services that is essential to improve quality of care and reduce ‘system-introduced’ risk. Conclusion Evidence-informed redesign of maternity services and delivery of care has improved clinical effectiveness and quality for women. However, more work is needed to address substandard care provided for infants and their parents. PMID:24890910

Population-Based Prevalence of Intellectual Disability and Autism Spectrum Disorders in Western Australia: A Comparison With Previous Estimates.

PubMed

Bourke, Jenny; de Klerk, Nick; Smith, Timothy; Leonard, Helen

2016-05-01

To investigate the prevalence of intellectual disability (ID) and/or autism spectrum disorders (ASDs) in Western Australia (WA).A cohort of children born from 1983 to 2010 in WA with an ID and/or ASD were identified using the population-based IDEA (Intellectual Disability Exploring Answers) database, which ascertains cases through the Disability Services Commission (DSC) as well as education sources. Information on race, gender, mother's residence at birth and deaths was obtained through linkage to the Midwives Notification System and the Mortality Register. Diagnostic information on the cause of ID was obtained through review of medical records where available and children were classified as biomedical cause, ASD, or unknown cause.An overall prevalence of ID of 17.0/1000 livebirths (95% CI: 16.7, 17.4) showed an increase from the 10-year previous prevalence of 14.3/1000. The prevalence for mild or moderate ID was 15.0 (95% CI: 14.6, 15.3), severe ID was 1.2 (95% CI: 1.1, 1.3), and unknown level of ID was 0.9 (95% CI: 0.8, 1.0)/1000 livebirths. The prevalence for Aboriginal children was 39.0/1000 compared with 15.7/1000 for non-Aboriginal children, giving a prevalence ratio of 2.5 (95% CI: 2.4, 2.6). Prevalence of all ASD was 5.1/1000 of which 3.8/1000 had ASD and ID.The prevalence of ID has risen in WA over the last 10 years with most of this increase due to mild or moderate ID. Whilst the prevalence of ASD has also increased over this time this does not fully explain the observed increase. Aboriginal children are at a 2.5-fold risk of ID but are less likely to be accessing disability services.

2009-2010 Influenza A(H1N1)-related critical illness among Aboriginal and non-Aboriginal Canadians.

PubMed

Jung, James J; Pinto, Ruxandra; Zarychanski, Ryan; Cook, Deborah J; Jouvet, Philippe; Marshall, John C; Kumar, Anand; Long, Jennifer; Rodin, Rachel; Fowler, Robert A

2017-01-01

Preliminary studies suggested that Aboriginal Canadians had disproportionately higher rates of infection, hospitalization, and critical illness due to pandemic Influenza A(H1N1)pdm09. We used a prospective cohort study of critically ill patients with laboratory confirmed or probable H1N1 infection in Canada between April 16 2009 and April 12 2010. Baseline characteristics, medical interventions, clinical course and outcomes were compared between Aboriginal and non-Aboriginal patients. The primary outcome was hospital mortality. Of 647 critically ill adult patients with known ethnicity, 81 (12.5%) were Aboriginal, 566 (87.5%) were non-Aboriginal. Aboriginal patients were younger (mean [SD] age 40.7[13.7] v. 49.0[14.9] years, p < 0.001) and more frequently female (64.2% v. 51.1%, p = 0.027). Rates of any co-morbid illnesses (Aboriginal v. non-Aboriginal, 92.6% v. 91.0%, p = 0.63), time from symptom onset to hospital admission (median [interquartile range] 4 [2-7] v. 4 [2-7] days, p = 0.84), time to ICU admission (5 [3-8] v.5 [3-8] days, p = 0.91), and severity of illness (mean APACHE II score (19.9 [9.6] v. 21.1 [9.9], p = 0.33) were similar. A similar proportion of Aboriginal patients received antiviral medication before ICU admission than non-Aboriginal patients (91.4% v. 93.8%, p = 0.40). Among Aboriginal versus non-Aboriginal patients, the need for mechanical ventilation (93.8% v. 88.6%, p = 0.15), ventilator-free days (14 [3-23] v. 17 [0-24], p = 0.62), durations of stay in ICU (13[7-19.5] v. 11 [5-8] days, p = 0.05), hospital (19 [12.5-33.5] v. 18 [11-35] days, p = 0.63), and hospital mortality were similar (19.8% v. 22.6%, p = 0.56). In multiple logistic regression analyses, higher APACHE II score (1.06; 1.04-1.09, p<0.001) was independently associated with an increased risk of death; antiviral treatment with a lower risk of death (0.34; 0.15 - 0.78, p = 0.01). Ethnicity was not associated with mortality. During the 2009-2010 Influenza A (H1N1) pandemic, Aboriginal and non-Aboriginal Canadians with H1N1-related critical illness had a similar risk of death, after adjusting for potential confounding factors.

2009–2010 Influenza A(H1N1)-related critical illness among Aboriginal and non-Aboriginal Canadians

PubMed Central

Jung, James J.; Pinto, Ruxandra; Zarychanski, Ryan; Cook, Deborah J.; Jouvet, Philippe; Marshall, John C.; Kumar, Anand; Long, Jennifer; Rodin, Rachel; Fowler, Robert A.

2017-01-01

Background Preliminary studies suggested that Aboriginal Canadians had disproportionately higher rates of infection, hospitalization, and critical illness due to pandemic Influenza A(H1N1)pdm09. Methods We used a prospective cohort study of critically ill patients with laboratory confirmed or probable H1N1 infection in Canada between April 16 2009 and April 12 2010. Baseline characteristics, medical interventions, clinical course and outcomes were compared between Aboriginal and non-Aboriginal patients. The primary outcome was hospital mortality. Results Of 647 critically ill adult patients with known ethnicity, 81 (12.5%) were Aboriginal, 566 (87.5%) were non-Aboriginal. Aboriginal patients were younger (mean [SD] age 40.7[13.7] v. 49.0[14.9] years, p < 0.001) and more frequently female (64.2% v. 51.1%, p = 0.027). Rates of any co-morbid illnesses (Aboriginal v. non-Aboriginal, 92.6% v. 91.0%, p = 0.63), time from symptom onset to hospital admission (median [interquartile range] 4 [2–7] v. 4 [2–7] days, p = 0.84), time to ICU admission (5 [3–8] v.5 [3–8] days, p = 0.91), and severity of illness (mean APACHE II score (19.9 [9.6] v. 21.1 [9.9], p = 0.33) were similar. A similar proportion of Aboriginal patients received antiviral medication before ICU admission than non-Aboriginal patients (91.4% v. 93.8%, p = 0.40). Among Aboriginal versus non-Aboriginal patients, the need for mechanical ventilation (93.8% v. 88.6%, p = 0.15), ventilator-free days (14 [3–23] v. 17 [0–24], p = 0.62), durations of stay in ICU (13[7-19.5] v. 11 [5–8] days, p = 0.05), hospital (19 [12.5-33.5] v. 18 [11-35] days, p = 0.63), and hospital mortality were similar (19.8% v. 22.6%, p = 0.56). In multiple logistic regression analyses, higher APACHE II score (1.06; 1.04-1.09, p<0.001) was independently associated with an increased risk of death; antiviral treatment with a lower risk of death (0.34; 0.15 – 0.78, p = 0.01). Ethnicity was not associated with mortality. Interpretation During the 2009-2010 Influenza A (H1N1) pandemic, Aboriginal and non-Aboriginal Canadians with H1N1-related critical illness had a similar risk of death, after adjusting for potential confounding factors. PMID:29049285

Strongyloides seroprevalence before and after an ivermectin mass drug administration in a remote Australian Aboriginal community

PubMed Central

Currie, Bart J.; Cheng, Allen C.; McCarthy, James; Carapetis, Jonathan R.; Holt, Deborah C.; Page, Wendy; Shield, Jennifer; Gundjirryirr, Roslyn; Mulholland, Eddie; Ward, Linda; Andrews, Ross M.

2017-01-01

Background Strongyloides seroprevalence is hyper-endemic in many Australian Aboriginal and Torres Strait Islander communities, ranging from 35–60%. We report the impact on Strongyloides seroprevalence after two oral ivermectin mass drug administrations (MDAs) delivered 12 months apart in a remote Australian Aboriginal community. Methods Utilizing a before and after study design, we measured Strongyloides seroprevalence through population census with sequential MDAs at baseline and month 12. Surveys at months 6 and 18 determined changes in serostatus. Serodiagnosis was undertaken by ELISA that used sonicated Strongyloides ratti antigen to detect anti-Strongyloides IgG. Non-pregnant participants weighing ≥15 kg were administered a single 200 μg/kg ivermectin dose, repeated after 10–42 days if Strongyloides and/or scabies was diagnosed; others followed a standard alternative algorithm. A questionnaire on clinical symptoms was administered to identify adverse events from treatment and self-reported symptoms associated with serostatus. Findings We surveyed 1013 participants at the baseline population census and 1060 (n = 700 from baseline cohort and 360 new entrants) at month 12. Strongyloides seroprevalence fell from 21% (175/818) at baseline to 5% at month 6. For participants from the baseline cohort this reduction was sustained at month 12 (34/618, 6%), falling to 2% at month 18 after the second MDA. For new entrants to the cohort at month 12, seroprevalence reduced from 25% (75/297) to 7% at month 18. Strongyloides positive seroconversions for the baseline cohort six months after each MDA were 2.5% (4/157) at month 6 and 1% at month 18, whilst failure to serorevert remained unchanged at 18%. At 12 months, eosinophilia was identified in 59% of baseline seropositive participants and 89% of seropositive new entrants, compared with 47%baseline seronegative participants and 51% seronegative new entrants. Seropositivity was not correlated with haemoglobin or any self-reported clinical symptoms. Clinical symptoms ascertained on the day of treatment and 24–72 hrs after, did not identify any adverse events. Significance Two community ivermectin MDAs delivered 12 months apart by trained Aboriginal researchers in collaboration with non-Indigenous researchers resulted in a sustained and significant reduction in Strongyloides seroprevalence over 18 months. Similar reductions were seen in the baseline cohort and new entrants. PMID:28505198

Fall-related hospitalisations of older Aboriginal and Torres Strait Islander people and other Australians.

PubMed

Lukaszyk, Caroline; Harvey, Lara A; Sherrington, Catherine; Close, Jacqueline Ct; Coombes, Julieann; Mitchell, Rebecca J; Moore, Robyn; Ivers, Rebecca

2017-07-03

To compare the socio-demographic characteristics and type of injury sustained, the use of hospital resources and rates of hospitalisation by injury type, and survival following fall injuries to older Aboriginal people and non-Indigenous Australian people hospitalised for fall-related injuries. Population-based retrospective cohort data linkage study. Setting, participants: New South Wales residents aged 50 years or more admitted to a public or private NSW hospital for a fall-related injury during 1 January 2003 - 31 December 2012. Proportions of patients with defined injury types, mean hospital length of stay (LOS), 30-day mortality, age-standardised hospitalisation rates and age-adjusted rate ratios, 28-day re-admission rates. There were 312 758 fall-related injury hospitalisations for 234 979 individuals; 2660 admissions (0.85%) were of Aboriginal people. The proportion of hospitalisations for fall-related fracture injuries was lower for Aboriginal than for non-Indigenous Australians (49% v 60% of fall-related hospitalisations; P < 0.001). The major injury type for Aboriginal patients was non-fracture injury to head or neck (19% of hospitalisations); for non-Indigenous patients it was hip fractures (18%). Age-adjusted LOS was lower for Aboriginal than for non-Indigenous patients (9.1 v 14.0 days; P < 0.001), as was 30-day mortality (2.9% v 4.2%; P < 0.001). For Aboriginal people, fall injury hospitalisations increased at an annual rate of 5.8% (95% CI, 4.0-7.7%; P < 0.001); for non-Indigenous patients, the mean annual increase was 2.5% (95% CI, 2.1-3.0; P < 0.001). The patterns of injury and outcomes of fall injury hospitalisations were different for older Aboriginal people and other older Australians, suggesting that different approaches are required to prevent and treat fall injuries.

Hospital admissions for skin infections among Western Australian children and adolescents from 1996 to 2012.

PubMed

Abdalla, Tasnim; Hendrickx, David; Fathima, Parveen; Walker, Roz; Blyth, Christopher C; Carapetis, Jonathan R; Bowen, Asha C; Moore, Hannah C

2017-01-01

The objective of this study was to describe the occurrence of skin infection associated hospitalizations in children born in Western Australia (WA). We conducted a retrospective cohort study of all children born in WA between 1996 and 2012 (n = 469,589). Of these, 31,348 (6.7%) were Aboriginal and 240,237 (51.2%) were boys. We report the annual age-specific hospital admission rates by geographical location and diagnostic category. We applied log-linear regression modelling to analyse changes in temporal trends of hospitalizations. Hospitalization rates for skin infections in Aboriginal children (31.7/1000 child-years; 95% confidence interval [CI] 31.0-32.4) were 15.0 times higher (95% CI 14.5-15.5; P<0.001) than those of non-Aboriginal children (2.1/1000 child-years; 95% CI 2.0-2.1). Most admissions in Aboriginal children were due to abscess, cellulitis and scabies (84.3%), while impetigo and pyoderma were the predominant causes in non-Aboriginal children (97.7%). Admissions declined with age, with the highest rates for all skin infections observed in infants. Admissions increased with remoteness. Multiple admissions were more common in Aboriginal children. Excess admissions in Aboriginal children were observed during the wet season in the Kimberley and during summer in metropolitan areas. Our study findings show that skin infections are a significant cause of severe disease, requiring hospitalization in Western Australian children, with Aboriginal children at a particularly high risk. Improved community-level prevention of skin infections and the provision of effective primary care are crucial in reducing the burden of skin infection associated hospitalizations. The contribution of sociodemographic and environmental risk factors warrant further investigation.

Favourable IFNL3 genotypes are associated with spontaneous clearance and are differentially distributed in Aboriginals in Canadian HIV-hepatitis C co-infected individuals.

PubMed

Moqueet, Nasheed; Infante-Rivard, Claire; Platt, Robert W; Young, Jim; Cooper, Curtis; Hull, Mark; Walmsley, Sharon; Klein, Marina B

2015-03-20

Canadian Aboriginals are reported to clear Hepatitis C (HCV) more frequently. We tested the association of spontaneous clearance and three single nucleotide polymorphisms (SNPs) near the Interferon-lambda 3 (IFNL3) gene (rs12979860, rs8099917, functional variant rs8103142) and compared the SNP frequencies between HIV-HCV co-infected whites and Aboriginals from the Canadian Co-infection Cohort. HCV treatment-naïve individuals with at least two HCV RNA tests were included (n = 538). A spontaneous clearance case was defined as someone with two consecutive HCV RNA-negative tests, at least six months apart. Data were analyzed using Cox proportional hazards adjusted for sex and ethnicity. Advantageous variants and haplotypes were more common in Aboriginals than Caucasians: 57% vs. 46% had the rs12979860 CC genotype, respectively; 58% vs. 48%, rs8103142 TT; 74% vs. 67%, the rs12979860 C allele; and 67% vs. 64% the TCT haplotype with three favourable alleles. The adjusted Hazard Ratios (95% CI) for spontaneous clearance were: rs12979860: 3.80 (2.20, 6.54); rs8099917: 5.14 (2.46, 10.72); and rs8103142: 4.36 (2.49, 7.62). Even after adjusting for rs12979860, Aboriginals and females cleared HCV more often, HR (95% CI) = 1.53 (0.89, 2.61) and 1.42 (0.79, 2.53), respectively. Our results suggest that favourable IFNL3 genotypes are more common among Aboriginals than Caucasians, and may partly explain the higher HCV clearance rates seen among Aboriginals.

Aboriginal and Torres Strait Islander community governance of health research: Turning principles into practice.

PubMed

Gwynn, Josephine; Lock, Mark; Turner, Nicole; Dennison, Ray; Coleman, Clare; Kelly, Brian; Wiggers, John

2015-08-01

Gaps exist in researchers' understanding of the 'practice' of community governance in relation to research with Aboriginal and Torres Strait Islander peoples. We examine Aboriginal community governance of two rural NSW research projects by applying principles-based criteria from two independent sources. One research project possessed a strong Aboriginal community governance structure and evaluated a 2-year healthy lifestyle program for children; the other was a 5-year cohort study examining factors influencing the mental health and well-being of participants. The National Health and Medical Research Council of Australia's 'Values and ethics: guidelines for ethical conduct in Aboriginal and Torres Strait Islander research' and 'Ten principles relevant to health research among Indigenous Australian populations' described by experts in the field. Adopt community-based participatory research constructs. Develop clear governance structures and procedures at the beginning of the study and allow sufficient time for their establishment. Capacity-building must be a key component of the research. Ensure sufficient resources to enable community engagement, conduct of research governance procedures, capacity-building and results dissemination. The implementation of governance structures and procedures ensures research addresses the priorities of the participating Aboriginal and Torres Strait Islander communities, minimises risks and improves outcomes for the communities. Principles-based Aboriginal and Torres Strait Islander community governance of research is very achievable. Next steps include developing a comprehensive evidence base for appropriate governance structures and procedures, and consolidating a suite of practical guides for structuring clear governance in health research. © 2015 National Rural Health Alliance Inc.

Injuries to Aboriginal populations living on- and off-reserve in metropolitan and non-metropolitan areas in British Columbia, Canada: Incidence and trends, 1986-2010.

PubMed

Brussoni, Mariana; George, M Anne; Jin, Andrew; Lalonde, Christopher E; McCormick, Rod

2016-05-13

Disparities in injury rates between Aboriginal and non-Aboriginal populations in British Columbia (BC) are well established. Information regarding the influence of residence on disparities is scarce. We sought to fill these gaps by examining hospitalization rates for all injuries, unintentional injuries and intentional injuries across 24 years among i) Aboriginal and total populations; ii) populations living in metropolitan and non-metropolitan areas; and iii) Aboriginal populations living on- and off-reserve. We used data spanning 1986 through 2010 from BC's universal health care insurance plan, linked to vital statistics databases. Aboriginal people were identified by insurance premium group and birth and death record notations, and their residence was determined by postal code. "On-reserve" residence was established by postal code areas associated with an Indian reserve or settlement. Health Service Delivery Areas (HSDAs) were classified as "metropolitan" if they contained a population of at least 100,000 with a density of 400 or more people per square kilometre. We calculated the crude hospitalization incidence rate and the Standardized Relative Risk (SRR) of hospitalization due to injury standardizing by gender, 5-year age group, and HSDA. We assessed cumulative change in SRR over time as the relative change between the first and last years of the observation period. Aboriginal metropolitan populations living off-reserve had the lowest SRR of injury (2.0), but this was 2.3 times greater than the general British Columbia metropolitan population (0.86). For intentional injuries, Aboriginal populations living on-reserve in non-metropolitan areas were at 5.9 times greater risk than the total BC population. In general, the largest injury disparities were evident for Aboriginal non-metropolitan populations living on-reserve (SRR 3.0); 2.5 times greater than the general BC non-metropolitan population (1.2). Time trends indicated decreasing disparities, with Aboriginal non-metropolitan populations experiencing the largest declines in injury rates. Metropolitan/non-metropolitan residence appears to be a more important predictor than on/off-reserve residence for all injuries and unintentional injuries, and the relationship was even more pronounced for intentional injuries. The persistent disparities highlight the need for culturally sensitive and geographically relevant injury prevention approaches.

Voices from the margins Part 1: narrative accounts of indigenous family violence.

PubMed

Davis, Kierrynn; Taylor, Bev

2002-12-01

The needs of informal supporters of rural women surviving domestic violence from the supporter's perspective were explored through the use of storytelling. Eleven women were interviewed. Of those eleven, three informal supporters spoke about supporting Indigenous women in family violence. These three stories have been grouped as a separate cohort and are discussed in two papers. Of the women who told stories of supporting Aboriginal women, two were Indigenous and one was non Aboriginal, although her partner was Indigenous. It was clear from the stories told by these women that Indigenous family violence is situated in a context of a history and experience of colonisation and human rights abuses. Therefore, this article explores the context of Indigenous family violence and the second explores the strategies for strengthening support for Aboriginal families experiencing violence.

Health service utilisation amongst urban Aboriginal and Torres Strait Islander children aged younger than 5 years registered with a primary health-care service in South-East Queensland.

PubMed

Hall, Kerry K; Chang, Anne B; Anderson, Jennie; Arnold, Daniel; Otim, Michael; O'Grady, Kerry-Ann F

2018-06-01

The majority of Australia's Aboriginal and/or Torres Strait Islander children live in urban areas; however, little is known about their health service use. We aimed to describe health service utilisation amongst a cohort of urban Aboriginal and/or Torres Strait Islander children aged <5 years. We analysed health service utilisation data collected in an ongoing prospective cohort study of children aged <5 years registered with an Aboriginal-owned and operated primary health-care service. Enrolled children were followed monthly for 12 months, with data on health service utilisation collected at baseline and at each monthly follow-up. Health service utilisation rates, overall and by service provider and reason for presentation, were calculated and reported as incidence rates per 100 child-months with the corresponding 95% confidence intervals (CIs). Between February 2013 and November 2015, 180 children were enrolled, and 1541 child-months of observation were available for analysis. The overall incidence of health service utilisation was 52.5 per 100 child-months (95% CI 48.7-56.5); 81% of encounters were with general practitioners. Presentation rates were the highest for acute respiratory illnesses (30.7/100 child-months, 95% CI 27.8-33.9). In this community, acute respiratory illnesses are predominant causes of health service utilisation in young children. The health-care utilisation profile of these children presents important opportunities for health promotion and intervention. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Diet and anthropometry at 2 years of age following an oral health promotion programme for Australian Aboriginal children and their carers: a randomised controlled trial.

PubMed

Smithers, Lisa G; Lynch, John; Hedges, Joanne; Jamieson, Lisa M

2017-12-01

There are marked disparities between indigenous and non-indigenous children's diets and oral health. Both diet and oral health are linked to longer-term health problems. We aimed to investigate whether a culturally appropriate multi-faceted oral health promotion intervention reduced Aboriginal children's intake of sugars from discretionary foods at 2 years of age. We conducted a single-blind, parallel-arm randomised controlled trial involving women who were pregnant or had given birth to an Aboriginal child in the previous 6 weeks. The treatment group received anticipatory guidance, Motivational Interviewing, health and dental care for mothers during pregnancy and children at 6, 12 and 18 months. The control group received usual care. The key dietary outcome was the percent energy intake from sugars in discretionary foods (%EI), collected from up to three 24-h dietary recalls by trained research officers who were blind to intervention group. Secondary outcomes included intake of macronutrients, food groups, anthropometric z scores (weight, height, BMI and mid-upper arm circumference) and blood pressure. We enrolled 224 children to the treatment group and 230 to the control group. Intention-to-treat analyses showed that the %EI of sugars in discretionary foods was 1·6 % lower in the treatment group compared with control (95 % CI -3·4, 0·2). This culturally appropriate intervention at four time-points from pregnancy to 18 months resulted in small changes to 2-year-old Aboriginal children's diets, which was insufficient to warrant broader implementation of the intervention. Further consultation with Aboriginal communities is necessary for understanding how to improve the diet and diet-related health outcomes of young Aboriginal children.

Avoidable mortality among First Nations adults in Canada: A cohort analysis.

PubMed

Park, Jungwee; Tjepkema, Michael; Goedhuis, Neil; Pennock, Jennifer

2015-08-01

Avoidable mortality is a measure of deaths that potentially could have been averted through effective prevention practices, public health policies, and/or provision of timely and adequate health care. This longitudinal analysis compares avoidable mortality among First Nations and non-Aboriginal adults. Data are from the 1991-to-2006 Canadian Census Mortality and Cancer Follow-up Study. A 15% sample of 1991 Census respondents aged 25 or older was linked to 16 years of mortality data. This study examines avoidable mortality among 61,220 First Nations and 2,510,285 non-Aboriginal people aged 25 to 74. During the 1991-to-2006 period, First Nations adults had more than twice the risk of dying from avoidable causes compared with non-Aboriginal adults. The age-standardized avoidable mortality rate (ASMR) per 100,000 person-years at risk for First Nations men was 679.2 versus 337.6 for non-Aboriginal men (rate ratio = 2.01). For women, ASMRs were lower, but the gap was wider. The ASMR for First Nations women was 453.2, compared with 183.5 for non-Aboriginal women (rate ratio = 2.47). Disparities were greater at younger ages. Diabetes, alcohol and drug use disorders, and unintentional injuries were the main contributors to excess avoidable deaths among First Nations adults. Education and income accounted for a substantial share of the disparities. The results highlight the gap in avoidable mortality between First Nations and non-Aboriginal adults due to specific causes of death and the association with socioeconomic factors.

Transformation of mortality in a remote Australian Aboriginal community: a retrospective observational study.

PubMed

Hoy, Wendy E; Mott, Susan Anne; McLeod, Beverly June

2017-08-11

To describe trends in ages and causes of death in a remote-living Australian Aboriginal group over a recent 50-year period. A retrospective observational study, from 1960 to 2010, of deaths and people starting dialysis, using data from local clinic, parish, dialysis and birthweight registers. A remote island community in the Top End of Australia's Northern Territory, where a Catholic mission was established in 1911. The estimated Aboriginal population was about 800 in 1960 and 2260 in 2011. All Aboriginal residents of this community whose deaths had been recorded. Annual frequencies and rates of terminal events (deaths and dialysis starts) by age group and cause of death. Against a background of high rates of low birth weight, 223 deaths in infants and children and 934 deaths in adults (age > 15 years) were recorded; 88% were of natural causes. Most deaths in the 1960s were in infants and children. However, over time these fell dramatically, across the birthweight spectrum, while adult deaths progressively increased. The leading causes of adult natural deaths were chronic lung disease, cardiovascular disease and, more recently, renal failure, and rates were increased twofold in those of low birth weight. However, rates of natural adult deaths have been falling briskly since 1986, most markedly among people of age ≥45 years. The population is increasing and its age structure is maturing. The changes in death profiles, the expression of the Barker hypothesis and the ongoing increases in adult life expectancy reflect epidemiological and health transitions of astonishing rapidity. These probably flow from advances in public health policy and healthcare delivery, as well as improved inter-sectoral services, which are all to be celebrated. Other remote communities in Australia are experiencing the same phenomena, and similar events are well advanced in many developing countries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Association between pre-eclampsia and locally derived traffic-related air pollution: a retrospective cohort study.

PubMed

Pereira, Gavin; Haggar, Fatima; Shand, Antonia W; Bower, Carol; Cook, Angus; Nassar, Natasha

2013-02-01

Pre-eclampsia is a common complication of pregnancy and is a major cause of fetal-maternal mortality and morbidity. Despite a number of plausible mechanisms by which air pollutants might contribute to this process, few studies have investigated the association between pre-eclampsia and traffic emissions, a major contributor to air pollution in urban areas. The authors investigated the association between traffic-related air pollution and risk of pre-eclampsia in a maternal population in the urban centre of Perth, Western Australia. The authors estimated maternal residential exposure to a marker for traffic-related air pollution (nitrogen dioxide, NO(2)) during pregnancy for 23 452 births using temporally adjusted land-use regression. Logistic regression was used to investigate associations with pre-eclampsia. Each IQR increase in levels of traffic-related air pollution in whole pregnancy and third trimester was associated with a 12% (1%-25%) and 30% (7%-58%) increased risk of pre-eclampsia, respectively. The largest effect sizes were observed for women aged younger than 20 years or 40 years or older, aboriginal women and women with pre-existing and gestational diabetes, for whom an IQR increase in traffic-related air pollution in whole pregnancy was associated with a 34% (5%-72%), 35% (0%-82%) and 53% (7%-219%) increase in risk of pre-eclampsia, respectively. Elevated exposure to traffic-related air pollution in pregnancy was associated with increased risk of pre-eclampsia. Effect sizes were highest for elevated exposures in third trimester and among younger and older women, aboriginal women and women with diabetes.

Changing Sociodemographic Factors and Teen Fertility: 1991-2009.

PubMed

Driscoll, Anne K; Abma, Joyce C

2015-10-01

This study analyzed the roles of trends in sociodemographic factors known to be related to the risk of a teen birth. The goal was to analyze the roles of these trends in maternal education, family structure and mother's age at first birth in the likelihood of adolescents becoming teen mothers across multiple birth cohorts of women covering the years since 1991. Data are from the 1995, 2002, 2006-2010 and 2011-2013 National Surveys of Family Growth (NSFG). Consecutive birth cohorts of female respondents were constructed and retrospectively followed to estimate the risk of a teen birth for each cohort. Logistic regression models estimate the odds of a teen birth across cohorts and within strata of the predictors across cohorts. Maternal education rose across cohorts; the proportion who were non-Hispanic white declined. In general, the likelihood of an adolescent birth did not change within categories of the predictors that are considered at higher risk for a teen birth across birth cohorts. Specifically, there was no change in the odds of a teen birth among women whose mothers did not finish high school, those born to teen mothers and those not from two-parent families. The odds of a birth declined across cohorts for black women. The findings suggest that much of the decline in teen birth rates is due to declines in the proportion of teens in higher risk categories, rather than to declines within those categories.

Distribution of volumes of individual glomeruli in kidneys at autopsy: association with physical and clinical characteristics and with ethnic group.

PubMed

Hoy, Wendy E; Hughson, Michael D; Diouf, Boucar; Zimanyi, Monika; Samuel, Terence; McNamara, Bridgette J; Douglas-Denton, Rebecca N; Holden, Libby; Mott, Susan A; Bertram, John F

2011-01-01

We have demonstrated considerable variability in the volumes of different glomeruli in given individuals (individual glomerular volume: IGV) in a stereologic study of kidneys at forensic autopsy performed to investigate sudden or unexpected death in people without manifest kidney disease. We review some important associations of IGV by subject characteristics and by ethnic groups. IGVs were measured by the Cavalieri method in 30 glomeruli in each of 111 adult males who belonged to 4 ethnic groups, i.e. US Whites, African-Americans, Africans from Senegal, and Australian Aborigines. Correlations of pooled IGV values with certain subject characteristics were evaluated in the US Whites. Pooled IGV data were compared in subjects across the 4 ethnic groups. In US Whites, mean IGV and its variance were greater with higher age, lower nephron number, lower birth weight, and with gross obesity, hypertension and cardiovascular death. In comparisons by ethnic group, mean IGV and IGV ranges were higher in African-Americans and Australian Aborigines than in US Whites and African Senegalese subjects. We conclude that glomerular enlargement with volume heterogeneity marks more advanced age, relative nephron deficiency, lower birth weight, obesity, hypertension, and advanced cardiovascular disease. The findings in African-Americans and Australian Aborigines suggest that larger IGVs and volume heterogeneity might mark populations with accentuated susceptibility to hypertension and kidney disease, but the data need to be further examined in the context of the determining characteristics defined in the US Whites. Copyright © 2011 S. Karger AG, Basel.

Changing Sociodemographic Factors and Teen Fertility: 1991–2009

PubMed Central

Abma, Joyce C.

2018-01-01

This study analyzed the roles of trends in sociodemographic factors known to be related to the risk of a teen birth. The goal was to analyze the roles of these trends in maternal education, family structure and mother’s age at first birth in the likelihood of adolescents becoming teen mothers across multiple birth cohorts of women covering the years since 1991. Data are from the 1995, 2002, 2006–2010 and 2011–2013 National Surveys of Family Growth (NSFG). Consecutive birth cohorts of female respondents were constructed and retrospectively followed to estimate the risk of a teen birth for each cohort. Logistic regression models estimate the odds of a teen birth across cohorts and within strata of the predictors across cohorts. Maternal education rose across cohorts; the proportion who were non-Hispanic white declined. In general, the likelihood of an adolescent birth did not change within categories of the predictors that are considered at higher risk for a teen birth across birth cohorts. Specifically, there was no change in the odds of a teen birth among women whose mothers did not finish high school, those born to teen mothers and those not from two-parent families. The odds of a birth declined across cohorts for black women. The findings suggest that much of the decline in teen birth rates is due to declines in the proportion of teens in higher risk categories, rather than to declines within those categories. PMID:25680702

Interplay wellbeing framework: a collaborative methodology 'bringing together stories and numbers' to quantify Aboriginal cultural values in remote Australia.

PubMed

Cairney, Sheree; Abbott, Tammy; Quinn, Stephen; Yamaguchi, Jessica; Wilson, Byron; Wakerman, John

2017-05-03

Wellbeing has been difficult to understand, measure and strengthen for Aboriginal people in remote Australia. Part of the challenge has been genuinely involving community members and incorporating their values and priorities into assessment and policy. Taking a 'shared space' collaborative approach between remote Aboriginal communities, governments and scientists, we merged Aboriginal knowledge with western science - by bringing together stories and numbers. This research aims to statistically validate the holistic Interplay Wellbeing Framework and Survey that bring together Aboriginal-identified priorities of culture, empowerment and community with government priorities including education, employment and health. Quantitative survey data were collected from a cohort of 842 Aboriginal people aged 15-34 years, recruited from four different Aboriginal communities in remote Australia. Aboriginal community researchers designed and administered the survey. Structural equation modeling showed good fit statistics (χ/df = 2.69, CFI = 0.95 and RMSEA = 0.045) confirming the holistic nature of the Interplay Wellbeing Framework. The strongest direct impacts on wellbeing were 'social and emotional wellbeing' (r = 0.23; p < 0.001), 'English literacy and numeracy' (r = 0.15; p < 0.001), 'Aboriginal literacy' (r = 0.14; p < 0.001), 'substances' (lack thereof; r = 0.13; p = 0.003), 'work' (r = 0.12; p = 0.02) and 'community' (r = 0.08; p = 0.05). Correlation analyses suggested cultural factors have indirect impacts on wellbeing, such as through Aboriginal literacy. All cultural variables correlated highly with each other, and with empowerment and community. Empowerment also correlated highly with all education and work variables. 'Substances' (lack thereof) was linked with positive outcomes across culture, education and work. Specific interrelationships will be explored in detail separately. The Interplay Wellbeing Framework and Survey were statistically validated as a collaborative approach to assessing wellbeing that is inclusive of other cultural worldviews, values and practices. New community-derived social and cultural indicators were established, contributing valuable insight to psychometric assessment across cultures. These analyses confirm that culture, empowerment and community play key roles in the interplay with education, employment and health, as part of a holistic and quantifiable system of wellbeing. This research supports the holistic concept of wellbeing confirming that everything is interrelated and needs to be considered at the 'whole of system' level in policy approaches.

Birth cohorts in asthma and allergic diseases: Report of a NIAID, NHLBI, MeDALL joint workshop

PubMed Central

Bousquet, J; Gern, JE; Martinez, FD; Anto, JM; Johnson, CC; Holt, PG; Lemanske, RF; Le Souef, PN; Tepper, R; von Mutius, ERM; Arshad, SH; Bacharier, LB; Becker, A; Belanger, K; Bergstrom, A; Bernstein, D; Cabana, MD; Carroll, KN; Castro, M; Cooper, PJ; Gillman, MW; Gold, DR; Henderson, J; Heinrich, J; S-J, Hong; Jackson, DJ; Keil, T; Kozyrskyj, AL; Lodrup-Carlsen, K; Miller, RL; Momas, I; Morgan, WJ; Noel, P; Ownby, DR; Pinart, M; Ryan, P; Schwaninger, JM; Sears, MR; Simpson, A; Smit, HA; Stern, D; Subbarao, P; Valenta, R; Wang, X; Weiss, ST; Wood, R; Wright, AL; Wright, RJ; Togias, A; Gergen, PJ

2014-01-01

Population-based birth cohorts on asthma and allergies increasingly provide new insights into the development and natural history of the diseases. Over 130 birth cohorts focusing on asthma and allergy have been initiated in the last 30 years. A NIAID (National Institute of Allergy and Infectious Diseases), NHLBI (National Heart Lung and Blood Institute), MeDALL (Mechanisms of the Development of Allergy, Framework Programme 7 of the European Commission) joint workshop was held in Bethesda, MD, USA September 11–12, 2012 with 3 objectives (1) documenting the knowledge that asthma/allergy birth cohorts have provided, (2) identifying the knowledge gaps and inconsistencies and (3) developing strategies for moving forward, including potential new study designs and the harmonization of existing asthma birth cohort data. The meeting was organized around the presentations of 5 distinct workgroups: (1) clinical phenotypes, (2) risk factors, (3) immune development of asthma and allergy, (4) pulmonary development and (5) harmonization of existing birth cohorts. This manuscript presents the workgroup reports and provides web links (AsthmaBirthCohorts.niaid.nih.gov or www.medall-fp7.eu) where the reader will find tables describing the characteristics of the birth cohorts included in this report, type of data collected at differing ages, and a selected bibliography provided by the participating birth cohorts. PMID:24636091

The role of birth cohorts in long-term trends in liver cirrhosis mortality across eight European countries.

PubMed

Trias-Llimós, Sergi; Bijlsma, Maarten J; Janssen, Fanny

2017-02-01

Understanding why inequalities in alcohol-related mortality trends by sex and country exist is essential for developing health policies. Birth cohort effects, indicative of differences by generation in drinking, have rarely been studied. This study estimated the relative contributions of birth cohorts to liver cirrhosis mortality trends and compared sex- and country-specific cohort patterns across eight European countries. Time-series analysis of population-level mortality data. Austria, Finland, Hungary, Italy, the Netherlands, Poland, Spain and Sweden; 1950-2011. National populations aged 15-94 years. We modelled country- and sex-specific liver cirrhosis mortality (from national vital registers) adjusting for age, period and birth cohort. Birth cohorts (adjusted for age and period) made statistically significant contributions to liver cirrhosis mortality in all countries and for both sexes (P < 0.001), and more so among women (average contribution to deviance reduction of 38.8%) than among men (17.4%). The observed cohort patterns were statistically different between all but two country pairs (P < 0.001). Sex differences existed overall (P < 0.001), but not in the majority of countries (P > 0.999). Visual inspection of birth cohort patterns reveals birth cohorts at higher risk of liver cirrhosis mortality. The inclusion of the birth cohort dimension improves the understanding of alcohol-attributable mortality trends in Europe. Birth cohorts at higher risk of liver cirrhosis mortality were born during 1935-49 in Sweden and Finland, around 1950 in Austria and the Netherlands and 1960 or later in Hungary, Italy, Poland and Spain. © 2016 Society for the Study of Addiction.

The change in the sex ratio in multiple sclerosis is driven by birth cohort effects.

PubMed

Ajdacic-Gross, V; Schmid, M; Mutsch, M; Steinemann, N; von Wyl, V; Bopp, M

2017-01-01

Birth cohort effects have greatly shaped long-term trends in multiple sclerosis (MS). This study examined whether birth cohort effects have also determined trends in the sex ratio. Age-period-cohort analyses were applied to Swiss mortality data, 1901-2010, using logit models. Sex was introduced as an additional main effect (overall effect) and in interaction terms with A, P and C. Birth cohort effects strongly impacted the trends of MS risk in Switzerland, with a peak in cohorts born in the 1910s and 1920s. Similarly, birth cohort effects accounted for the change in the sex ratios during the 20th century. The balanced sex ratio at the beginning of the 20th century has been superseded by a ratio with a preponderance of women. Despite similarities in timing, the patterns of overall and sex-specific birth cohort estimates were not congruent. The change in the sex ratio in MS is driven by birth cohort related factors. Overall and sex-specific trends indicate that the appearance of MS has changed dramatically in the 20th century. The driving force behind these trends is related to yet unknown environmental factors. © 2016 EAN.

Decline in the negative association between low birth weight and cognitive ability.

PubMed

Goisis, Alice; Özcan, Berkay; Myrskylä, Mikko

2017-01-03

Low birth weight predicts compromised cognitive ability. We used data from the 1958 National Child Development Study (NCDS), the 1970 British Cohort Study (BCS), and the 2000-2002 Millennium Cohort Study (MCS) to analyze how this association has changed over time. Birth weight was divided into two categories, <2,500 g (low) and 2,500-4,500 g (normal) and verbal cognitive ability was measured at the age of 10 or 11 y. A range of maternal and family characteristics collected at or soon after the time of birth were considered. Linear regression was used to analyze the association between birth weight and cognitive ability in a baseline model and in a model that adjusted for family characteristics. The standardized difference (SD) in cognitive scores between low-birth-weight and normal-birth-weight children was large in the NCDS [-0.37 SD, 95% confidence interval (CI): -0.46, -0.27] and in the BCS (-0.34, 95% CI: -0.43, -0.25) cohorts, and it was more than halved for children born in the MCS cohort (-0.14, 95% CI: -0.22, -0.06). The adjustment for family characteristics did not explain the cross-cohort differences. The results show that the association between low birth weight and decreased cognitive ability has declined between the 1950s and 1970s birth cohorts and the 2000--2002 birth cohort, despite a higher proportion of the low-birth-weight babies having a very low birth weight (<1,500 g) in the more recent birth cohort. Advancements in obstetric and neonatal care may have attenuated the negative consequences associated with being born small.

Decline in the negative association between low birth weight and cognitive ability

PubMed Central

Özcan, Berkay; Myrskylä, Mikko

2017-01-01

Low birth weight predicts compromised cognitive ability. We used data from the 1958 National Child Development Study (NCDS), the 1970 British Cohort Study (BCS), and the 2000–2002 Millennium Cohort Study (MCS) to analyze how this association has changed over time. Birth weight was divided into two categories, <2,500 g (low) and 2,500–4,500 g (normal) and verbal cognitive ability was measured at the age of 10 or 11 y. A range of maternal and family characteristics collected at or soon after the time of birth were considered. Linear regression was used to analyze the association between birth weight and cognitive ability in a baseline model and in a model that adjusted for family characteristics. The standardized difference (SD) in cognitive scores between low-birth-weight and normal-birth-weight children was large in the NCDS [−0.37 SD, 95% confidence interval (CI): −0.46, −0.27] and in the BCS (−0.34, 95% CI: −0.43, −0.25) cohorts, and it was more than halved for children born in the MCS cohort (−0.14, 95% CI: −0.22, −0.06). The adjustment for family characteristics did not explain the cross-cohort differences. The results show that the association between low birth weight and decreased cognitive ability has declined between the 1950s and 1970s birth cohorts and the 2000--2002 birth cohort, despite a higher proportion of the low-birth-weight babies having a very low birth weight (<1,500 g) in the more recent birth cohort. Advancements in obstetric and neonatal care may have attenuated the negative consequences associated with being born small. PMID:27994141

Influence of birth cohort on age of onset cluster analysis in bipolar I disorder.

PubMed

Bauer, M; Glenn, T; Alda, M; Andreassen, O A; Angelopoulos, E; Ardau, R; Baethge, C; Bauer, R; Bellivier, F; Belmaker, R H; Berk, M; Bjella, T D; Bossini, L; Bersudsky, Y; Cheung, E Y W; Conell, J; Del Zompo, M; Dodd, S; Etain, B; Fagiolini, A; Frye, M A; Fountoulakis, K N; Garneau-Fournier, J; Gonzalez-Pinto, A; Harima, H; Hassel, S; Henry, C; Iacovides, A; Isometsä, E T; Kapczinski, F; Kliwicki, S; König, B; Krogh, R; Kunz, M; Lafer, B; Larsen, E R; Lewitzka, U; Lopez-Jaramillo, C; MacQueen, G; Manchia, M; Marsh, W; Martinez-Cengotitabengoa, M; Melle, I; Monteith, S; Morken, G; Munoz, R; Nery, F G; O'Donovan, C; Osher, Y; Pfennig, A; Quiroz, D; Ramesar, R; Rasgon, N; Reif, A; Ritter, P; Rybakowski, J K; Sagduyu, K; Scippa, A M; Severus, E; Simhandl, C; Stein, D J; Strejilevich, S; Hatim Sulaiman, A; Suominen, K; Tagata, H; Tatebayashi, Y; Torrent, C; Vieta, E; Viswanath, B; Wanchoo, M J; Zetin, M; Whybrow, P C

2015-01-01

Two common approaches to identify subgroups of patients with bipolar disorder are clustering methodology (mixture analysis) based on the age of onset, and a birth cohort analysis. This study investigates if a birth cohort effect will influence the results of clustering on the age of onset, using a large, international database. The database includes 4037 patients with a diagnosis of bipolar I disorder, previously collected at 36 collection sites in 23 countries. Generalized estimating equations (GEE) were used to adjust the data for country median age, and in some models, birth cohort. Model-based clustering (mixture analysis) was then performed on the age of onset data using the residuals. Clinical variables in subgroups were compared. There was a strong birth cohort effect. Without adjusting for the birth cohort, three subgroups were found by clustering. After adjusting for the birth cohort or when considering only those born after 1959, two subgroups were found. With results of either two or three subgroups, the youngest subgroup was more likely to have a family history of mood disorders and a first episode with depressed polarity. However, without adjusting for birth cohort (three subgroups), family history and polarity of the first episode could not be distinguished between the middle and oldest subgroups. These results using international data confirm prior findings using single country data, that there are subgroups of bipolar I disorder based on the age of onset, and that there is a birth cohort effect. Including the birth cohort adjustment altered the number and characteristics of subgroups detected when clustering by age of onset. Further investigation is needed to determine if combining both approaches will identify subgroups that are more useful for research. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Twenty-Five Year Survival of Children with Intellectual Disability in Western Australia.

PubMed

Bourke, Jenny; Nembhard, Wendy N; Wong, Kingsley; Leonard, Helen

2017-09-01

To investigate survival up to early adulthood for children with intellectual disability and compare their risk of mortality with that of children without intellectual disability. This was a retrospective cohort study of all live births in Western Australia between January 1, 1983 and December 31, 2010. Children with an intellectual disability (n = 10 593) were identified from the Western Australian Intellectual Disability Exploring Answers Database. Vital status was determined from linkage to the Western Australian Mortality database. Kaplan-Meier product limit estimates and 95% CIs were computed by level of intellectual disability. Hazard ratios (HRs) and 95% CIs were calculated from Cox proportional hazard regression models adjusting for potential confounders. After adjusting for potential confounders, compared with those without intellectual disability, children with intellectual disability had a 6-fold increased risk of mortality at 1-5 years of age (adjusted HR [aHR] = 6.0, 95%CI: 4.8, 7.6), a 12-fold increased risk at 6-10 years of age (aHR = 12.6, 95% CI: 9.0, 17.7) and a 5-fold increased risk at 11-25 years of age (aHR = 4.9, 95% CI: 3.9, 6.1). Children with severe intellectual disability were at even greater risk. No difference in survival was observed for Aboriginal children with intellectual disability compared with non-Aboriginal children with intellectual disability. Although children with intellectual disability experience higher mortality at all ages compared with those without intellectual disability, the greatest burden is for those with severe intellectual disability. However, even children with mild to moderate intellectual disability have increased risk of death compared with unaffected children. Copyright © 2017 Elsevier Inc. All rights reserved.

Chronological narratives from smoking initiation through to pregnancy of Indigenous Australian women: A qualitative study.

PubMed

Gould, Gillian S; Bovill, Michelle; Clarke, Marilyn J; Gruppetta, Maree; Cadet-James, Yvonne; Bonevski, Billie

2017-09-01

One in two Indigenous Australian pregnant women smoke, yet little is known about their trajectory of smoking. This study aimed to explore Aboriginal women's narratives from starting smoking through to pregnancy. A female Aboriginal Researcher conducted individual face-to-face interviews with 20 Aboriginal women from New South Wales, Australia. Recruitment, through Aboriginal services and community networks, continued until saturation was reached. Audio-recorded transcripts were independently open coded by two researchers, inductively analysed and reported using a three-dimensional structure of looking backwards, forwards, inwards, outwards and a sense of place, to elucidate the chronology of events, life stages, characters, environments, and turning points of the stories. A chronology emerged from smoking initiation in childhood, coming of age, becoming pregnant, through to attempts at quitting, and relapse post-partum. Several new themes emerged: the role mothers play in women's smoking and quitting; the contribution of nausea to spontaneous quitting; depression as a barrier to quitting; and the hopes of women for their own and their children's future. The epiphany of pregnancy was a key turning point for many - including the interplay of successive pregnancies; and the intensity of expressed regret. Aboriginal women report multiple influences in the progression of early smoking to pregnancy and beyond. Potential opportunities to intervene include: a) childhood, coming of age, pregnancy, post-natal, in-between births; b) key influencers; c) environments, and d) targeting concurrent substance use. Morning sickness appears to be a natural deterrent to continued smoking. Depression, and its relationship to smoking and quitting in Australian Indigenous pregnant women, requires further research. Copyright © 2017. Published by Elsevier Ltd.

Geography of breast cancer incidence according to age & birth cohorts.

PubMed

Gregorio, David I; Ford, Chandler; Samociuk, Holly

2017-06-01

Geographic variation in breast cancer incidence across Connecticut was examined according to age and birth cohort -specific groups. We assigned each of 60,937 incident breast cancer cases diagnosed in Connecticut, 1986-2009, to one of 828 census tracts around the state. Global and local spatial statistics estimated rate variation across the state according to age and birth cohorts. We found the global distribution of incidence rates across places to be more heterogeneous for younger women and later birth cohorts. Concurrently, the spatial scan identified more locations with significantly high rates that pertained to larger proportions of at-risk women within these groups. Geographic variation by age groups was more pronounced than by birth cohorts. Geographic patterns of cancer incidence exhibit differences within and across age and birth cohorts. With the continued insights from descriptive epidemiology, our capacity to effectively limit spatial disparities in cancer will improve. Copyright © 2017 Elsevier Ltd. All rights reserved.

Change in social status and risk of low birth weight in Denmark: population based cohort study.

PubMed Central

Basso, O.; Olsen, J.; Johansen, A. M.; Christensen, K.

1997-01-01

OBJECTIVE: To estimate the risk of having a low birthweight infant associated with changes in social, environmental, and genetic factors. DESIGN: Population based, historical cohort study using the Danish medical birth registry and Statistic Denmark's fertility database. SUBJECTS: All women who had a low birthweight infant (< 2500 g) (index birth) and a subsequent liveborn infant (outcome birth) in Denmark between 1980 and 1992 (exposed cohort, n = 11,069) and a random sample of the population who gave birth to an infant weighing > or = 2500 g and to a subsequent liveborn infant (unexposed cohort, n = 10,211). MAIN OUTCOME MEASURES: Risk of having a low birthweight infant in the outcome birth as a function of changes in male partner, area of residence, type of job, and social status between the two births. RESULTS: Women in the exposed cohort showed a high risk (18.5%) of having a subsequent low birthweight infant while women in the unexposed cohort had a risk of 2.8%. After adjustment for initial social status, a decline in social status increased the absolute risk of having a low birthweight infant by about 5% in both cohorts, though this was significant only in the unexposed cohort. Change of male partner did not modify the risk of low birth weight in either cohort. CONCLUSION: Having had a low birthweight infant and a decline in social status are strong risk factors for having a low birthweight infant subsequently. PMID:9420490

Pregnancy and birth cohort resources in europe: a large opportunity for aetiological child health research.

PubMed

Larsen, Pernille Stemann; Kamper-Jørgensen, Mads; Adamson, Ashley; Barros, Henrique; Bonde, Jens Peter; Brescianini, Sonia; Brophy, Sinead; Casas, Maribel; Charles, Marie-Aline; Devereux, Graham; Eggesbø, Merete; Fantini, Maria Pia; Frey, Urs; Gehring, Ulrike; Grazuleviciene, Regina; Henriksen, Tine Brink; Hertz-Picciotto, Irva; Heude, Barbara; Hryhorczuk, Daniel O; Inskip, Hazel; Jaddoe, Vincent W V; Lawlor, Debbie A; Ludvigsson, Johnny; Kelleher, Cecily; Kiess, Wieland; Koletzko, Berthold; Kuehni, Claudia Elisabeth; Kull, Inger; Kyhl, Henriette Boye; Magnus, Per; Momas, Isabelle; Murray, Dierdre; Pekkanen, Juha; Polanska, Kinga; Porta, Daniela; Poulsen, Gry; Richiardi, Lorenzo; Roeleveld, Nel; Skovgaard, Anne Mette; Sram, Radim J; Strandberg-Larsen, Katrine; Thijs, Carel; Van Eijsden, Manon; Wright, John; Vrijheid, Martine; Andersen, Anne-Marie Nybo

2013-07-01

During the past 25 years, many pregnancy and birth cohorts have been established. Each cohort provides unique opportunities for examining associations of early-life exposures with child development and health. However, to fully exploit the large amount of available resources and to facilitate cross-cohort collaboration, it is necessary to have accessible information on each cohort and its individual characteristics. The aim of this work was to provide an overview of European pregnancy and birth cohorts registered in a freely accessible database located at http://www.birthcohorts.net. European pregnancy and birth cohorts initiated in 1980 or later with at least 300 mother-child pairs enrolled during pregnancy or at birth, and with postnatal data, were eligible for inclusion. Eligible cohorts were invited to provide information on the data and biological samples collected, as well as the timing of data collection. In total, 70 cohorts were identified. Of these, 56 fulfilled the inclusion criteria encompassing a total of more than 500,000 live-born European children. The cohorts represented 19 countries with the majority of cohorts located in Northern and Western Europe. Some cohorts were general with multiple aims, whilst others focused on specific health or exposure-related research questions. This work demonstrates a great potential for cross-cohort collaboration addressing important aspects of child health. The web site, http://www.birthcohorts.net, proved to be a useful tool for accessing information on European pregnancy and birth cohorts and their characteristics. © 2013 John Wiley & Sons Ltd.

European Birth Cohorts for Environmental Health Research

PubMed Central

Casas, Maribel; Bergström, Anna; Carmichael, Amanda; Cordier, Sylvaine; Eggesbø, Merete; Eller, Esben; Fantini, Maria P.; Fernández, Mariana F.; Fernández-Somoano, Ana; Gehring, Ulrike; Grazuleviciene, Regina; Hohmann, Cynthia; Karvonen, Anne M.; Keil, Thomas; Kogevinas, Manolis; Koppen, Gudrun; Krämer, Ursula; Kuehni, Claudia E.; Magnus, Per; Majewska, Renata; Andersen, Anne-Marie Nybo; Patelarou, Evridiki; Petersen, Maria Skaalum; Pierik, Frank H.; Polanska, Kinga; Porta, Daniela; Richiardi, Lorenzo; Santos, Ana Cristina; Slama, Rémy; Sram, Radim J.; Thijs, Carel; Tischer, Christina; Toft, Gunnar; Trnovec, Tomáš; Vandentorren, Stephanie; Vrijkotte, Tanja G.M.; Wilhelm, Michael; Wright, John; Nieuwenhuijsen, Mark

2011-01-01

Background: Many pregnancy and birth cohort studies investigate the health effects of early-life environmental contaminant exposure. An overview of existing studies and their data is needed to improve collaboration, harmonization, and future project planning. Objectives: Our goal was to create a comprehensive overview of European birth cohorts with environmental exposure data. Methods: Birth cohort studies were included if they a) collected data on at least one environmental exposure, b) started enrollment during pregnancy or at birth, c) included at least one follow-up point after birth, d) included at least 200 mother–child pairs, and e) were based in a European country. A questionnaire collected information on basic protocol details and exposure and health outcome assessments, including specific contaminants, methods and samples, timing, and number of subjects. A full inventory can be searched on www.birthcohortsenrieco.net. Results: Questionnaires were completed by 37 cohort studies of > 350,000 mother–child pairs in 19 European countries. Only three cohorts did not participate. All cohorts collected biological specimens of children or parents. Many cohorts collected information on passive smoking (n = 36), maternal occupation (n = 33), outdoor air pollution (n = 27), and allergens/biological organisms (n = 27). Fewer cohorts (n = 12–19) collected information on water contamination, ionizing or nonionizing radiation exposures, noise, metals, persistent organic pollutants, or other pollutants. All cohorts have information on birth outcomes; nearly all on asthma, allergies, childhood growth and obesity; and 26 collected information on child neurodevelopment. Conclusion: Combining forces in this field will yield more efficient and conclusive studies and ultimately improve causal inference. This impressive resource of existing birth cohort data could form the basis for longer-term and worldwide coordination of research on environment and child health. PMID:21878421

Suicide ideation and attempt in a community cohort of urban Aboriginal youth: a cross-sectional study.

PubMed

Luke, Joanne N; Anderson, Ian P; Gee, Graham J; Thorpe, Reg; Rowley, Kevin G; Reilly, Rachel E; Thorpe, Alister; Stewart, Paul J

2013-01-01

There has been increasing attention over the last decade on the issue of indigenous youth suicide. A number of studies have documented the high prevalence of suicide behavior and mortality in Australia and internationally. However, no studies have focused on documenting the correlates of suicide behavior for indigenous youth in Australia. To examine the prevalence of suicide ideation and attempt and the associated factors for a community1 cohort of Koori2 (Aboriginal) youth. Data were obtained from the Victorian Aboriginal Health Service (VAHS) Young People's Project (YPP), a community initiated cross-sectional data set. In 1997/1998, self-reported data were collected for 172 Koori youth aged 12-26 years living in Melbourne, Australia. The data were analyzed to assess the prevalence of current suicide ideation and lifetime suicide attempt. Principal components analysis (PCA) was used to identify closely associated social, emotional, behavioral, and cultural variables at baseline and Cox regression modeling was then used to identify associations between PCA components and suicide ideation and attempt. Ideation and attempt were reported at 23.3% and 24.4%, respectively. PCA yielded five components: (1) emotional distress, (2) social distress A, (3) social distress B, (4) cultural connection, (5) behavioral. All were positively and independently associated with suicide ideation and attempt, while cultural connection showed a negative association. Suicide ideation and attempt were common in this cross-section of indigenous youth with an unfavorable profile for the emotional, social, cultural, and behavioral factors.

Trends in Dementia Incidence in a Birth Cohort Analysis of the Einstein Aging Study.

PubMed

Derby, Carol A; Katz, Mindy J; Lipton, Richard B; Hall, Charles B

2017-11-01

Trends in dementia incidence rates have important implications for planning and prevention. To better understand incidence trends over time requires separation of age and cohort effects, and few prior studies have used this approach. To examine trends in dementia incidence and concomitant trends in cardiovascular comorbidities among individuals aged 70 years or older who were enrolled in the Einstein Aging Study between 1993 and 2015. In this birth cohort analysis of all-cause dementia incidence in persons enrolled in the Einstein Aging Study from October 20, 1993, through November 17, 2015, a systematically recruited, population-based sample of 1348 participants from Bronx County, New York, who were 70 years or older without dementia at enrollment and at least one annual follow-up was studied. Poisson regression was used to model dementia incidence as a function of age, sex, educational level, race, and birth cohort, with profile likelihood used to identify the timing of significant increases or decreases in incidence. Birth year and age. Incident dementia defined by consensus case conference based on annual, standardized neuropsychological and neurologic examination findings, using criteria from the DSM-IV. Among 1348 individuals (mean [SD] baseline age, 78.5 [5.4] years; 830 [61.6%] female; 915 [67.9%] non-Hispanic white), 150 incident dementia cases developed during 5932 person-years (mean [SD] follow-up, 4.4 [3.4] years). Dementia incidence decreased in successive birth cohorts. Incidence per 100 person-years was 5.09 in birth cohorts before 1920, 3.11 in the 1920 through 1924 birth cohorts, 1.73 in the 1925 through 1929 birth cohorts, and 0.23 in cohorts born after 1929. Change point analyses identified a significant decrease in dementia incidence among those born after July 1929 (95% CI, June 1929 to January 1930). The relative rate for birth cohorts before July 1929 vs after was 0.13 (95% CI, 0.04-0.41). Prevalence of stroke and myocardial infarction decreased across successive birth cohorts, whereas diabetes prevalence increased. Adjustment for these cardiovascular comorbidities did not explain the decreased dementia incidence rates for more recent birth cohorts. Analyses confirm decreasing dementia incidence in this population-based sample. Whether decreasing incidence will contribute to reduced burden of dementia given the aging of the population is not known.

Within-Cohort Age-Related Differences in Cognitive Functioning

PubMed Central

Salthouse, Timothy A.

2013-01-01

It is widely accepted that the level of cognitive functioning can be influenced by characteristics of the environment that change over time. Many developmental researchers have referred to these influences as cohort effects, and have used year of birth as the basis for determining cohort membership. Furthermore, age-related differences in cognitive functioning are sometimes assumed to be primarily attributable to cohort differences, which implies that differences between birth cohorts should be much larger than differences within birth cohorts. Comparisons of composite scores for five cognitive abilities in different people tested at different ages in different years revealed that within-cohort differences across ages were often as large as between-cohort differences across ages. These results lead to questions about the practice of relying on birth cohort to represent influences on cognitive functioning associated with temporal shifts in characteristics of the environment. PMID:23319401

The beyond borders initiative: Aboriginal, Torres Strait Islander and international public health students: engaging partners in cross-cultural learning.

PubMed

Dickson, Michelle; Manalo, Giselle

2014-01-01

The University of Sydney's Graduate Diploma in Indigenous Health Promotion (GDIHP) and Masters of International Public Health (MIPH) students have expressed a consistent desire to engage more with each other through student tutorials or any small group activity. MIPH students have expressed an interest in learning about Aboriginal and Torres Strait Islander Aboriginal and Torres Strait Islanderpeople and their health issues recognising contextual similarities in health priorities and social-cultural determinants. A and TSI students enrolled in the GDIHP have traditionally had very little contact with other students and are often unaware of the innovative solutions implemented in developing countries. Through this inclusive teaching innovation the MIPH and GDIHP programmes utilised diversity in the student population and responded to the University's Strategic Plan to promote and enhance pathways for supporting Indigenous students. This innovation provided an opportunity for both groups to learn more about each other as they develop into globally competitive public health practitioners. The 'Beyond Borders' initiative exposed MIPH and GDIHP students to problem-based learning that incorporated global perspectives as well as focusing on the very specific and unique realities of life in Aboriginal and Torres Strait Islander communities. Both student cohorts reported that the knowledge and skill exchange was highly valuable and contributed to their development as health professionals. This simple yet effective initiative created a sustainable cross-cultural, interdisciplinary and community-oriented partnership that benefited all involved and assisted in addressing health inequities in Aboriginal and Torres Strait Islander communities and in developing countries.

Prevalences of overweight and obesity among children in remote Aboriginal communities in central Australia.

PubMed

Schultz, Rosalie

2012-01-01

The chronic diseases associated with overweight and obesity are major contributors to the excess disease burden of Aboriginal Australians. Surveillance of overweight and obesity is required to monitor these conditions, and to develop and evaluate interventions to improve health and wellbeing. Remote Aboriginal communities in Australia's Northern Territory (NT) are where approximately two-thirds of the NT Aboriginal people live, a proportion which has been stable over many years. However the remote communities suffer significant socioeconomic disadvantage including limited education and employment opportunities, and poor quality and overcrowded housing. Approximately one-third of Aboriginal people in NT live in central Australia, which consists of the Alice Springs and Barkly districts. The Healthy School-Aged Kids Program includes health promotion and child health screening, and is run in remote Aboriginal communities of NT. This report provides estimates of prevalences of overweight and obesity among children in central Australia who participated in health checks as part of Healthy School-Aged Kids Program in 2010. All children in remote central Australian Aboriginal communities were invited to participate in health checks. Children who attended were weighed and measured. Date of birth, sex, height and weight for each child were used to determine prevalence of overweight (≥+1 standard deviation [SD] BMI-for-age) and obesity (≥+2 SD BMI-for-age) according to WHO Growth standards. Differences in proportions of overweight and obesity by age group and sex, and their statistical significance were calculated. Weight, height, sex and age data were available for 996 children from a population of 1764. It was found that 22.1% of girls and 20.7% of boys were overweight; and 5.1% of girls and 5.8% of boys were obese as defined by BMI-for-age. Prevalence of overweight but not obesity increased with age (for overweight z=3.28, p=0.0011; for obesity z=0.68; p=0.50). The prevalences of overweight and obesity as estimated by BMI-for-age among children in remote central Australian Aboriginal communities were compared with those in other Australian surveys. They appear unlikely to reflect future relative risk of the chronic diseases with which overweight and obesity are associated. Routine collection of data on BMI-for-age may not provide adequate estimation of future risk of chronic disease burden attributable to overweight and obesity among these children. Alternative measures for surveillance for overweight such as waist circumference may prove more useful. Appropriate interventions to reduce risk of chronic disease are required, including interventions to reduce prevalences of overweight and obesity.

Cohort Differences in Received Social Support in Later Life: The Role of Network Type.

PubMed

Suanet, Bianca; Antonucci, Toni C

2017-07-01

The objective is to assess cohort differences in received emotional and instrumental support in relation to network types. The main guiding hypothesis is that due to increased salience of non-kin with recent social change, those in friend-focused and diverse network types receive more support in later birth cohorts than earlier birth cohorts. Data from the Longitudinal Aging Study Amsterdam are employed. We investigate cohort differences in total received emotional and instrumental support in a series of linear regression models comparing birth cohorts aged 55-64, 65-74, 75-84, and 85-94 across three time periods (1992, 2002, and 2012). Four network types (friend, family, restricted, and diverse) are identified. Friend-focused networks are more common in later birth cohorts, restrictive networks less common. Those in friend-focused networks in later cohorts report receiving more emotional and instrumental support. No differences in received support are evident upon diverse networks. The increased salience of non-kin is reflected in an increase in received emotional and instrumental support in friend-focused networks in later birth cohorts. The preponderance of non-kin in networks should not be perceived as a deficit model for social relationships as restrictive networks are declining across birth cohorts. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

On the Astronomical Knowledge and Traditions of Aboriginal Australians

NASA Astrophysics Data System (ADS)

Hamacher, Duane W.

2011-12-01

Historian of science David Pingree defines science in a broad context as the process of systematically explaining perceived or imaginary phenomena. Although Westerners tend to think of science being restricted to Western culture, I argue in this thesis that astronomical scientific knowledge is found in Aboriginal traditions. Although research into the astronomical traditions of Aboriginal Australians stretches back for more than 150 years, it is relatively scant in the literature. We do know that the sun, moon, and night sky have been an important and inseparable component of the landscape to hundreds of Australian Aboriginal groups for thousands (perhaps tens-of-thousands) of years. The literature reveals that astronomical knowledge was used for time keeping, denoting seasonal change and the availability of food sources, navigation, and tidal prediction. It was also important for rituals and ceremonies, birth totems, marriage systems, cultural mnemonics, and folklore. Despite this, the field remains relatively unresearched considering the diversity of Aboriginal cultures and the length of time people have inhabited Australia (well over 40,000 years). Additionally, very little research investigating the nature and role of transient celestial phenomena has been conducted, leaving our understanding of Indigenous astronomical knowledge grossly incomplete. This thesis is an attempt to overcome this deficiency, with a specific focus on transient celestial phenomena. My research, situated in the field of cultural astronomy, draws from the sub-disciplines of archaeoastronomy, ethnoastronomy, historical astronomy, and geomythology. This approach incorporates the methodologies and theories of disciplines in the natural sciences, social sciences, and humanities. This thesis, by publication, makes use of archaeological, ethnographic, and historical records, astronomical software packages, and geographic programs to better understand the ages of astronomical traditions and the role and nature of eclipses, comets, meteors, impact events, and certain variable stars. I also test the hypothesis that certain types of stone arrangements have preferred orientations that probably relate to astronomical phenomena. This research shows that Aboriginal astronomical traditions explain the motions of celestial bodies and the relationship between events in the sky and events on Earth. I explore how Aboriginal people perceived and made use of particular astronomical phenomena, such as meteors and comets, and show that Aboriginal people made careful observations of the motions of celestial bodies. I provide evidence that Aboriginal people noticed the change in brightness of particular stars, described the kinematics of eclipses, explained how lunar phases are related to ocean tides, and acknowledged the relationship between meteors, meteorites, impact events, and impact craters. I then show that linear stone arrangements in New South Wales have a preferred orientation to the cardinal points and explore astronomical reasons for this. In the Appendix, I include biographical details of William Edward Stanbridge, one of the first people to write in depth about Aboriginal astronomical traditions, which were compiled from historic records.

Developing and Refining the Taiwan Birth Cohort Study (TBCS): Five Years of Experience

ERIC Educational Resources Information Center

Lung, For-Wey; Chiang, Tung-Liang; Lin, Shio-Jean; Shu, Bih-Ching; Lee, Meng-Chih

2011-01-01

The Taiwan Birth Cohort Study (TBCS) is the first nationwide birth cohort database in Asia designed to establish national norms of children's development. Several challenges during database development and data analysis were identified. Challenges include sampling methods, instrument development and statistical approach to missing data. The…

What are the factors associated with good mental health among Aboriginal children in urban New South Wales, Australia? Phase I findings from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH).

PubMed

Williamson, Anna; D'Este, Catherine; Clapham, Kathleen; Redman, Sally; Manton, Toni; Eades, Sandra; Schuster, Leanne; Raphael, Beverley

2016-07-05

To identify the factors associated with 'good' mental health among Aboriginal children living in urban communities in New South Wales, Australia. Cross-sectional survey (phase I of a longitudinal study). 4 Aboriginal Community Controlled Health Services that deliver primary care. All services were located in urban communities in New South Wales, Australia. 1005 Aboriginal children aged 4-17 years who participated in phase I of the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Carer report version of the Strengths and Difficulties Questionnaire. Scores <17 were considered to indicate 'good' mental health for the purposes of this article. The majority (72%) of SEARCH participants were not at high risk for emotional or behavioural problems. After adjusting for the relative contributions of significant demographic, child and carer health factors, the factors associated with good mental health among SEARCH children were having a carer who was not highly psychologically distressed (OR=2.8, 95% CI 1.6 to 5.1); not suffering from frequent chest, gastrointestinal or skin infections (OR=2.8, 95% CI 1.8 to 4.3); and eating two or more servings of vegetables per day (OR=2.1, 95% CI 1.2 to 3.8). Being raised by a foster carer (OR=0.2, 95% CI 0.01 to 0.71) and having lived in 4 or more homes since birth (OR=0.62, 95% CI 0.39 to 1.0) were associated with significantly lower odds of good mental health. Slightly different patterns of results were noted for adolescents than younger children. Most children who participated in SEARCH were not at high risk for emotional or behavioural problems. Promising targets for efforts to promote mental health among urban Aboriginal children may include the timely provision of medical care for children and provision of additional support for parents and carers experiencing mental or physical health problems, for adolescent boys and for young people in the foster care system. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Waist circumference values equivalent to body mass index points for predicting absolute cardiovascular disease risks among adults in an Aboriginal community: a prospective cohort study.

PubMed

Adegbija, Odewumi; Hoy, Wendy E; Wang, Zhiqiang

2015-11-13

There have been suggestions that currently recommended waist circumference (WC) cut-off points for Australians of European origin may not be applicable to Aboriginal people who have different body habitus profiles. We aimed to generate equivalent WC values that correspond to body mass index (BMI) points for identifying absolute cardiovascular disease (CVD) risks. Prospective cohort study. An Aboriginal community in Australia's Northern Territory. From 1992 to 1998, 920 adults without CVD, with age, WC and BMI measurements were followed-up for up to 20 years. Incident CVD, coronary artery disease (CAD) and heart failure (HF) events during the follow-up period ascertained from hospitalisation data. We generated WC values with 10-year absolute risks equivalent for the development of CVD as BMI values (20-34 kg/m(2)) using the Weibull accelerated time-failure model. There were 211 incident cases of CVD over 13,669 person-years of follow-up. At the average age of 35 years, WC values with absolute CVD, CAD and HF risks equivalent to BMI of 25 kg/m(2) were 91.5, 91.8 and 91.7 cm, respectively, for males, and corresponding WC values were 92.5, 92.7 and 93 cm for females. WC values with equal absolute CVD, CAD and HF risks to BMI of 30 kg/m(2) were 101.7, 103.1 and 102.6 cm, respectively, for males, and corresponding values were 99.2, 101.6 and 101.5 cm for females. Association between WC and CVD did not depend on gender (p=0.54). WC ranging from 91 to 93 cm was equivalent to BMI 25 kg/m(2) for overweight, and 99 to 103 cm was equivalent to BMI of 30 kg/m(2) for obesity in terms of predicting 10-year absolute CVD risk. Replicating the absolute risk method in other Aboriginal communities will further validate the WC values generated for future development of WC cut-off points for Aboriginal people. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The contribution of maternal birth cohort to term small for gestational age in the United States 1989-2010: an age, period, and cohort analysis.

PubMed

Margerison-Zilko, Claire

2014-07-01

After decades of steady increase, mean birthweight in the US declined throughout the 1990s and early 2000s, a trend not fully explained by changes in length of gestation, medical practice, demographics, or maternal behaviours. We hypothesised that secular changes in health or social factors across women's life courses may have contributed to this unexplained trend and examined maternal birth cohort as a proxy measure of life-course determinants of fetal growth in the US. We used the age, period, and cohort (APC) intrinsic estimator (IE) approach to estimate the contribution of maternal birth cohort (independent of maternal age and period of birth) to small for gestational age (SGA), overall and among term births, in the US from 1989 to 2010. We conducted analyses separately among foreign- and US-born Hispanic, non-Hispanic black (NHB), and non-Hispanic white mothers. We found evidence of a U-shaped relationship between maternal birth cohort and SGA among NHB women only. After accounting for maternal age and period of birth, risk of SGA among NHB women born in 1950 was 21.1% and decreased to 15.9% in 1970. However, NHB women born after 1970 experienced increasing risk (19.6% by the 1986 birth cohort). Our findings suggest that NHB women born after 1970 have experienced increasing risk of SGA. Declining risk of SGA across NHB maternal birth cohorts from 1950 to 1970, however, suggests the potential to reverse this trend. Results illustrate the need for research on health and social risk factors for SGA across the pre-pregnancy life course. © 2014 John Wiley & Sons Ltd.

Birth weight and stuttering: Evidence from three birth cohorts.

PubMed

McAllister, Jan; Collier, Jacqueline

2014-03-01

Previous studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples. Logistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mother's level of education. Birth weight was analysed both as a categorical variable (low birth weight, <2500g; normal range; high birth weight, ≥4000g) and as a continuous variable. Separate analyses were carried out to determine the impact of birth weight and the other predictors on stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent. None of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6-3.6 times more likely than females to stutter. Our results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering. Copyright © 2013 Elsevier Inc. All rights reserved.

Enhancing national data to align with policy objectives: Aboriginal and Torres Strait Islander smoking prevalence at finer geographic levels.

PubMed

Wright, Alyson; Lovett, Ray; Roe, Yvette; Richardson, Alice

2017-06-05

Objectives The aim of the study was to assess the utility of national Aboriginal survey data in a regional geospatial analysis of daily smoking prevalence for Aboriginal and Torres Strait Islander Australians and discuss the appropriateness of this analysis for policy and program impact assessment. Methods Data from the last two Australian Bureau of Statistics (ABS) national surveys of Aboriginal and Torres Strait Islander people, the National Aboriginal and Torres Strait Islander Social Survey 2014-15 (n=7022 adults) and the National Aboriginal and Torres Strait Islander Health Survey 2012-13 (n=10896 adults), were used to map the prevalence of smoking by Indigenous regions. Results Daily smoking prevalence in 2014-15 at Indigenous regions ranges from 27.1% (95%CI 18.9-35.3) in the Toowoomba region in Queensland to 68.0% (95%CI 58.1-77.9) in the Katherine region in the Northern Territory. The confidence intervals are wide and there is no significant difference in daily smoking prevalence between the two time periods for any region. Conclusion There are significant limitations with analysing national survey data at finer geographical scales. Given the national program for Indigenous tobacco control is a regional model, evaluation requires finer geographical analysis of smoking prevalence to inform public health progress, policy and program effects. Options to improve the data currently collected include increasing national survey sample sizes, implementing a smoking status question in census surveys, investing in current cohort studies focused on this population or implementing localised surveys. What is known about the topic? The last geospatial analysis of Aboriginal and Torres Strait Islander smoking prevalence was undertaken in 1997. Current national survey data have not been analysed geospatially. What does this paper add? This paper provides new insights into the use of national survey data for understanding regional patterns and prevalence levels of smoking in Aboriginal and Torres Strait Islander populations. What are the implications for practitioners? The findings of the study suggest caution when interpreting prevalence maps and highlight the need for greater sample sizes in national survey data. The analysis is also an opportunity to assess the use of national survey data in evaluating the policy impact of programs targeted at a regional level.

Impact of Month of Birth on the Risk of Development of Autoimmune Addison's Disease.

PubMed

Pazderska, Agnieszka; Fichna, Marta; Mitchell, Anna L; Napier, Catherine M; Gan, Earn; Ruchała, Marek; Santibanez-Koref, Mauro; Pearce, Simon H

2016-11-01

The pathogenesis of autoimmune Addison's disease (AAD) is thought to be due to interplay of genetic, immune, and environmental factors. A month-of-birth effect, with increased risk for those born in autumn/winter months, has been described in autoimmune conditions such as type 1 diabetes and autoimmune thyroid disease. Month-of-birth effect was investigated in 2 independent cohorts of AAD subjects. The monthly distribution of birth in AAD patients was compared with that of the general population using the cosinor test. A total of 415 AAD subjects from the United Kingdom cohort were compared with 8 180 180 United Kingdom births, and 231 AAD subjects from the Polish cohort were compared with 2 421 384 Polish births. Association between month of birth and the susceptibility to AAD. In the entire cohort of AAD subjects, month-of-birth distribution analysis showed significant periodicity with peak of births in December and trough in May (P = .028). Analysis of the odds ratio distribution based on month of birth in 2 cohorts of patients with AAD versus the general population revealed a December peak and May trough, and January peak and July trough, in the United Kingdom and Polish cohorts, respectively. For the first time, we demonstrate that month of birth exerts an effect on the risk of developing AAD, with excess risk in individuals born in winter months and a protective effect when born in the summer. Exposure to seasonal viral infections in the perinatal period, coupled with vitamin D deficiency, could lead to dysregulation of innate immunity affecting the risk of developing AAD.

The Cedar Project: a comparison of HIV-related vulnerabilities amongst young Aboriginal women surviving drug use and sex work in two Canadian cities.

PubMed

Mehrabadi, Azar; Craib, Kevin J P; Patterson, Katharina; Adam, Warner; Moniruzzaman, Akm; Ward-Burkitt, Barbara; Schechter, Martin T; Spittal, Patricia M

2008-04-01

In Canada, Aboriginal women and youth continue to be overrepresented amongst new cases of HIV, and are considered at increased risk for sex and drug-related harm. Young women involved in sex work are particularly vulnerable. The purpose of this study is to determine HIV-related vulnerabilities associated with sex work amongst young Aboriginal women in two Canadian cities. This study is based on a community-based cohort of Aboriginal young people (status and non-status First Nations, Inuit and Métis) between the ages of 14 and 30 who used injection or non-injection illegal drugs (street drugs) in the previous month. Participants lived in Vancouver, Canada, or Prince George, a remote, northern Canadian city. Between October 2003 and July 2005, 543 participants were recruited by word of mouth, posters, and street outreach. A baseline questionnaire was administered by Aboriginal interviewers, and trained nurses drew blood samples for HIV and HCV antibodies and provided pre- and post-test counselling. This study included 262 young women who participated at baseline. Analyses were conducted to compare socio-demographics, drug use patterns, injection practices, sexual experiences, and HIV and HCV prevalence between young women who reported being involved in sex work in the last 6 months (n=154) versus young women who did not (n=108). Logistic regression was used to identify factors independently associated with recent sex work involvement. Both sexual violence and drug using patterns were found to be markedly different for women having recently been involved in sex work. Multivariate analysis revealed daily injection of cocaine (AOR=4.4; 95% CI: 1.9, 10.1 and smoking crack (AOR=2.9; 95% CI: 1.6, 5.2) in the previous 6 months, and lifetime sexual abuse (AOR=2.5; 95% CI: 1.4, 4.4) to be independently associated with sex work. Harm reduction and treatment programs that address historical and lifetime trauma amongst Aboriginal people and prioritize emotional and physical safety for young Aboriginal women involved in sex work are required.

Birth cohorts in Asia: The importance, advantages, and disadvantages of different-sized cohorts.

PubMed

Kishi, Reiko; Araki, Atsuko; Minatoya, Machiko; Itoh, Sachiko; Goudarzi, Houman; Miyashita, Chihiro

2018-02-15

Asia contains half of the world's children, and the countries of Asia are the most rapidly industrializing nations on the globe. Environmental threats to the health of children in Asia are myriad. Several birth cohorts were started in Asia in early 2000, and currently more than 30 cohorts in 13 countries have been established for study. Cohorts can contain from approximately 100-200 to 20,000-30,000 participants. Furthermore, national cohorts targeting over 100,000 participants have been launched in Japan and Korea. The aim of this manuscript is to discuss the importance of Asian cohorts, and the advantages and disadvantages of different-sized cohorts. As for case, one small-sized (n=514) cohort indicate that even relatively low level exposure to dioxin in utero could alter birth size, neurodevelopment, and immune and hormonal functions. Several Asian cohorts focus prenatal exposure to perfluoroalkyo substances and reported associations with birth size, thyroid hormone levels, allergies and neurodevelopment. Inconsistent findings may possibly be explained by the differences in exposure levels and target chemicals, and by possible statistical errors. In a smaller cohort, novel hypotheses or preliminary examinations are more easily verifiable. In larger cohorts, the etiology of rare diseases, such as birth defects, can be analyzed; however, they require a large cost and significant human resources. Therefore, conducting studies in only one large cohort may not always be the best strategy. International collaborations, such as the Birth Cohort Consortium of Asia, would cover the inherent limitation of sample size in addition to heterogeneity of exposure, ethnicity, and socioeconomic conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

Visual-motor integration, visual perception, and fine motor coordination in a population of children with high levels of Fetal Alcohol Spectrum Disorder.

PubMed

Doney, Robyn; Lucas, Barbara R; Watkins, Rochelle E; Tsang, Tracey W; Sauer, Kay; Howat, Peter; Latimer, Jane; Fitzpatrick, James P; Oscar, June; Carter, Maureen; Elliott, Elizabeth J

2016-08-01

Visual-motor integration (VMI) skills are essential for successful academic performance, but to date no studies have assessed these skills in a population-based cohort of Australian Aboriginal children who, like many children in other remote, disadvantaged communities, consistently underperform academically. Furthermore, many children in remote areas of Australia have prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorder (FASD), which are often associated with VMI deficits. VMI, visual perception, and fine motor coordination were assessed using The Beery-Buktenica Developmental Test of Visual-Motor Integration, including its associated subtests of Visual Perception and Fine Motor Coordination, in a cohort of predominantly Australian Aboriginal children (7.5-9.6 years, n=108) in remote Western Australia to explore whether PAE adversely affected test performance. Cohort results were reported, and comparisons made between children i) without PAE; ii) with PAE (no FASD); and iii) FASD. The prevalence of moderate (≤16th percentile) and severe (≤2nd percentile) impairment was established. Mean VMI scores were 'below average' (M=87.8±9.6), and visual perception scores were 'average' (M=97.6±12.5), with no differences between groups. Few children had severe VMI impairment (1.9%), but moderate impairment rates were high (47.2%). Children with FASD had significantly lower fine motor coordination scores and higher moderate impairment rates (M=87.9±12.5; 66.7%) than children without PAE (M=95.1±10.7; 23.3%) and PAE (no FASD) (M=96.1±10.9; 15.4%). Aboriginal children living in remote Western Australia have poor VMI skills regardless of PAE or FASD. Children with FASD additionally had fine motor coordination problems. VMI and fine motor coordination should be assessed in children with PAE, and included in FASD diagnostic assessments. Copyright © 2016 Elsevier Ltd. All rights reserved.

Genetic and environmental factors affecting birth size variation: a pooled individual-based analysis of secular trends and global geographical differences using 26 twin cohorts.

PubMed

Yokoyama, Yoshie; Jelenkovic, Aline; Hur, Yoon-Mi; Sund, Reijo; Fagnani, Corrado; Stazi, Maria A; Brescianini, Sonia; Ji, Fuling; Ning, Feng; Pang, Zengchang; Knafo-Noam, Ariel; Mankuta, David; Abramson, Lior; Rebato, Esther; Hopper, John L; Cutler, Tessa L; Saudino, Kimberly J; Nelson, Tracy L; Whitfield, Keith E; Corley, Robin P; Huibregtse, Brooke M; Derom, Catherine A; Vlietinck, Robert F; Loos, Ruth J F; Llewellyn, Clare H; Fisher, Abigail; Bjerregaard-Andersen, Morten; Beck-Nielsen, Henning; Sodemann, Morten; Krueger, Robert F; McGue, Matt; Pahlen, Shandell; Bartels, Meike; van Beijsterveldt, Catharina E M; Willemsen, Gonneke; Harris, Jennifer R; Brandt, Ingunn; Nilsen, Thomas S; Craig, Jeffrey M; Saffery, Richard; Dubois, Lise; Boivin, Michel; Brendgen, Mara; Dionne, Ginette; Vitaro, Frank; Haworth, Claire M A; Plomin, Robert; Bayasgalan, Gombojav; Narandalai, Danshiitsoodol; Rasmussen, Finn; Tynelius, Per; Tarnoki, Adam D; Tarnoki, David L; Ooki, Syuichi; Rose, Richard J; Pietiläinen, Kirsi H; Sørensen, Thorkild I A; Boomsma, Dorret I; Kaprio, Jaakko; Silventoinen, Karri

2018-05-19

The genetic architecture of birth size may differ geographically and over time. We examined differences in the genetic and environmental contributions to birthweight, length and ponderal index (PI) across geographical-cultural regions (Europe, North America and Australia, and East Asia) and across birth cohorts, and how gestational age modifies these effects. Data from 26 twin cohorts in 16 countries including 57 613 monozygotic and dizygotic twin pairs were pooled. Genetic and environmental variations of birth size were estimated using genetic structural equation modelling. The variance of birthweight and length was predominantly explained by shared environmental factors, whereas the variance of PI was explained both by shared and unique environmental factors. Genetic variance contributing to birth size was small. Adjusting for gestational age decreased the proportions of shared environmental variance and increased the propositions of unique environmental variance. Genetic variance was similar in the geographical-cultural regions, but shared environmental variance was smaller in East Asia than in Europe and North America and Australia. The total variance and shared environmental variance of birth length and PI were greater from the birth cohort 1990-99 onwards compared with the birth cohorts from 1970-79 to 1980-89. The contribution of genetic factors to birth size is smaller than that of shared environmental factors, which is partly explained by gestational age. Shared environmental variances of birth length and PI were greater in the latest birth cohorts and differed also across geographical-cultural regions. Shared environmental factors are important when explaining differences in the variation of birth size globally and over time.

Hepatitis C Virus in American Indian/Alaskan Native and Aboriginal Peoples of North America

PubMed Central

Rempel, Julia D.; Uhanova, Julia

2012-01-01

Liver diseases, such as hepatitis C virus (HCV), are “broken spirit” diseases. The prevalence of HCV infection for American Indian/Alaskan Native (AI/AN) in the United States and Canadian Aboriginals varies; nonetheless, incidence rates of newly diagnosed HCV infection are typically higher relative to non-indigenous people. For AI/AN and Aboriginal peoples risk factors for the diagnosis of HCV can reflect that of the general population: predominately male, a history of injection drug use, in midlife years, with a connection with urban centers. However, the face of the indigenous HCV infected individual is becoming increasingly female and younger compared to non-indigenous counterparts. Epidemiology studies indicate that more effective clearance of acute HCV infection can occur for select Aboriginal populations, a phenomenon which may be linked to unique immune characteristics. For individuals progressing to chronic HCV infection treatment outcomes are comparable to other racial cohorts. Disease progression, however, is propelled by elevated rates of co-morbidities including type 2 diabetes and alcohol use, along with human immunodeficiency virus (HIV) co-infection relative to non-indigenous patients. Historical and personal trauma has a major role in the participation of high risk behaviors and associated diseases. Although emerging treatments provide hope, combating HCV related morbidity and mortality will require interventions that address the etiology of broken spirit diseases. PMID:23342378

Resting heart rate, physiological stress and disadvantage in Aboriginal and Torres Strait Islander Australians: analysis from a cross-sectional study.

PubMed

Zhang, Alice; Hughes, Jaquelyne T; Brown, Alex; Lawton, Paul D; Cass, Alan; Hoy, Wendy; O'Dea, Kerin; Maple-Brown, Louise J

2016-02-11

Lower socioeconomic status has been linked to long-term stress, which can manifest in individuals as physiological stress. The aim was to explore the relationship between low socioeconomic status and physiological stress in Aboriginal and Torres Strait Islander Australians. Using data from the eGFR Study (a cross-sectional study of 634 Indigenous Australians in urban and remote areas of northern and central Australia), we examined associations between resting heart rate and demographic, socioeconomic, and biomedical factors. An elevated resting heart rate has been proposed as a measure of sustained stress activation and was used as a marker of physiological stress. Relationships were assessed between heart rate and the above variables using univariate and multiple regression analyses. We reported a mean resting heart rate of 74 beats/min in the cohort (mean age 45 years). On multiple regression analysis, higher heart rate was found to be independently associated with Aboriginal ethnicity, being a current smoker, having only primary level schooling, higher HbA1c and higher diastolic blood pressure (model R(2) 0.25). Elevated resting heart rate was associated with lower socioeconomic status and poorer health profile in Aboriginal and Torres Strait Islander Australians. Higher resting heart rate may be an indicator of stress and disadvantage in this population at high risk of chronic diseases.

Understanding burn injuries in Aboriginal and Torres Strait Islander children: protocol for a prospective cohort study

PubMed Central

Ivers, Rebecca Q; Hunter, Kate; Clapham, Kathleen; Coombes, Julieann; Fraser, Sarah; Lo, Serigne; Gabbe, Belinda; Hendrie, Delia; Read, David; Kimble, Roy; Sparnon, Anthony; Stockton, Kellie; Simpson, Renee; Quinn, Linda; Towers, Kurt; Potokar, Tom; Mackean, Tamara; Grant, Julian; Lyons, Ronan A; Jones, Lindsey; Eades, Sandra; Daniels, John; Holland, Andrew J A

2015-01-01

Introduction Although Aboriginal and Torres Strait Islander children in Australia have higher risk of burns compared with non-Aboriginal children, their access to burn care, particularly postdischarge care, is poorly understood, including the impact of care on functional outcomes. The objective of this study is to describe the burden of burns, access to care and functional outcomes in Aboriginal and Torres Strait Islander children in Australia, and develop appropriate models of care. Methods and analysis All Aboriginal and Torres Strait Islander children aged under 16 years of age (and their families) presenting with a burn to a tertiary paediatric burn unit in 4 Australian States (New South Wales (NSW), Queensland, Northern Territory (NT), South Australia (SA)) will be invited to participate. Participants and carers will complete a baseline questionnaire; follow-ups will be completed at 3, 6, 12 and 24 months. Data collected will include sociodemographic information; out of pocket costs; functional outcome; and measures of pain, itch and scarring. Health-related quality of life will be measured using the PedsQL, and impact of injury using the family impact scale. Clinical data and treatment will also be recorded. Around 225 participants will be recruited allowing complete data on around 130 children. Qualitative data collected by in-depth interviews with families, healthcare providers and policymakers will explore the impact of burn injury and outcomes on family life, needs of patients and barriers to healthcare; interviews with families will be conducted by experienced Aboriginal research staff using Indigenous methodologies. Health systems mapping will describe the provision of care. Ethics and dissemination The study has been approved by ethics committees in NSW, SA, NT and Queensland. Study results will be distributed to community members by study newsletters, meetings and via the website; to policymakers and clinicians via policy fora, presentations and publication in peer-reviewed journals. PMID:26463225

Trends in tobacco consumption in three different birth cohorts of elderly of São Paulo, Brazil.

PubMed

Wagner, Gabriela Arantes; Rocha, Francisco Marcelo Monteiro da; Lebrão, Maria Lúcia; Duarte, Yeda Aparecida de Oliveira; Zanetta, Dirce Maria Trevisan

2015-02-01

The effects of birth cohorts reflect the historical differences in physical and social environments. The objectives of the present study were to describe the tobacco consumption and to evaluate the behavioral trends with respect to smoking in three different birth cohorts of a population-based sample of elderly individuals. A series of three cross-sectional studies conducted with elderly individuals of 60-64 years of age interviewed in 2000 (birth cohort 1936-1940; n=427), 2006 (birth cohort 1942-1946; n=298) and 2011 (birth cohort 1947-1951; n=355) in a population-based sample from the city of São Paulo, Brazil. The interviewees were participating in a prospective cohort study entitled Health, Well-Being and Aging (Saúde, Bem-Estar e Envelhecimento [SABE]). Data on tobacco consumption were self-reported and interviewees were then classified as never smokers, former smokers or current smokers. Linear model for categorical data was used to test differences on tobacco consumption between three birth elderly cohorts. Men were more likely than women to be smokers. Being evangelical and having more schooling constituted protective factors against smoking. Regarding trends, the tobacco consumption of the men did not change in any of the three cohorts studied (p=0.7454), whereas there was an increase in the number of women smokers, principally former smokers, over the periods evaluated (p=0.0189). These results suggest that the anti-smoking policies implemented in Brazil were effective in women of this age group; however, different prevention strategies are required to target elderly men. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The role of under-employment and unemployment in recent birth cohort effects in Australian suicide.

PubMed

Page, Andrew; Milner, Allison; Morrell, Stephen; Taylor, Richard

2013-09-01

High suicide rates evident in Australian young adults during an epidemic period in the 1990s appear to have been sustained in older age-groups in the subsequent decade. This period also coincides with changes in employment patterns in Australia. This study investigates age, period, and birth cohort effects in Australian suicide over the 20th century, with particular reference to the period subsequent to the 1990s youth suicide epidemic in young males. Period- and cohort-specific trends in suicide were examined for 1907-2010 based on descriptive analysis of age-specific suicide rates and a series of age-period-cohort (APC) models using Poisson regression. Under-employment rates (those employed part-time seeking additional hours of work) and unemployment rates (those currently seeking employment) for the latter part of this time series (1978-2010) were also examined and compared with period- and cohort-specific trends in suicide. A significant increasing birth cohort effect in male suicide rates was evident in birth cohorts born after 1970-74, after adjusting for the effects age and period. An increasing birth cohort effect was also evident in female suicide rates, but was of a lesser magnitude. Increases in male cohort-specific suicide rates were significantly correlated with increases in cohort-specific under-employment and unemployment rates. Birth cohorts that experienced the peak of the suicide epidemic during the 1990s have continued to have higher suicide rates than cohorts born in earlier epochs. This increase coincides with changes to a labour force characterised by greater 'flexibility' and 'casualised' employment, especially in younger aged cohorts. Copyright © 2013 Elsevier Ltd. All rights reserved.

The impact of breast cancer-specific birth cohort effects among younger and older Chinese populations.

PubMed

Sung, Hyuna; Rosenberg, Philip S; Chen, Wan-Qing; Hartman, Mikael; Lim, Wei-Yen; Chia, Kee Seng; Wai-Kong Mang, Oscar; Tse, Lapah; Anderson, William F; Yang, Xiaohong R

2016-08-01

Historically low breast cancer incidence rates among Asian women have risen worldwide; purportedly due to the adoption of a "Western" life style among younger generations (i.e., the more recent birth cohorts). However, no study has simultaneously compared birth cohort effects between both younger and older women in different Asian and Western populations. Using cancer registry data from rural and urban China, Singapore and the United States (1990-2008), we estimated age-standardized incidence rates (ASR), annual percentage change (EAPC) in the ASR, net drifts, birth cohort specific incidence rates and cohort rate ratios (CRR). Younger (30-49 years, 1943-1977 birth cohorts) and older women (50-79 years; 1913-1957 birth cohorts) were assessed separately. CRRs among Chinese populations were estimated using birth cohort specific rates with US non-Hispanic white women (NHW) serving as the reference population with an assigned CRR of 1.0. We observed higher EAPCs and net drifts among those Chinese populations with lower ASRs. Similarly, we observed the most rapidly increasing cohort-specific incidence rates among those Chinese populations with the lowest baseline CRRs. Both trends were more significant among older than younger women. Average CRRs were 0.06-0.44 among older and 0.18-0.81 among younger women. Rapidly rising cohort specific rates have narrowed the historic disparity between Chinese and US NHW breast cancer populations particularly in regions with the lowest baseline rates and among older women. Future analytic studies are needed to investigate risk factors accounting for the rapid increase of breast cancer among older and younger women separately in Asian populations. © 2016 UICC.

Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community.

PubMed

Kearns, Thérèse M; Speare, Richard; Cheng, Allen C; McCarthy, James; Carapetis, Jonathan R; Holt, Deborah C; Currie, Bart J; Page, Wendy; Shield, Jennifer; Gundjirryirr, Roslyn; Bundhala, Leanne; Mulholland, Eddie; Chatfield, Mark; Andrews, Ross M

2015-10-01

Scabies is endemic in many Aboriginal and Torres Strait Islander communities, with 69% of infants infected in the first year of life. We report the outcomes against scabies of two oral ivermectin mass drug administrations (MDAs) delivered 12 months apart in a remote Australian Aboriginal community. Utilizing a before and after study design, we measured scabies prevalence through population census with sequential MDAs at baseline and month 12. Surveys at months 6 and 18 determined disease acquisition and treatment failures. Scabies infestations were diagnosed clinically with additional laboratory investigations for crusted scabies. Non-pregnant participants weighing ≥15 kg were administered a single 200 μg/kg ivermectin dose, repeated after 2-3 weeks if scabies was diagnosed, others followed a standard alternative algorithm. We saw >1000 participants at each population census. Scabies prevalence fell from 4% at baseline to 1% at month 6. Prevalence rose to 9% at month 12 amongst the baseline cohort in association with an identified exposure to a presumptive crusted scabies case with a higher prevalence of 14% amongst new entries to the cohort. At month 18, scabies prevalence fell to 2%. Scabies acquisitions six months after each MDA were 1% and 2% whilst treatment failures were 6% and 5% respectively. Scabies prevalence reduced in the six months after each MDA with a low risk of acquisition (1-2%). However, in a setting where living conditions are conducive to high scabies transmissibility, exposure to presumptive crusted scabies and population mobility, a sustained reduction in prevalence was not achieved. Australian New Zealand Clinical Trial Register (ACTRN-12609000654257).

An analysis of suicide trends in Scotland 1950-2014: comparison with England & Wales.

PubMed

Dougall, Nadine; Stark, Cameron; Agnew, Tim; Henderson, Rob; Maxwell, Margaret; Lambert, Paul

2017-12-20

Scotland has disproportionately high rates of suicide compared with England. An analysis of trends may help reveal whether rates appear driven more by birth cohort, period or age. A 'birth cohort effect' for England & Wales has been previously reported by Gunnell et al. (B J Psych 182:164-70, 2003). This study replicates this analysis for Scotland, makes comparisons between the countries, and provides information on 'vulnerable' cohorts. Suicide and corresponding general population data were obtained from the National Records of Scotland, 1950 to 2014. Age and gender specific mortality rates were estimated. Age, period and cohort patterns were explored graphically by trend analysis. A pattern was found whereby successive male birth cohorts born after 1940 experienced higher suicide rates, in increasingly younger age groups, echoing findings reported for England & Wales. Young men (aged 20-39) were found to have a marked and statistically significant increase in suicide between those in the 1960 and 1965 birth cohorts. The 1965 cohort peaked in suicide rate aged 35-39, and the subsequent 1970 cohort peaked even younger, aged 25-29; it is possible that these 1965 and 1970 cohorts are at greater mass vulnerability to suicide than earlier cohorts. This was reflected in data for England & Wales, but to a lesser extent. Suicide rates associated with male birth cohorts subsequent to 1975 were less severe, and not statistically significantly different from earlier cohorts, suggestive of an amelioration of any possible influential 'cohort' effect. Scottish female suicide rates for all age groups converged and stabilised over time. Women have not been as affected as men, with less variation in patterns by different birth cohorts and with a much less convincing corresponding pattern suggestive of a 'cohort' effect. Trend analysis is useful in identifying 'vulnerable' cohorts, providing opportunities to develop suicide prevention strategies addressing these cohorts as they age.

Impact of Month of Birth on the Risk of Development of Autoimmune Addison's Disease

PubMed Central

Fichna, Marta; Mitchell, Anna L.; Napier, Catherine M.; Gan, Earn; Ruchała, Marek; Santibanez-Koref, Mauro; Pearce, Simon H.

2016-01-01

Context: The pathogenesis of autoimmune Addison's disease (AAD) is thought to be due to interplay of genetic, immune, and environmental factors. A month-of-birth effect, with increased risk for those born in autumn/winter months, has been described in autoimmune conditions such as type 1 diabetes and autoimmune thyroid disease. Objective: Month-of-birth effect was investigated in 2 independent cohorts of AAD subjects. Design, Setting, and Patients: The monthly distribution of birth in AAD patients was compared with that of the general population using the cosinor test. A total of 415 AAD subjects from the United Kingdom cohort were compared with 8 180 180 United Kingdom births, and 231 AAD subjects from the Polish cohort were compared with 2 421 384 Polish births. Main Outcome Measures: Association between month of birth and the susceptibility to AAD. Results: In the entire cohort of AAD subjects, month-of-birth distribution analysis showed significant periodicity with peak of births in December and trough in May (P = .028). Analysis of the odds ratio distribution based on month of birth in 2 cohorts of patients with AAD versus the general population revealed a December peak and May trough, and January peak and July trough, in the United Kingdom and Polish cohorts, respectively. Conclusion: For the first time, we demonstrate that month of birth exerts an effect on the risk of developing AAD, with excess risk in individuals born in winter months and a protective effect when born in the summer. Exposure to seasonal viral infections in the perinatal period, coupled with vitamin D deficiency, could lead to dysregulation of innate immunity affecting the risk of developing AAD. PMID:27575942

Trends in Hip Fracture Rates in Canada: An Age-Period-Cohort Analysis

PubMed Central

Jean, Sonia; O’Donnell, Siobhan; Lagacé, Claudia; Walsh, Peter; Bancej, Christina; Brown, Jacques P.; Morin, Suzanne; Papaioannou, Alexandra; Jaglal, Susan B.; Leslie, William D.

2016-01-01

Age-standardized rates of hip fracture in Canada declined during the period 1985 to 2005. We investigated whether this incidence pattern is explained by period effects, cohort effects, or both. All hospitalizations during the study period with primary diagnosis of hip fracture were identified. Age- and sex-specific hip fracture rates were calculated for nineteen 5-year age groups and four 5-year calendar periods, resulting in 20 birth cohorts. The effect of age, calendar period, and birth cohort on hip fracture rates was assessed using age-period-cohort models as proposed by Clayton and Schiffers. From 1985 to 2005, a total of 570,872 hospitalizations for hip fracture were identified. Age-standardized rates for hip fracture have progressively declined for females and males. The annual linear decrease in rates per 5-year period were 12% for females and 7% for males (both p < 0.0001). Significant birth cohort effects were also observed for both sexes (p < 0.0001). Cohorts born before 1950 had a higher risk of hip fracture, whereas those born after 1954 had a lower risk. After adjusting for age and constant annual linear change (drift term common to both period and cohort effects), we observed a significant nonlinear birth cohort effect for males (p = 0.0126) but not for females (p = 0.9960). In contrast, the nonlinear period effect, after adjustment for age and drift term, was significant for females (p = 0.0373) but not for males (p = 0.2515). For males, we observed no additional nonlinear period effect after adjusting for age and birth cohort, whereas for females, we observed no additional nonlinear birth cohort effect after adjusting for age and period. Although hip fracture rates decreased in both sexes, different factors may explain these changes. In addition to the constant annual linear decrease, nonlinear birth cohort effects were identified for males, and calendar period effects were identified for females as possible explanations. PMID:23426882

Epidemiology of Hepatitis C Virus in Pennsylvania State Prisons, 2004–2012: Limitations of 1945–1965 Birth Cohort Screening in Correctional Settings

PubMed Central

Mahowald, Madeline K.; Scharff, Nicholas; Flanigan, Timothy P.; Beckwith, Curt G.; Zaller, Nickolas D.

2014-01-01

Objectives. We described hepatitis C virus antibody (anti-HCV) prevalence in a state prison system and retrospectively evaluated the case-finding performance of targeted testing of the 1945 to 1965 birth cohort in this population. Methods. We used observational data from universal testing of Pennsylvania state prison entrants (June 2004–December 2012) to determine anti-HCV prevalence by birth cohort. We compared anti-HCV prevalence and the burden of anti-HCV in the 1945 to 1965 birth cohort with that in all other birth years. Results. Anti-HCV prevalence among 101 727 adults entering prison was 18.1%. Prevalence was highest among those born from 1945 to 1965, but most anti-HCV cases were in people born after 1965. Targeted testing of the 1945 to 1965 birth cohort would have identified a decreasing proportion of cases with time. Conclusions. HCV is endemic in correctional populations. Targeted testing of the 1945 to 1965 birth cohort would produce a high yield of positive test results but would identify only a minority of cases. We recommend universal anti-HCV screening in correctional settings to allow for maximum case identification, secondary prevention, and treatment of affected prisoners. PMID:24825235

The Hokkaido Birth Cohort Study on Environment and Children's Health: cohort profile-updated 2017.

PubMed

Kishi, Reiko; Araki, Atsuko; Minatoya, Machiko; Hanaoka, Tomoyuki; Miyashita, Chihiro; Itoh, Sachiko; Kobayashi, Sumitaka; Ait Bamai, Yu; Yamazaki, Keiko; Miura, Ryu; Tamura, Naomi; Ito, Kumiko; Goudarzi, Houman

2017-05-18

The Hokkaido Study on Environment and Children's Health is an ongoing study consisting of two birth cohorts of different population sizes: the Sapporo cohort and the Hokkaido cohort. Our primary study goals are (1) to examine the effects of low-level environmental chemical exposures on birth outcomes, including birth defects and growth retardation; (2) to follow the development of allergies, infectious diseases, and neurobehavioral developmental disorders and perform a longitudinal observation of child development; (3) to identify high-risk groups based on genetic susceptibility to environmental chemicals; and (4) to identify the additive effects of various chemicals, including tobacco smoking. The purpose of this report is to update the progress of the Hokkaido Study, to summarize the recent results, and to suggest future directions. In particular, this report provides the basic characteristics of the cohort populations, discusses the population remaining in the cohorts and those who were lost to follow-up at birth, and introduces the newly added follow-up studies and case-cohort study design. In the Sapporo cohort of 514 enrolled pregnant women, various specimens, including maternal and cord blood, maternal hair, and breast milk, were collected for the assessment of exposures to dioxins, polychlorinated biphenyls, organochlorine pesticides, perfluoroalkyl substances, phthalates, bisphenol A, and methylmercury. As follow-ups, face-to-face neurobehavioral developmental tests were conducted at several different ages. In the Hokkaido cohort of 20,926 enrolled pregnant women, the prevalence of complicated pregnancies and birth outcomes, such as miscarriage, stillbirth, low birth weight, preterm birth, and small for gestational age were examined. The levels of exposure to environmental chemicals were relatively low in these study populations compared to those reported previously. We also studied environmental chemical exposure in association with health outcomes, including birth size, neonatal hormone levels, neurobehavioral development, asthma, allergies, and infectious diseases. In addition, genetic and epigenetic analyses were conducted. The results of this study demonstrate the effects of environmental chemical exposures on genetically susceptible populations and on DNA methylation. Further study and continuous follow-up are necessary to elucidate the combined effects of chemical exposure on health outcomes.

Low Birth Weight and Cognitive Outcomes: Evidence for a Gradient Relationship in an Urban, Poor, African American Birth Cohort

ERIC Educational Resources Information Center

Dombrowski, Stefan C.; Noonan, Kelly; Martin, Roy P.

2007-01-01

This study is one of the first to investigate the relationship between low birth weight and cognitive outcomes in an urban, poor, prospectively designed African-American birth cohort. Multivariate analyses of the Pathways to Adulthood study, a subset of the Johns Hopkins Collaborative Perinatal study, compared low birth weight African-American…

Age, time period, and birth cohort differences in self-esteem: Reexamining a cohort-sequential longitudinal study.

PubMed

Twenge, Jean M; Carter, Nathan T; Campbell, W Keith

2017-05-01

Orth, Trzesniewski, and Robins (2010) concluded that the nationally representative Americans' Changing Lives (ACL) cohort-sequential study demonstrated moderate to large age differences in self-esteem, and no birth cohort (generational) differences in the age trajectory. In a reanalysis of these data using 2 different statistical techniques, we find significant increases in self-esteem that could be attributed to birth cohort or time period. First, hierarchical linear modeling analyses with birth cohort as a continuous variable (vs. the multiple group formulation used by Orth et al.) find that birth cohort has a measurable influence on self-esteem through its interaction with age. Participants born in later years (e.g., 1960) were higher in self-esteem and were more likely to increase in self-esteem as they aged than participants born in earlier years (e.g., 1920). However, the estimated age trajectory up to age 60 is similar in Orth et al.'s results and in the results from our analyses including cohort. Second, comparing ACL respondents of the same age in 1986 versus 2002 (a time-lag design) yields significant birth cohort differences in self-esteem, with 2002 participants of the same age higher in self-esteem than those in 1986. Combined with some previous studies finding significant increases in self-esteem and positive self-views over time, these results suggest that cultural change in the form of cohort and time period cannot be ignored as influences in cross-sectional and longitudinal studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Substantia nigra depigmentation and exposure to encephalitis lethargica.

PubMed

Hack, Nawaz; Jicha, Gregory A; Abell, Annalisa; Dean, Dawson; Vitek, Jerrold L; Berger, Joseph R

2012-12-01

Parkinsonism has occasionally been reported as a consequence of infectious diseases. The present study examines the clinical and pathological correlates of parkinsonism across birth cohorts in relation to critical exposure to the encephalitis lethargica epidemic in the early 1900s. The study population consisted of 678 participants in the Nun Study, of whom 432 died and came to autopsy. Qualitative indices of substantia nigra (SN) depigmentation were verified in a subset of 40 randomly selected subjects using quantitative stereological techniques. SN depigmentation, detected neuropathologically, was correlated with clinical parameters of Parkinson disease, age, and birth cohort. SN depigmentation was detected in 57 (13.2%) of the cohort. Although qualitative SN depigmentation correlated modestly with age (p = 0.02), it correlated best with birth cohort (p = 0.009) for women born in the years 1895-1899. Quantitative measures of SN depigmentation were increased in this birth cohort compared to age matched subjects from flanking birth cohorts 1890-1894 and 1900-1904 (p < 0.001). SN depigmentation correlated with speed of 6- and 50-foot walk (p < 0.0001), up and go test (p < 0.0001), and hand coordination (p < 0.0001). Subjects in the birth cohort 1895-1899 would have been in their late teens and 20s at the onset and during the peak of the encephalitis lethargica epidemic. These were precisely the age ranges of persons who were most often affected by the illness. These data suggest the possibility that the coexistence of parkinsonism and SN depigmentation in this birth cohort may have resulted from the yet undetermined infectious agent responsible for encephalitis lethargica. Copyright © 2012 American Neurological Association.

Reduction of frequent otitis media and pressure-equalizing tube insertions in children after introduction of pneumococcal conjugate vaccine.

PubMed

Poehling, Katherine A; Szilagyi, Peter G; Grijalva, Carlos G; Martin, Stacey W; LaFleur, Bonnie; Mitchel, Ed; Barth, Richard D; Nuorti, J Pekka; Griffin, Marie R

2007-04-01

Streptococcus pneumoniae is an important cause of otitis media in children. In this study we estimated the effect of routine childhood immunization with heptavalent pneumococcal conjugate vaccine on frequent otitis media (3 episodes in 6 months or 4 episodes in 1 year) and pressure-equalizing tube insertions. The study population included all children who were enrolled at birth in TennCare or selected upstate New York commercial insurance plans as of July 1998 and continuously followed until 5 years old, loss of health plan enrollment, study outcome, or end of the study. We compared the risk of developing frequent otitis media or having pressure-equalizing tube insertion for 4 birth cohorts (1998-1999, 1999-2000, 2000-2001, and 2001-2002) by using Cox regression analysis. We used data from the National Immunization Survey to estimate the heptavalent pneumococcal conjugate vaccine uptake for children in these 4 birth cohorts in Tennessee and New York. The proportion of children in Tennessee and New York who received at least 3 doses of heptavalent pneumococcal conjugate vaccine by 2 years of age increased from < or = 1% for the 1998-1999 birth cohort to approximately 75% for the 2000-2001 birth cohort. By age 2 years, 29% of Tennessee and New York children born in 2000-2001 had developed frequent otitis media, and 6% of each of these birth cohorts had pressure-equalizing tubes inserted. Comparing the 2000-2001 birth cohort to the 1998-1999 birth cohort, frequent otitis media declined by 17% and 28%, and pressure-equalizing tube insertions declined by 16% and 23% for Tennessee and New York children, respectively. For the 2000-2001 to the 2001-2002 birth cohort, frequent otitis media and pressure-equalizing tubes remained stable in New York but increased in Tennessee. After heptavalent pneumococcal conjugate vaccine introduction, children were less likely to develop frequent otitis media or have pressure-equalizing tube insertions.

Cohort Trends in Premarital First Births: What Role for the Retreat From Marriage?

PubMed Central

Wu, Lawrence L.; Shafer, Emily Fitzgibbons

2015-01-01

We examine cohort trends in premarital first births for U.S. women born between 1920 and 1964. The rise in premarital first births is often argued to be a consequence of the retreat from marriage, with later ages at first marriage resulting in more years of exposure to the risk of a premarital first birth. However, cohort trends in premarital first births may also reflect trends in premarital sexual activity, premarital conceptions, and how premarital conceptions are resolved. We decompose observed cohort trends in premarital first births into components reflecting cohort trends in (1) the age-specific risk of a premarital conception taken to term; (2) the age-specific risk of first marriages not preceded by such a conception, which will influence women’s years of exposure to the risk of a premarital conception; and (3) whether a premarital conception is resolved by entering a first marriage before the resulting first birth (a “shotgun marriage”). For women born between 1920–1924 and 1945–1949, increases in premarital first births were primarily attributable to increases in premarital conceptions. For women born between 1945–1949 and 1960–1964, increases in premarital first births were primarily attributable to declines in responding to premarital conceptions by marrying before the birth. Trends in premarital first births were affected only modestly by the retreat from marriages not preceded by conceptions—a finding that holds for both whites and blacks. These results cast doubt on hypotheses concerning “marriageable” men and instead suggest that increases in premarital first births resulted initially from increases in premarital sex and then later from decreases in responding to a conception by marrying before a first birth. PMID:24072609

Birth cohort and the specialization gap between same-sex and different-sex couples.

PubMed

Giddings, Lisa; Nunley, John M; Schneebaum, Alyssa; Zietz, Joachim

2014-04-01

We examine differences in household specialization between same-sex and different-sex couples within and across three birth cohorts: Baby Boomers, Generation X, and Generation Y. Using three measures of household specialization, we find that same-sex couples are less likely than their different-sex counterparts to exhibit a high degree of specialization. However, the "specialization gap" between same-sex and different-sex couples narrows across birth cohorts. These findings are indicative of a cohort effect. Our results are largely robust to the inclusion of a control for the presence of children and for subsets of couples with and without children. We provide three potential explanations for why the specialization gap narrows across cohorts. First, different-sex couples from more recent birth cohorts may have become more like same-sex couples in terms of household specialization. Second, social and legal changes may have prompted a greater degree of specialization within same-sex couples relative to different-sex couples. Last, the advent of reproductive technologies, which made having children easier for same-sex couples from more recent birth cohorts, could result in more specialization in such couples relative to different-sex couples.

Cesarean Outcomes in US Birth Centers and Collaborating Hospitals: A Cohort Comparison.

PubMed

Thornton, Patrick; McFarlin, Barbara L; Park, Chang; Rankin, Kristin; Schorn, Mavis; Finnegan, Lorna; Stapleton, Susan

2017-01-01

High rates of cesarean birth are a significant health care quality issue, and birth centers have shown potential to reduce rates of cesarean birth. Measuring this potential is complicated by lack of randomized trials and limited observational comparisons. Cesarean rates vary by provider type, setting, and clinical and nonclinical characteristics of women, but our understanding of these dynamics is incomplete. We sought to isolate labor setting from other risk factors in order to assess the effect of birth centers on the odds of cesarean birth. We generated low-risk cohorts admitted in labor to hospitals (n = 2527) and birth centers (n = 8776) using secondary data obtained from the American Association of Birth Centers (AABC). All women received prenatal care in the birth center and midwifery care in labor, but some chose hospital admission for labor. Analysis was intent to treat according to site of admission in spontaneous labor. We used propensity score adjustment and multivariable logistic regression to control for cohort differences and measured effect sizes associated with setting. There was a 37% (adjusted odds ratio [OR], 0.63; 95% confidence interval [CI], 0.50-0.79) to 38% (adjusted OR, 0.62; 95% CI, 0.49-0.79) decreased odds of cesarean in the birth center cohort and a remarkably low overall cesarean rate of less than 5% in both cohorts. These findings suggest that low rates of cesarean in birth centers are not attributable to labor setting alone. The entire birth center care model, including prenatal preparation and relationship-based midwifery care, should be studied, promoted, and implemented by policy makers interested in achieving appropriate cesarean rates in the United States. © 2016 by the American College of Nurse-Midwives.

The association between height and birth order: evidence from 652,518 Swedish men.

PubMed

Myrskylä, Mikko; Silventoinen, Karri; Jelenkovic, Aline; Tynelius, Per; Rasmussen, Finn

2013-07-01

Birth order is associated with outcomes such as birth weight and adult socioeconomic position (SEP), but little is known about the association with adult height. This potential birth order-height association is important because height predicts health, and because the association may help explain population-level height trends. We studied the birth order-height association and whether it varies by family characteristics or birth cohort. We used the Swedish Military Conscription Register to analyse adult height among 652,518 men born in 1951-1983 using fixed effects regression models that compare brothers and account for genetic and social factors shared by brothers. We stratified the analysis by family size, parental SEP and birth cohort. We compared models with and without birth weight and birth length controls. Unadjusted analyses showed no differences between the first two birth orders but in the fixed effects regression, birth orders 2, 3 and 4 were associated with 0.4, 0.7 and 0.8 cm (p<0.001 for each) shorter height than birth order 1, respectively. The associations were similar in large and small and high-SEP and low-SEP families, but were attenuated in recent cohorts. Birth characteristics did not explain these associations. Birth order is an important determinant of height. The height difference between birth orders 3 and 1 is larger than the population-level height increase achieved over 10 years. The attenuation of the effect over cohorts may reflect improvements in living standards. Decreases in family size may explain some of the secular-height increases in countries with decreasing fertility.

Using cultural immersion as the platform for teaching Aboriginal and Torres Strait Islander health in an undergraduate medical curriculum.

PubMed

Smith, Janie D; Wolfe, Christina; Springer, Shannon; Martin, Mary; Togno, John; Bramstedt, Katrina A; Sargeant, Sally; Murphy, Bradley

2015-01-01

In 2011 Bond University was looking for innovative ways to meet the professional standards and guidelines in Aboriginal and Torres Strait Islander health in its Bachelor of Medicine, Bachelor of Surgery (MBBS) curriculum. In 2012 Bond piloted a compulsory cultural immersion program for all first year students, which is now a usual part of the MBBS program. Three phases were included - establishing an Indigenous health group, determining the Aboriginal and Torres Strait Islander educational content based on the professional standards and developing nine educational sessions and resources - as well as significant administrative processes. The cultural immersion was piloted in 2012 with 92 first year medical students. Following refinements it was repeated in 2013 with 95 students and in 2014 with 94 students. A comprehensive evaluation process was undertaken that included a paper-based evaluation form using a five-point Likert scale, as well as a confidential talking circle evaluation. The response rate was 95.4% (n=271, pooled cohort). Data were entered separately into SPSS and annual reports were written to the Faculty. Descriptive statistics are reported alongside themed qualitative data. The three combined student evaluation results were extremely positive. Students (n=271) strongly agreed that the workshop was well organised (M=4.3), that the facilitators contributed very positively to their experience (M=4.3), and that they were very satisfied overall with the activity (M=4.2). They agreed that the eight overall objectives had been well met (M=3.9-4.3). The nine sessions were highly evaluated with mean ratings of between 3.9 and 4.8. The 'best thing' about the immersion identified by more than half of the students was overwhelmingly (n=140) the Storytelling session, followed by bonding with the cohort, the Torres Strait Islander session and learning more about culture. The item identified as needing most improvement was the food (n=87), followed by the accommodation (n=65). The use of immersion in the early part of a cultural awareness program for medical students provides an extremely valuable platform from which to launch more detailed information about the history of Aboriginal and Torres Strait Islander Australia and its impact on the current health status of Aboriginal and Torres Strait Islander Australians. Doing this in a safe, supportive cross-cultural environment with highly skilled facilitators is essential. Key to success is strong leadership, commitment and support from Faculty level, a structured educational program and educating all staff and students about its importance throughout the journey.

Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community

PubMed Central

Kearns, Thérèse M.; Speare, Richard; Cheng, Allen C.; McCarthy, James; Carapetis, Jonathan R.; Holt, Deborah C.; Currie, Bart J.; Page, Wendy; Shield, Jennifer; Gundjirryirr, Roslyn; Bundhala, Leanne; Mulholland, Eddie; Chatfield, Mark; Andrews, Ross M.

2015-01-01

Background Scabies is endemic in many Aboriginal and Torres Strait Islander communities, with 69% of infants infected in the first year of life. We report the outcomes against scabies of two oral ivermectin mass drug administrations (MDAs) delivered 12 months apart in a remote Australian Aboriginal community. Methods Utilizing a before and after study design, we measured scabies prevalence through population census with sequential MDAs at baseline and month 12. Surveys at months 6 and 18 determined disease acquisition and treatment failures. Scabies infestations were diagnosed clinically with additional laboratory investigations for crusted scabies. Non-pregnant participants weighing ≥15 kg were administered a single 200 μg/kg ivermectin dose, repeated after 2–3 weeks if scabies was diagnosed, others followed a standard alternative algorithm. Principal Findings We saw >1000 participants at each population census. Scabies prevalence fell from 4% at baseline to 1% at month 6. Prevalence rose to 9% at month 12 amongst the baseline cohort in association with an identified exposure to a presumptive crusted scabies case with a higher prevalence of 14% amongst new entries to the cohort. At month 18, scabies prevalence fell to 2%. Scabies acquisitions six months after each MDA were 1% and 2% whilst treatment failures were 6% and 5% respectively. Conclusion Scabies prevalence reduced in the six months after each MDA with a low risk of acquisition (1–2%). However, in a setting where living conditions are conducive to high scabies transmissibility, exposure to presumptive crusted scabies and population mobility, a sustained reduction in prevalence was not achieved. Clinical Trial Registration Australian New Zealand Clinical Trial Register (ACTRN—12609000654257). PMID:26516764

Clinical outcomes associated with albuminuria in central Australia: a cohort study.

PubMed

Ritte, Rebecca; Luke, Joanne; Nelson, Craig; Brown, Alex; O'Dea, Kerin; Jenkins, Alicia; Best, James D; McDermott, Robyn; Daniel, Mark; Rowley, Kevin

2016-08-05

Chronic kidney disease (CKD) and end-stage-kidney disease (ESKD) continue to be under-diagnosed and a major burden for Aboriginal communities in central Australia. The aim of this study was to examine the risk of poor clinical outcomes associated with elevated albumin-to-creatinine ratio (ACR) among Aboriginal people in central Australia. Cox proportional hazards models were used to estimate the risk of end stage kidney disease (ESKD), dialysis, CVD (cardiovascular disease) and mortality associated with participants' baseline albuminuria reading from a 10-year cohort study of Aboriginal people (n = 623) from three communities in central Australia. Predictors of progression of albuminuria were also examined in the context of the Kidney Health Australia (KHA) Risk Matrix. A baseline ACR level of ≥3.5 mg/mmol was associated with an almost 10-fold increased risk of ESKD (95%CI 2.07-43.8) and a 15-fold risk of dialysis (95%CI 1.89-121). Albuminuria ≥3.5 mg/mmol was also associated with a borderline 63 % increased risk of CVD (95%CI 0.98-2.71). No significant association was observed with mortality from all-causes or chronic disease. Diabetes and a waist-to-hip ratio ≥0.90 independently predicted a two-fold increased risk of a progression to higher ACR levels. A single measure of moderately increased albuminuria was a strong predictor of renal failure in this population. A single spot urine ACR analysis in conjunction with the KHA Risk Matrix may be a useful and efficient strategy to screen for risk of CKD and progression to dialysis in remote communities. A focus on individuals with diabetes and/or central obesity for strategies to avoid increases in albuminuria may also prevent future CKD and CVD complications.

Oral health in a life-course: birth-cohorts from 1929 to 2006 in Norway.

PubMed

Holst, D; Schuller, A A

2012-06-01

The purpose of the work was to study the influence of the oral health environment at age 10, of adolescent and adulthood dental behaviours and of social status on oral health of three birth-cohorts in 1983 and two of the three birth-cohorts in 2006 in Norway. The material comprised data from random samples of three birth-cohorts living in the counties of Sør- and Nord-Trøndelag in 1983. The birth-cohorts were 1929-1938, 1939-1948 and 1959-1960. In 2006 two samples were drawn from the 1929-1938 and 1959-1960 birth-cohort. The data collection comprised standard clinical measurements and self-administered questionnaires. The early oral health environment and social status and gender were related to oral health in 1983 by multiple regressions. The impact of social status was studied in combined datafiles from 1983 and 2006. The oral health environment in childhood was important for adults' oral health. The attention from parents and the local environment lead to a better oral health outcome in adulthood. Social status affected choices leading to better oral health. Regular dental visits were important especially for the eldest birth-cohort. Good oral health behaviours early and during adulthood were also important for oral health. Judged by number of tooth surfaces the difference between social status groups had not increased by 2006. A life-course perspective provides an opportunity to understand oral health over time. The present study supports the assumption that oral health is continuously exposed to environmental and behavioural risks that lead to accumulated diseases in the dental tissues.

The cost-effectiveness of birth-cohort screening for hepatitis C antibody in U.S. primary care settings.

PubMed

Rein, David B; Smith, Bryce D; Wittenborn, John S; Lesesne, Sarah B; Wagner, Laura D; Roblin, Douglas W; Patel, Nita; Ward, John W; Weinbaum, Cindy M

2012-02-21

In the United States, hepatitis C virus (HCV) infection is most prevalent among adults born from 1945 through 1965, and approximately 50% to 75% of infected adults are unaware of their infection. To estimate the cost-effectiveness of birth-cohort screening. Cost-effectiveness simulation. National Health and Nutrition Examination Survey, U.S. Census, Medicare reimbursement schedule, and published sources. Adults born from 1945 through 1965 with 1 or more visits to a primary care provider annually. Lifetime. Societal, health care. One-time antibody test of 1945-1965 birth cohort. Numbers of cases that were identified and treated and that achieved a sustained viral response; liver disease and death from HCV; medical and productivity costs; quality-adjusted life-years (QALYs); incremental cost-effectiveness ratio (ICER). Compared with the status quo, birth-cohort screening identified 808,580 additional cases of chronic HCV infection at a screening cost of $2874 per case identified. Assuming that birth-cohort screening was followed by pegylated interferon and ribavirin (PEG-IFN+R) for treated patients, screening increased QALYs by 348,800 and costs by $5.5 billion, for an ICER of $15,700 per QALY gained. Assuming that birth-cohort screening was followed by direct-acting antiviral plus PEG-IFN+R treatment for treated patients, screening increased QALYs by 532,200 and costs by $19.0 billion, for an ICER of $35,700 per QALY saved. The ICER of birth-cohort screening was most sensitive to sustained viral response of antiviral therapy, the cost of therapy, the discount rate, and the QALY losses assigned to disease states. Empirical data on screening and direct-acting antiviral treatment in real-world clinical settings are scarce. Birth-cohort screening for HCV in primary care settings was cost-effective. Division of Viral Hepatitis, Centers for Disease Control and Prevention.

Placental weight and foetal growth rate as predictors of ischaemic heart disease in a Swedish cohort.

PubMed

Heshmati, A; Koupil, I

2014-06-01

Studies on placental size and cardiovascular disease have shown inconsistent results. We followed 10,503 men and women born in Uppsala, Sweden, 1915-1929 from 1964 to 2008 to assess whether birth characteristics, including placental weight and placenta/birth weight ratio, were predictive of future ischaemic heart disease (IHD). Adjustments were made for birth cohort, age, sex, mother's parity, birth weight, gestational age and social class at birth. Placental weight and birth weight were negatively associated with IHD. The effect of placental weight on IHD was stronger in individuals from medium social class at birth and in those with low education. Men and women from non-manual social class at birth had the lowest risk for IHD as adults. We conclude that low foetal growth rate rather than placental weight was more predictive of IHD in the Swedish cohort. However, the strong effect of social class at birth on risk for IHD did not appear to be mediated by foetal growth rate.

Understanding burn injuries in Aboriginal and Torres Strait Islander children: protocol for a prospective cohort study.

PubMed

Ivers, Rebecca Q; Hunter, Kate; Clapham, Kathleen; Coombes, Julieann; Fraser, Sarah; Lo, Serigne; Gabbe, Belinda; Hendrie, Delia; Read, David; Kimble, Roy; Sparnon, Anthony; Stockton, Kellie; Simpson, Renee; Quinn, Linda; Towers, Kurt; Potokar, Tom; Mackean, Tamara; Grant, Julian; Lyons, Ronan A; Jones, Lindsey; Eades, Sandra; Daniels, John; Holland, Andrew J A

2015-10-13

Although Aboriginal and Torres Strait Islander children in Australia have higher risk of burns compared with non-Aboriginal children, their access to burn care, particularly postdischarge care, is poorly understood, including the impact of care on functional outcomes. The objective of this study is to describe the burden of burns, access to care and functional outcomes in Aboriginal and Torres Strait Islander children in Australia, and develop appropriate models of care. All Aboriginal and Torres Strait Islander children aged under 16 years of age (and their families) presenting with a burn to a tertiary paediatric burn unit in 4 Australian States (New South Wales (NSW), Queensland, Northern Territory (NT), South Australia (SA)) will be invited to participate. Participants and carers will complete a baseline questionnaire; follow-ups will be completed at 3, 6, 12 and 24 months. Data collected will include sociodemographic information; out of pocket costs; functional outcome; and measures of pain, itch and scarring. Health-related quality of life will be measured using the PedsQL, and impact of injury using the family impact scale. Clinical data and treatment will also be recorded. Around 225 participants will be recruited allowing complete data on around 130 children. Qualitative data collected by in-depth interviews with families, healthcare providers and policymakers will explore the impact of burn injury and outcomes on family life, needs of patients and barriers to healthcare; interviews with families will be conducted by experienced Aboriginal research staff using Indigenous methodologies. Health systems mapping will describe the provision of care. The study has been approved by ethics committees in NSW, SA, NT and Queensland. Study results will be distributed to community members by study newsletters, meetings and via the website; to policymakers and clinicians via policy fora, presentations and publication in peer-reviewed journals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Nonparametric evaluation of birth cohort trends in disease rates.

PubMed

Tarone, R E; Chu, K C

2000-01-01

Although interpretation of age-period-cohort analyses is complicated by the non-identifiability of maximum likelihood estimates, changes in the slope of the birth-cohort effect curve are identifiable and have potential aetiologic significance. A nonparametric test for a change in the slope of the birth-cohort trend has been developed. The test is a generalisation of the sign test and is based on permutational distributions. A method for identifying interactions between age and calendar-period effects is also presented. The nonparametric method is shown to be powerful in detecting changes in the slope of the birth-cohort trend, although its power can be reduced considerably by calendar-period patterns of risk. The method identifies a previously unidentified decrease in the birth-cohort risk of lung-cancer mortality from 1912 to 1919, which appears to reflect a reduction in the initiation of smoking by young men at the beginning of the Great Depression (1930s). The method also detects an interaction between age and calendar period in leukemia mortality rates, reflecting the better response of children to chemotherapy. The proposed nonparametric method provides a data analytic approach, which is a useful adjunct to log-linear Poisson analysis of age-period-cohort models, either in the initial model building stage, or in the final interpretation stage.

Effects of age, time period, and birth cohort on the prevalence of diabetes and obesity in Korean men.

PubMed

Kwon, Jin-Won; Song, Yun-mi; Park, Hye soon; Sung, Joohon; Kim, Ho; Cho, Sung-il

2008-02-01

We examined changes in the prevalence of diabetes, obesity, and overweight in 412,881 Korean men in birth cohorts from 1933 to 1972 over 8 years from 1992 to 2000 and separately analyzed the effects of age, time period, and birth cohort. The study included male employees of Korean government organizations and schools who were between 20 and 59 years of age in 1992. Diabetes was diagnosed on the basis of self-reports in 1992 or fasting blood glucose levels (>or=126 mg/ml, 7.0 mmol/l). The age-period-cohort model was used to estimate the effects of age, time period, and birth cohort. In Korean male birth cohorts from 1933 to 1972, the age-specific prevalence of diabetes, obesity, and overweight in men aged 28-59 years increased annually by 0.41% (3.03 to 6.29%), 0.18% (0.70 to 2.16%), and 1.49% (23.48 to 35.41%), respectively, from 1992 to 2000. The relative change in diabetes was largest among the younger cohorts (>400% increase over 8 years) and corresponded to the change in obesity. Apart from the contribution of age, clear cohort and period effects were evident for diabetes, although the magnitude of the effect was slightly less than that for obesity. Prevention of diabetes through the control of obesity, particularly in young men, clearly needs to be emphasized.

The Co-Occurrence of Autism and Birth Defects: Prevalence and Risk in a Population-Based Cohort

ERIC Educational Resources Information Center

Schendel, Diana E.; Autry, Andrew; Wines, Roberta; Moore, Cynthia

2009-01-01

Aim: To estimate the prevalence of major birth defects among children with autism, the prevalence of autism in children with birth defects, and the risk for autism associated with having birth defects. Method: Retrospective cohort including all children born in Atlanta, GA, USA, 1986 to 1993, who survived to age 3 years and were identified through…

A Deeper Understanding of Cultural Safety, Colonising and Seating in a Teacher Education Program: a Preliminary Study

ERIC Educational Resources Information Center

Harrison, Ed; McKay, Peter; Spencer, Marsha; Trimble, Bernadette

2017-01-01

This preliminary study considers the implications of where students of Aboriginal descent sat in a teacher education classroom, its significance in relation to the space of the classroom, the importance of the place to the individual and its links to creating a climate of cultural safety in the classroom. Six students from two cohorts of varying…

Increasing incidence of testicular cancer--birth cohort effects.

PubMed

Ekbom, A; Akre, O

1998-01-01

The incidence of testicular cancer is rising in most Western populations. A collaborative study between nine population-based cancer registries in countries around the Baltic Sea was utilized in order to analyze in detail geographic variations and temporal trends in the occurrence of testicular cancer. There were 34,309 cases registered up until 1989 starting in Denmark in 1942 and most recently in Latvia in 1977. From the descriptive epidemiology it was obvious that there was a substantial variation in the age-standardized incidence amounting to about a 10-fold difference between the different countries ranging from 0.8 per 100,000 person-years in Lithuania to 7.6 per 100,000 person-years in Denmark. Previous studies have indicated that this increase is due to birth cohort effects. A more detailed analysis was therefore performed in those six countries with a sufficiently long period of cancer registration; Poland, former East Germany, Norway, Finland, Denmark and Sweden. This analysis showed that birth cohort is a more important determinant of testicular cancer risk than year of diagnosis. In Poland, former East Germany and Finland, there was an increasing risk for all birth cohorts. Among men born in Denmark, Norway or Sweden between 1930 and 1945, this increasing trend in risk was interrupted in these birth cohorts but followed thereafter by an uninterrupted increase by birth cohort. In conclusion, life time exposure to environmental factors which are associated with the incidence of testicular cancer appear to be more related to birth cohort than to year of diagnosis. Because testicular cancer typically occurs at an early age, major etiological factors therefore need to operate early in life, perhaps even in utero.

Are baby boomer women unique? The moderating effect of birth cohort on age in substance use patterns during midlife.

PubMed

Sarabia, Stephanie Elias; Martin, James I

2016-01-01

This study examined the relationships of age to use of alcohol, marijuana, and illicit drugs, and misuse of prescription drugs, among midlife women and whether these relationships are modified by birth cohort. Structural Equation Modeling was used to analyze National Survey on Drug Use and Health data, which included 2,035 baby boomer and silent generation cohort women, ages 30 to 55. Midlife women across cohorts reduced alcohol and marijuana use, but not illicit and prescription drug misuse, as they aged. A modifying effect of birth cohort was not supported, but findings did support differential aging effects across substances. Implications are discussed.

Birth weight and gestational age characteristics of children with autism, including a comparison with other developmental disabilities.

PubMed

Schendel, Diana; Bhasin, Tanya Karapurkar

2008-06-01

The objectives of this study were to compare the birth weight and gestational age distributions and prevalence rates of autism with those of other developmental disabilities and to estimate the birth weight-and gestational age-specific risks for autism. For the first objective, a retrospective cohort of children born in Atlanta, Georgia, in 1981-1993 who survived to 3 years of age was identified through vital records. Children in the cohort who had developmental disabilities (autism, mental retardation, cerebral palsy, hearing loss, or vision impairment) and were still residing in metropolitan Atlanta at 3 to 10 years of age were identified through the Metropolitan Atlanta Developmental Disabilities Surveillance Program. A nested case-control sample from the cohort was used for the second objective; all cohort children identified with autism were case participants, and control participants were cohort children who were not identified as having developmental disabilities or receiving special education services. The prevalence of autism in low birth weight or preterm children was markedly lower than those of other developmental disabilities. In multivariate analyses, birth weight of <2500 g and preterm birth at <33 weeks' gestation were associated with an approximately twofold increased risk for autism, although the magnitude of risk from these factors varied according to gender (higher in girls) and autism subgroup (higher for autism accompanied by other developmental disabilities). For example, a significant fourfold increased risk was observed in low birth weight girls for autism accompanied by mental retardation, whereas there was no significantly increased risk observed in low birth weight boys for autism alone. Gender and autism subgroup differences in birth weight and gestational age, resulting in lower gender ratios with declining birth weight or gestational age across all autism subgroups, might be markers for etiologic heterogeneity in autism.

Gestational Age and Autism Spectrum Disorder: Trends in Risk Over Time.

PubMed

Atladóttir, H Ó; Schendel, D E; Henriksen, T B; Hjort, L; Parner, E T

2016-02-01

Autism Spectrum Disorder (ASD) is a serious neurodevelopmental disorder. Several previous studies have identified preterm birth as a risk factor for ASD but none has studied whether the association between gestational age and ASD has changed over time. This is a Danish population-based follow-up study including live-born singletons born in Denmark between 1980 and 2009, identified in the Danish Medical Birth Registry, a study population of 1,775,397 children. We used a Cox regression model combined with spline to study the risk for ASD by gestational age across three decades of birth cohorts. We included 19,020 children diagnosed with ASD. Across all birth year cohorts, we found that the risk of being diagnosed with ASD increased with lower gestational age (P-value: <0.01). Across all gestational weeks, we found a statistically significant higher risk estimates in birth cohort 1980 to 1989, compared to birth cohorts 1990 to 1999 and 2000 to 2009, respectively. No statistically significant difference in risk estimates was observed between birth cohort 1990 to 1999 and 2000 to 2009. The observed time trend in risk of ASD after preterm birth may reflect: (1) a change in the risk profile of persons with ASD due to the broadening of ASD diagnostic criteria over time; or (2) improved neonatal care for low GA infants, which has reduced risk of adverse outcomes like ASD in preterm children. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Neighbourhood socioeconomic status and maternal factors at birth as moderators of the association between birth characteristics and school attainment: a population study of children attending government schools in Western Australia.

PubMed

Malacova, E; Li, J; Blair, E; Mattes, E; de Klerk, N; Stanley, F

2009-10-01

This article investigates whether reading and writing skills among children of equivalent perinatal characteristics differ by neighbourhood socioeconomic status and maternal factors. Notifications of births for all non-Aboriginal singletons born in 1990-7 in Western Australia subsequently attending government primary schools were linked to the State literacy tests in grade three and with information on socioeconomic status of the school and the residential area. Using multilevel modelling, the associations between birth characteristics (gestational age, intrauterine growth, birth order and Apgar score at 5 minutes) and literacy attainment in grade three were examined in models that included socioeconomic and demographic factors of the child, mother and community. Higher percentages of optimal head circumference and birth length and term birth were positively and independently associated with literacy scores. A higher percentage of optimal birth weight was associated with higher reading scores especially for children born to mothers residing in educationally advantaged areas. First birth was positively associated with reading and writing attainment: this association was stronger for children born to single mothers and additional advantage in writing was also associated with first birth in children living in disadvantaged areas. These findings suggest that having suboptimal growth in utero or an older sibling at birth increases vulnerability to poor literacy attainment especially among children born to single mothers or those in disadvantaged neighbourhoods. These data provide evidence for advocating lifestyles compatible with optimum fetal growth and socioeconomic conditions conducive to healthy lifestyles, particularly during pregnancy.

The Cost-Effectiveness of Birth-Cohort Screening for Hepatitis C Antibody in U.S. Primary Care Settings

PubMed Central

Rein, David B.; Smith, Bryce D.; Wittenborn, John S.; Lesesne, Sarah B.; Wagner, Laura D.; Roblin, Douglas W.; Patel, Nita; Ward, John W.; Weinbaum, Cindy M.

2017-01-01

Background In the United States, hepatitis C virus (HCV) infection is most prevalent among adults born from 1945 through 1965, and approximately 50% to 75% of infected adults are unaware of their infection. Objective To estimate the cost-effectiveness of birth-cohort screening. Design Cost-effectiveness simulation. Data Sources National Health and Nutrition Examination Survey, U.S. Census, Medicare reimbursement schedule, and published sources. Target Population Adults born from 1945 through 1965 with 1 or more visits to a primary care provider annually. Time Horizon Lifetime. Perspective Societal, health care. Intervention One-time antibody test of 1945–1965 birth cohort. Outcome Measures Numbers of cases that were identified and treated and that achieved a sustained viral response; liver disease and death from HCV; medical and productivity costs; quality-adjusted life-years (QALYs); incremental cost-effectiveness ratio (ICER). Results of Base-Case Analysis Compared with the status quo, birth-cohort screening identified 808 580 additional cases of chronic HCV infection at a screening cost of $2874 per case identified. Assuming that birth-cohort screening was followed by pegylated interferon and ribavirin (PEG-IFN + R) for treated patients, screening increased QALYs by 348 800 and costs by $5.5 billion, for an ICER of $15 700 per QALY gained. Assuming that birth-cohort screening was followed by direct-acting antiviral plus PEG-IFN + R treatment for treated patients, screening increased QALYs by 532 200 and costs by $19.0 billion, for an ICER of $35 700 per QALY saved. Results of Sensitivity Analysis The ICER of birth-cohort screening was most sensitive to sustained viral response of antiviral therapy, the cost of therapy, the discount rate, and the QALY losses assigned to disease states. Limitation Empirical data on screening and direct-acting antiviral treatment in real-world clinical settings are scarce. Conclusion Birth-cohort screening for HCV in primary care settings was cost-effective. Primary Funding Source Division of Viral Hepatitis, Centers for Disease Control and Prevention. PMID:22056542

Cost-effectiveness analysis of risk-factor guided and birth-cohort screening for chronic hepatitis C infection in the United States.

PubMed

Liu, Shan; Cipriano, Lauren E; Holodniy, Mark; Goldhaber-Fiebert, Jeremy D

2013-01-01

No consensus exists on screening to detect the estimated 2 million Americans unaware of their chronic hepatitis C infections. Advisory groups differ, recommending birth-cohort screening for baby boomers, screening only high-risk individuals, or no screening. We assessed one-time risk assessment and screening to identify previously undiagnosed 40-74 year-olds given newly available hepatitis C treatments. A Markov model evaluated alternative risk-factor guided and birth-cohort screening and treatment strategies. Risk factors included drug use history, blood transfusion before 1992, and multiple sexual partners. Analyses of the National Health and Nutrition Examination Survey provided sex-, race-, age-, and risk-factor-specific hepatitis C prevalence and mortality rates. Nine strategies combined screening (no screening, risk-factor guided screening, or birth-cohort screening) and treatment (standard therapy-peginterferon alfa and ribavirin, Interleukin-28B-guided (IL28B) triple-therapy-standard therapy plus a protease inhibitor, or universal triple therapy). Response-guided treatment depended on HCV genotype. Outcomes include discounted lifetime costs (2010 dollars) and quality adjusted life-years (QALYs). Compared to no screening, risk-factor guided and birth-cohort screening for 50 year-olds gained 0.7 to 3.5 quality adjusted life-days and cost $168 to $568 per person. Birth-cohort screening provided more benefit per dollar than risk-factor guided screening and cost $65,749 per QALY if followed by universal triple therapy compared to screening followed by IL28B-guided triple therapy. If only 10% of screen-detected, eligible patients initiate treatment at each opportunity, birth-cohort screening with universal triple therapy costs $241,100 per QALY. Assuming treatment with triple therapy, screening all individuals aged 40-64 years costs less than $100,000 per QALY. The cost-effectiveness of one-time birth-cohort hepatitis C screening for 40-64 year olds is comparable to other screening programs, provided that the healthcare system has sufficient capacity to deliver prompt treatment and appropriate follow-on care to many newly screen-detected individuals.

Racial disparities in self-rated health: Trends, explanatory factors, and the changing role of socio-demographics

PubMed Central

Beck, Audrey N.; Finch, Brian K.; Lin, Shih-Fan; Hummer, Robert A.; Masters, Ryan K.

2014-01-01

This paper uses data from the U.S. National Health Interview Surveys (N = 1,513,097) to describe and explain temporal patterns in black-white health disparities with models that simultaneously consider the unique effects of age, period, and cohort. First, we employ cross-classified random effects age–period–cohort (APC) models to document black-white disparities in self-rated health across temporal dimensions. Second, we use decomposition techniques to shed light on the extent to which socio-economic shifts in cohort composition explain the age and period adjusted racial health disparities across successive birth cohorts. Third, we examine the extent to which exogenous conditions at the time of birth help explain the racial disparities across successive cohorts. Results show that black-white disparities are wider among the pre-1935 cohorts for women, falling thereafter; disparities for men exhibit a similar pattern but exhibit narrowing among cohorts born earlier in the century. Differences in socioeconomic composition consistently contribute to racial health disparities across cohorts; notably, marital status differences by race emerge as an increasingly important explanatory factor in more recent cohorts for women whereas employment differences by race emerge as increasingly salient in more recent cohorts for men. Finally, our cohort characteristics models suggest that cohort economic conditions at the time of birth (percent large family, farm or Southern birth) help explain racial disparities in health for both men and women. PMID:24581075

Testicular cancer risk and maternal parity: a population-based cohort study.

PubMed

Westergaard, T; Andersen, P K; Pedersen, J B; Frisch, M; Olsen, J H; Melbye, M

1998-04-01

The aim was to study, in a population-based cohort design, whether first-born sons run a higher risk of testicular cancer than later born sons; to investigate whether this difference in risk was affected by birth cohort, age of the son, maternal age, interval to previous delivery and other reproductive factors; and, finally, to evaluate to what extent changes in women's parity over time might explain the increasing incidence of testicular cancer. By using data from the Civil Registration System, a database was established of all women born in Denmark since 1935 and all their children alive in 1968 or born later. Sons with testicular cancer were identified in the Danish Cancer Registry. Among 1015994 sons followed for 15981 967 person-years, 626 developed testicular cancer (443 non-seminomas, 183 seminomas). Later born sons had a decreased risk of testicular cancer (RR = 0.80, 95% CI = 0.67-0.95) compared with first-born sons. The RR was 0.79 (95% CI = 0.64-0.98) for non-seminomas and 0.81 (95% CI = 0.58-1.13) for seminomas. There was no association between testicular cancer risk and overall parity of the mother, maternal or paternal age at the birth of the son, or maternal age at first birth. The decreased risk of testicular cancer among later born sons was not modified by age, birth cohort, interval to the previous birth, sex of the first-born child, or maternal age at birth of the son or at first birth. The increased proportion of first-borns from birth cohort 1946 to birth cohort 1969 only explained around 3% of an approximated two-fold increase in incidence between the cohorts. Our data document a distinctly higher risk of testicular cancer in first-born compared with later born sons and suggest that the most likely explanation should be sought among exposures in utero. The increase in the proportion of first-borns in the population has only contributed marginally to the increase in testicular cancer incidence.

The Durkheim-Tarde debate and the social study of aboriginal youth suicide.

PubMed

Niezen, Ronald

2015-02-01

A debate that took place in France in the early 20th century still has much to tell us about the interpretation and strategies of intervention of suicide, particularly the "cohort effect" of aboriginal youth suicide. The act of suicide, for Durkheim, was inseparable from the problem of social cohesion, with extremes in solidarity and regulation predictably reflected in high rates of suicide. For Gabriel Tarde, by contrast, suicide was seen as an outcome of changeable ideas found in processes of innovation and imitation among creatively receptive individuals. This latter approach remains overlooked in favor of a growing reliance on conceptions of historical trauma and conditions of social disintegration. Recognizing the idea of suicide itself as a potential locus of solidarity opens up other possibilities for responding to and intervening in suicide crises or "clusters." © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

How are European birth-cohort studies engaging and consulting with young cohort members?

PubMed

Lucas, Patricia J; Allnock, Debra; Jessiman, Tricia

2013-04-11

Birth cohort studies, where parents consent for their child to be enrolled in a longitudinal study prior to or soon after birth, are a powerful study design in epidemiology and developmental research. Participation often continues into adulthood. Where participants are enrolled as infants, provision should be made for consent, consultation and involvement in study design as they age. This study aims to audit and describe the extent and types of consultation and engagement currently used in birth cohorts in Europe. Seventy study groups (representing 84 cohorts) were contacted to ask about their practice in engaging and involving study members. Information was gathered from study websites and publications, 15 cohorts provided additional information via email and 17 cohorts were interviewed over the phone. The cohorts identified confirm the growth of this study design, with more than half beginning since 1990, and 4 since 2011. Most studies maintain a website open to the general public, although many are written for the scientific community only. Five studies have web pages specifically for young cohort members and one study provides a dedicated page for fathers. Cohorts send newsletters, cards, and summaries of findings to participants to stay in touch. Six cohorts use Facebook for this purpose. Five cohorts provide feedback opportunities for participants after completing a round of data collection. We know of just 8 cohorts who have a mechanism for consulting with parents and 3 a mechanism for consulting with young people themselves, although these were 'one off' consultations for some groups. Barriers to further consultation with cohort members were: concerns about impact on quality of research, ethical constraints, resource limitations, lack of importance, and previous adverse experiences. Although the children in some of the cohorts are still young (born in the last 10 years) many are old enough to include some element of consultation. Barriers to greater participation identified here have been overcome in some cohorts and in other fields. Within the scope of their funding and resources, birth cohort studies should consider ways in which they could increase engagement, consultation, and co-production with research participants.

The rise and the recent decline of childhood obesity in Swedish boys: the BEST cohort.

PubMed

Bygdell, M; Ohlsson, C; Célind, J; Saternus, J; Sondén, A; Kindblom, J M

2017-05-01

Childhood obesity increases the risk for adult obesity and diseases. The aim of this study was to investigate secular changes of childhood body mass index (BMI), overweight and obesity in boys born during 1946-2006, using the population-based BMI Epidemiology STudy (BEST) cohort in Gothenburg, Sweden. We collected height and weight from archived school health records for boys born every 5 years 1946-2006 (birth cohort 1946 n=1584, each birth cohort 1951-2006 n=425). Childhood BMI at 8 years of age was obtained for all the participants. Childhood BMI increased 0.18 kg m -2 (95% confidence interval: 0.16-0.20) per decade increase in birth year, during 1946-2006. The increase was significant from birth year 1971, peaked 1991 and was then followed by a stabilization or tendency to a reduction. Next, we aimed to thoroughly explore the trend after birth year 1991 and therefore expanded birth cohorts 1991 (n=1566), 2001 (n=6478) and 2006 (n=6515). Importantly, decreases in mean BMI (P<0.01), prevalences of overweight (P<0.01) and obesity (P<0.05) were observed after birth year 1991. For boys born in Sweden and with parents born in Sweden, a substantial reduction in the prevalences of overweight (-28.6%, P<0.001) and obesity (-44.3%, P<0.001) were observed between birth year 1991 and birth year 2006. This long-term study captures both the rise and the recent decline of childhood obesity. As childhood obesity is strongly associated with subsequent adult obesity, we anticipate a similar reduction in adult obesity during the coming decades in Swedish men.

Eczema in early life: Genetics, the skin barrier, and lessons learned from birth cohort studies

PubMed Central

Biagini Myers, Jocelyn M.; Khurana Hershey, Gurjit K.

2010-01-01

Eczema is a chronic inflammatory disorder of the skin that affects up to 30% of children. It often afflicts infants in the first few months of life and can be the first indicator of the atopic march. Recent results from birth cohort studies have uncovered novel information regarding genetic and environmental factors that promote the development of eczema. Birth cohort studies provide an optimal study design to elucidate these associations and prospectively track longitudinal data including exposure assessment and health outcomes from birth into early life and childhood. This is especially relevant for eczema given the age specific emergence of this disease. In this review, we will provide a general overview of pediatric eczema and discuss the important findings in the literature with respect to genetics and environmental exposures, highlighting those derived from birth cohort studies. Additionally, we will review how these relate to the atopic march, the hygiene hypothesis and the integrity of the skin barrier. PMID:20739029

Hypothesis-Free Search for Connections between Birth Month and Disease Prevalence in Large, Geographically Varied Cohorts

PubMed Central

Borsi, John P.

2016-01-01

We have sought to replicate and extend the Season-wide Association Study (SeaWAS) of Boland, et al.1 in identifying birth month-disease associations from electronic health records (EHRs). We used methodology similar to that implemented by Boland on three geographically distinct cohorts, for a total of 11.8 million individuals derived from multiple data sources. We were able to identify eleven out of sixteen literature-supported birth month associations as compared to seven of sixteen for SeaWAS. Of the nine novel cardiovascular birth month associations discovered by SeaWAS, we were able to replicate four. None of the novel non-cardiovascular associations discovered by SeaWAS emerged as significant relations in our study. We identified thirty birth month disease associations not previously reported; of those, only six associations were validated in more than one cohort. These results suggest that differences in cohort composition and location can cause consequential variation in results of hypothesis-free searches. PMID:28269826

A Chinese Birth Cohort: Theoretical Implications

ERIC Educational Resources Information Center

Friday, Paul C.; Ren, Xin; Weitekamp, Elmar; Kerner, Hans-Jurgen; Taylor, Terrance

2005-01-01

Research on delinquency has shown consistent results across Western industrialized countries. Few studies have been done in non-Western cultures. This study reports on the results of a birth cohort study in China, which was started by Marvin Wolfgang but never completed. The cohort, born in 1973, was traced through official and community files.…

Risk of maternal and neonatal complications in subsequent pregnancy after planned caesarean section in a first birth, compared with emergency caesarean section: a nationwide comparative cohort study.

PubMed

Kok, N; Ruiter, L; Hof, M; Ravelli, A; Mol, B W; Pajkrt, E; Kazemier, B

2014-01-01

To compare the difference in risks of neonatal and maternal complications, including uterine rupture, in a second birth following a planned caesarean section versus emergency caesarean section in the first birth. Prospective cohort study. Population-based cohort in the Netherlands. Linked data set of outcomes for term caesarean section in a first birth followed by a consecutive delivery. We conducted a prospective cohort analysis using data from the Dutch Perinatal Registry. We included primiparous women who gave birth to term singleton infants through planned or emergency caesarean from January 2000 through December 2007, and who had a second singleton delivery during the same period (n = 41,109). Odds ratios and adjusted odds ratios were calculated. Maternal and neonatal complications, specifically uterine rupture, in second births associated with planned and emergency caesareans in the first birth. Women with a history of a planned caesarean section in the first birth (n = 11,445) had a 0.24% risk for uterine rupture, compared with a 0.16% risk for women with a history of emergency caesarean section (n = 29,664; aOR 1.4, 95% CI 0.8-2.4). In multivariate logistic regression, women with planned caesareans in a first birth had a significantly increased risk of stillbirth (aOR 1.5, 95% CI 1.0-2.2) and postpartum haemorrhage (aOR 1.1, 95% CI 1.0-1.2) in second births, compared with women with emergency caesareans in the first birth. We found a moderately increased risk of postpartum haemorrhage and a small to moderately increased risk of uterine rupture and stillbirth as a long-term effect of prior planned caesarean delivery on second births. © 2013 Royal College of Obstetricians and Gynaecologists.

An Evaluation of Voluntary Varicella Vaccination Coverage in Zhejiang Province, East China.

PubMed

Hu, Yu; Chen, Yaping; Zhang, Bing; Li, Qian

2016-06-03

In 2014 a 2-doses varicella vaccine (VarV) schedule was recommended by the Zhejiang Provincial Center for Disease Control and Prevention. We aimed to assess the coverage of the 1st dose of VarV (VarV₁) and the 2nd dose of VarV (VarV₂) among children aged 2-6 years through the Zhejiang Provincial Immunization Information System (ZJIIS) and to explore the determinants associated with the VarV coverage. Children aged 2-6 years (born from 1 January 2009 to 31 December 2013) registered in ZJIIS were enrolled. Anonymized individual records of target children were extracted from the ZJIIS database on 1 January 2016, including their VarV and (measles-containing vaccine) MCV vaccination information. The VarV₁ and VarV₂ coverage rates were evaluated for each birth cohorts. The coverage of VarV also was estimated among strata defined by cities, gender and immigration status. We also evaluated the difference in coverage between VarV and MCV. A total of 3,028,222 children aged 2-6 years were enrolled. The coverage of VarV₁ ranged from 84.8% to 87.9% in the 2009-2013 birth cohorts, while the coverage of VarV₂ increased from 31.8% for the 2009 birth cohort to 48.7% for the 2011 birth cohort. Higher coverage rates for both VarV₁ and VarV₂ were observed among resident children in relevant birth cohorts. The coverage rates of VarV₁ and VarV₂ were lower than those for the 1st and 2nd dose of MCV, which were above 95%. The proportion of children who were vaccinated with VarV₁ at the recommended age increased from 34.6% for the 2009 birth cohort to 75.2% for the 2013 birth cohort, while the proportion of children who were vaccinated with VarV₂ at the recommended age increased from 19.7% for the 2009 birth cohort to 48.7% for the 2011 birth cohort. Our study showed a rapid increasing VarV₂ coverage of children, indicating a growing acceptance of the 2-doses VarV schedule among children's caregivers and physicians after the new recommendation released. We highlighted the necessity for a 2-doses VarV vaccination school-entry requirement to achieve the high coverage of >90% and to eliminate disparities in coverage among sub-populations. We also recommended continuous monitoring of the VarV coverage via ZJIIS over time.

Genetic and environmental influences on adult human height across birth cohorts from 1886 to 1994.

PubMed

Jelenkovic, Aline; Hur, Yoon-Mi; Sund, Reijo; Yokoyama, Yoshie; Siribaddana, Sisira H; Hotopf, Matthew; Sumathipala, Athula; Rijsdijk, Fruhling; Tan, Qihua; Zhang, Dongfeng; Pang, Zengchang; Aaltonen, Sari; Heikkilä, Kauko; Öncel, Sevgi Y; Aliev, Fazil; Rebato, Esther; Tarnoki, Adam D; Tarnoki, David L; Christensen, Kaare; Skytthe, Axel; Kyvik, Kirsten O; Silberg, Judy L; Eaves, Lindon J; Maes, Hermine H; Cutler, Tessa L; Hopper, John L; Ordoñana, Juan R; Sánchez-Romera, Juan F; Colodro-Conde, Lucia; Cozen, Wendy; Hwang, Amie E; Mack, Thomas M; Sung, Joohon; Song, Yun-Mi; Yang, Sarah; Lee, Kayoung; Franz, Carol E; Kremen, William S; Lyons, Michael J; Busjahn, Andreas; Nelson, Tracy L; Whitfield, Keith E; Kandler, Christian; Jang, Kerry L; Gatz, Margaret; Butler, David A; Stazi, Maria A; Fagnani, Corrado; D'Ippolito, Cristina; Duncan, Glen E; Buchwald, Dedra; Derom, Catherine A; Vlietinck, Robert F; Loos, Ruth Jf; Martin, Nicholas G; Medland, Sarah E; Montgomery, Grant W; Jeong, Hoe-Uk; Swan, Gary E; Krasnow, Ruth; Magnusson, Patrik Ke; Pedersen, Nancy L; Dahl-Aslan, Anna K; McAdams, Tom A; Eley, Thalia C; Gregory, Alice M; Tynelius, Per; Baker, Laura A; Tuvblad, Catherine; Bayasgalan, Gombojav; Narandalai, Danshiitsoodol; Lichtenstein, Paul; Spector, Timothy D; Mangino, Massimo; Lachance, Genevieve; Bartels, Meike; van Beijsterveldt, Toos Cem; Willemsen, Gonneke; Burt, S Alexandra; Klump, Kelly L; Harris, Jennifer R; Brandt, Ingunn; Nilsen, Thomas Sevenius; Krueger, Robert F; McGue, Matt; Pahlen, Shandell; Corley, Robin P; Hjelmborg, Jacob V B; Goldberg, Jack H; Iwatani, Yoshinori; Watanabe, Mikio; Honda, Chika; Inui, Fujio; Rasmussen, Finn; Huibregtse, Brooke M; Boomsma, Dorret I; Sørensen, Thorkild I A; Kaprio, Jaakko; Silventoinen, Karri

2016-12-14

Human height variation is determined by genetic and environmental factors, but it remains unclear whether their influences differ across birth-year cohorts. We conducted an individual-based pooled analysis of 40 twin cohorts including 143,390 complete twin pairs born 1886-1994. Although genetic variance showed a generally increasing trend across the birth-year cohorts, heritability estimates (0.69-0.84 in men and 0.53-0.78 in women) did not present any clear pattern of secular changes. Comparing geographic-cultural regions (Europe, North America and Australia, and East Asia), total height variance was greatest in North America and Australia and lowest in East Asia, but no clear pattern in the heritability estimates across the birth-year cohorts emerged. Our findings do not support the hypothesis that heritability of height is lower in populations with low living standards than in affluent populations, nor that heritability of height will increase within a population as living standards improve.

Trend analysis and modelling of gender-specific age, period and birth cohort effects on alcohol abstention and consumption level for drinkers in Great Britain using the General Lifestyle Survey 1984-2009.

PubMed

Meng, Yang; Holmes, John; Hill-McManus, Daniel; Brennan, Alan; Meier, Petra Sylvia

2014-02-01

British alcohol consumption and abstinence rates have increased substantially in the last 3 decades. This study aims to disentangle age, period and birth cohort effects to improve our understanding of these trends and suggest groups for targeted interventions to reduce resultant harms. Age, period, cohort analysis of repeated cross-sectional surveys using separate logistic and negative binomial models for each gender. Great Britain 1984-2009. Annual nationally representative samples of approximately 20 000 adults (16+) within 13 000 households. Age (eight groups: 16-17 to 75+ years), period (six groups: 1980-84 to 2005-09) and birth cohorts (19 groups: 1900-04 to 1990-94). Outcome measures were abstinence and average weekly alcohol consumption. Controls were income, education, ethnicity and country. After accounting for period and cohort trends, 18-24-year-olds have the highest consumption levels (incident rate ratio = 1.18-1.15) and lower abstention rates (odds ratio = 0.67-0.87). Consumption generally decreases and abstention rates increase in later life. Until recently, successive birth cohorts' consumption levels were also increasing. However, for those born post-1985, abstention rates are increasing and male consumption is falling relative to preceding cohorts. In contrast, female drinking behaviours have polarized over the study period, with increasing abstention rates accompanying increases in drinkers' consumption levels. Rising female consumption of alcohol and progression of higher-consuming birth cohorts through the life course are key drivers of increased per capita alcohol consumption in the United Kingdom. Recent declines in alcohol consumption appear to be attributable to reduced consumption and increased abstinence rates among the most recent birth cohorts, especially males, and general increased rates of abstention across the study period. © 2013 Society for the Study of Addiction.

Work-family life courses and BMI trajectories in three British birth cohorts.

PubMed

Lacey, R E; Sacker, A; Bell, S; Kumari, M; Worts, D; McDonough, P; Kuh, D; McMunn, A

2017-02-01

Combining work and family responsibilities has previously been associated with improved health in mid-life, yet little is known about how these associations change over time (both biographical and historical) and whether this extends to body mass index (BMI) trajectories for British men and women. The purpose of this study was to investigate relationships between work-family life courses and BMI trajectories across adulthood (16-42 years) for men and women in three British birth cohorts. Multiply imputed data from three nationally representative British birth cohorts were used-the MRC National Survey of Health and Development (NSHD; 1946 birth cohort, n=3012), the National Child Development Study (NCDS; 1958 birth cohort, n=9614) and the British Cohort Study (BCS; 1970 birth cohort, n=8140). A typology of work-family life course types was developed using multi-channel sequence analysis, linking annual information on work, partnerships and parenthood from 16 to 42 years. Work-family life courses were related to BMI trajectories using multi-level growth models. Analyses adjusted for indicators of prior health, birthweight, child BMI, educational attainment and socioeconomic position across the life course, and were stratified by gender and cohort. Work-family life courses characterised by earlier transitions to parenthood and weaker long-term links to employment were associated with greater increases in BMI across adulthood. Some of these differences, particularly for work-family groups, which are becoming increasingly non-normative, became more pronounced across cohorts (for example, increases in BMI between 16 and 42 years in long-term homemaking women: NSHD: 4.35 kg m -2 , 95% confidence interval (CI): 3.44, 5.26; NCDS: 5.53 kg m - 2 , 95% CI: 5.18, 5.88; BCS: 6.69 kg m - 2 , 95% CI: 6.36, 7.02). Becoming a parent earlier and weaker long-term ties to employment are associated with greater increases in BMI across adulthood in British men and women.

Work-family life courses and BMI trajectories in three British birth cohorts

PubMed Central

Lacey, R E; Sacker, A; Bell, S; Kumari, M; Worts, D; McDonough, P; Kuh, D; McMunn, A

2017-01-01

BACKGROUND/OBJECTIVES: Combining work and family responsibilities has previously been associated with improved health in mid-life, yet little is known about how these associations change over time (both biographical and historical) and whether this extends to body mass index (BMI) trajectories for British men and women. The purpose of this study was to investigate relationships between work-family life courses and BMI trajectories across adulthood (16–42 years) for men and women in three British birth cohorts. SUBJECTS/METHODS: Multiply imputed data from three nationally representative British birth cohorts were used—the MRC National Survey of Health and Development (NSHD; 1946 birth cohort, n=3012), the National Child Development Study (NCDS; 1958 birth cohort, n=9614) and the British Cohort Study (BCS; 1970 birth cohort, n=8140). A typology of work-family life course types was developed using multi-channel sequence analysis, linking annual information on work, partnerships and parenthood from 16 to 42 years. Work-family life courses were related to BMI trajectories using multi-level growth models. Analyses adjusted for indicators of prior health, birthweight, child BMI, educational attainment and socioeconomic position across the life course, and were stratified by gender and cohort. RESULTS: Work-family life courses characterised by earlier transitions to parenthood and weaker long-term links to employment were associated with greater increases in BMI across adulthood. Some of these differences, particularly for work-family groups, which are becoming increasingly non-normative, became more pronounced across cohorts (for example, increases in BMI between 16 and 42 years in long-term homemaking women: NSHD: 4.35 kg m–2, 95% confidence interval (CI): 3.44, 5.26; NCDS: 5.53 kg m–2, 95% CI: 5.18, 5.88; BCS: 6.69 kg m–2, 95% CI: 6.36, 7.02). CONCLUSIONS: Becoming a parent earlier and weaker long-term ties to employment are associated with greater increases in BMI across adulthood in British men and women. PMID:27811951

The role of support person for Ngaanyatjarra women during pregnancy and birth.

PubMed

Simmonds, Donna M; West, Lalla; Porter, Julie; Davies, Melva; Holland, Carol; Preston-Thomas, Annie; O'Rourke, Peter K; Tangey, Annie

2012-06-01

This study took place in a remote community on the Ngaanyatjarra Lands, Western Australia. Ngaanyatjarra women's cultural practices have been subject to erosion during the past 70 years. Women are now expected to birth hundreds of kilometres from home and, due to financial barriers, without family support. Older women lament their lack of input into, and control of, contemporary birthing services. In order to provide culturally appropriate maternity services we asked: What issues would the Ngaanyatjarra women of the community like to see resolved in the area of antenatal and birthing services? Eligible participants were any Ngaanyatjarra women of the study community who had birthed at least once. We utilised a participatory research methodology. 36 women were interviewed. This paper discusses one finding related to support for child-bearing women. The role is important in many ways. Ngaanyatjarra women did not traditionally have their support persons with them during labour and birth, nor do they necessarily expect them to be present in current times. Most women do, however, wish to have a support person with them during antenatal checkups and when they travel to town to await birth. Aboriginal women from remote communities should be able to have a support person with them when they access regional birthing services, but the nature of this role must not be assumed. A culturally appropriate service has input from the community, provides options and respects choices. Copyright © 2011 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Selected birth defects among males following the United States terrorist attacks of 11 September 2001.

PubMed

Singh, Parvati; Yang, Wei; Shaw, Gary M; Catalano, Ralph; Bruckner, Tim A

2017-10-02

The terrorist attacks of 11 September 2001 (hereafter referred to as 9/11) preceded an increase in male fetal deaths and reduced male live births among exposed gestational cohorts across several geographic locations in the United States, including California. We analyze whether the extreme stressor of 9/11 may have selected against frail males in utero by testing if the prevalence of male births with selected defects in California fell among cohorts exposed to the stressor during gestation. We used data from the California Birth Defects Monitoring Program from July 1985 to January 2004 (223 conception cohorts). We included six birth defects that as a group of phenotypes disproportionately affect males. We applied time-series methods and defined as "exposed to 9/11" the cohorts conceived in February, March, April, May, June, July, and August 2001. Three of the seven monthly conception cohorts exposed to 9/11 in utero show lower than expected odds of live born males with the studied defects: February 2001 (odds ratio [OR] = 0.39; 95% confidence interval [CI], 0.21-0.71), May 2001 (OR = 0.36; 95% CI, 0.16-0.81), and August 2001 (OR = 0.51; 95% CI, 0.28-0.93). The population-wide stressor of 9/11 precedes a reduction in the risk of live born males with selected birth defects. Our analysis contributes to the understanding of adaptation to stress among pregnant women exposed to large and unexpected ambient stressors. Results further support the notion that the prevalence of live born defects may reflect temporal variation in cohort selection in utero against frail males. Birth Defects Research 109:1277-1283, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Prevalence of asthma and chronic obstructive pulmonary disease in Aboriginal and non-Aboriginal populations: A systematic review and meta-analysis of epidemiological studies

PubMed Central

Ospina, Maria B; Voaklander, Donald C; Stickland, Michael K; King, Malcolm; Senthilselvan, Ambikaipakan; Rowe, Brian H

2012-01-01

BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) have considerable potential for inequities in diagnosis and treatment, thereby affecting vulnerable groups. OBJECTIVE: To evaluate differences in asthma and COPD prevalence between adult Aboriginal and non-Aboriginal populations. METHODS: MEDLINE, EMBASE, specialized databases and the grey literature up to October 2011 were searched to identify epidemiological studies comparing asthma and COPD prevalence between Aboriginal and non-Aboriginal adult populations. Prevalence ORs (PORs) and 95% CIs were calculated in a random-effects meta-analysis. RESULTS: Of 132 studies, eight contained relevant data. Aboriginal populations included Native Americans, Canadian Aboriginals, Australian Aboriginals and New Zealand Maori. Overall, Aboriginals were more likely to report having asthma than non-Aboriginals (POR 1.41 [95% CI 1.23 to 1.60]), particularly among Canadian Aboriginals (POR 1.80 [95% CI 1.68 to 1.93]), Native Americans (POR 1.41 [95% CI 1.13 to 1.76]) and Maori (POR 1.64 [95% CI 1.40 to 1.91]). Australian Aboriginals were less likely to report asthma (POR 0.49 [95% CI 0.28 to 0.86]). Sex differences in asthma prevalence between Aboriginals and their non-Aboriginal counterparts were not identified. One study compared COPD prevalence between Native and non-Native Americans, with similar rates in both groups (POR 1.08 [95% CI 0.81 to 1.44]). CONCLUSIONS: Differences in asthma prevalence between Aboriginal and non-Aboriginal populations exist in a variety of countries. Studies comparing COPD prevalence between Aboriginal and non-Aboriginal populations are scarce. Further investigation is needed to identify and account for factors associated with respiratory health inequalities among Aboriginal peoples. PMID:23248798

Background, offence characteristics, and criminal outcomes of Aboriginal youth who sexually offend: a closer look at Aboriginal youth intervention needs.

PubMed

Rojas, Erika Y; Gretton, Heather M

2007-09-01

Canada's Aboriginal peoples face a number of social and health issues. Research shows that Aboriginal youths are over-represented in the criminal justice system and youth forensic psychiatric programmes. Within the literature on sex offending youth, there appears to be no published data available to inform clinicians working with adjudicated Aboriginal youth. Therefore, the present study examines the background, offence characteristics, and criminal outcomes of Aboriginal (n = 102) and non-Aboriginal (n = 257) youths who engaged in sexual offending behaviour and were ordered to attend a sexual offender treatment programme in British Columbia between 1985 and 2004. Overall, Aboriginal youths were more likely than non-Aboriginal youths to have background histories of fetal alcohol spectrum disorders (FASD), substance abuse, childhood victimization, academic difficulties, and instability in the living environment. Both Aboriginal and non-Aboriginal youths had a tendency to target children under 12-years-old, females, and non-strangers. Aboriginal youths were more likely than non-Aboriginal youths to use substances at the time of their sexual index offence. Outcome data revealed that Aboriginal youths were more likely than their non-Aboriginal counterparts to recidivate sexually, violently, and non-violently during the 10-year follow-up period. Furthermore, the time between discharge and commission of all types of re-offences was significantly shorter for Aboriginal youths than for non-Aboriginal youths. Implications of these findings are discussed with regards to the needs of Aboriginal youth and intervention.

Decreases in Smoking-Related Cancer Mortality Rates Are Associated with Birth Cohort Effects in Korean Men.

PubMed

Jee, Yon Ho; Shin, Aesun; Lee, Jong-Keun; Oh, Chang-Mo

2016-12-05

Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984-2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): -3.1 (95% CI, -4.6 to -1.6)) and lung cancers decreased from 2002 to 2013 (APC -2.4 (95% CI -2.7 to -2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC -2.5 (95% CI -4.1 to -0.8)) and from 2002 to 2013 (APC -5.2 (95% CI -5.7 to -4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): -3.3 (95% CI -4.7 to -1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates.

Decreases in Smoking-Related Cancer Mortality Rates Are Associated with Birth Cohort Effects in Korean Men

PubMed Central

Jee, Yon Ho; Shin, Aesun; Lee, Jong-Keun; Oh, Chang-Mo

2016-01-01

Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984–2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): −3.1 (95% CI, −4.6 to −1.6)) and lung cancers decreased from 2002 to 2013 (APC −2.4 (95% CI −2.7 to −2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC −2.5 (95% CI −4.1 to −0.8)) and from 2002 to 2013 (APC −5.2 (95% CI −5.7 to −4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): −3.3 (95% CI −4.7 to −1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates. PMID:27929405

Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort.

PubMed

Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta; Langhoff-Roos, Jens; Damm, Peter; Bech, Bodil H; Vaag, Allan A; Zhang, Cuilin

2017-05-01

The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus. Our aim was to identify and validate the gestational diabetes mellitus cases in the cohort. We extracted clinical information from hospital records for 1609 pregnancies included in the Danish National Birth Cohort with a diagnosis of diabetes during or before pregnancy registered in the Danish National Patient Register and/or from a Danish National Birth Cohort interview during pregnancy. We further validated the diagnosis of gestational diabetes mellitus in 2126 randomly selected pregnancies from the entire Danish National Birth Cohort. From the individual hospital records, an expert panel evaluated gestational diabetes mellitus status based on results from oral glucose tolerance tests, fasting blood glucose and Hb1c values, as well as diagnoses made by local obstetricians. The audit categorized 783 pregnancies as gestational diabetes mellitus, corresponding to 0.89% of the 87 792 pregnancies for which a pregnancy interview for self-reported diabetes in pregnancy was available. From the randomly selected group the combined information from register and interviews could correctly identify 96% (95% CI 80-99.9%) of all cases in the entire Danish National Birth Cohort population. Positive predictive value, however, was only 59% (56-61%). The combined use of data from register and interview provided a high sensitivity for gestational diabetes mellitus diagnosis. The low positive predictive value, however, suggests that systematic validation by hospital record review is essential not to underestimate the health consequences of gestational diabetes mellitus in future studies. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Economic model of a birth cohort screening program for hepatitis C virus.

PubMed

McGarry, Lisa J; Pawar, Vivek S; Panchmatia, Hemangi R; Rubin, Jaime L; Davis, Gary L; Younossi, Zobair M; Capretta, James C; O'Grady, Michael J; Weinstein, Milton C

2012-05-01

Recent research has identified high hepatitis C virus (HCV) prevalence among older U.S. residents who contracted HCV decades ago and may no longer be recognized as high risk. We assessed the cost-effectiveness of screening 100% of U.S. residents born 1946-1970 over 5 years (birth-cohort screening), compared with current risk-based screening, by projecting costs and outcomes of screening over the remaining lifetime of this birth cohort. A Markov model of the natural history of HCV was developed using data synthesized from surveillance data, published literature, expert opinion, and other secondary sources. We assumed eligible patients were treated with pegylated interferon plus ribavirin, with genotype 1 patients receiving a direct-acting antiviral in combination. The target population is U.S. residents born 1946-1970 with no previous HCV diagnosis. Among the estimated 102 million (1.6 million chronically HCV infected) eligible for screening, birth-cohort screening leads to 84,000 fewer cases of decompensated cirrhosis, 46,000 fewer cases of hepatocellular carcinoma, 10,000 fewer liver transplants, and 78,000 fewer HCV-related deaths. Birth-cohort screening leads to higher overall costs than risk-based screening ($80.4 billion versus $53.7 billion), but yields lower costs related to advanced liver disease ($31.2 billion versus $39.8 billion); birth-cohort screening produces an incremental cost-effectiveness ratio (ICER) of $37,700 per quality-adjusted life year gained versus risk-based screening. Sensitivity analyses showed that reducing the time horizon during which health and economic consequences are evaluated increases the ICER; similarly, decreasing the treatment rates and efficacy increases the ICER. Model results were relatively insensitive to other inputs. Birth-cohort screening for HCV is likely to provide important health benefits by reducing lifetime cases of advanced liver disease and HCV-related deaths and is cost-effective at conventional willingness-to-pay thresholds. Copyright © 2011 American Association for the Study of Liver Diseases.

Obesity and its association with sociodemographic factors, health behaviours and health status among Aboriginal and non-Aboriginal adults in New South Wales, Australia.

PubMed

Thurber, Katherine Ann; Joshy, Grace; Korda, Rosemary; Eades, Sandra J; Wade, Vicki; Bambrick, Hilary; Liu, Bette; Banks, Emily

2018-06-01

High body mass index (BMI) is the second leading contributor to Australia's burden of disease and is particularly prevalent among Aboriginal peoples. This paper aims to provide insight into factors relating to obesity among Aboriginal adults and Aboriginal-non-Aboriginal differences. Cross-sectional analysis of data from the 45 and Up Study, comparing obesity (BMI ≥30 kg/m 2 ) prevalence and risk factors among 1515 Aboriginal and 213 301 non-Aboriginal adults in New South Wales. Age-sex-adjusted prevalence ratios (PRs) for obesity by sociodemographic factors, health behaviours and health status were estimated (multivariable log-binomial regression) for Aboriginal and non-Aboriginal participants separately. We quantified the extent to which key factors (physical activity, screen time, education, remoteness, area-level disadvantage) accounted for any excess Aboriginal obesity prevalence. Obesity prevalence was 39% among Aboriginal and 22% among non-Aboriginal participants (PR=1.65, 95% CI 1.55 to 1.76). Risk factors for obesity were generally similar for Aboriginal and non-Aboriginal participants and included individual-level and area-level disadvantage, physical inactivity, and poor physical and mental health, with steeper gradients observed among non-Aboriginal participants for some factors (P interaction <0.05). Many risk factors were more common among Aboriginal versus non-Aboriginal participants; key factors accounted for >40% of the excess Aboriginal obesity prevalence. A substantial proportion of the excess obesity prevalence among Aboriginal versus non-Aboriginal participants was explained by physical activity, screen time, education, remoteness and area-level disadvantage. Socioeconomic and health behaviour factors are potential targets for promoting healthy BMI, but these must be considered within the context of upstream social and cultural factors. Adults with health needs and disability require particular attention. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Thyroid cancer incidence in New Jersey: time trend, birth cohort and socioeconomic status analysis (1979-2006).

PubMed

Roche, Lisa M; Niu, Xiaoling; Pawlish, Karen S; Henry, Kevin A

2011-01-01

The study's purpose was to investigate thyroid cancer incidence time trends, birth cohort effects, and association with socioeconomic status (SES) in New Jersey (NJ), a high incidence state, using NJ State Cancer Registry data. Thyroid cancer incidence rates in each sex, nearly all age groups, two major histologies and all stages significantly increased between 1979 and 2006. For each sex, age-specific incidence rates began greatly increasing in the 1924 birth cohort and, generally, the highest thyroid cancer incidence rate for each five-year age group occurred in the latest birth cohort and diagnosis period. Thyroid cancer incidence rates were significantly higher in NJ Census tracts with higher SES and in counties with a higher percentage of insured residents. These results support further investigation into the relationship between rising thyroid cancer incidence and increasing population exposure to medical (including diagnostic) radiation, as well as widespread use of more sensitive diagnostic techniques.

Season and region of birth as risk factors for coeliac disease a key to the aetiology?

PubMed Central

Namatovu, Fredinah; Lindkvist, Marie; Olsson, Cecilia; Ivarsson, Anneli; Sandström, Olof

2016-01-01

Background Coeliac disease (CD) incidence has increased in recent decades, characterised by variations according to sex, age at diagnosis, year of birth, month of birth and region of birth. Genetic susceptibility and exposure to gluten are the necessary factors in CD aetiology, although several environmental factors are considered. Methods A nationwide prospective cohort longitudinal study was conducted consisting of 1 912 204 children aged 0–14.9 years born in Sweden from 1991 to 2009. A total of 6569 children were diagnosed with biopsy-verified CD from 47 paediatric departments. Using Cox regression, we examined the association between CD diagnosis and season of birth, region of birth and year of birth. Results Overall, CD risk was higher for children born during spring, summer and autumn as compared with children born during winter: adjusted HR for spring 1.08 (95% CI 1.01 to 1.16), summer 1.10 (95% CI 1.03 to 1.18) and autumn 1.10 (95% CI 1.02 to 1.18). Increased CD risk was highest if born in the south, followed by central Sweden when compared with children born in northern Sweden. Children diagnosed at <2 years had an increased CD risk if born in spring while those diagnosed at 2–14.9 years the risk was increased for summer and autumn births. The birth cohort of 1991–1996 had increased CD risk if born during spring, for the 1997–2002 birth cohort the risk increased for summer and autumn births, while for the birth cohort of 2003–2009 the risk was increased if born during autumn. Conclusions Season of birth and region of birth are independently and jointly associated with increased risk of developing CD during the first 15 years of life. Seasonal variation in infectious load is the likely explanation. PMID:27528621

Relative prevalence of Aboriginal patients in a Canadian uveitic population.

PubMed

Roy, Mili

2012-04-01

To determine whether the prevalence of Aboriginal patients in a consecutive series of patients with uveitis differs significantly from the prevalence of Aboriginal persons in the general population. Retrospective chart review. 133 consecutive patients with uveitis. The proportion of Aboriginal patients in a series of 133 consecutive patients with uveitis was compared to the proportion of Aboriginal persons within the general population to determine whether Aboriginal patients were under- or overrepresented in the population with uveitis, relative to their numbers in the population in general. The main outcome measure was the self-reported race of patients. The mean age, sex, and prior disease duration were also compared between Aboriginal and non-Aboriginal patients in the consecutive series. There was no significant difference (p = 0.84) between the proportion of Aboriginal persons in the uveitis population studied (22 of 133; 16.5%) compared to general population census data (15.5% Aboriginal). Mean age at presentation was 36.8 years in the Aboriginal population versus 47.3 years in the control non-Aboriginal group (p = 0.01). Mean prior disease duration was 20.3 months in the Aboriginal population versus 21.1 months in the control group (p = 0.79). The gender proportion was 68.2% female in the Aboriginal group versus 53.2% female in the non-Aboriginal group (p = 0.02). This study finds no statistically significant difference between the prevalence of Aboriginal versus non-Aboriginal persons occurring within a consecutive series of uveitis patients as compared to the general population. Mean age at presentation was significantly younger, and female preponderance was significantly greater in the Aboriginal than in the non-Aboriginal group. Prior disease duration was comparable in the 2 groups. Copyright © 2012 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Birth order and risk of childhood cancer in the Danish birth cohort of 1973-2010.

PubMed

Schüz, Joachim; Luta, George; Erdmann, Friederike; Ferro, Gilles; Bautz, Andrea; Simony, Sofie Bay; Dalton, Susanne Oksbjerg; Lightfoot, Tracy; Winther, Jeanette Falck

2015-11-01

Many studies have investigated the possible association between birth order and risk of childhood cancer, although the evidence to date has been inconsistent. Birth order has been used as a marker for various in utero or childhood exposures and is relatively straightforward to assess. Data were obtained on all children born in Denmark between 1973 and 2010, involving almost 2.5 million births and about 5,700 newly diagnosed childhood cancers before the age of 20 years. Data were analyzed using Poisson regression models. We failed to observe associations between birth order and risk of any childhood cancer subtype, including acute lymphoblastic leukemia; all rate ratios were close to one. Further analyses stratified by birth cohort (those born between 1973 and 1990, and those born between 1991 and 2010) also failed to show any associations. Considering stillbirths and/or controlling for birth weight and parental age in the analyses had no effect on the results. Analyses by years of birth (those born between 1973 and 1990, and those born between 1991 and 2010) did not show any changes in the overall pattern of no association. In this large cohort of all children born in Denmark over an almost 40-year period, we did not observe an association between birth order and the risk of childhood cancer.

Cesarean section and risk of obesity in childhood, adolescence, and early adulthood: evidence from 3 Brazilian birth cohorts123

PubMed Central

Matijasevich, Alicia; Hallal, Pedro C; Horta, Bernardo L; Barros, Aluísio J; Menezes, Ana B; Santos, Iná S; Gigante, Denise P; Victora, Cesar G

2012-01-01

Background: The number of cesarean sections (CSs) is increasing in many countries, and there are concerns about their short- and long-term effects. A recent Brazilian study showed a 58% higher prevalence of obesity in young adults born by CS than in young adults born vaginally. Because CS-born individuals do not make contact at birth with maternal vaginal and intestinal bacteria, the authors proposed that this could lead to long-term changes in the gut microbiota that could contribute to obesity. Objective: We assessed whether CS births lead to increased obesity during childhood, adolescence, and early adulthood in 3 birth cohorts. Design: We analyzed data from 3 birth-cohort studies started in 1982, 1993, and 2004 in Southern Brazil. Subjects were assessed at different ages until 23 y of age. Poisson regression was used to estimate prevalence ratios with adjustment for ≤15 socioeconomic, demographic, maternal, anthropometric, and behavioral covariates. Results: In the crude analyses, subjects born by CS had ∼50% higher prevalence of obesity at 4, 11, and 15 y of age but not at 23 y of age. After adjustment for covariates, prevalence ratios were markedly reduced and no longer significant for men or women. The only exception was an association for 4-y-old boys in the 1993 cohort, which was not observed in the other 2 cohorts or for girls. Conclusion: In these 3 birth cohorts, CSs do not seem to lead to an important increased risk of obesity during childhood, adolescence, or early adulthood. PMID:22237058

Mother's education and the risk of preterm and small for gestational age birth: a DRIVERS meta-analysis of 12 European cohorts.

PubMed

Ruiz, Milagros; Goldblatt, Peter; Morrison, Joana; Kukla, Lubomír; Švancara, Jan; Riitta-Järvelin, Marjo; Taanila, Anja; Saurel-Cubizolles, Marie-Josèphe; Lioret, Sandrine; Bakoula, Chryssa; Veltsista, Alexandra; Porta, Daniela; Forastiere, Francesco; van Eijsden, Manon; Vrijkotte, Tanja G M; Eggesbø, Merete; White, Richard A; Barros, Henrique; Correia, Sofia; Vrijheid, Martine; Torrent, Maties; Rebagliato, Marisa; Larrañaga, Isabel; Ludvigsson, Johnny; Olsen Faresjö, Åshild; Hryhorczuk, Daniel; Antipkin, Youriy; Marmot, Michael; Pikhart, Hynek

2015-09-01

A healthy start to life is a major priority in efforts to reduce health inequalities across Europe, with important implications for the health of future generations. There is limited combined evidence on inequalities in health among newborns across a range of European countries. Prospective cohort data of 75 296 newborns from 12 European countries were used. Maternal education, preterm and small for gestational age births were determined at baseline along with covariate data. Regression models were estimated within each cohort and meta-analyses were conducted to compare and measure heterogeneity between cohorts. Mother's education was linked to an appreciable risk of preterm and small for gestational age (SGA) births across 12 European countries. The excess risk of preterm births associated with low maternal education was 1.48 (1.29 to 1.69) and 1.84 (0.99 to 2.69) in relative and absolute terms (Relative/Slope Index of Inequality, RII/SII) for all cohorts combined. Similar effects were found for SGA births, but absolute inequalities were greater, with an SII score of 3.64 (1.74 to 5.54). Inequalities at birth were strong in the Netherlands, the UK, Sweden and Spain and marginal in other countries studied. This study highlights the value of comparative cohort analysis to better understand the relationship between maternal education and markers of fetal growth in different settings across Europe. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Secular trends in the prevalence of dementia and depression in Swedish septuagenarians 1976-2006.

PubMed

Wiberg, P; Waern, M; Billstedt, E; Ostling, S; Skoog, I

2013-12-01

It is not clear whether the prevalence of dementia and depression among the elderly has changed during the past 30 years. Population-based samples from Gothenburg, Sweden were examined with identical psychiatric and neuropsychiatric examinations at age 70 years in 1976-1977 (n = 404, response rate 78.8%) and 2000-2001 (n = 579, response rate 66.4%), and at age 75 in 1976-1977 (n = 303, response rate 78%) and 2005-2006 (n = 753, response rate 63.4%). Depression was diagnosed according to DSM-IV and dementia according to Kay's criteria. General linear models (GLMs) were used to test for differences between groups. Dementia was related to age but not to birth cohort or sex. Major depression was related to sex (higher in women) but not to birth cohort or age. Minor depression was related to birth cohort, sex (higher in women), age (higher at age 75) and the interaction effect of birth cohort × age; that is, the prevalence of minor depression increased with age in the 2000s but not in the 1970s. Thus, the prevalence of minor depression was higher in 2005-2006 than in 1976-1977 among 75-year-olds for both men (12.4% v. 3.7%) and women (19.1% v. 5.6%) whereas there were no birth cohort differences at age 70. Secular changes were observed only for minor depression, which is considered to be related more to psychosocial factors than major depression. The high prevalence of minor depression in later-born birth cohorts emphasizes the importance of detecting minor depression in the elderly.

Estimates of cancer incidence, mortality and survival in aboriginal people from NSW, Australia

PubMed Central

2012-01-01

Background Aboriginal status has been unreliably and incompletely recorded in health and vital registration data collections for the most populous areas of Australia, including NSW where 29% of Australian Aboriginal people reside. This paper reports an assessment of Aboriginal status recording in NSW cancer registrations and estimates incidence, mortality and survival from cancer in NSW Aboriginal people using multiple imputation of missing Aboriginal status in NSW Central Cancer Registry (CCR) records. Methods Logistic regression modelling and multiple imputation were used to assign Aboriginal status to those records of cancer diagnosed from 1999 to 2008 with missing Aboriginality (affecting 12-18% of NSW cancers registered in this period). Estimates of incidence, mortality and survival from cancer in NSW Aboriginal people were compared with the NSW total population, as standardised incidence and mortality ratios, and with the non-Aboriginal population. Results Following imputation, 146 (12.2%) extra cancers in Aboriginal males and 140 (12.5%) in Aboriginal females were found for 1999-2007. Mean annual cancer incidence in NSW Aboriginal people was estimated to be 660 per 100,000 and 462 per 100,000, 9% and 6% higher than all NSW males and females respectively. Mean annual cancer mortality in NSW Aboriginal people was estimated to be 373 per 100,000 in males and 240 per 100,000 in females, 68% and 73% higher than for all NSW males and females respectively. Despite similar incidence of localised cancer, mortality from localised cancer in Aboriginal people is significantly higher than in non-Aboriginal people, as is mortality from cancers with regional, distant and unknown degree of spread at diagnosis. Cancer survival in Aboriginal people is significantly lower: 51% of males and 43% of females had died of the cancer by 5 years following diagnosis, compared to 36% and 33% of non-Aboriginal males and females respectively. Conclusion The present study is the first to produce valid and reliable estimates of cancer incidence, survival and mortality in Australian Aboriginal people from NSW. Despite somewhat higher cancer incidence in Aboriginal than in non-Aboriginal people, substantially higher mortality and lower survival in Aboriginal people is only partly explained by more advanced cancer at diagnosis. PMID:22559220

Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers

PubMed Central

2013-01-01

Background Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians’ perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers’ (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs’ views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). Methods A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006 - September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. Results CSPs’ lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients’ limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient–provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people’s distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs, cancer education for Aboriginal stakeholders, continuity of care, avoiding use of medical jargon, accommodating patients’ psychosocial and logistical needs, and in-service coordination. Conclusion Individual CSPs identified challenges in cross-cultural communication and their willingness to accommodate culture-specific needs within the wider health care system including better communication with Aboriginal patients. However, participants’ comments indicated a lack of concerted effort at the system level to address Aboriginal disadvantage in cancer outcomes. PMID:24188503

Improving immunisation timeliness in Aboriginal children through personalised calendars

PubMed Central

2013-01-01

Background Delayed immunisation and vaccine preventable communicable disease remains a significant health issue in Aboriginal children. Strategies to increase immunisation coverage and timeliness can be resource intensive. In a low cost initiative at the Aboriginal Medical Service Western Sydney (AMSWS) in 2008–2009, a trial of personalised calendars to prompt timely childhood immunisation was undertaken. Methods Calendars were generated during attendances for early childhood immunisations. They were designed for display in the home and included the due date of the next immunisation, a photo of the child and Aboriginal artwork. In a retrospective cohort design, Australian Childhood Immunisation Register data from AMSWS and non-AMSWS providers were used to determine the delay in immunisation and percentage of immunisations on time in those who received a calendar compared to those who did not. Interviews were undertaken with carers and staff. Results Data on 2142 immunisation doses given to 505 children were analysed, utilising pre-intervention (2005–2007) and intervention (2008–2009) periods and a 2 year post-intervention observation period. 113 calendars were distributed (30% of eligible immunisation attendances). Improvements in timeliness were seen at each schedule point for those children who received a calendar. The average delay in those who received a calendar at their previous visit was 0.6 months (95% CI -0.8 to 2.6) after the due date, compared to 3.3 months (95% CI −0.6 to 7.5) in those who did not. 80% of doses were on time in the group who received a calendar at the preceding immunisation, 66% were on time for those who received a calendar at an earlier point and 57% of doses were on time for those who did not receive a calendar (P<0.0001, Cochran-Armitage trend test). Interview data further supported the value and effectiveness of the calendars as both a prompt to timely immunisations and a community health education project without undue resource implications. Conclusions Personalised calendars can increase the timeliness of immunisations in Aboriginal children. This simple, low cost tool appears practicable and effective in an Aboriginal community setting in improving early childhood vaccination timeliness and has high potential for local adaptation to suit the needs of diverse communities. PMID:23786829

Have children adapted to their mothers working, or was adaptation unnecessary? Cohort effects and the relationship between maternal employment and child well-being.

PubMed

Wills, Jeremiah B; Brauer, Jonathan R

2012-03-01

Drawing on previous theoretical and empirical work, we posit that maternal employment influences on child well-being vary across birth cohorts. We investigate this possibility by analyzing longitudinal data from a sample of children and their mothers drawn from the National Longitudinal Survey of Youth. We introduce a series of age, cohort, and maternal employment interaction terms into multilevel models predicting child well-being to assess whether any potential short-term or long-term effects of early and current maternal employment vary across birth cohorts. Results indicate that maternal employment largely is inconsequential to child well-being regardless of birth cohort, with a few exceptions. For instance, children born in earlier cohorts may have experienced long-term positive effects of having an employed mother; however, as maternal employment became more commonplace in recent cohorts, these beneficial effects appear to have disappeared. We discuss theoretical and methodological implications of these findings. Copyright © 2011 Elsevier Inc. All rights reserved.

A cohort study of the association between secondary sex ratio and parental exposure to polybrominated biphenyl (PBB) and polychlorinated biphenyl (PCB).

PubMed

Terrell, Metrecia L; Berzen, Alissa K; Small, Chanley M; Cameron, Lorraine L; Wirth, Julie J; Marcus, Michele

2009-08-15

Polybrominated biphenyl (PBB), a brominated flame retardant, was accidently mixed into animal feed in Michigan (1973-1974) resulting in human exposure through consumption of contaminated meat, milk and eggs. Beginning in 1976 individuals who consumed contaminated products were enrolled in the Michigan Long-Term PBB Study. This cohort presents a unique opportunity to study the association between parental exposures to PBB and offspring sex ratio. We identified offspring of female PBB cohort participants (born 1975-1988) and obtained electronic birth records for those born in the state of Michigan. We linked this information to parental serum PBB and PCB concentrations collected at enrollment into the cohort. We modeled the odds of a male birth with generalized estimating equations accounting for the non-independence of siblings born to the same parents. We explored potential confounders: parental age and education at offspring's birth, parental body mass index at cohort enrollment, birth order, gestational age and year of offspring's birth. The overall proportion of male offspring among 865 live births to cohort mothers was 0.542. This was higher than the national male proportion of 0.514 (binomial test: p = 0.10). When both parents were in the cohort (n = 300), we found increased odds of a male birth with combined parents' enrollment PBB exposure > or = the median concentrations (3 microg/L for mothers; 6 microg/L for fathers) compared to combined parents' PBB exposure < the median concentrations (AOR = 1.43, 95% CI: 0.89-2.29), although this did not reach statistical significance. In addition, there was a suggestion of increased odds of a male birth for combined parents' enrollment PCB exposure > or = the median concentrations (6 microg/L for mothers; 8 microg/L for fathers) compared to combined parents' enrollment PCB exposure < the median concentrations (AOR = 1.53, 95% CI: 0.93-2.52). This study adds to the body of literature on secondary sex ratio and exposure to environmental contaminants. In this population, combined parental exposure to PBBs or PCBs increased the odds of a male birth. Further research is needed to corroborate these findings and shed light on the biological mechanisms by which these types of chemicals may influence the secondary sex ratio.

Pregnancy outcomes among female hairdressers who participated in the Danish National Birth Cohort.

PubMed

Zhu, Jin Liang; Vestergaard, Mogens; Hjollund, Niels Henrik; Olsen, Jørn

2006-02-01

The Danish National Birth Cohort (DNBC) was used to examine pregnancy outcomes among female hairdressers and neurodevelopment in their offspring. A population-based cohort study was conducted of 550 hairdressers and 3216 shop assistants (reference group) by using data from the Danish National Birth Cohort between 1997 and 2003. Information on job characteristics was reported by the women in the first interview (around 17 weeks of gestation). Pregnancy outcomes were obtained by linkage to the national registers. Developmental milestones were reported by the mother at the fourth interview, when the child was approximately 19 months old. Cox regression was applied to analyze fetal loss and congenital malformation. Logistic regression was used to analyze other pregnancy outcomes and developmental milestones. We found no significant differences in fetal loss, multiple births, gender ratio, preterm birth, small-for-gestational age, congenital malformations, or achievement of developmental milestones among the children of hairdressers and shop assistants. The results do not indicate that children of hairdressers in Denmark currently have a high risk of fetal impairment or delayed psychomotor development.

Systematic review of birth cohort studies in Africa

PubMed Central

Campbell, Alasdair; Rudan, Igor

2011-01-01

Aim In sub-Saharan Africa, unacceptably high rates of mortality amongst women and children continue to persist. The emergence of research employing new genomic technologies is advancing knowledge on cause of disease. This review aims to identify birth cohort studies conducted in sub-Saharan Africa and to consider their suitability as a platform to support genetic epidemiological studies. Methods A systematic literature review was conducted to identify birth cohort studies in sub-Saharan Africa across the following databases: MEDLINE, EMBASE, AFRO and OpenSIGLE. A total of 8110 papers were retrieved. Application of inclusion/exclusion criteria retained only 189 papers, of which 71 met minimum quality criteria and were retained for full text analysis. Results The search revealed 28 birth cohorts: 14 of which collected biological data, 10 collected blood samples and only one study collected DNA for storage. These studies face many methodological challenges: notably, high rates of attrition and lack of funding for several rounds of study follow up. Population-based ‘biobanks’ have emerged as a major approach to harness genomic technologies in health research and yet the sub-Saharan African region still awaits large scale birth cohort biobanks collecting DNA and associated health and lifestyle data. Conclusion Investment in this field, together with related endeavours to foster and develop research capacity for these studies, may lead to an improved understanding of the determinants of intrauterine growth and development, birth outcomes such as prematurity and low birth weight, the links between maternal and infant health, survival of infectious diseases in the first years of life, and response to vaccines and antibiotic treatment. PMID:23198102

Birth order and mortality: a population-based cohort study.

PubMed

Barclay, Kieron; Kolk, Martin

2015-04-01

This study uses Swedish population register data to investigate the relationship between birth order and mortality at ages 30 to 69 for Swedish cohorts born between 1938 and 1960, using a within-family comparison. The main analyses are conducted with discrete-time survival analysis using a within-family comparison, and the estimates are adjusted for age, mother's age at the time of birth, and cohort. Focusing on sibships ranging in size from two to six, we find that mortality risk in adulthood increases with later birth order. The results show that the relative effect of birth order is greater among women than among men. This pattern is consistent for all the major causes of death but is particularly pronounced for mortality attributable to cancers of the respiratory system and to external causes. Further analyses in which we adjust for adult socioeconomic status and adult educational attainment suggest that social pathways only mediate the relationship between birth order and mortality risk in adulthood to a limited degree.

Gestational age and newborn size according to parental social mobility: an intergenerational cohort study.

PubMed

Gigante, Denise P; Horta, Bernardo L; Matijasevich, Alicia; Mola, Christian Loret de; Barros, Aluisio J D; Santos, Ina S; Barros, Fernando C; Victora, Cesar G

2015-10-01

We examined the associations between socioeconomic trajectories from birth to adulthood and gestational age and birth size in the next generation, using linked data from two population-based birth cohorts carried out in a Brazilian city. By comparing socioeconomic trajectories of mothers and fathers, we attempted to identify-specific effects of maternal and paternal socioeconomic trajectory on offspring birth weight, birth length, head circumference and gestational age at birth. 2 population-based birth cohort studies were carried out in 1982 and 2004 in Pelotas (Brazil); 156 mothers and 110 fathers from the earlier cohort had children in 2004. Gestational age and birth length, weight and head circumference were measured. Analyses were carried out separately for mothers and fathers. Mediation analyses assessed the role of birth weight and adult body mass index (BMI). Among mothers, but not for fathers, childhood poverty was strongly associated with smaller size in the next generation (about 400 g in weight and 1.5 cm in height) and shorter gestations (about 2 weeks). Adult poverty did not play a role. For mothers, the associations with gestational age, birth length and weight-but not with head circumference-persisted after adjusting for maternal birth weight and for the height and weight of the grandmother. Maternal birth weight did not mediate the observed associations, but high maternal BMI in adulthood was partly responsible for the association with gestational age. Strong effects of early poverty on gestational age and birth size in the next generation were observed among mothers, but not among fathers. These findings suggest a specific maternal effect of socioeconomic trajectory, and in particular of early poverty on offspring size and duration of pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Immunisation timeliness in a cohort of urban Aboriginal and Torres Strait Islander children.

PubMed

Lovie-Toon, Yolanda G; Hall, Kerry K; Chang, Anne B; Anderson, Jennie; O'Grady, Kerry-Ann F

2016-11-14

To evaluate immunisation coverage, timeliness and predictors of delayed receipt in urban Australian Indigenous children during the first 18 months of life. Cross-sectional retrospective analysis of data collected from 140 Australian Indigenous children aged < 5 years at the time of enrolment in a prospective cohort study on respiratory illness between 14 February 2013 and 28 January 2015. Children were recruited through an urban community primary health care centre in the Northern suburbs of Brisbane, Queensland. The proportion of children with completed immunisation schedules was 50 of 105 (47.6%) at 7 months, 30 of 85 (35.3%) at 13 months and 12 of 65 (18.5%) at 19 months. Timely receipt of diphtheria-tetanus-pertussis decreased from 78.4% at 2 months of age to 63.7 and 59.3% at 4 and 6 months respectively. Amongst the 105 parents/guardians with children ≥7 months at enrolment, 71 (67.6%) incorrectly reported their child's immunisation status. Delayed vaccine receipt was significantly associated (p ≤0.05) with having multiple children in the household, mother's unemployment and premature birth. Coverage and timeliness among this population is suboptimal and decreases as children age. Parent/guardian reporting of vaccination status was unreliable. Children of unemployed mothers and those with multiple siblings should be targeted to improve community immunisation timeliness due to a greater risk of vaccination delay. High quality trials, conducted in several settings to account for the diversity of Australian Indigenous communities are urgently needed to identify culturally appropriate, effective and sustainable strategies to improve immunisation targets in children.

Vaginal birth after caesarean section: a cohort study investigating factors associated with its uptake and success.

PubMed

Knight, H E; Gurol-Urganci, I; van der Meulen, J H; Mahmood, T A; Richmond, D H; Dougall, A; Cromwell, D A

2014-01-01

To investigate the demographic and obstetric factors associated with the uptake and success rate of vaginal birth after caesarean section (VBAC). Cohort study using data from Hospital Episode Statistics. English National Health Service. Women whose first birth resulted in a live singleton delivery by caesarean section between 1 April 2004 and 31 March 2011, and who had a second birth before 31 March 2012. Logistic regression to estimate adjusted odds ratios (OR). Attempted and successful VBAC. Among the 143,970 women in the cohort, 75,086 (52.2%) attempted a VBAC for their second birth. Younger women, those of non-white ethnicity and those living in a more deprived area had higher rates of attempted VBAC. Overall, 47,602 women (63.4%) who attempted a VBAC had a successful vaginal birth. Younger women and women of white ethnicity had higher success rates. Black women had a particularly low success rate (OR, 0.54; 95% confidence interval [CI], 0.50-0.57). Women who had an emergency caesarean section in their first birth also had a lower VBAC success rate, particularly those with a history of failed induction of labour (OR, 0.59; 95% CI, 0.53-0.67). In this national cohort, just over one-half of women with a primary caesarean section who were eligible for a trial of labour attempted a VBAC for their second birth. Of these, almost two-thirds successfully achieved a vaginal delivery. © 2013 Royal College of Obstetricians and Gynaecologists.

Birth-cohort patterns in Crohn's disease and ulcerative colitis.

PubMed

Sonnenberg, Amnon

2014-01-01

To test the long-term time trends of mortality from inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), for the presence of birth-cohort phenomena. We analyzed mortality data from the national statistical offices of Canada, England and Wales, Italy, the Netherlands, Switzerland, and the USA for the past 60-80 years. Age-specific rates of death were plotted against the period of death, as period-age contours, and against the period of birth, as cohort-age contours. In all six countries alike, the general time trends of IBD have been shaped by an underlying birth-cohort pattern. This pattern was also observed in the data of CD and UC analyzed separately. UC mortality increased in all generations born during the 19th century. It peaked among generations born shortly before the turn of the century and then decreased in all subsequent generations born throughout the 20th century. Compared with UC, the birth-cohort pattern of CD was delayed by 30-50 years. In addition to one risk factor responsible for the general occurrence of IBD and possibly UC alone, there exists at least one additional risk factor responsible for CD. Exposure to both separate risk factors must occur during early life.

Genetic and environmental influences on adult human height across birth cohorts from 1886 to 1994

PubMed Central

Jelenkovic, Aline; Hur, Yoon-Mi; Sund, Reijo; Yokoyama, Yoshie; Siribaddana, Sisira H; Hotopf, Matthew; Sumathipala, Athula; Rijsdijk, Fruhling; Tan, Qihua; Zhang, Dongfeng; Pang, Zengchang; Aaltonen, Sari; Heikkilä, Kauko; Öncel, Sevgi Y; Aliev, Fazil; Rebato, Esther; Tarnoki, Adam D; Tarnoki, David L; Christensen, Kaare; Skytthe, Axel; Kyvik, Kirsten O; Silberg, Judy L; Eaves, Lindon J; Maes, Hermine H; Cutler, Tessa L; Hopper, John L; Ordoñana, Juan R; Sánchez-Romera, Juan F; Colodro-Conde, Lucia; Cozen, Wendy; Hwang, Amie E; Mack, Thomas M; Sung, Joohon; Song, Yun-Mi; Yang, Sarah; Lee, Kayoung; Franz, Carol E; Kremen, William S; Lyons, Michael J; Busjahn, Andreas; Nelson, Tracy L; Whitfield, Keith E; Kandler, Christian; Jang, Kerry L; Gatz, Margaret; Butler, David A; Stazi, Maria A; Fagnani, Corrado; D'Ippolito, Cristina; Duncan, Glen E; Buchwald, Dedra; Derom, Catherine A; Vlietinck, Robert F; Loos, Ruth JF; Martin, Nicholas G; Medland, Sarah E; Montgomery, Grant W; Jeong, Hoe-Uk; Swan, Gary E; Krasnow, Ruth; Magnusson, Patrik KE; Pedersen, Nancy L; Dahl-Aslan, Anna K; McAdams, Tom A; Eley, Thalia C; Gregory, Alice M; Tynelius, Per; Baker, Laura A; Tuvblad, Catherine; Bayasgalan, Gombojav; Narandalai, Danshiitsoodol; Lichtenstein, Paul; Spector, Timothy D; Mangino, Massimo; Lachance, Genevieve; Bartels, Meike; van Beijsterveldt, Toos CEM; Willemsen, Gonneke; Burt, S Alexandra; Klump, Kelly L; Harris, Jennifer R; Brandt, Ingunn; Nilsen, Thomas Sevenius; Krueger, Robert F; McGue, Matt; Pahlen, Shandell; Corley, Robin P; Hjelmborg, Jacob v B; Goldberg, Jack H; Iwatani, Yoshinori; Watanabe, Mikio; Honda, Chika; Inui, Fujio; Rasmussen, Finn; Huibregtse, Brooke M; Boomsma, Dorret I; Sørensen, Thorkild I A; Kaprio, Jaakko; Silventoinen, Karri

2016-01-01

Human height variation is determined by genetic and environmental factors, but it remains unclear whether their influences differ across birth-year cohorts. We conducted an individual-based pooled analysis of 40 twin cohorts including 143,390 complete twin pairs born 1886–1994. Although genetic variance showed a generally increasing trend across the birth-year cohorts, heritability estimates (0.69-0.84 in men and 0.53-0.78 in women) did not present any clear pattern of secular changes. Comparing geographic-cultural regions (Europe, North America and Australia, and East Asia), total height variance was greatest in North America and Australia and lowest in East Asia, but no clear pattern in the heritability estimates across the birth-year cohorts emerged. Our findings do not support the hypothesis that heritability of height is lower in populations with low living standards than in affluent populations, nor that heritability of height will increase within a population as living standards improve. DOI: http://dx.doi.org/10.7554/eLife.20320.001 PMID:27964777

Gender-specific selection in utero among contemporary human birth cohorts.

PubMed

Catalano, Ralph; Ahern, Jennifer; Bruckner, Tim; Anderson, Elizabeth; Saxton, Katherine

2009-05-01

Much literature argues that natural selection has conserved mechanisms by which stressed females cull frail males in utero. This argument implies that males from low sex ratio birth cohorts should, on average, live longer than those from high sex ratio cohorts. Research reports such associations but these tests use completed lifespan as the outcome and, therefore, must end with cohorts born in 1913 because too many males survive from more contemporary cohorts to determine average lifespan. The empirical literature does not, therefore, address whether selection affects male mortality in contemporary cohorts. We apply time-series methods to monthly cohorts born in California between 1989 and 2003 to measure the association between the ratio of male to female live births and infant mortality, controlling for all forms of autocorrelation that induce spurious correlations. Consistent with theories of selection in utero, we find a positive correlation between cohort sex ratio and male infant mortality. The results suggest that natural selection conserved the stress mechanism in females to end the gestation of relatively less fit males and that this mechanism manifests itself in contemporary human societies.

Years of life lost to incarceration: inequities between Aboriginal and non-Aboriginal Canadians.

PubMed

Owusu-Bempah, Akwasi; Kanters, Steve; Druyts, Eric; Toor, Kabirraaj; Muldoon, Katherine A; Farquhar, John W; Mills, Edward J

2014-06-11

Aboriginal representation in Canadian correctional institutions has increased rapidly over the past decade. We calculated "years of life lost to incarceration" for Aboriginal and non-Aboriginal Canadians. Incarceration data from provincial databases were used conjointly with demographic data to estimate rates of incarceration and years of life lost to provincial incarceration in (BC) and federal incarceration, by Aboriginal status. We used the Sullivan method to estimate the years of life lost to incarceration. Aboriginal males can expect to spend approximately 3.6 months in federal prison and within BC spend an average of 3.2 months in custody in the provincial penal system. Aboriginal Canadians on average spend more time in custody than their non-Aboriginal counterparts. The ratio of the Aboriginal incarceration rate to the non-Aboriginal incarceration rate ranged from a low of 4.28 in Newfoundland and Labrador to a high of 25.93 in Saskatchewan. Rates of incarceration at the provincial level were highest among Aboriginals in Manitoba with an estimated rate of 1377.6 individuals in prison per 100,000 population (95% confidence interval [CI]: 1311.8-1443.4). The results indicate substantial differences in life years lost to incarceration for Aboriginal versus non-Aboriginal Canadians. In light of on-going prison expansion in Canada, future research and policy attention should be paid to the public health consequences of incarceration, particularly among Aboriginal Canadians.

Time Trends in Murray's Psychogenic Needs over Three Decades in Swedish 75-Year-Olds.

PubMed

Billstedt, Eva; Waern, Margda; Falk, Hanna; Duberstein, Paul; Östling, Svante; Hällström, Tore; Skoog, Ingmar

2017-01-01

While time trends in personality traits have been suggested in younger cohorts, little is known regarding this issue in older adults. To test for birth cohort changes in psychogenic needs according to Murray's theory of personality in two birth cohorts of 75-year-olds born 1901-1902 and 1930. Two population-based birth cohorts were examined at the age of 75 years in 1976-1977 and in 2005-2006. Psychogenic needs according to Murray were measured with the Cesarec-Marke Personality Schedule (CMPS), a Swedish version of the Edwards Personal Preference Schedule. Scores on the CMPS subscales (achievement, affiliation, aggression, defence of status, guilt feelings, dominance, exhibition, autonomy, nurturance, order, succorance, and acquiescence) were compared between cohorts. Achievement, exhibition, dominance, aggression, affiliation, and succorance scores were higher, and order and acquiescence scores lower, in the more recent birth cohort of 75-year-olds. Women scored lower than men on exhibition and dominance, and higher on defence of status, guilt feelings, affiliation, nurturance, and succorance. Interaction effects between cohort and sex were found for achievement (women scored lower than men in 1976-1977 but not in 2005-2006), order (the lower scores in 2005-2006 were more accentuated among men), and acquiescence (increased in men and decreased in women). The later-born birth cohort scored higher on self-centred traits, such as more dominant, competitive, and exhibitive traits as well as the need to be taken care of and have friends around, but it scored lower on the need for order. The gap between men and women regarding achievement decreased, possibly reflecting women's more prominent role in society. © 2016 S. Karger AG, Basel.

A study of the birth weight-obesity relation using a longitudinal cohort and sibling and twin pairs.

PubMed

The, Natalie S; Adair, Linda S; Gordon-Larsen, Penny

2010-09-01

Sibling and twin study designs provide control for confounding factors that are typically unmeasured in traditional cohort studies. Using nationally representative data from the National Longitudinal Study of Adolescent Health collected at 3 visits during 1994-2002, the authors evaluated the longitudinal association between birth weight and later obesity in a traditional cohort study (n = 13,763; ages 11-21 years at baseline), controlling for sex, age, race/ethnicity, and parental education. Among persons with a nonobese mother, high birth weight (>4 kg) participants were more likely than normal birth weight (>/=2.5-

Comparing profiles of mental disorder across birth cohorts: results from the 2007 Australian National Survey of Mental Health and Wellbeing.

PubMed

Sunderland, Matthew; Carragher, Natacha; Buchan, Heather; Batterham, Philip J; Slade, Tim

2014-05-01

To describe and compare individuals with any DSM-IV mental disorder from three different birth cohorts - young (16-34 years), middle age (35-59 years) and older age (60-85 years) - on a range of clinically relevant factors. Data were derived from the 2007 Australian National Survey of Mental Health and Wellbeing. Individuals from three birth cohorts with a range of mental health and substance use disorders were identified using DSM-IV criteria and compared using regression analysis. The specific factors that were compared include: (1) type of disorder/disorders present; (2) suicidality; (3) number of co-occurring disorders; (4) levels of distress and impairment; (5) self-assessed physical and mental health; (6) presence of physical conditions; (7) size and quality of social support/network; and (8) treatment-seeking behaviour. The birth cohorts differed dramatically in terms of the specific disorders that were present. The older cohort were significantly more likely to experience internalising disorders and significantly less likely to experience externalising disorders in comparison to the young cohort. The older cohort were significantly more likely to experience co-morbid physical conditions as well as lower life satisfaction, poorer self-rated physical health, increased functional impairment, and more days out of role. The younger cohort had a significantly larger peer group that they could confide in and rely on in comparison to the older cohort. Clinicians and researchers need to be cognisant that mental disorders manifest as highly heterogeneous constructs. The presentation of a disorder in a younger individual could be vastly different from the presentation of the same disorder in an older individual. The additional burden associated with these factors and how they apply to different birth cohorts must be taken into consideration when planning mental health services and effective treatment for the general population.

Aboriginal Representation: Conflict or Dialogue in the Academy

ERIC Educational Resources Information Center

Leane, Jeanine

2010-01-01

This research begins with the premise that non-Aboriginal students are challenged by much Aboriginal writing and also challenge its representations as they struggle to re-position themselves in relation to possible meanings within Aboriginal writing. Many non-Aboriginal students come to read an Aboriginal narrative against their understanding of…

The impact of fatal pediatric trauma on aboriginal children.

PubMed

Bratu, Ioana; Lowe, Danielle; Phillips, Leah

2013-05-01

Injuries are the leading cause of death in young people. Our aim is to examine the differences between aboriginal and non-aboriginal pediatric trauma mortality as a means to focus on prevention strategies. The records for all traumatic pediatric (0-18 years) deaths between 1996 and 2010 were reviewed from the regional Medical Examiner's office. The majority of the total 932 pediatric deaths were the result of non-intentional injuries (640) followed by suicide (195), homicide (65), child abuse (15), and undetermined (17). Despite being only 3.3% of the provincial population, Aboriginals represented 30.9% of pediatric trauma fatalities. Aboriginal fatalities occurred most commonly in the home, with males and females equally affected. Road related events were the main causes of injury overall. Up to three-quarters of Aboriginal children who died in a non-pedestrian road related event did not wear an indicated protective device. Pedestrian deaths were over-represented in Aboriginal children. The second most common cause of death was suicide for both non-Aboriginal and Aboriginal children. Almost half of all of the suicides were Aboriginal. Homicide and child abuse had similar proportions for both non-Aboriginal and Aboriginal children. Pediatric Aboriginal injury prevention should be a priority and tailored for Aboriginal communities. Copyright © 2013 Elsevier Inc. All rights reserved.

Owning solutions: a collaborative model to improve quality in hospital care for Aboriginal Australians.

PubMed

Durey, Angela; Wynaden, Dianne; Thompson, Sandra C; Davidson, Patricia M; Bessarab, Dawn; Katzenellenbogen, Judith M

2012-06-01

Well-documented health disparities between Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) and non-Aboriginal Australians are underpinned by complex historical and social factors. The effects of colonisation including racism continue to impact negatively on Aboriginal health outcomes, despite being under-recognised and under-reported. Many Aboriginal people find hospitals unwelcoming and are reluctant to attend for diagnosis and treatment, particularly with few Aboriginal health professionals employed on these facilities. In this paper, scientific literature and reports on Aboriginal health-care, methodology and cross-cultural education are reviewed to inform a collaborative model of hospital-based organisational change. The paper proposes a collaborative model of care to improve health service delivery by building capacity in Aboriginal and non-Aboriginal personnel by recruiting more Aboriginal health professionals, increasing knowledge and skills to establish good relationships between non-Aboriginal care providers and Aboriginal patients and their families, delivering quality care that is respectful of culture and improving Aboriginal health outcomes. A key element of model design, implementation and evaluation is critical reflection on barriers and facilitators to providing respectful and culturally safe quality care at systemic, interpersonal and patient/family-centred levels. Nurses are central to addressing the current state of inequity and are pivotal change agents within the proposed model. © 2011 Blackwell Publishing Ltd.

Fall prevention services for older Aboriginal people: investigating availability and acceptability.

PubMed

Lukaszyk, Caroline; Coombes, Julieann; Keay, Lisa; Sherrington, Catherine; Tiedemann, Anne; Broe, Tony; Lovitt, Lorraine; Ivers, Rebecca

2016-12-14

Falls and fall-related injury are emerging issues for older Aboriginal people. Despite this, it is unknown whether older Aboriginal people access available fall prevention programs, or whether these programs are effective or acceptable to this population. To investigate the use of available fall prevention services by older Aboriginal people and identify features that are likely to contribute to program acceptability for Aboriginal communities in New South Wales (NSW), Australia. A questionnaire was distributed to Aboriginal and mainstream health and community services across NSW to identify the fall prevention and healthy ageing programs currently used by older Aboriginal people. Services with experience in providing fall prevention interventions for Aboriginal communities, and key Aboriginal health services that delivered programs specifically for older Aboriginal people, were followed up and staff members were nominated from within each service to be interviewed. Service providers offered their suggestions as to how a fall prevention program could be designed and delivered to meet the health and social needs of their older Aboriginal clients. Of the 131 services that completed the questionnaire, four services (3%) had past experience in providing a mainstream fall prevention program to Aboriginal people; however, there were no programs being offered at the time of data collection. From these four services, and from a further five key Aboriginal health services, 10 staff members experienced in working with older Aboriginal people were interviewed. Barriers preventing services from offering appropriate fall prevention programs to their older Aboriginal clients were identified, including limited funding, a lack of available Aboriginal staff, and communication difficulties between health services and sectors. According to the service providers, an effective and acceptable fall prevention intervention would be evidence based, flexible, community-oriented and social, held in a familiar and culturally safe location and delivered free of cost. This study identified a gap in the availability of acceptable fall prevention programs designed for, and delivered to, older Aboriginal people in NSW. Further consultation with older Aboriginal people is necessary to determine how an appropriate and effective program can be designed and delivered. Terminology: The authors recognise the two distinctive Indigenous populations of Australia: Aboriginal and Torres Strait Islander people. Because the vast majority of the NSW Aboriginal and Torres Strait Islander population is Aboriginal (95.4%)1, this population will be referred to as 'Aboriginal' in this manuscript.

Comparison of bias analysis strategies applied to a large data set.

PubMed

Lash, Timothy L; Abrams, Barbara; Bodnar, Lisa M

2014-07-01

Epidemiologic data sets continue to grow larger. Probabilistic-bias analyses, which simulate hundreds of thousands of replications of the original data set, may challenge desktop computational resources. We implemented a probabilistic-bias analysis to evaluate the direction, magnitude, and uncertainty of the bias arising from misclassification of prepregnancy body mass index when studying its association with early preterm birth in a cohort of 773,625 singleton births. We compared 3 bias analysis strategies: (1) using the full cohort, (2) using a case-cohort design, and (3) weighting records by their frequency in the full cohort. Underweight and overweight mothers were more likely to deliver early preterm. A validation substudy demonstrated misclassification of prepregnancy body mass index derived from birth certificates. Probabilistic-bias analyses suggested that the association between underweight and early preterm birth was overestimated by the conventional approach, whereas the associations between overweight categories and early preterm birth were underestimated. The 3 bias analyses yielded equivalent results and challenged our typical desktop computing environment. Analyses applied to the full cohort, case cohort, and weighted full cohort required 7.75 days and 4 terabytes, 15.8 hours and 287 gigabytes, and 8.5 hours and 202 gigabytes, respectively. Large epidemiologic data sets often include variables that are imperfectly measured, often because data were collected for other purposes. Probabilistic-bias analysis allows quantification of errors but may be difficult in a desktop computing environment. Solutions that allow these analyses in this environment can be achieved without new hardware and within reasonable computational time frames.

UK bovine carcass meat consumed as burgers, sausages and other meat products: by birth cohort and gender.

PubMed

Cooper, J D; Bird, S M

2002-01-01

The most likely human exposure to bovine spongiform encephalopathy (BSE) is dietary, through beef mechanically recovered meat (MRM) and head meat used in burgers, sausages and other meat products. The majority, reportedly 90% of beef MRM and 80% of head meat, was used in burgers. To enable quantification of UK dietary exposure to BSE, we quantified bovine carcass meat consumed as burgers, sausages and other meat products by birth cohort, gender and calendar period (1980-1989, 1990-1996). Synthesis of dietary data (cross-sectional National Dietary and Nutrition Surveys, and serial National Food Surveys and Realeat Surveys) to simulate weekly consumption by one-thousandth of the UK population in each year from 1980 to 1996. In 1980-1989, the highest number of consumers (per 7 days) of all three food groups was in the 1940-1969 birth cohort - averaging 3.7 million male consumers of burgers, 2.6 million of sausages and 8.5 million of other meat products. The post-1969 birth cohort had the next highest number of consumers of burgers (1.8 million males). In 1990-1996, consumer numbers declined for the two older cohorts, most strikingly for burgers (down to 2.5 million males in the 1940-1969 cohort). The 1940-1969 cohort retained the highest number of consumers of sausages and other meat products, and second place for burgers. Male consumption was higher, even in the pre-1940 birth cohort where, for demographic reasons, female consumers outnumbered males. In the post-1969 birth cohort, female consumption of bovine carcass meat weight as burgers increased from 68 tonnes in 1980-1989 to 81 tonnes in 1990-1996, and male consumption increased more markedly (by 41%) from 84 tonnes to 119 tonnes; and similarly for other meat products. Properly marshalled age-group and gender-specific consumption data contribute to a clearer understanding of the demography of those who were at risk of dietary exposure to BSE and of when their exposure intensity was greatest. Other countries may need to consider using dietary data to model their human BSE exposure from UK and other BSE-affected regions.

Early life risk factors for testicular cancer: a case-cohort study based on the Copenhagen School Health Records Register.

PubMed

Piltoft, Johanne Spanggaard; Larsen, Signe Benzon; Dalton, Susanne Oksbjerg; Johansen, Christoffer; Baker, Jennifer L; Cederkvist, Luise; Andersen, Ingelise

2017-02-01

One established risk factors for testicular cancer is cryptorchidism. However, it remains unclear whether cryptorchidism is a risk factor in itself or whether the two conditions share common causes in early life (estrogen hypothesis), such as birth weight and birth order. The objective of this study is to utilize data from the Copenhagen School Health Records Register (CSHRR) to evaluate cryptorchidism, birth weight and birth order as risk factors for testicular cancer. The study population consisted of 408 cases of testicular cancer identified by a government issued identification number linkage of the entire CSHRR with the Danish Cancer Registry and a random subsample of 4819 males from the CSHRR. The study design was case-cohort and the period of follow-up between 2 April 1968 and 31 December 2003. Cryptorchidism was significantly associated with testicular cancer in crude analyses [hazard ratio (HR) = 3.60, 95% CI 2.79-4.65]. Birth weight was inversely associated with testicular cancer and no clear association with birth order was observed. The positive association between cryptorchidism and testicular cancer was only slightly attenuated controlling for birth weight and birth order and stratified on birth cohort (HR = 3.46, 95% CI 2.67-4.48). This study confirmed the robustness of the association between cryptorchidism and testicular cancer even after adjustment for birth weight and birth order. Furthermore, the study showed an inverse association between birth weight and testicular cancer.

Comparison of the 1996 and 2001 census data for Aboriginal and non-Aboriginal workers in health care occupations.

PubMed

Lecompte, Emily; Baril, Mireille

2008-01-01

To meet the unique health needs of Aboriginal peoples (First Nations, Inuit and Métis), it is important to increase and encourage Aboriginal representation in health care. One Federal initiative, the Aboriginal Health Human Resource Initiative (AHHRI) at Health Canada, focuses on: (1) increasing the number of Aboriginal people working in health careers; (2) adapting health care educational curricula to support the development of cultural competencies; and (3) improving the retention of health care workers in Aboriginal communities. A health care system that focuses on understanding the unique challenges, concerns, and needs of Aboriginal people can better respond to this specific population, which suffers disproportionately from ill health in comparison to their non-Aboriginal counterparts. This report examines the supply of Aboriginal health care providers in Canada, based on geographic region, area of residence, Aboriginal identity, and occupation. Findings are drawn from the 1996 and 2001 censuses from Statistics Canada. Quantitative results provide a greater understanding of labour force characteristics of First Nation, Inuit, Métis, and non-Aboriginal health providers.

Alpha brain-wave neurofeedback training reduces psychopathology in a cohort of male and female Canadian aboriginals.

PubMed

Hardt, James V

2012-01-01

The study was conducted to determine if alpha brain-wave neurofeedback training can have positive psychological results by reducing anxiety and other psychopathology. The cohort participated in alpha brain-wave neurofeedback training for 76 minutes (day 1) to 120 or more minutes (days 5-7) daily for 7 days. Electroencephalogram (EEG) electrodes were attached to the head with conductive gel according to the 10-20 International Electrode Placement System. During training, participants were seated in a comfortable armchair within a soundproof and lightproof room. Brain-wave signals were amplified for processing by analog-to-digital converters and polygraphs, then filtered to the pure delta, theta, alpha, beta, and gamma bands as well as subbands of these bands of the EEG. For 2-minute epochs, trainees sat with their eyes closed in the dark listening to their feedback tones as the filtered alpha brain-wave EEG signals controlled the loudness of the tones. Then a "ding" sounded and the tones stopped. For 8 seconds, a monitor lit up with dimly illuminated, static numbers, indicating the strength of their alpha brain waves, after which the feedback tones resumed and the process was repeated. 40 adult volunteers were recruited from the aboriginal population (First Nations, Métis, and Inuit) of Canada. The cohort ranged in age from 25 to 60 years and included males and females. The study was conducted at Biocybernaut Institute of Canada in Victoria, British Columbia. Data was obtained to determine the effectiveness of this training by giving four psychological tests (Minnesota Multi-Phasic Personality Inventory, and the trait forms of the Multiple Affect Adjective Check List, Clyde Mood Scale, and Profile of Mood States) on the first day prior to commencing training and on the seventh day upon completion of the training. EEG data was also compiled throughout the training and analyzed as a factor of the training process. Postintervention data showed positive results with reduction of psychopathology when compared to the data from testing prior to the training. Analysis of this data showed improvement in several areas of psychopathology. Alpha brain-wave neurofeedback training daily for 7 days does have positive psychological results in adult male and female Canadian aboriginals as measured by data from four psychological tests on the participants.

Addressing HIV/AIDS among Aboriginal People using a Health Status, Health Determinants and Health Care Framework: A Literature Review and Conceptual Analysis

PubMed Central

Nowgesic, Earl

2016-01-01

Objectives (1) To describe the Human Immunodeficiency Virus (HIV) infection among Aboriginal populations using a mixed methods approach (i.e. quantitative and qualitative methods); (2) to examine the individual-level and community-level relationships between HIV/AIDS, health determinants, and health care (e.g. diagnosis, access to treatment and health services planning); and (3) to explore innovative solutions to address HIV/AIDS among Aboriginal populations based upon research and infrastructure (e.g. partnerships, data sources and management, health indicators and culture) and policy (i.e. self-determination of Aboriginal Peoples). Methods Literature review and conceptual analysis using a health status, health determinants and health care framework. Results In comparison to non-Aboriginal persons, HIV infection is higher among Aboriginal persons, is more directly attributable to unique risk factors and socio-demographic characteristics, and yields more adverse health outcomes. Culture, poverty and self-determination are determinants of health for Aboriginal populations. Aboriginal people have inadequate primary care and, in particular, specialist care. It is necessary to include traditional Aboriginal approaches and culture when addressing Aboriginal health while understanding competing paradigms between modern medicine and Aboriginal traditions. Conclusion There is a need for self-determination of Aboriginal Peoples in order to improve the health of Aboriginal communities and those living with HIV/AIDS. Research and policy affecting Aboriginal people should be of the highest quality and based upon Aboriginal community relevance and involvement. PMID:27398110

Attitudes to participating in a birth cohort study, views from a multiethnic population: a qualitative study using focus groups.

PubMed

Garg, Neeru; Round, Thomas P; Daker-White, Gavin; Bower, Peter; Griffiths, Chris J

2017-02-01

Recruitment to birth cohort studies is a challenge. Few studies have addressed the attitudes of women about taking part in birth cohort studies particularly those from ethnic minority groups. To seek the views of people from diverse ethnic backgrounds about participation in a proposed birth cohort examining the impact of infections. Eight focus groups of pregnant women and mothers of young children took place in GP surgeries and community centres in an ethnically diverse area of east London. Purposeful sampling and language support ensured representation of people from ethnic minority groups. Audio recordings were taken and transcripts were analysed using the Framework approach. The views of participants about taking part in the proposed birth cohort study, in particular concerning incentives to taking part, disincentives and attitudes to consenting children. There was more convergence of opinion than divergence across groups. Altruism, perceived health gains of participating and financial rewards were motivating factors for most women. Worries about causing harm to their child, inconvenience, time pressure and blood sample taking as well as a perceived lack of health gains were disincentives to most. Mistrust of researchers did not appear to be a significant barrier. The study indicates that ethnicity and other demographic factors influence attitudes to participation. To recruit better, birth cohort studies should incorporate financial and health gains as rewards for participation, promote the altruistic goals of research, give assurances regarding the safety of the participating children and sensitive data, avoid discomfort and maximize convenience. Ethnicity influences attitudes to participation in many ways, and researchers should explore these factors in their target population. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Prenatal Exposure to Maternal Cigarette Smoking and DNA Methylation: Epigenome-Wide Association in a Discovery Sample of Adolescents and Replication in an Independent Cohort at Birth through 17 Years of Age

PubMed Central

Lee, Ken W.K.; Richmond, Rebecca; Hu, Pingzhao; French, Leon; Shin, Jean; Bourdon, Celine; Reischl, Eva; Waldenberger, Melanie; Zeilinger, Sonja; Gaunt, Tom; McArdle, Wendy; Ring, Susan; Woodward, Geoff; Bouchard, Luigi; Gaudet, Daniel; Smith, George Davey; Relton, Caroline; Paus, Tomas

2014-01-01

Background: Prenatal exposure to maternal cigarette smoking (prenatal smoke exposure) had been associated with altered DNA methylation (DNAm) at birth. Objective: We examined whether such alterations are present from birth through adolescence. Methods: We used the Infinium HumanMethylation450K BeadChip to search across 473,395 CpGs for differential DNAm associated with prenatal smoke exposure during adolescence in a discovery cohort (n = 132) and at birth, during childhood, and during adolescence in a replication cohort (n = 447). Results: In the discovery cohort, we found five CpGs in MYO1G (top-ranking CpG: cg12803068, p = 3.3 × 10–11) and CNTNAP2 (cg25949550, p = 4.0 × 10–9) to be differentially methylated between exposed and nonexposed individuals during adolescence. The CpGs in MYO1G and CNTNAP2 were associated, respectively, with higher and lower DNAm in exposed versus nonexposed adolescents. The same CpGs were differentially methylated at birth, during childhood, and during adolescence in the replication cohort. In both cohorts and at all developmental time points, the differential DNAm was in the same direction and of a similar magnitude, and was not altered appreciably by adjustment for current smoking by the participants or their parents. In addition, four of the five EWAS (epigenome-wide association study)–significant CpGs in the adolescent discovery cohort were also among the top sites of differential methylation in a previous birth cohort, and differential methylation of CpGs in CYP1A1, AHRR, and GFI1 observed in that study was also evident in our discovery cohort. Conclusions: Our findings suggest that modifications of DNAm associated with prenatal maternal smoking may persist in exposed offspring for many years—at least until adolescence. Citation: Lee KW, Richmond R, Hu P, French L, Shin J, Bourdon C, Reischl E, Waldenberger M, Zeilinger S, Gaunt T, McArdle W, Ring S, Woodward G, Bouchard L, Gaudet D, Davey Smith G, Relton C, Paus T, Pausova Z. 2015. Prenatal exposure to maternal cigarette smoking and DNA methylation: epigenome-wide association in a discovery sample of adolescents and replication in an independent cohort at birth through 17 years of age. Environ Health Perspect 123:193–199; http://dx.doi.org/10.1289/ehp.1408614 PMID:25325234

Profile and programming needs of federal offenders with histories of intimate partner violence.

PubMed

Stewart, Lynn A; Power, Jenelle

2014-10-01

This study presents data on male perpetrators of domestic violence (DV) in the Correctional Service of Canada (CSC) using two samples: (a) a snapshot of all male offenders in CSC who had been assessed for DV (n = 15,166) and (b) a cumulative sample of male offenders in CSC from 2002-2010 who had been assessed as moderate or high risk for further DV (n = 4,261) DV offenders were compared to a cohort sample of non-DV offenders (n = 4,261). Analyses were disaggregated for Aboriginal and non-Aboriginal offenders. Results indicated that 40% of the federal male population had a suspected history of DV and were therefore screened in for in-depth DV risk assessment. Of these, 45% were assessed as moderate or high risk for future DV. DV offenders had higher risk and criminogenic need ratings, more learning disabilities, more mental health problems, and more extensive criminal histories than those without DV histories. Aboriginal DV offenders had high levels of alcohol dependence, suggesting a need for substance abuse treatment as part of DV programming. Most federal offenders with DV histories would be described as belonging to the Antisocial/Generalized Aggressive typology and, therefore, adhering to the Risk-Need-Responsivity principles of the effective correctional literature, cognitive-behavioral treatment that focuses on teaching skills of self-management, and changing attitudes supporting relationship violence would be recommended. © The Author(s) 2014.

Learning through an Aboriginal Language: The Impact on Students' English and Aboriginal Language Skills

ERIC Educational Resources Information Center

Usborne, Esther; Peck, Josephine; Smith, Donna-Lee; Taylor, Donald M.

2011-01-01

Aboriginal communities across Canada are implementing Aboriginal language programs in their schools. In the present research, we explore the impact of learning through an Aboriginal language on students' English and Aboriginal language skills by contrasting a Mi'kmaq language immersion program with a Mi'kmaq as a second language program. The…

Food choices and practices during pregnancy of immigrant and Aboriginal women in Canada: a study protocol

PubMed Central

2011-01-01

Background Facilitating the provision of appropriate health care for immigrant and Aboriginal populations in Canada is critical for maximizing health potential and well-being. Numerous reports describe heightened risks of poor maternal and birth outcomes for immigrant and Aboriginal women. Many of these outcomes may relate to food consumption/practices and thus may be obviated through provision of resources which suit the women's ethnocultural preferences. This project aims to understand ethnocultural food and health practices of Aboriginal and immigrant women, and how these intersect with respect to the legacy of Aboriginal colonialism and to the social contexts of cultural adaptation and adjustment of immigrants. The findings will inform the development of visual tools for health promotion by practitioners. Methods/Design This four-phase study employs a case study design allowing for multiple means of data collection and different units of analysis. Phase 1 consists of a scoping review of the literature. Phases 2 and 3 incorporate pictorial representations of food choices (photovoice in Phase 2) with semi-structured photo-elicited interviews (in Phase 3). The findings from Phases 1-3 and consultations with key stakeholders will generate key understandings for Phase 4, the production of culturally appropriate visual tools. For the scoping review, an emerging methodological framework will be utilized in addition to systematic review guidelines. A research librarian will assist with the search strategy and retrieval of literature. For Phases 2 and 3, recruitment of 20-24 women will be facilitated by team member affiliations at perinatal clinics in one of the city's most diverse neighbourhoods. The interviews will reveal culturally normative practices surrounding maternal food choices and consumption, including how women negotiate these practices within their own worldview and experiences. A structured and comprehensive integrated knowledge translation plan has been formulated. Discussion The findings of this study will provide practitioners with an understanding of the cultural differences that affect women's dietary choices during maternity. We expect that the developed resources will be of immediate use within the women's units and will enhance counseling efforts. Wide dissemination of outputs may have a greater long term impact in the primary and secondary prevention of these high risk conditions. PMID:22152052

Increasing rates of surgical treatment and preventing comorbidities may increase breast cancer survival for Aboriginal women

PubMed Central

2014-01-01

Background Lower breast cancer survival has been reported for Australian Aboriginal women compared to non-Aboriginal women, however the reasons for this disparity have not been fully explored. We compared the surgical treatment and survival of Aboriginal and non-Aboriginal women diagnosed with breast cancer in New South Wales (NSW), Australia. Methods We analysed NSW cancer registry records of breast cancers diagnosed in 2001–2007, linked to hospital inpatient episodes and deaths. We used unconditional logistic regression to compare the odds of Aboriginal and non-Aboriginal women receiving surgical treatment. Breast cancer-specific survival was examined using cumulative mortality curves and Cox proportional hazards regression models. Results Of the 27 850 eligible women, 288 (1.03%) identified as Aboriginal. The Aboriginal women were younger and more likely to have advanced spread of disease when diagnosed than non-Aboriginal women. Aboriginal women were less likely than non-Aboriginal women to receive surgical treatment (odds ratio 0.59, 95% confidence interval (CI) 0.42-0.86). The five-year crude breast cancer-specific mortality was 6.1% higher for Aboriginal women (17.7%, 95% CI 12.9-23.2) compared with non-Aboriginal women (11.6%, 95% CI 11.2-12.0). After accounting for differences in age at diagnosis, year of diagnosis, spread of disease and surgical treatment received the risk of death from breast cancer was 39% higher in Aboriginal women (HR 1.39, 95% CI 1.01-1.86). Finally after also accounting for differences in comorbidities, socioeconomic disadvantage and place of residence the hazard ratio was reduced to 1.30 (95% CI 0.94-1.75). Conclusion Preventing comorbidities and increasing rates of surgical treatment may increase breast cancer survival for NSW Aboriginal women. PMID:24606675

Mortality Measurement at Advanced Ages: A Study of the Social Security Administration Death Master File

PubMed Central

Gavrilov, Leonid A.; Gavrilova, Natalia S.

2011-01-01

Accurate estimates of mortality at advanced ages are essential to improving forecasts of mortality and the population size of the oldest old age group. However, estimation of hazard rates at extremely old ages poses serious challenges to researchers: (1) The observed mortality deceleration may be at least partially an artifact of mixing different birth cohorts with different mortality (heterogeneity effect); (2) standard assumptions of hazard rate estimates may be invalid when risk of death is extremely high at old ages and (3) ages of very old people may be exaggerated. One way of obtaining estimates of mortality at extreme ages is to pool together international records of persons surviving to extreme ages with subsequent efforts of strict age validation. This approach helps researchers to resolve the third of the above-mentioned problems but does not resolve the first two problems because of inevitable data heterogeneity when data for people belonging to different birth cohorts and countries are pooled together. In this paper we propose an alternative approach, which gives an opportunity to resolve the first two problems by compiling data for more homogeneous single-year birth cohorts with hazard rates measured at narrow (monthly) age intervals. Possible ways of resolving the third problem of hazard rate estimation are elaborated. This approach is based on data from the Social Security Administration Death Master File (DMF). Some birth cohorts covered by DMF could be studied by the method of extinct generations. Availability of month of birth and month of death information provides a unique opportunity to obtain hazard rate estimates for every month of age. Study of several single-year extinct birth cohorts shows that mortality trajectory at advanced ages follows the Gompertz law up to the ages 102–105 years without a noticeable deceleration. Earlier reports of mortality deceleration (deviation of mortality from the Gompertz law) at ages below 100 appear to be artifacts of mixing together several birth cohorts with different mortality levels and using cross-sectional instead of cohort data. Age exaggeration and crude assumptions applied to mortality estimates at advanced ages may also contribute to mortality underestimation at very advanced ages. PMID:22308064

Disparities in acute in-hospital cardiovascular care for Aboriginal and non-Aboriginal South Australians.

PubMed

Tavella, Rosanna; McBride, Katharine; Keech, Wendy; Kelly, Janet; Rischbieth, Amanda; Zeitz, Christopher; Beltrame, John F; Tideman, Philip A; Brown, Alex

2016-09-05

To assess differences in the rates of angiography and subsequent revascularisation for Aboriginal and non-Aboriginal South Australians who presented with an acute coronary syndrome (ACS); to explore the reasons for any observed differences. Analysis of administrative data with logistic regression modelling to assess the relationship between Aboriginal status and the decision to undertake diagnostic angiography. A detailed medical record review of Aboriginal admissions was subsequently undertaken. Emergency ACS admissions to SA cardiac catheterisation hospitals, 2007-2012. 13 701 admissions of patients with an ACS, including 274 Aboriginal patients (2.1%). Rates of coronary angiography and revascularisation; documentation of justification for non-invasive management. After adjustment for age, comorbidities and remoteness, Aboriginal patients presenting with an ACS were significantly less likely than non-Aboriginal patients to undergo angiography (odds ratio [OR], 0.4; 95% CI, 0.3-0.5; P < 0.001). There was no significant difference in the rates of revascularisation for Aboriginal and non-Aboriginal patients who had undergone angiography. Reasons for Aboriginal patients not undergoing angiography included symptoms being deemed non-cardiac (16%), non-invasive test performed (8%), and discharge against medical advice (11%); the reasons were unclear for 36% of Aboriginal patients. After controlling for age and other factors, the rate of coronary angiography was lower among Aboriginal patients with an ACS in SA. The reasons for this disparity are complex, including patient-related factors and their preferences, as well as the appropriateness of the intervention. Improved consideration of the hospital experience of Aboriginal patients must be a priority for reducing health care disparities.

Incidence of and case fatality following acute myocardial infarction in Aboriginal and non-Aboriginal Western Australians (2000-2004): a linked data study.

PubMed

Katzenellenbogen, Judith M; Sanfilippo, Frank M; Hobbs, Michael S T; Briffa, Tom G; Ridout, Steve C; Knuiman, Matthew W; Dimer, Lyn; Taylor, Kate P; Thompson, Peter L; Thompson, Sandra C

2010-12-01

Despite Coronary Heart Disease exacting a heavy toll among Aboriginal Australians, accurate estimates of its epidemiology are limited. This study compared the incidence of acute myocardial infarction (AMI) and 28-day case fatality (CF) among Aboriginal and non-Aboriginal Western Australians aged 25-74 years from 2000-2004. Incident (AMI hospital admission-free for 15 years) AMI events and 28-day CF were estimated using person-based linked hospital and mortality data. Age-standardised incidence rates and case fatality percentages were calculated by Aboriginality and sex. Of 740 Aboriginal and 6933 non-Aboriginal incident events, 208 and 2352 died within 28 days, respectively. The Aboriginal age-specific incidence rates were 27 (males) and 35 (females) times higher than non-Aboriginal rates in the 25-29 year age group, decreasing to 2-3 at 70-74 years. The male:female age-standardised incidence rate ratio was 2.2 in Aboriginal people 25-54 years compared with 4.5 in non-Aboriginal people. Aboriginal age-standardised CF percentages were 1.4 (males) and 1.1 (females) times higher at age 25-54 years and 1.5 times higher at age 55-74 years. These data suggest higher CF and, more importantly, AMI incidence contribute to the excess ischaemic heart disease mortality in Aboriginal Western Australians. The poorer cardiovascular health in Aboriginal women, particularly in younger age groups, should be investigated. Copyright © 2010 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier B.V. All rights reserved.

Reduction in incidence of Johne's disease associated with implementation of a disease control program in Minnesota demonstration herds.

PubMed

Espejo, L A; Godden, S; Hartmann, W L; Wells, S J

2012-07-01

This prospective longitudinal observational study was conducted to evaluate the effect of a standardized control program on the incidence of Johne's disease in 8 dairy herds in Minnesota. Depending on recruitment year, herds were followed for between 5 and 10 yr. Program compliance was evaluated using a cohort risk assessment score by birth cohort. Fecal samples from cows in study herds were tested annually using bacterial culture to detect Mycobacterium avium ssp. paratuberculosis (MAP), and serum samples from study cows were tested using an ELISA to detect antibodies to MAP. Clinical Johne's disease was also recorded. Cohort risk assessment score decreased along birth cohorts. Depending on the follow-up period in each herd, 5 to 8 birth cohorts were followed to describe changes in time to MAP bacterial culture positivity, serum ELISA positivity, MAP heavy shedding status, and clinical Johne's disease. The analysis of time to bacterial culture positivity, serum ELISA positivity, heavy fecal shedding status, and clinical Johne's disease using a time-dependent Cox regression indicated a reduction of the instantaneous hazard ratio by birth cohorts and by cohort risk score; however, the strength of association between the cohort risk score and each of the 4 disease outcomes decreased over time. The age at which the cows first tested positive for bacterial culture, serum ELISA, and heavy fecal shedding, and the age of the cows at onset of clinical Johne's disease signs remained constant for all birth cohorts. Based on herd risk scores, overall herds complied with the recommended management practices in the program. Results were consistent with a within-herd reduction of Johne's disease transmission, and that reduction was associated with herd-level management practices implemented as part of the control program. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Birth-cohort patterns of mortality from ulcerative colitis and peptic ulcer.

PubMed

Sonnenberg, Amnon

2008-10-01

The aim was to follow the time trends of mortality from ulcerative colitis and compare them with those of gastric and duodenal ulcer. Mortality data from 21 different countries between 1941 and 2004 were analyzed. The age-specific death rates of each individual country, as well as the average age-specific rates of all countries, were plotted against the periods of birth and death. The average trends of mortality from ulcerative colitis, gastric and duodenal ulcer reveal distinctive and unique birth-cohort patterns of all three diseases. Similar to both types of peptic ulcer, the risk of developing ulcerative colitis started to rise in successive generations born during the second half of the 19(th) century. It peaked shortly before the turn of the century and has continued to decline since then. The rise and fall in the occurrence of ulcerative colitis preceded those of both ulcer types. The birth-cohort pattern indicates that exposure to the relevant risk factors of ulcerative colitis occurs during early life. As the model of H. pylori and its associated birth-cohort patterns of gastric and duodenal ulcer suggest, an enteric infection provides a possible explanation for such temporal trends of ulcerative colitis as well.

Aboriginal users of Canadian quitlines: an exploratory analysis

PubMed Central

Hayward, Lynda M; Campbell, H Sharon; Sutherland‐Brown, Carol

2007-01-01

Objectives To conduct an exploratory, comparative study of the utilisation and effectiveness of tobacco cessation quitlines among aboriginal and non‐aboriginal Canadian smokers. Setting Population based quitlines that provide free cessation information, advice and counselling to Canadian smokers. Subjects First time quitline callers, age 18 years of age and over, who called the quitline between August 2001 and December 2005 and who completed the evaluation and provided data on their ethnic status (n = 7082). Main measures Demographic characteristics and tobacco behaviours of participants at intake and follow‐up; reasons for calling; actions taken toward quitting, and 6‐month follow‐up quit rates. Results 7% of evaluation participants in the time period reported aboriginal origins. Aboriginal participants were younger than non‐aboriginals but had similar smoking status and level of addiction at intake. Concern about future health and current health problems were the most common reasons aboriginal participants called. Six months after intake aboriginals and non‐aboriginals had taken similar actions with 57% making a 24‐hour quit attempt. Quit rates were higher for aboriginals than non‐aboriginals, particularly for men. The 6‐month prolonged abstinence rate for aboriginal men was 16.7% compared with 7.2% for aboriginal women and 9.4% and 8.3% for non‐aboriginal men and women, respectively. Conclusions This exploratory analysis showed that even without targeted promotion, aboriginal smokers do call Canadian quitlines, primarily for health related reasons. We also showed that the quitlines are effective at helping them to quit. As a population focused intervention, quitlines can reach a large proportion of smokers in a cost efficient manner. In aboriginal communities where smoking rates exceed 50% and multiple health risks and chronic diseases already exist, eliminating non‐ceremonial tobacco use must be a priority. Our results, although exploratory, suggest quitlines can be an effective addition to aboriginal tobacco cessation strategies. PMID:18048634

Impact of Perinatal Different Intrauterine Environments on Child Growth and Development in the First Six Months of Life--IVAPSA Birth Cohort: rationale, design, and methods.

PubMed

Bernardi, Juliana Rombaldi; Ferreira, Charles Francisco; Nunes, Marina; da Silva, Clécio Homrich; Bosa, Vera Lúcia; Silveira, Patrícia Pelufo; Goldani, Marcelo Zubaran

2012-04-02

In the last twenty years, retrospective studies have shown that perinatal events may impact the individual health in the medium and long term. However, only a few prospective studies were designed to address this phenomenon. This study aims to describe the design and methods of the Impact of Perinatal Environmental Variations in the First Six Months of Life - the IVAPSA Birth Cohort. This is a clinical study and involves the recruitment of a birth cohort from hospitals in Porto Alegre, Rio Grande do Sul, Brazil. Mothers from different clinical backgrounds (hypertensive, diabetics, smokers, having an intrauterine growth restricted child for idiopathic reasons, and controls) will be invited to join the study twenty-four hours after the birth of their child. Data on economic, social, and maternal health care, feeding practices, anthropometric measures, physical activity, and neuropsychological evaluation will be obtained in interviews at postpartum, 7 and 15 days, 1, 3 and 6 months of life. To our knowledge, this is the first thematic cohort focused on the effects of intrauterine growth restriction to prospectively enroll mothers from different clinical backgrounds. The IVAPSA Birth Cohort is a promising research platform that can contribute to the knowledge on the relationship between perinatal events and their consequences on the children's early life.

Environmental exposure assessment in European birth cohorts: results from the ENRIECO project

PubMed Central

2013-01-01

Environmental exposures during pregnancy and early life may have adverse health effects. Single birth cohort studies often lack statistical power to tease out such effects reliably. To improve the use of existing data and to facilitate collaboration among these studies, an inventory of the environmental exposure and health data in these studies was made as part of the ENRIECO (Environmental Health Risks in European Birth Cohorts) project. The focus with regard to exposure was on outdoor air pollution, water contamination, allergens and biological organisms, metals, pesticides, smoking and second hand tobacco smoke (SHS), persistent organic pollutants (POPs), noise, radiation, and occupational exposures. The review lists methods and data on environmental exposures in 37 European birth cohort studies. Most data is currently available for smoking and SHS (N=37 cohorts), occupational exposures (N=33), outdoor air pollution, and allergens and microbial agents (N=27). Exposure modeling is increasingly used for long-term air pollution exposure assessment; biomonitoring is used for assessment of exposure to metals, POPs and other chemicals; and environmental monitoring for house dust mite exposure assessment. Collaborative analyses with data from several birth cohorts have already been performed successfully for outdoor air pollution, water contamination, allergens, biological contaminants, molds, POPs and SHS. Key success factors for collaborative analyses are common definitions of main exposure and health variables. Our review emphasizes that such common definitions need ideally be arrived at in the study design phase. However, careful comparison of methods used in existing studies also offers excellent opportunities for collaborative analyses. Investigators can use this review to evaluate the potential for future collaborative analyses with respect to data availability and methods used in the different cohorts and to identify potential partners for a specific research question. PMID:23343014

Population-based study of the incidence, complexity, and severity of neurologic disability among survivors weighing 500 through 1250 grams at birth: a comparison of two birth cohorts.

PubMed

Robertson, C M; Hrynchyshyn, G J; Etches, P C; Pain, K S

1992-11-01

Mortality and incidence, complexity, and severity of early childhood neurodevelopmental disability are reported for two cohorts of preterm infants of 500 through 1250 g birth weight. Comparing 1978-1979 (cohort 1) and 1988-1989 (cohort 2), 1-year survival improved from 82 (36%) of 226 to 197 (67%) of 291. Cohort 1 survivors were heavier and more mature than cohort 2 survivors (1047 g vs 930 g, 29.6 vs 27.3 weeks). Parental demographic variables were similar. The incidence of specific disabilities with greater than 97% follow-up to 1.5 years adjusted age did not change: cerebral palsy, 14 (17%) vs 20 (10%); vision loss, 5 (6%) vs 9 (5%); mental retardation, 9 (11%) vs 13 (7%); hearing loss, 3 (4%) vs 7 (4%); and convulsive disorders, 2 (2%) vs 3 (2%). The overall number of disabled children (17 [21%] vs 30 [15%]), complexity of disability (> or = 2 disabilities per child: 11 [13%] vs 10 [5%]), and severity of disability (projected dependency: 6 [7%] vs 10 [5%]) did not differ between cohorts 1 and 2. The cerebral palsy prevalence, based on neonatal survival, dropped from 157 per 1000 to 93 per 1000. Analysis by birth weight-specific categories in 250-g increments did not alter results, but disability rates were highest for those of lowest weight. In contrast to other reports this population-based North American study from a well-developed perinatal regional program reports no increase in incidence, complexity, or severity of disability in preterm infants weighing 500 through 1250 g at birth.

All Our Babies Cohort Study: recruitment of a cohort to predict women at risk of preterm birth through the examination of gene expression profiles and the environment

PubMed Central

2010-01-01

Background Preterm birth is the leading cause of perinatal morbidity and mortality. Risk factors for preterm birth include a personal or familial history of preterm delivery, ethnicity and low socioeconomic status yet the ability to predict preterm delivery before the onset of preterm labour evades clinical practice. Evidence suggests that genetics may play a role in the multi-factorial pathophysiology of preterm birth. The All Our Babies Study is an on-going community based longitudinal cohort study that was designed to establish a cohort of women to investigate how a women's genetics and environment contribute to the pathophysiology of preterm birth. Specifically this study will examine the predictive potential of maternal leukocytes for predicting preterm birth in non-labouring women through the examination of gene expression profiles and gene-environment interactions. Methods/Design Collaborations have been established between clinical lab services, the provincial health service provider and researchers to create an interdisciplinary study design for the All Our Babies Study. A birth cohort of 2000 women has been established to address this research question. Women provide informed consent for blood sample collection, linkage to medical records and complete questionnaires related to prenatal health, service utilization, social support, emotional and physical health, demographics, and breast and infant feeding. Maternal blood samples are collected in PAXgene™ RNA tubes between 18-22 and 28-32 weeks gestation for transcriptomic analyses. Discussion The All Our Babies Study is an example of how investment in clinical-academic-community partnerships can improve research efficiency and accelerate the recruitment and data collection phases of a study. Establishing these partnerships during the study design phase and maintaining these relationships through the duration of the study provides the unique opportunity to investigate the multi-causal factors of preterm birth. The overall All Our Babies Study results can potentially lead to healthier pregnancies, mothers, infants and children. PMID:21192811

Low birth weight in São Luís, northeastern Brazil: trends and associated factors

PubMed Central

2014-01-01

Background To analyze trends in LBW (low birth weight) rate using birth registry data and identify factors associated with LBW in São Luís comparing two birth cohorts separated by a 12-year interval. Methods 2,426 births were included in 1997/98 and 5,040 in 2010. The dependent variable was LBW (<2,500 g). Multiple logistic regression was performed to determine the association of independent variables with LBW. Data were also obtained from SINASC (Brazilian National Birth Registry) to analyze stillbirth and LBW rates trends from 1996 to 2010, using 3-year moving averages. Results LBW, intrauterine growth restriction (IUGR) and preterm birth rates did not differ between the two cohorts. Despite this, birth registry data showed increasing LBW rate up to 2001, coinciding with decreasing stillbirth rate. Both stillbirth and LBW rates decreased thereafter. A significant reduction was observed in the percentage of teenage mothers, mothers with up to 4 years of education, family income up to one minimum wage and mothers who did not attend prenatal care. There was an increase in maternal age ≥35 years and schooling ≥12 years. The variables associated with LBW in 1997/98 were young maternal age (<18 years), maternal smoking during pregnancy and primiparity. Variables that remained in the adjusted model in 2010 were female gender, income <3 minimum wages, lack of prenatal care, maternal smoking during pregnancy and primiparity. Conclusions Although LBW rate did not differ between the two cohorts, this apparent stability masked an increase up to 2001 and a decrease thereafter. The rise in LBW rate paralleled reduction in the stillbirth rate, suggesting improvement in obstetrical and newborn care. Maternal, socioeconomic and demographic factors associated with LBW differed between the two cohorts, except for smoking during pregnancy and parity that were significantly associated with LBW in both cohorts. PMID:24885887

Improving healthcare for Aboriginal Australians through effective engagement between community and health services.

PubMed

Durey, Angela; McEvoy, Suzanne; Swift-Otero, Val; Taylor, Kate; Katzenellenbogen, Judith; Bessarab, Dawn

2016-07-07

Effectively addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue. Health services engaging Aboriginal communities in designing and delivering healthcare is one way to tackle the issue. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. Local Aboriginal community members formed District Aboriginal Health Action Groups (DAHAGs) to collaborate with health providers in designing culturally-responsive healthcare. The purpose of the strategy was to improve local health service delivery for Aboriginal Australians. The evaluation aimed to identify whether the Aboriginal community considered the community engagement strategy effective in identifying their health service needs, translating them to action by local health services and increasing their trust in these health services. Participants were recruited using purposive sampling. Qualitative data was collected from Aboriginal participants and health service providers using semi-structured interviews or yarning circles that were recorded, transcribed and independently analysed by two senior non-Aboriginal researchers. Responses were coded for key themes, further analysed for similarities and differences between districts and cross-checked by the senior lead Aboriginal researcher to avoid bias and establish reliability in interpreting the data. Three ethics committees approved conducting the evaluation. Findings from 60 participants suggested the engagement process was effective: it was driven and owned by the Aboriginal community, captured a broad range of views and increased Aboriginal community participation in decisions about their healthcare. It built community capacity through regular community forums and established DAHAGs comprising local Aboriginal community members and health service representatives who met quarterly and were supported by the Aboriginal Health Team at the local Population Health Unit. Participants reported health services improved in community and hospital settings, leading to increased access and trust in local health services. The evaluation concluded that this process of actively engaging the Aboriginal community in decisions about their health care was a key element in improving local health services, increasing Aboriginal people's trust and access to care.

Validation of the first peoples cultural capability measurement tool with undergraduate health students: A descriptive cohort study.

PubMed

West, Roianne; Mills, Kyly; Rowland, Dale; Creedy, Debra K

2018-05-01

Health professional graduates require the capacity to work safely, both clinically and culturally, when delivering care to Indigenous peoples worldwide. In the Australian context, the Aboriginal and Torres Strait Islander Health Curriculum Framework (The Framework) provides guidance for health professional programs to integrate, teach and assess Aboriginal and Torres Strait Islander peoples' (First Peoples) health content. There is, however, a lack of validated tools that measure the development of students' cultural capabilities. To validate the Cultural Capability Measurement Tool with a cohort of health professional students. A descriptive cohort design was used. All students (N = 753) enrolled in a discrete First Peoples Health course at an Australian university were invited to complete the Cultural Capability Measurement Tool. The tool was tested for reliability, content and construct validity using confirmatory factor analysis; and concurrent validity using and the Cultural Understanding Self-Assessment Tool. A sample of 418 (73% response rate) was recruited. Most participants were enrolled in the Bachelor of Nursing program (n = 369, 82%). The Cultural Capability Measurement Tool had a Cronbach's alpha coefficient of 0.86. A five-factor solution was confirmed which reflected the cultural capability domains and accounted for 51% of the variance. Scores correlated with students' cultural understanding (r = 0.28, p < 0.001). Successful implementation of The Framework requires instruments to measure changes in students' cultural capabilities. Measuring nursing students' cultural capabilities can inform their development, identify areas of strengths and deficits for educators, and will ultimately contribute to the development of a culturally safe nursing workforce. Copyright © 2018 Elsevier Ltd. All rights reserved.

Attitudes and characteristics of health professionals working in Aboriginal health.

PubMed

Wilson, Annabelle M; Magarey, Anthea M; Jones, Michelle; O'Donnell, Kim; Kelly, Janet

2015-01-01

There is an unacceptable gap in health status between Aboriginal and non-Aboriginal people in Australia. Linked to social inequalities in health and political and historical marginalisation, this health gap must be urgently addressed. It is important that health professionals, the majority of whom in Australia are non-Aboriginal, are confident and equipped to work in Aboriginal health in order to contribute towards closing the health gap. The purpose of this study was to explore the attitudes and characteristics of non-Aboriginal health professionals working in Aboriginal health. The research was guided and informed by a social constructionist epistemology and a critical theoretical approach. It was set within a larger healthy eating and physical activity program delivered in one rural and one metropolitan community in South Australia from 2005 to 2010. Non-Aboriginal staff working in the health services where the program was delivered and who had some experience or an interest working in Aboriginal health were invited to participate in a semi-structured interview. Dietitians working across South Australia (rural and metropolitan locations) were also invited to participate in an interview. Data were coded into themes that recurred throughout the interview and this process was guided by critical social research. Thirty-five non-Aboriginal health professionals participated in a semi-structured interview about their experiences working in Aboriginal health. The general attitudes and characteristics of non-Aboriginal health professionals were classified using four main groupings, ranging from a lack of practical knowledge ('don't know how'), a fear of practice ('too scared'), the area of Aboriginal health perceived as too difficult ('too hard') and learning to practice regardless ('barrier breaker'). Workers in each group had different characteristics including various levels of willingness to work in the area; various understandings of Australia's historical relationship with Aboriginal peoples; varying awareness of their own cultural identity and influence on working with Aboriginal people; and different levels of (dis)comfort expressed in discussions about social, political and intercultural issues that impact on the healthcare encounter. These groupings can be used to assist non-Aboriginal health professionals to reflect on their own levels of confidence, attitudes, characteristics, experiences, approaches and assumptions to Aboriginal health, as an important precursor to further practice and development in Aboriginal health. By encouraging self-reflection of non-Aboriginal health professionals about where their experiences, characteristics and confidence lie, the groupings presented in this paper can be used to encourage non-Aboriginal health professionals, rather than Aboriginal clients or workers, to be the focus for change and deliver health care that is more acceptable to patients and clients, hence influencing health service delivery. The groupings presented can also begin to enable discussions between all health professionals about working together in Aboriginal health.

Are fetal growth impairment and preterm birth causally related to child attention problems and ADHD? Evidence from a comparison between high-income and middle-income cohorts

PubMed Central

Murray, Elizabeth; Pearson, Rebecca; Fernandes, Michelle; Santos, Iná S; Barros, Fernando C; Victora, Cesar G; Stein, Alan; Matijasevich, Alicia

2016-01-01

Background Cross-cohort comparison is an established method for improving causal inference. This study compared 2 cohorts, 1 from a high-income country and another from a middle-income country, to (1) establish whether birth exposures may play a causal role in the development of childhood attention problems; and (2) identify whether confounding structures play a different role in parent-reported attention difficulties compared with attention deficit hyperactivity disorder (ADHD) diagnoses. Methods Birth exposures included low birth weight (LBW), small-for-gestational age (SGA), small head circumference (HC) and preterm birth (PTB)). Outcomes of interest were attention difficulties (Strengths and Difficulties Questionnaire, SDQ) and ADHD (Development and Well-Being Assessment, DAWBA). Associations between exposures and outcomes were compared between 7-year-old children from the Avon Longitudinal Study of Parents and Children (ALSPAC) in the UK (N=6849) and the 2004 Pelotas cohort in Brazil (N=3509). Results For attention difficulties (SDQ), the pattern of association with birth exposures was similar between cohorts: following adjustment, attention difficulties were associated with SGA (OR=1.59, 95% CI 1.20 to 2.19) and small HC (OR=1.64, 95% CI 1.11 to 2.41) in ALSPAC and SGA (OR=1.35, 95% CI 1.04 to 1.75) in Pelotas. For ADHD, however, the pattern of association following adjustment differed markedly between cohorts. In ALSPAC, ADHD was associated with LBW (OR=2.29, 95% CI 1.09 to 4.80) and PTB (OR=2.33, 95% CI 1.23 to 4.42). In the Pelotas cohort, however, ADHD was associated with SGA (OR=1.69, 95% CI 1.02 to 2.82). Conclusions The findings suggest that fetal growth impairment may play a causal role in the development of attention difficulties in childhood, as similar associations were identified across both cohorts. Confounding structures, however, appear to play a greater role in determining whether a child meets the full diagnostic criteria for ADHD. PMID:26767410

Exploring disparities in acute myocardial infarction events between Aboriginal and non-Aboriginal Australians: roles of age, gender, geography and area-level disadvantage.

PubMed

Randall, D A; Jorm, L R; Lujic, S; Eades, S J; Churches, T R; O'Loughlin, A J; Leyland, A H

2014-07-01

We investigated disparities in rates of acute myocardial infarction (AMI) between Aboriginal and non-Aboriginal people in the 199 Statistical Local Areas (SLAs) in New South Wales, Australia. Using routinely collected and linked hospital and mortality data from 2002 to 2007, we developed multilevel Poisson regression models to estimate the relative rates of first AMI events in the study period accounting for area of residence. Rates of AMI in Aboriginal people were more than two times that in non-Aboriginal people, with the disparity greatest in more disadvantaged and remote areas. AMI rates in Aboriginal people varied significantly by SLA, as did the Aboriginal to non-Aboriginal rate ratio. We identified almost 30 priority areas for universal and targeted preventive interventions that had both high rates of AMI for Aboriginal people and large disparities in rates. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

A Guide for Health Professionals Working with Aboriginal Peoples: Executive Summary

PubMed Central

2013-01-01

Objective to provide Canadian health professionals with a network of information and recommendations regarding Aboriginal health. Options health professionals working with Aboriginal individuals and communities in the area of women’s health care. Outcomes improved health status of Aboriginal peoples in Canada. Appropriateness and accessibility of women’s health services for Aboriginal peoples. Improved communication and clinical skills of health professionals in the area of Aboriginal health. Improved quality of relationship between health professionals and Aboriginal individuals and communities. Improved quality of relationship between health care professionals and Aboriginal individuals and communities. Evidence recommendations are based on expert opinion and a review of the literature. Published references were identified by a Medline search of all review articles, randomized clinical control trials, meta-analyses, and practice guidelines from 1966 to February 1999, using the MeSH headings “Indians, North American or Eskimos” and “Health.”* Subsequently published articles were brought to the attention of the authors in the process of writing and reviewing the document. Ancillary and unpublished references were recommended by members of the SOGC Aboriginal Health Issues Committee and the panel of expert reviewers. Values information collected was reviewed by the principal author. The social, cultural, political, and historic context of Aboriginal peoples in Canada, systemic barriers regarding the publication of information by Aboriginal authors, the diversity of Aboriginal peoples in Canada, and the need for a culturally appropriate and balanced presentation were carefully considered in addition to more traditional scientific evaluation. The majority of information collected consisted of descriptive health and social information and such evaluation tools as the evidence guidelines of the Canadian Task Force on the Periodic Health exam were not appropriate. Benefits, costs, and harms utilization of the information and recommendations by Canadian health professionals will enhance understanding, communication, and clinical skills in the area of Aboriginal health. The resulting enhancement of collaborative relationships between Aboriginal peoples and their women’s health providers may contribute to health services that are more appropriate, effective, efficient, and accessible for Aboriginal peoples in Canada. The educational process may require an initial investment of time from the health professional. Recommendations Recommendations were grouped according to four themes: sociocultural context, health concerns, cross-cultural understanding, and Aboriginal health resources. Health professionals are encouraged to learn the appropriate names, demographics, and traditional geographic territories and language groups of the various Aboriginal groups in Canada. In addition, sensitivity to the impact of colonization and current socioeconomic challenges to the health status of Aboriginal peoples is warranted. Health services for Aboriginal peoples should take place as close to home as possible. Governmental obligations and policies regarding determination are recognized. With respect to health concerns, holistic definitions of health, based on Aboriginal perspectives, are put forward. Aboriginal peoples continue to experience a disproportionate burden of health problems. Health professionals are encouraged to become familiar with several key areas of morbidity and mortality. Relationships between Aboriginal peoples and their care providers need to be based on a foundation of mutual respect. Gaps and barriers in the current health care system for Aboriginal peoples are identified. Health professionals are encouraged to work with Aboriginal individuals and communities to address these gaps and barriers. Aboriginal peoples require culturally appropriate health care, including treatment in their own languages when possible. This may require interpreters or Aboriginal health advocates. Health professionals are encouraged to recognize the importance of family and community roles, and to respect traditional medicines and healers. Health professionals can develop their sensitivities towards Aboriginal peoples by participating in workshops, making use of educational resources, and by spending time with Aboriginal peoples in their communities. Aboriginal communities and health professionals are encouraged to support community-based, community-directed health services and health research for Aboriginal peoples. In addition, the education of more Aboriginal health professionals is essential. The need for a preventative approach to health programming in Aboriginal communities is stressed. Validation recommendations were reviewed and revised by the SOGC Aboriginal Health Issues Committee, a panel of expert reviewers, and the SOGC Council. In addition, this document was also reviewed and supported by the Assembly of First Nations, Canadian Institute of Child Health, Canadian Paediatric Society, College of Family Physicians of Canada, Congress of Aboriginal Peoples, Federation of Medical Women of Canada, Inuit Tapirisat of Canada, Metis National Council, National Indian and Inuit Community Health Representatives Organization, and Pauktuutit Inuit Women’s Association. Sponsor Society of Obstetricians and Gynaecologists of Canada. PMID:23682204

Baseline investigations of folate status in Aboriginal and non-Aboriginal West Australians prior to the introduction of mandatory fortification.

PubMed

Maxwell, Susannah J; Brameld, Kate J; Bower, Caroline; D'Antoine, Heather; Hickling, Siobhan; Marley, Julia; O'Leary, Peter

2013-02-01

In September 2009, Australia implemented mandatory folic acid fortification of wheat flour for bread-making to reduce the incidence of neural tube defects. Our study aimed to establish baseline folate status data in Aboriginal and non-Aboriginal Western Australians. Patients who presented at a health service or collection centre for blood tests were invited to participate. One hundred and ninety-one Aboriginals and 159 non-Aboriginals were recruited between April 2008 and September 2009. Participants completed a five-minute questionnaire and had blood taken for red blood cell (RBC) folate and serum vitamin B12. Data were analysed using SPSS (version 17.0.2, SPSS Inc., Chicago, IL, USA). Ten per cent (95% confidence intervals (CI): 5, 19) of the Aboriginal women participants and 26% (95% CI: 16, 40) of men had RBC folate concentrations below 250 ng/mL, the cut-off associated with folate deficiency. None of the non-Aboriginal women (95% CI: 0, 4) and 4% of the non-Aboriginal men (95% CI: 2, 12) had RBC folate concentrations below 250 ng/mL. All participants were vitamin B12 replete. None of the 96 Aboriginal and 8% of non-Aboriginal women aged 16-44 reported consumption of supplements with a daily intake of >400 μg folic acid during the previous week. This study established a baseline of RBC folate, folate consumption and supplement use in Aboriginal and non-Aboriginal groups. We identified 10% of Aboriginal women and none of non-Aboriginal women participants with low folate concentrations. The higher prevalence of folate deficiency in Aboriginal participants suggests they are more likely to benefit from a universal program of folate fortification. © 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

When We Become People with a History

ERIC Educational Resources Information Center

Kerwin, Dale Wayne

2011-01-01

Aboriginal children learn a two-way pedagogy and most Aboriginal learners have to engage in bicultural and bilingual education to succeed in the dominant educational setting. Aboriginal Australians pride themselves on being Aboriginal, however Aboriginal epistemology and ontology are never considered as true methodologies within a dominant…

The inherited risk of retained placenta: a population based cohort study.

PubMed

Endler, M; Cnattingius, S; Granfors, M; Wikström, A-K

2018-05-01

To investigate whether retained placenta in the first generation is associated with an increased risk of retained placenta in the second generation. Population-based cohort study. Sweden. Using linked generational data from the Swedish Medical Birth Register 1973-2012, we identified 494 000 second-generation births with information on the birth of the mother (first-generation index birth). For 292 897 of these births there was information also on the birth of the father. Risk of retained placenta in the second generation was calculated as adjusted odds ratios (aOR) by unconditional logistic regression with 95% confidence intervals (95% CI) according to whether retained placenta occurred in a first generation birth or not. Retained placenta in the second generation. The risk of retained placenta in a second-generation birth was increased if retained placenta had occurred at the mother's own birth (aOR 1.66, 95% CI 1.52-1.82), at the birth of one of her siblings (aOR 1.58, 95% CI 1.43-1.76) or both (aOR 2.75, 95% CI 2.18-3.46). The risk was slightly increased if retained placenta had occurred at the birth of the father (aOR 1.23, 95% CI 1.07-1.41). For preterm births in both generations, the risk of retained placenta in the second generation was increased six-fold if retained placenta had occurred at the mother's birth (OR 6.55, 95% CI 2.68-16.02). There is an intergenerational recurrence of retained placenta on the maternal and most likely also on the paternal side. The recurrence risk seems strongest in preterm pregnancies. A population-based cohort study suggests that there is an intergenerational recurrence of retained placenta. © 2017 Royal College of Obstetricians and Gynaecologists.

Literacy in Aboriginal Education: An Historical Perspective.

ERIC Educational Resources Information Center

Doige, Lynda A. Curwen

2001-01-01

A historical overview of Aboriginal education in the Maritime Provinces of Canada reveals that an Aboriginal form of literacy that existed before European contact met all the requirements of a valid literacy and is worthy of respect. Teachers' understanding and valuing of Aboriginal literacy would transform Aboriginal education. (Contains 26…

Aboriginal Education in Winnipeg Inner City High Schools.

ERIC Educational Resources Information Center

Silver, Jim; Mallett, Kathy

This study investigated the educational circumstances of Aboriginal students in inner city high schools in Winnipeg, Manitoba, Canada. It is based on a literature review and interviews with Aboriginal high school students, Aboriginal school dropouts, adult members of the Aboriginal community, and teachers. Results indicate that there is a…

Bullying in an Aboriginal Context

ERIC Educational Resources Information Center

Coffin, Juli; Larson, Ann; Cross, Donna

2010-01-01

Aboriginal children appear to be more likely to be involved in bullying than non-Aboriginal children. This paper describes part of the "Solid Kids Solid Schools" research process and discusses some of the results from this three year study involving over 260 Aboriginal children, youth, elders, teachers and Aboriginal Indigenous Education…

The Relationship of Intelligence, Self-Concept and Locus of Control to School Achievement for Aboriginal and Non-Aboriginal Children.

ERIC Educational Resources Information Center

Wright, Marilyn M.; Parker, J. L.

1978-01-01

To examine variables related to the school achievement of Aboriginal and non-Aboriginal students, 35 indigenous students and 58 non-Aboriginals in grade 8 completed a Coopersmith Self-Esteem Inventory and the Intellectual Responsibility Questionnaire. (Author/SBH)

Bioethics for clinicians: 18. Aboriginal cultures

PubMed Central

Ellerby, Jonathan H.; McKenzie, John; McKay, Stanley; Gariépy, Gilbert J.; Kaufert, Joseph M.

2000-01-01

Although philosophies and practices analogous to bioethics exist in Aboriginal cultures, the terms and categorical distinctions of "ethics" and "bioethics" do not generally exist. In this article we address ethical values appropriate to Aboriginal patients, rather than a preconceived "Aboriginal bioethic." Aboriginal beliefs are rooted in the context of oral history and culture. For Aboriginal people, decision-making is best understood as a process and not as the correct interpretation of a unified code. Aboriginal cultures differ from religious and cultural groups that draw on Scripture and textual foundations for their ethical beliefs and practices. Aboriginal ethical values generally emphasize holism, pluralism, autonomy, community- or family-based decision-making, and the maintenance of quality of life rather than the exclusive pursuit of a cure. Most Aboriginal belief systems also emphasize achieving balance and wellness within the domains of human life (mental, physical, emotional and spiritual). Although these bioethical tenets are important to understand and apply, examining specific applications in detail is not as useful as developing a more generalized understanding of how to approach ethical decision-making with Aboriginal people. Aboriginal ethical decisions are often situational and highly dependent on the values of the individual within the context of his or her family and community. PMID:11033715

Bioethics for clinicians: 18. Aboriginal cultures.

PubMed

Ellerby, J H; McKenzie, J; McKay, S; Gariépy, G J; Kaufert, J M

2000-10-03

Although philosophies and practices analogous to bioethics exist in Aboriginal cultures, the terms and categorical distinctions of "ethics" and "bioethics" do not generally exist. In this article we address ethical values appropriate to Aboriginal patients, rather than a preconceived "Aboriginal bioethic." Aboriginal beliefs are rooted in the context of oral history and culture. For Aboriginal people, decision-making is best understood as a process and not as the correct interpretation of a unified code. Aboriginal cultures differ from religious and cultural groups that draw on Scripture and textual foundations for their ethical beliefs and practices. Aboriginal ethical values generally emphasize holism, pluralism, autonomy, community- or family-based decision-making, and the maintenance of quality of life rather than the exclusive pursuit of a cure. Most Aboriginal belief systems also emphasize achieving balance and wellness within the domains of human life (mental, physical, emotional and spiritual). Although these bioethical tenets are important to understand and apply, examining specific applications in detail is not as useful as developing a more generalized understanding of how to approach ethical decision-making with Aboriginal people. Aboriginal ethical decisions are often situational and highly dependent on the values of the individual within the context of his or her family and community.

Gender variations in waist circumference levels between Aboriginal and non-Aboriginal Australian populations: a systematic review.

PubMed

Adegbija, Odewumi Oluwarotimi; Wang, Zhiqiang

2014-01-01

To compare gender-specific waist circumference (WC) levels of Aboriginal Australians with non-Aboriginal Australians. A systematic search on Medline, PubMed, EMBASE and Google Scholar databases was conducted to identify papers that reported gender-specific waist circumference (WC) estimates of participants from the age of 15 years and above among Aboriginal and non-Aboriginal Australians. Means and their 95% confidence intervals of gender differences in WC, height and weight were recorded or calculated where they were not provided. Gender-specific WC, height and weight mean estimates were pooled and the I(2) statistic was used to test heterogeneity among Aboriginal and non-Aboriginal Australians. Of 17 selected cross-sectional studies, 9 focused on Aboriginal and 8 on non-Aboriginal Australians. Seven studies reported significantly higher WC estimates among indigenous females than males. On the other hand, non-indigenous males had significantly higher WC levels than females. Males had greater height and weight estimates than females in both groups. Although indigenous women were shorter and had lower weight estimates, they had greater WC levels than indigenous men. This is the first systematic review to assess the gender-specific differences between Aboriginal and non-Aboriginal Australians. The findings of this review warrant more efforts to understand and reduce the high prevalence of central obesity and related chronic diseases among Aboriginal women. Copyright © 2014 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

A postcolonial feminist discourse analysis of urban Aboriginal women's description of pregnancy-related weight gain and physical activity.

PubMed

Darroch, Francine E; Giles, Audrey R

2016-02-01

Excessive weight gain and physical inactivity in pregnancy have been identified as risk factors for negative health outcomes for mothers and fetuses, particularly among Aboriginal women. In this paper we engage with postcolonial feminist theory and critical discourse analysis to examine the question, "how do urban Aboriginal women understand pregnancy-related weight gain and physical activity." We conducted focus groups and semi-structured interviews with 25 urban Aboriginal pregnant or postpartum women between the ages of 16 and 39 in Ottawa, Canada. Three prominent discourses emerged: Aboriginal women have different pregnancies than non-Aboriginal women because Aboriginal women gain more weight and are more likely to develop gestational diabetes; Aboriginal women feel personally responsible for and shameful about excessive weight gain; finally, Aboriginal women need culturally safe pregnancy resources. Our results illuminate the complex and often paradoxical ways in which discourses around weight gain and physical activity are produced and taken-up by Aboriginal women and their healthcare providers. Based on these findings, we argue there is a lack of accessible and culturally safe resources for urban Aboriginal women, specifically concerning weight gain and physical activity in pregnancy. We recommend the development of resources that are created for/by/with Aboriginal women to better address that issues that urban Aboriginal women themselves identify as being of key importance. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Aboriginal health workers experience multilevel barriers to quitting smoking: a qualitative study.

PubMed

Dawson, Anna P; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

2012-05-23

Long-term measures to reduce tobacco consumption in Australia have had differential effects in the population. The prevalence of smoking in Aboriginal peoples is currently more than double that of the non-Aboriginal population. Aboriginal Health Workers are responsible for providing primary health care to Aboriginal clients including smoking cessation programs. However, Aboriginal Health Workers are frequently smokers themselves, and their smoking undermines the smoking cessation services they deliver to Aboriginal clients. An understanding of the barriers to quitting smoking experienced by Aboriginal Health Workers is needed to design culturally relevant smoking cessation programs. Once smoking is reduced in Aboriginal Health Workers, they may then be able to support Aboriginal clients to quit smoking. We undertook a fundamental qualitative description study underpinned by social ecological theory. The research was participatory, and academic researchers worked in partnership with personnel from the local Aboriginal health council. The barriers Aboriginal Health Workers experience in relation to quitting smoking were explored in 34 semi-structured interviews (with 23 Aboriginal Health Workers and 11 other health staff) and 3 focus groups (n = 17 participants) with key informants. Content analysis was performed on transcribed text and interview notes. Aboriginal Health Workers spoke of burdensome stress and grief which made them unable to prioritise quitting smoking. They lacked knowledge about quitting and access to culturally relevant quitting resources. Interpersonal obstacles included a social pressure to smoke, social exclusion when quitting, and few role models. In many workplaces, smoking was part of organisational culture and there were challenges to implementation of Smokefree policy. Respondents identified inadequate funding of tobacco programs and a lack of Smokefree public spaces as policy level barriers. The normalisation of smoking in Aboriginal society was an overarching challenge to quitting. Aboriginal Health Workers experience multilevel barriers to quitting smoking that include personal, social, cultural and environmental factors. Multidimensional smoking cessation programs are needed that reduce the stress and burden for Aboriginal Health Workers; provide access to culturally relevant quitting resources; and address the prevailing normalisation of smoking in the family, workplace and community.

Implementing a working together model for Aboriginal patients with acute coronary syndrome: an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse working together to improve hospital care.

PubMed

Daws, Karen; Punch, Amanda; Winters, Michelle; Posenelli, Sonia; Willis, John; MacIsaac, Andrew; Rahman, Muhammad Aziz; Worrall-Carter, Linda

2014-11-01

Acute coronary syndrome (ACS) contributes to the disparity in life expectancy between Aboriginal and non-Aboriginal Australians. Improving hospital care for Aboriginal patients has been identified as a means of addressing this disparity. This project developed and implemented a working together model of care, comprising an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse, providing care coordination specifically directed at improving attendance at cardiac rehabilitation services for Aboriginal Australians in a large metropolitan hospital in Melbourne. A quality improvement framework using a retrospective case notes audit evaluated Aboriginal patients' admissions to hospital and identified low attendance rates at cardiac rehabilitation services. A working together model of care coordination by an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse was implemented to improve cardiac rehabilitation attendance in Aboriginal patients admitted with ACS to the cardiac wards of the hospital. A retrospective medical records audit showed that there were 68 Aboriginal patients admitted to the cardiac wards with ACS from 1 July 2008 to 30 June 2011. A referral to cardiac rehabilitation was recorded for 42% of these. During the implementation of the model of care, 13 of 15 patients (86%) received a referral to cardiac rehabilitation and eight of the 13 (62%) attended. Implementation of the working together model demonstrated improved referral to and attendance at cardiac rehabilitation services, thereby, has potential to prevent complications and mortality. WHAT IS KNOWN ABOUT THE TOPIC?: Aboriginal Australians experience disparities in access to recommended care for acute coronary syndrome. This may contribute to the life expectancy gap between Aboriginal and non-Aboriginal Australians. WHAT DOES THIS PAPER ADD?: This paper describes a model of care involving an Aboriginal Hospital Liaisons Officer and a specialist cardiac nurse working together to improve hospital care and attendance at cardiac rehabilitation services for Aboriginal Australians with acute coronary syndrome. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS?: The working together model of care could be implemented across mainstream health services where Aboriginal people attend for specialist care.

Aboriginal Health Workers experience multilevel barriers to quitting smoking: a qualitative study

PubMed Central

2012-01-01

Introduction Long-term measures to reduce tobacco consumption in Australia have had differential effects in the population. The prevalence of smoking in Aboriginal peoples is currently more than double that of the non-Aboriginal population. Aboriginal Health Workers are responsible for providing primary health care to Aboriginal clients including smoking cessation programs. However, Aboriginal Health Workers are frequently smokers themselves, and their smoking undermines the smoking cessation services they deliver to Aboriginal clients. An understanding of the barriers to quitting smoking experienced by Aboriginal Health Workers is needed to design culturally relevant smoking cessation programs. Once smoking is reduced in Aboriginal Health Workers, they may then be able to support Aboriginal clients to quit smoking. Methods We undertook a fundamental qualitative description study underpinned by social ecological theory. The research was participatory, and academic researchers worked in partnership with personnel from the local Aboriginal health council. The barriers Aboriginal Health Workers experience in relation to quitting smoking were explored in 34 semi-structured interviews (with 23 Aboriginal Health Workers and 11 other health staff) and 3 focus groups (n = 17 participants) with key informants. Content analysis was performed on transcribed text and interview notes. Results Aboriginal Health Workers spoke of burdensome stress and grief which made them unable to prioritise quitting smoking. They lacked knowledge about quitting and access to culturally relevant quitting resources. Interpersonal obstacles included a social pressure to smoke, social exclusion when quitting, and few role models. In many workplaces, smoking was part of organisational culture and there were challenges to implementation of Smokefree policy. Respondents identified inadequate funding of tobacco programs and a lack of Smokefree public spaces as policy level barriers. The normalisation of smoking in Aboriginal society was an overarching challenge to quitting. Conclusions Aboriginal Health Workers experience multilevel barriers to quitting smoking that include personal, social, cultural and environmental factors. Multidimensional smoking cessation programs are needed that reduce the stress and burden for Aboriginal Health Workers; provide access to culturally relevant quitting resources; and address the prevailing normalisation of smoking in the family, workplace and community. PMID:22621767

Intrauterine stress and male cohort quality: the case of September 11, 2001.

PubMed

Bruckner, Tim A; Nobles, Jenna

2013-01-01

Empirical research and the theory of natural selection assert that male mortality more than female mortality responds to ambient stressors in utero. Although population stressors may adversely damage males that survive to birth, the rival culled cohort hypothesis contends that males born during stressful times may exhibit better health than males in other cohorts because fetal loss has "culled" the frailest males. We tested these hypotheses by examining child developmental outcomes in a U.S. birth cohort reportedly affected in utero by the September 11, 2001 attacks. We used as outcomes the Bayley cognitive score and child height-for-age from the Early Childhood Longitudinal Study-Birth Cohort. Previous research demonstrates a male-specific effect of 9/11 on California infants born in December 2001. We, therefore, compared cognition and height of this cohort with males born prior to the 9/11 attacks. We controlled for unobserved confounding across gender, season, and region by using triple-difference regression models (N = 6950). At 24 months, California males born in December scored greater than expected in cognitive ability (coef = 9.55, standard error = 3.37; p = 0.004). We observed no relation with height. Results remained robust to alternative specifications. Findings offer partial support for the culled cohort hypothesis in that we observed greater than expected cognitive scores at two years of age among a cohort of males affected by 9/11 in utero. Contemporary population stressors may induce male-specific culling, thereby resulting in relatively improved development among males that survive to birth. Copyright © 2012 Elsevier Ltd. All rights reserved.

The association of maternal vitamin D status with infant birth outcomes, postnatal growth and adiposity in the first two years of life in a multi-ethnic Asian population: the GUSTO cohort study

PubMed Central

Ong, Yi Lin; Quah, Phaik Ling; Tint, Mya Thway; Aris, Izzuddin M.; Chen, Ling Wei; van Dam, Rob M.; Heppe, Denise; Saw, Seang-Mei; Godfrey, Keith M.; Gluckman, Peter D.; Chong, Yap Seng; Yap, Fabian; Lee, Yung Seng; Mary, Chong Foong-Fong

2016-01-01

Maternal vitamin D status during pregnancy has been associated with infant birth and postnatal growth outcomes, but reported findings have been inconsistent especially in relation to postnatal growth and adiposity outcomes. In a mother-offspring cohort in Singapore, maternal plasma vitamin D was measured between 26 to 28 weeks gestation, and anthropometric measurements were conducted on singleton offspring during the first 2 years of life with 3-month follow-up intervals to examine birth, growth and adiposity outcomes. Associations were analysed using multivariable linear regression. Of the total of 910 mothers, 13.2% were vitamin D deficient (< 50 nmol/L) and 26.5% were insufficient (50 to 75 nmol/L). After adjustment for potential confounders and multiple testing, no statistically significant associations were observed between maternal vitamin D status and any of the birth outcomes: small for gestational age: (OR1.00 [95% CI 0.56- 1.79]) and pre-term birth: (OR 1.16 [95%CI 0.64- 2.11]) or growth outcomes: weight-for-age z-scores, length-for-age z-scores, circumferences of the head, abdomen and mid-arm at birth or at postnatal, and adiposity outcomes: body mass index, and skinfold thickness (triceps, biceps and subscapular) at birth or postnatal. Maternal vitamin D status in pregnancy did not influence infant birth outcomes, postnatal growth and adiposity outcomes in this cohort, perhaps due to the low prevalence (1.6% of the cohort) of severe maternal vitamin D deficiency (defined as of<30.0 nmol/L) in our population. PMID:27339329

The association of maternal vitamin D status with infant birth outcomes, postnatal growth and adiposity in the first 2 years of life in a multi-ethnic Asian population: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort study.

PubMed

Ong, Yi Lin; Quah, Phaik Ling; Tint, Mya Thway; Aris, Izzuddin M; Chen, Ling Wei; van Dam, Rob M; Heppe, Denise; Saw, Seang-Mei; Godfrey, Keith M; Gluckman, Peter D; Chong, Yap Seng; Yap, Fabian; Lee, Yung Seng; Foong-Fong Chong, Mary

2016-08-01

Maternal vitamin D status during pregnancy has been associated with infant birth and postnatal growth outcomes, but reported findings have been inconsistent, especially in relation to postnatal growth and adiposity outcomes. In a mother-offspring cohort in Singapore, maternal plasma vitamin D was measured between 26 and 28 weeks of gestation, and anthropometric measurements were obtained from singleton offspring during the first 2 years of life with 3-month follow-up intervals to examine birth, growth and adiposity outcomes. Associations were analysed using multivariable linear regression. Of a total of 910 mothers, 13·2 % were vitamin D deficient (<50 nmol/l) and 26·5 % were insufficient (50-75 nmol/l). After adjustment for potential confounders and multiple testing, no statistically significant associations were observed between maternal vitamin D status and any of the birth outcomes - small for gestational age (OR 1·00; 95 % CI 0·56, 1·79) and pre-term birth (OR 1·16; 95 % CI 0·64, 2·11) - growth outcomes - weight-for-age z-scores, length-for-age z-scores, circumferences of the head, abdomen and mid-arm at birth or postnatally - and adiposity outcomes - BMI, and skinfold thickness (triceps, biceps and subscapular) at birth or postnatally. Maternal vitamin D status in pregnancy did not influence infant birth outcomes, postnatal growth and adiposity outcomes in this cohort, perhaps due to the low prevalence (1·6 % of the cohort) of severe maternal vitamin D deficiency (defined as of <30·0 nmol/l) in our population.

Comparison of annual percentage change in breast cancer incidence rate between Taiwan and the United States-A smoothed Lexis diagram approach.

PubMed

Chien, Li-Hsin; Tseng, Tzu-Jui; Chen, Chung-Hsing; Jiang, Hsin-Fang; Tsai, Fang-Yu; Liu, Tsang-Wu; Hsiung, Chao A; Chang, I-Shou

2017-07-01

Recent studies compared the age effects and birth cohort effects on female invasive breast cancer (FIBC) incidence in Asian populations with those in the US white population. They were based on age-period-cohort model extrapolation and estimated annual percentage change (EAPC) in the age-standardized incidence rates (ASR). It is of interest to examine these results based on cohort-specific annual percentage change in rate (APCR) by age and without age-period-cohort model extrapolation. FIBC data (1991-2010) were obtained from the Taiwan Cancer Registry and the U.S. SEER 9 registries. APCR based on smoothed Lexis diagrams were constructed to study the age, period, and cohort effects on FIBC incidence. The patterns of age-specific rates by birth cohort are similar between Taiwan and the US. Given any age-at-diagnosis group, cohort-specific rates increased overtime in Taiwan but not in the US; cohort-specific APCR by age decreased with birth year in both Taiwan and the US but was always positive and large in Taiwan. Given a diagnosis year, APCR decreased as birth year increased in Taiwan but not in the US. In Taiwan, the proportion of APCR attributable to cohort effect was substantial and that due to case ascertainment was becoming smaller. Although our study shows that incidence rates of FIBC have increased rapidly in Taiwan, thereby confirming previous results, the rate of increase over time is slowing. Continued monitoring of APCR and further investigation of the cause of the APCR decrease in Taiwan are warranted. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Tobacco, alcohol and illicit drug use among Aboriginal youth living off-reserve: results from the Youth Smoking Survey

PubMed Central

Elton-Marshall, Tara; Leatherdale, Scott T.; Burkhalter, Robin

2011-01-01

Background Despite the high prevalence of smoking among Aboriginal youth, there is a paucity of research related to tobacco use and other risk behaviours among Aboriginal youth living off-reserve in Canada. We used data from the national Youth Smoking Survey to characterize non-traditional tobacco use, exposure to second-hand smoke, and alcohol and drug use among Aboriginal youth living off-reserve. We examined whether these youth were at increased health risk compared with non-Aboriginal youth. Methods We examined cigarette smoking behaviour, use of other tobacco products, use of alcohol and other drugs, and exposure to second-hand smoke among 2620 Aboriginal youth living off-reserve and 26 223 non-Aboriginal youth in grades 9 to 12 who participated in the 2008/09 Youth Smoking Survey. Results The prevalence of current smoking among the Aboriginal youth was more than double that among non-Aboriginal youth (24.9% v. 10.4%). Aboriginal youth also had a higher prevalence of regular exposure to second-hand smoke at home (37.3% v. 19.7%) and in cars (51.0% v. 30.3%). Aboriginal youth were more likely than non-Aboriginal youth to be current smokers, to be regularly exposed to second-hand smoke, to have tried marijuana and other illicit drugs, and to engage in binge drinking. They were less likely than non-Aboriginal youth to have tried to quit smoking. Interpretation Current national estimates of smoking, and alcohol and illicit drug use among youth underestimate the prevalence of these behaviours among Aboriginal youth living off-reserve. Our findings highlight the need for culturally appropriate prevention and cessation policies and programs for this at-risk population. PMID:21555383

Predictive Accuracy of Violence Risk Scale-Sexual Offender Version Risk and Change Scores in Treated Canadian Aboriginal and Non-Aboriginal Sexual Offenders.

PubMed

Olver, Mark E; Sowden, Justina N; Kingston, Drew A; Nicholaichuk, Terry P; Gordon, Audrey; Beggs Christofferson, Sarah M; Wong, Stephen C P

2018-04-01

The present study examined the predictive properties of Violence Risk Scale-Sexual Offender version (VRS-SO) risk and change scores among Aboriginal and non-Aboriginal sexual offenders in a combined sample of 1,063 Canadian federally incarcerated men. All men participated in sexual offender treatment programming through the Correctional Service of Canada (CSC) at sites across its five regions. The Static-99R was also examined for comparison purposes. In total, 393 of the men were identified as Aboriginal (i.e., First Nations, Métis, Circumpolar) while 670 were non-Aboriginal and primarily White. Aboriginal men scored significantly higher on the Static-99R and VRS-SO and had higher rates of sexual and violent recidivism; however, there were no significant differences between Aboriginal and non-Aboriginal groups on treatment change with both groups demonstrating close to a half-standard deviation of change pre and post treatment. VRS-SO risk and change scores significantly predicted sexual and violent recidivism over fixed 5- and 10-year follow-ups for both racial/ancestral groups. Cox regression survival analyses also demonstrated positive treatment changes to be significantly associated with reductions in sexual and violent recidivism among Aboriginal and non-Aboriginal men after controlling baseline risk. A series of follow-up Cox regression analyses demonstrated that risk and change score information accounted for much of the observed differences between Aboriginal and non-Aboriginal men in rates of sexual recidivism; however, marked group differences persisted in rates of general violent recidivism even after controlling for these covariates. The results support the predictive properties of VRS-SO risk and change scores with treated Canadian Aboriginal sexual offenders.

Tobacco, alcohol and illicit drug use among Aboriginal youth living off-reserve: results from the Youth Smoking Survey.

PubMed

Elton-Marshall, Tara; Leatherdale, Scott T; Burkhalter, Robin

2011-05-17

Despite the high prevalence of smoking among Aboriginal youth, there is a paucity of research related to tobacco use and other risk behaviours among Aboriginal youth living off-reserve in Canada. We used data from the national Youth Smoking Survey to characterize non-traditional tobacco use, exposure to second-hand smoke, and alcohol and drug use among Aboriginal youth living off-reserve. We examined whether these youth were at increased health risk compared with non-Aboriginal youth. We examined cigarette smoking behaviour, use of other tobacco products, use of alcohol and other drugs, and exposure to second-hand smoke among 2620 Aboriginal youth living off-reserve and 26,223 non-Aboriginal youth in grades 9 to 12 who participated in the 2008/09 Youth Smoking Survey. The prevalence of current smoking among the Aboriginal youth was more than double that among non-Aboriginal youth (24.9% v. 10.4%). Aboriginal youth also had a higher prevalence of regular exposure to second-hand smoke at home (37.3% v. 19.7%) and in cars (51.0% v. 30.3%). Aboriginal youth were more likely than non-Aboriginal youth to be current smokers, to be regularly exposed to second-hand smoke, to have tried marijuana and other illicit drugs, and to engage in binge drinking. They were less likely than non-Aboriginal youth to have tried to quit smoking. Current national estimates of smoking, and alcohol and illicit drug use among youth underestimate the prevalence of these behaviours among Aboriginal youth living off-reserve. Our findings highlight the need for culturally appropriate prevention and cessation policies and programs for this at-risk population.

Improving forensic mental health care for Aboriginal Australians: challenges and opportunities.

PubMed

Durey, Angela; Wynaden, Dianne; Barr, Lesley; Ali, Mohammed

2014-06-01

Mental illnesses constitute a major burden of disease in Aboriginal Australians and Torres Strait Islanders (hereafter Aboriginal Australians), who are also overrepresented in the prison system. A legacy of colonization compounds such prevalence, and is further exacerbated by the persistence of racial discrimination and insensitivity across many sectors, including health. This research completed in a Western Australian forensic mental health setting identifies non-Aboriginal health professionals' support needs to deliver high-quality, culturally-safe care to Aboriginal patients. Data were collected from health professionals using an online survey and 10 semistructured interviews. Survey and interview results found that ongoing education was needed for staff to provide culturally-safe care, where Aboriginal knowledge, beliefs, and values were respected. The findings also support previous research linking Aboriginal health providers to improved health outcomes for Aboriginal patients. In a colonized country, such as Australia, education programmes that critically reflect on power relations privileging white Anglo-Australian cultural dominance and subjugating Aboriginal knowledge, beliefs, and values are important to identify factors promoting or compromising the care of Aboriginal patients and developing a deeper understanding of 'cultural safety' and its clinical application. Organizational commitment is needed to translate the findings to support non-Aboriginal health professionals deliver high-quality care to Aboriginal patients that is respectful of cultural differences. © 2013 Australian College of Mental Health Nurses Inc.

Maternal Risk Exposure and Adult Daughters' Health, Schooling, and Employment: A Constructed Cohort Analysis of 50 Developing Countries.

PubMed

Li, Qingfeng; Tsui, Amy O

2016-06-01

This study analyzes the relationships between maternal risk factors present at the time of daughters' births-namely, young mother, high parity, and short preceding birth interval-and their subsequent adult developmental, reproductive, and socioeconomic outcomes. Pseudo-cohorts are constructed using female respondent data from 189 cross-sectional rounds of Demographic and Health Surveys conducted in 50 developing countries between 1986 and 2013. Generalized linear models are estimated to test the relationships and calculate cohort-level outcome proportions with the systematic elimination of the three maternal risk factors. The simulation exercise for the full sample of 2,546 pseudo-cohorts shows that the combined elimination of risk exposures is associated with lower mean proportions of adult daughters experiencing child mortality, having a small infant at birth, and having a low body mass index. Among sub-Saharan African cohorts, the estimated changes are larger, particularly for years of schooling. The pseudo-cohort approach can enable longitudinal testing of life course hypotheses using large-scale, standardized, repeated cross-sectional data and with considerable resource efficiency.

Mortality of breast cancer in Taiwan, 1971-2010: temporal changes and an age-period-cohort analysis.

PubMed

Ho, M-L; Hsiao, Y-H; Su, S-Y; Chou, M-C; Liaw, Y-P

2015-01-01

The current paper describes the age, period and cohort effects on breast cancer mortality in Taiwan. Female breast cancer mortality data were collected from the Taiwan death registries for 1971-2010. The annual percentage changes, age- standardised mortality rates (ASMR) and age-period-cohort model were calculated. The mortality rates increased with advancing age groups when fixing the period. The percentage change in the breast cancer mortality rate increased from 54.79% at aged 20-44 years, to 149.78% in those aged 45-64 years (between 1971-75 and 2006-10). The mortality rates in the 45-64 age group increased steadily from 1971 to 1975 and 2006-10. The 1951 birth cohorts (actual birth cohort; 1947-55) showed peak mortalities in both the 50-54 and 45-49 age groups. We found that the 1951 birth cohorts had the greatest mortality risk from breast cancer. This might be attributed to the DDT that was used in large amounts to prevent deaths from malaria in Taiwan. However, future researches require DDT data to evaluate the association between breast cancer and DDT use.

Development of the Ovarian Cancer Cohort Consortium: Risk Factor Associations by Heterogeneity of Disease

DTIC Science & Technology

2013-10-01

10 cohorts have collected pathology reports – we currently are working with these cohorts to have personnel from the DCC either train on- site staff...for abstraction or to travel to the site and conduct the abstraction directly. Due to the difficulties in obtaining the appropriate permissions to...REPRODUCTIVE HISTORY PREG Number of pregnancies lasting > 6 months Twins count as a single birth; 999=unknown AGEFIRST Age at first birth

Fostering Aboriginal Leadership: Increasing Enrollment and Completion Rates in Canadian Post-Secondary Institutions

ERIC Educational Resources Information Center

King, Tracey

2008-01-01

Aboriginal people have philosophies with a holistic approach to learning that are imperative to Aboriginal leadership development. The Aboriginal worldview is needed in any long-term education strategies of Aboriginal students to increase the awareness of higher education and to address cultural, financial, and academic barriers. This article…

Factors Influencing Enrolment: A Case Study from Birth to Twenty, the 1990 Birth Cohort in Soweto-Johannesburg

ERIC Educational Resources Information Center

Richter, Linda M.; Panday, Saadhna; Norris, Shane A.

2009-01-01

Longitudinal studies offer significant advantages in rendering data commensurate with the complexity of human development. However, incomplete enrolment and attrition over time can introduce bias. Furthermore, there is a scarcity of evaluative information on cohorts in developing countries. This paper documents various strategies adopted to…

Premorbid Anomalies and Risk of Schizophrenia and Depressive Disorders in a Birth Cohort Exposed to Prenatal Rubella

ERIC Educational Resources Information Center

Penner, Justin D.; Brown, Alan S.

2007-01-01

In a birth cohort prenatally exposed to rubella, we assessed whether prospectively documented premorbid neuromotor dysfunction, mannerisms, deviant behaviors, and temperament during childhood and adolescence were impaired in cases who developed depressive disorder (DD) relative to rubella-exposed controls and cases who developed schizophrenia…

Birth Cohort Change in the Vocational Interests of Female and Male College Students

ERIC Educational Resources Information Center

Bubany, Shawn T.; Hansen, Jo-Ida C.

2011-01-01

The purpose of this research was to investigate the extent to which vocational interests have changed across birth cohorts of college students to better understand how socio-cultural factors may have an impact on career development. Using meta-analytic data collection methods, dissertations and journal articles presenting interests scores…

Birth Cohort Changes in Chinese College Students' Loneliness and Social Support

ERIC Educational Resources Information Center

Xin, Sufei; Xin, Ziqiang

2016-01-01

With the dramatic recent changes in Chinese society, Chinese college students' average levels of loneliness and social support might also have changed across their birth cohorts. The present cross-temporal meta-analysis of 56 studies (N = 21,541) found that Chinese college students' scores on the UCLA Loneliness Scale (Version 3) increased…

The Incidence of Infant Physical Abuse in Alaska

ERIC Educational Resources Information Center

Gessner, Bradford D.; Moore, Martha; Hamilton, Bernita; Muth, Pam T.

2004-01-01

Objectives: To determine the incidence of and risk factors associated with infant (less than 1 year of age) physical abuse in Alaska. Methods: A population-based retrospective cohort study for the 1994-2000 resident birth cohort was conducted by linking data from birth certificates, Child Protective Services, a statewide hospital-based trauma…

Child Maltreatment and Adolescent Mental Health Problems in a Large Birth Cohort

ERIC Educational Resources Information Center

Mills, Ryan; Scott, James; Alati, Rosa; O'Callaghan, Michael; Najman, Jake M.; Strathearn, Lane

2013-01-01

Objective: To examine whether notified child maltreatment is associated with adverse psychological outcomes in adolescence, and whether differing patterns of psychological outcome are seen depending on the type of maltreatment. Methods: The participants were 7,223 mother and child pairs enrolled in a population-based birth cohort study in…

Education and fertility decline in China during transitional times: A cohort approach.

PubMed

Piotrowski, Martin; Tong, Yuying

2016-01-01

We examine the effect of education on birth outcomes in China during the period of economic transition and large-scale changes in mass education and population control measures. Retrospective micro data from the 2008 Chinese General Social Survey and discrete time event history analysis are used to examine the fertility history of several cohorts of women born between 1945 and 1968. We observed births at different parities, distinguishing the education effect across cohorts and rural/urban sectors. We found differences across cohorts consistent with unique features of the Chinese context, such as the radical egalitarian era of educational expansion, and the Reform Era. We also found that despite the increase in some education levels across cohorts (e.g., junior high school in rural areas), birth chances were more likely to be concentrated among less educated women, suggesting the impact of factors related to returns to education and hence the desire for children. Copyright © 2015 Elsevier Inc. All rights reserved.

Congenital Microphthalmia, Anophthalmia and Coloboma among Live Births in Denmark.

PubMed

Roos, Laura; Jensen, Hanne; Grønskov, Karen; Holst, René; Tümer, Zeynep

2016-10-01

This study aims to quantify the occurrence of the congenital eye malformations anophthalmia (AO), microphthalmia (MO) and coloboma among liveborn infants in Denmark, and to estimate the rate of chromosomal abnormalities in this group of patients. A cohort of patients born in 1995-2012 with diagnoses of MO/AO or coloboma was identified from the Danish National Patient Registry (DNPR), and their ocular and extra-ocular diagnoses were reviewed. In order to assess the occurrence of chromosomal abnormalities in the cohort, the data were cross-referenced with the Danish Cytogenetic Central Registry (DCCR). We identified 415 patients with MO/AO/coloboma in the DNPR. The total number of live births from 1995-2012 was 1,174,299, and the average birth prevalence of MO/AO/coloboma was 3.6/10,000 live births and of MO/AO was 1.2/10,000 live births. Extra-ocular abnormalities were observed in 32.1% of MO/AO cases and 21.7% of coloboma cases. Chromosome analysis was performed in 36.1% of the cohort, and 14.7% of cases had an abnormal karyotype. In 8.7% of the cohort, a chromosome microarray analysis was performed, and in 44.4% of cases, a possibly pathogenic copy number variation was observed. The birth prevalence of MO/AO/coloboma in Denmark has been steady at 3.6/10,000 live births during the last 17 years. The rate of syndromic cases was lower compared to other studies. A relatively high rate of pathogenic chromosomal aberrations was observed, suggesting an important role for cytogenetic analysis in this group of patients.

Successful partnerships are the key to improving Aboriginal health.

PubMed

Bailey, Sandra; Hunt, Jennifer

2012-06-01

Partnership is a process that must be recognised as a fundamental part of any strategy for improving health outcomes for Aboriginal people. Addressing the inequities in health outcomes between Aboriginal people and other Australians will require a sustained, coordinated and well-informed approach that works to a set of goals and targets developed with input from the Aboriginal community. Partnerships provide the most effective mechanism for obtaining this essential input from Aboriginal communities and their representative organisations, enabling Aboriginal people to have an influence at all stages of the health-care process. Within the health sector, effective partnerships harness the efforts of governments and the expertise of Aboriginal Community Controlled Health Services, which offer the most effective means of delivering comprehensive primary health care to Aboriginal people.

Improving the efficacy of healthcare services for Aboriginal Australians.

PubMed

Gwynne, Kylie; Jeffries, Thomas; Lincoln, Michelle

2018-01-16

Objective The aim of the present systematic review was to examine the enablers for effective health service delivery for Aboriginal Australians. Methods This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Papers were included if they had data related to health services for Australian Aboriginal people and were published between 2000 and 2015. The 21 papers that met the inclusion criteria were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Seven papers were subsequently excluded due to weak methodological approaches. Results There were two findings in the present study: (1) that Aboriginal people fare worse than non-Aboriginal people when accessing usual healthcare services; and (2) there are five enablers for effective health care services for Australian Aboriginal people: cultural competence, participation rates, organisational, clinical governance and compliance, and availability of services. Conclusions Health services for Australian Aboriginal people must be tailored and implementation of the five enablers is likely to affect the effectiveness of health services for Aboriginal people. The findings of the present study have significant implications in directing the future design, funding, delivery and evaluation of health care services for Aboriginal Australians. What is known about the topic? There is significant evidence about poor health outcomes and the 10-year gap in life expectancy between Aboriginal and non-Aboriginal people, and limited evidence about improving health service efficacy. What does this paper add? This systematic review found that with usual health care delivery, Aboriginal people experience worse health outcomes. This paper identifies five strategies in the literature that improve the effectiveness of health care services intended for Aboriginal people. What are the implications for practitioners? Aboriginal people fare worse in both experience and outcomes when they access usual care services. Health services intended for Aboriginal people should be tailored using the five enablers to provide timely, culturally safe and high-quality care.

Preconception care for women with type 2 diabetes mellitus: A mixed-methods study of provider knowledge and practice.

PubMed

Klein, J; Boyle, J A; Kirkham, R; Connors, C; Whitbread, C; Oats, J; Barzi, F; McIntyre, D; Lee, I; Luey, M; Shaw, J; Brown, A D H; Maple-Brown, L J

2017-07-01

Preconception care may decrease adverse pregnancy outcomes associated with pre-existing diabetes mellitus. Aboriginal Australians are at high risk of type 2 diabetes mellitus (T2DM), with earlier onset. We explored practitioner views on preconception care delivery for women with T2DM in the Northern Territory, where 31% of births are to Aboriginal women. Mixed-methods study including cross-sectional survey of 156 health practitioners and 11 semi-structured interviews. Practitioners reported low attendance for preconception care however, 51% provided counselling on an opportunistic basis. Rural/remote practitioners were most likely to find counselling feasible. The majority (69%) utilised appropriate guidelines and addressed lifestyle modifications including smoking (81%), weight management (79%), and change medications appropriately such as ceasing ACE inhibitors (69%). Fewer (40%) prescribed the recommended dose of folate (5mg) or felt comfortable recommending delaying pregnancy to achieve optimal preconception glucose control (42%). Themes identified as barriers to care included the complexity of care setting and infrequent preconception consultations. There was a focus on motivation of women to make informed choices about conception, including birth spacing, timing and contraception. Preconception care enablers included cross-cultural communication, a multi-disciplinary care team and strong client-based relationships. Health practitioners are keen to provide preconception counselling and reported knowledge of evidence-based guidelines. Improvements are needed in recommending high dose folate and optimising glucose control. Cross-cultural communication and team-based care were reported as fundamental to successful preconception care in women with T2DM. Continued education and policy changes are required to support practitioners in opportunities to enhance pregnancy planning. Copyright © 2017 Elsevier B.V. All rights reserved.

Exploration of preterm birth rates associated with different models of antenatal midwifery care in Scotland: Unmatched retrospective cohort analysis.

PubMed

Symon, Andrew; Winter, Clare; Cochrane, Lynda

2015-06-01

preterm birth represents a significant personal, clinical, organisational and financial burden. Strategies to reduce the preterm birth rate have had limited success. Limited evidence indicates that certain antenatal care models may offer some protection, although the causal mechanism is not understood. We sought to compare preterm birth rates for mixed-risk pregnant women accessing antenatal care organised at a freestanding midwifery unit (FMU) and mixed-risk pregnant women attending an obstetric unit (OU) with related community-based antenatal care. unmatched retrospective 4-year Scottish cohort analysis (2008-2011) of mixed-risk pregnant women accessing (i) FMU antenatal care (n=1107); (ii) combined community-based and OU antenatal care (n=7567). Data were accessed via the Information and Statistics Division of the NHS in Scotland. Aggregates analysis and binary logistic regression were used to compare the cohorts׳ rates of preterm birth; and of spontaneous labour onset, use of pharmacological analgesia, unassisted vertex birth, and low birth weight. Odds ratios were adjusted for age, parity, deprivation score and smoking status in pregnancy. after adjustment the 'mixed risk' FMU cohort had a statistically significantly reduced risk of preterm birth (5.1% [n=57] versus 7.7% [n=583]; AOR 0.73 [95% CI 0.55-0.98]; p=0.034). Differences in these secondary outcome measures were also statistically significant: spontaneous labour onset (FMU 83.9% versus OU 74.6%; AOR 1.74 [95% CI 1.46-2.08]; p<0.001); minimal intrapartum analgesia (FMU 53.7% versus OU 34.4%; AOR 2.17 [95% CI 1.90-2.49]; p<0.001); spontaneous vertex delivery (FMU 71.9% versus OU 63.5%; AOR 1.46 [95% CI 1.32-1.78]; p<0.001). Incidence of low birth weight was not statistically significant after adjustment for other variables. There was no significant difference in the rate of perinatal or neonatal death. given this study׳s methodological limitations, we can only claim associations between the care model and or chosen outcomes. Although both cohorts were mixed risk, differences in risk levels could have contributed to these findings. Nevertheless, the significant difference in preterm birth rates in this study resonates with other research, including the recent Cochrane review of midwife-led continuity models. Because of the multiplicity of risk factors for preterm birth we need to explore the salient features of the FMU model which may be contributing to this apparent protective effect. Because a randomised controlled trial would necessarily restrict choice to pregnant women, we feel that this option is problematic in exploring this further. We therefore plan to conduct a prospective matched cohort analysis together with a survey of unit practices and experiences. Copyright © 2015 Elsevier Ltd. All rights reserved.

Assessing Very Early Infant Diagnosis Turnaround Times: Findings from a Birth Testing Pilot in Lesotho

PubMed Central

Hoffman, Heather J.; Mokone, Majoalane; Tukei, Vincent J.; Nchephe, Matsepeli; Phalatse, Mamakhetha; Tiam, Appolinaire; Guay, Laura; Mofenson, Lynne

2017-01-01

Very early infant diagnosis (VEID) (testing within two weeks of life), combined with rapid treatment initiation, could reduce early infant mortality. Our study evaluated turnaround time (TAT) to receipt of infants' HIV test results and ART initiation if HIV-infected, with and without birth testing availability. Data from facility records and national databases were collected for 12 facilities offering VEID, as part of an observational prospective cohort study, and 10 noncohort facilities. HIV-exposed infants born in January–June 2016 and any cohort infant diagnosed as HIV-infected at birth or six weeks were included. The median TAT from blood draw to caregiver result receipt was 76.5 days at birth and 63 and 70 days at six weeks at cohort and noncohort facilities, respectively. HIV-exposed infants tested at birth were approximately one month younger when their caregivers received results versus those tested at six weeks. Infants diagnosed at birth initiated ART about two months earlier (median 6.4 weeks old) than those identified at six weeks (median 14.8 weeks). However, the long TAT for testing at both birth and six weeks illustrates the prolonged process for specimen transport and result return that could compromise the effectiveness of adding VEID to existing overburdened EID systems. PMID:29410914

Presence and process of fear of birth during pregnancy-Findings from a longitudinal cohort study.

PubMed

Hildingsson, Ingegerd; Haines, Helen; Karlström, Annika; Nystedt, Astrid

2017-10-01

The prevalence of fear of birth has been estimated between 8-30%, but there is considerable heterogeneity in research design, definitions, measurement tools used and populations. There are some inconclusive findings about the stability of childbirth fear. to assess the prevalence and characteristics of women presenting with scores ≥60 on FOBS-The Fear of Birth Scale, in mid and late pregnancy, and to study change in fear of birth and associated factors. A prospective longitudinal cohort study of a one-year cohort of 1212 pregnant women from a northern part of Sweden, recruited in mid pregnancy and followed up in late pregnancy. Fear of birth was assessed using FOBS-The fear of birth scale, with the cut off at ≥60. The prevalence of fear of birth was 22% in mid pregnancy and 19% in late pregnancy, a statistically significant decrease. Different patterns were found where some women presented with increased fear and some with decreased fear. The women who experienced more fear or less fear later in pregnancy could not be differentiated by background factors. More research is needed to explore factors important to reduce fear of childbirth and the optimal time to measure it. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Selection bias and patterns of confounding in cohort studies: the case of the NINFEA web-based birth cohort.

PubMed

Pizzi, Costanza; De Stavola, Bianca L; Pearce, Neil; Lazzarato, Fulvio; Ghiotti, Paola; Merletti, Franco; Richiardi, Lorenzo

2012-11-01

Several studies have examined the effects of sample selection on the exposure-outcome association estimates in cohort studies, but the reasons why this selection may induce bias have not been fully explored. To investigate how sample selection of the web-based NINFEA birth cohort may change the confounding patterns present in the source population. The characteristics of the NINFEA participants (n=1105) were compared with those of the wider source population-the Piedmont Birth Registry (PBR)-(n=36 092), and the association of two exposures (parity and educational level) with two outcomes (low birth weight and birth by caesarean section), while controlling for other risk factors, was studied. Specifically the associations among measured risk factors within each dataset were examined and the exposure-outcome estimates compared in terms of relative ORs. The associations of educational level with the other risk factors (alcohol consumption, folic acid intake, maternal age, pregnancy weight gain, previous miscarriages) partly differed between PBR and NINFEA. This was not observed for parity. Overall, the exposure-outcome estimates derived from NINFEA only differed moderately from those obtained in PBR, with relative ORs ranging between 0.74 and 1.03. Sample selection in cohort studies may alter the confounding patterns originally present in the general population. However, this does not necessarily introduce selection bias in the exposure-outcome estimates, as sample selection may reduce some of the residual confounding present in the general population.

Infant mortality in Pelotas, Brazil: a comparison of risk factors in two birth cohorts.

PubMed

Menezes, Ana Maria Baptista; Hallal, Pedro Curi; Santos, Iná Silva dos; Victora, Cesar Gomes; Barros, Fernando Celso

2005-12-01

To compare two population-based birth cohorts to assess trends in infant mortality rates and the distribution of relevant risk factors, and how these changed after an 11-year period. Data from two population-based prospective birth cohorts (1982 and 1993) were analyzed. Both studies included all children born in a hospital (> 99% of all births) in the city of Pelotas, Southern Brazil. Infant mortality was monitored through surveillance of all maternity hospitals, mortality registries and cemeteries. There were 5,914 live-born children in 1982 and 5,249 in 1993. The infant mortality rate decreased by 41%, from 36.0 per 1,000 live births in 1982 to 21.1 per 1,000 in 1993. Socioeconomic and maternal factors tended to become more favorable during the study period, but there were unfavorable changes in birthweight and gestational age. Poverty, high parity, low birthweight, preterm delivery, and intrauterine growth restriction were the main risk factors for infant mortality in both cohorts. The 41% reduction in infant mortality between 1982 and 1993 would have been even greater had the prevalence of risk factors remained constant during the period studied here. There were impressive declines in infant mortality which were not due to changes in the risk factors we studied. Because no reduction was seen in the large social inequalities documented in the 1982 cohort, it is likely that the reduction in infant mortality resulted largely from improvements in health care.

Perinatal outcomes and changes in the oral cavity: Brazilian cohorts of Ribeirão Preto and São Luís.

PubMed

Thomaz, Érika Bárbara Abreu Fonseca; Alves, Cláudia Maria Coêlho; Ribeiro, Cecília Cláudia Costa; Batista, Rosângela Fernandes Lucena; Simões, Vanda Maria Ferreira; Cavalli, Ricardo; Saraiva, Maria da Conceição; Cardoso, Viviane Cunha; Bettiol, Heloisa; Barbieri, Marco Antonio; da Silva, Antônio Augusto Moura

2015-01-01

Studies have shown a possible association of oral diseases during pregnancy with preterm birth (PTB) and low birth weight (LBW). These perinatal outcomes appear to be associated with enamel defects in the primary dentition, which, in turn, seem to predispose to future development of caries in children. Therefore it is relevant to include oral health variables of the mother/child dyad in cohort studies to understand how these factors are associated. The objectives of this study are: 1) check if there is an association between diseases of the oral cavity of pregnant women and PTB, 2) test the hypothesis of association between perinatal outcomes and enamel defects/dental caries in children, 3) examine whether there are associations between perinatal outcomes and disorders of tooth eruption in children; 4) build theoretical models to study social inequities as a common factor between oral conditions and perinatal outcomes. We used an integrated, collaborative approach between two Brazilian cities with contrasting socioeconomic conditions: Sao Luis , MA, and Ribeirão Preto, SP - British Birth Cohort Studies study (BRISA Ribeirão Preto, São Luís). Two cohorts were evaluated: one initiated at birth, representative of the population of live births, and another, initiated prenatally. Participants were reassessed from the beginning of the second year of life. It is expected that these cohorts will contribute to foster the development and consolidation of population-based follow-up studies in Brazil.

Longitudinal Intergenerational Birth Cohort Designs: A Systematic Review of Australian and New Zealand Studies

PubMed Central

Townsend, Michelle L.; Riepsamen, Angelique; Georgiou, Christos; Flood, Victoria M.; Caputi, Peter; Wright, Ian M.; Davis, Warren S.; Jones, Alison; Larkin, Theresa A.; Williamson, Moira J.; Grenyer, Brin F. S.

2016-01-01

Background The longitudinal birth cohort design has yielded a substantial contribution to knowledge of child health and development. The last full review in New Zealand and Australia in 2004 identified 13 studies. Since then, birth cohort designs continue to be an important tool in understanding how intrauterine, infant and childhood development affect long-term health and well-being. This updated review in a defined geographical area was conducted to better understand the factors associated with successful quality and productivity, and greater scientific and policy contribution and scope. Methods We adopted the preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach, searching PubMed, Scopus, Cinahl, Medline, Science Direct and ProQuest between 1963 and 2013. Experts were consulted regarding further studies. Five inclusion criteria were used: (1) have longitudinally tracked a birth cohort, (2) have collected data on the child and at least one parent or caregiver (3) be based in Australia or New Zealand, (4) be empirical in design, and (5) have been published in English. Results 10665 records were initially retrieved from which 23 birth cohort studies met the selection criteria. Together these studies recruited 91,196 participants, with 38,600 mothers, 14,206 fathers and 38,390 live births. Seventeen studies were located in Australia and six in New Zealand. Research questions initially focused on the perinatal period, but as studies matured, longer-term effects and outcomes were examined. Conclusions This review demonstrates the significant yield from this effort both in terms of scientific discovery and social policy impact. Further opportunities have been recognised with cross-study collaboration and pooling of data between established and newer studies and international studies to investigate global health determinants. PMID:26991330

Large prospective birth cohort studies on environmental contaminants and child health - goals, challenges, limitations and needs.

PubMed

Luo, Zhong-Cheng; Liu, Jian-Meng; Fraser, William D

2010-02-01

The adverse health effects of environmental contaminants (ECs) are a rising public health concern, and a major threat to sustainable socioeconomic development. The developing fetuses and growing children are particularly vulnerable to the adverse effects of ECs. However, assessing the health impact of ECs presents a major challenge, given that multiple outcomes may arise from one exposure, multiple exposures may result in one outcome, and the complex interactions between ECs, and between ECs, nutrients and genetic factors, and the dynamic temporal changes in EC exposures during the life course. Large-scale prospective birth cohort studies collecting extensive data and specimen starting from the prenatal or pre-conception period, although costly, hold promise as a means to more clearly quantify the health effects of ECs, and to unravel the complex interactions between ECs, nutrients and genotypes. A number of such large-scale studies have been launched in some developed counties. We present an overview of "why", "what" and "how" behind these efforts with an objective to uncover major unidentified limitations and needs. Three major limitations were identified: (1) limited data and bio-specimens regarding early life EC exposure assessments in some birth cohort studies; (2) heavy participant burdens in some birth cohort studies may bias participant recruitment, and risk substantial loss to follow-up, protocol deviations limiting the quality of data and specimens collection, with an overall potential bias towards the null effect; (3) lack of concerted efforts in building comparable birth cohorts across countries to take advantage of natural "experiments" (large EC exposure level differences between countries) for more in-depth assessments of dose-response relationships, threshold exposure levels, and positive and negative effect modifiers. Addressing these concerns in current or future large-scale birth cohort studies may help to produce better evidence on the health effects of ECs.

Immunogenicity and safety of 3-dose primary vaccination with combined DTPa-HBV-IPV/Hib vaccine in Canadian Aboriginal and non-Aboriginal infants.

PubMed

Scheifele, David W; Ferguson, Murdo; Predy, Gerald; Dawar, Meena; Assudani, Deepak; Kuriyakose, Sherine; Van Der Meeren, Olivier; Han, Htay-Htay

2015-04-15

This study compared immune responses of healthy Aboriginal and non-Aboriginal infants to Haemophilus influenzae type b (Hib) and hepatitis B virus (HBV) components of a DTaP-HBV-IPV/Hib combination vaccine, 1 month after completing dosing at 2, 4 and 6 months of age. Of 112 infants enrolled in each group, 94 Aboriginal and 107 non-Aboriginal infants qualified for the immunogenicity analysis. Anti-PRP concentrations exceeded the protective minimum (≥0.15 μg/ml) in ≥97% of infants in both groups but geometric mean concentrations (GMCs) were higher in Aboriginal infants (6.12 μg/ml versus 3.51 μg/ml). All subjects were seroprotected (anti-HBs ≥10 mIU/mL) against HBV, with groups having similar GMCs (1797.9 versus 1544.4 mIU/mL, Aboriginal versus non-Aboriginal, respectively). No safety concerns were identified. We conclude that 3-dose primary vaccination with DTaP-HBV-IPV/Hib combination vaccine elicited immune responses to Hib and HBV components that were at least as high in Aboriginal as in non-Aboriginal Canadian infants. Clinical Trial Registration NCT00753649. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Maternal tea consumption and the risk of preterm delivery in urban China: a birth cohort study.

PubMed

Huang, Lei; Lerro, Catherine; Yang, Tao; Li, Jing; Qiu, Jie; Qiu, Weitao; He, Xiaochun; Cui, Hongmei; Lv, Ling; Xu, Ruifeng; Xu, Xiaoying; Huang, Huang; Liu, Qing; Zhang, Yawei

2016-05-31

Studies investigating the relationship between maternal tea drinking and risk of preterm birth have reached inconsistent results. The present study analyzed data from a birth cohort study including 10,179 women who delivered a singleton live birth were conducted in Lanzhou, China between 2010 and 2012. Drinking tea (OR = 1.36, 95 % CI: 1.09-1.69), and specifically green (OR = 1.42, 95 % CI: 1.08-1.85) or scented tea (OR = 1.61, 95 % CI: 1.04-2.50), was associated with an increased risk of preterm birth. Drinking tea was associated with both moderate preterm (OR = 1.41, 95 % CI: 1.12-1.79) and spontaneous preterm birth (OR = 1.41, 95 % CI: 1.09-1.83). Risk of preterm birth increased with decreasing age of starting tea drinking (<20 years, OR = 1.60, 95 % CI: 1.17-2.20) and increasing duration (p for trend < 0.01). The relationship between tea drinking and preterm birth is modified by both maternal age (p < 0.05) and gestational weight gain (p < 0.05). Despite conflicting findings in the previous literature, we saw a significant association with maternal tea drinking and risk of preterm birth in our cohort. More studies are needed both to confirm this finding and to elucidate the mechanism behind this association.

Prenatal Ambient Air Pollution, Placental Mitochondrial DNA Content, and Birth Weight in the INMA (Spain) and ENVIRONAGE (Belgium) Birth Cohorts.

PubMed

Clemente, Diana B P; Casas, Maribel; Vilahur, Nadia; Begiristain, Haizea; Bustamante, Mariona; Carsin, Anne-Elie; Fernández, Mariana F; Fierens, Frans; Gyselaers, Wilfried; Iñiguez, Carmen; Janssen, Bram G; Lefebvre, Wouter; Llop, Sabrina; Olea, Nicolás; Pedersen, Marie; Pieters, Nicky; Santa Marina, Loreto; Souto, Ana; Tardón, Adonina; Vanpoucke, Charlotte; Vrijheid, Martine; Sunyer, Jordi; Nawrot, Tim S

2016-05-01

Mitochondria are sensitive to environmental toxicants due to their lack of repair capacity. Changes in mitochondrial DNA (mtDNA) content may represent a biologically relevant intermediate outcome in mechanisms linking air pollution and fetal growth restriction. We investigated whether placental mtDNA content is a possible mediator of the association between prenatal nitrogen dioxide (NO2) exposure and birth weight. We used data from two independent European cohorts: INMA (n = 376; Spain) and ENVIRONAGE (n = 550; Belgium). Relative placental mtDNA content was determined as the ratio of two mitochondrial genes (MT-ND1 and MTF3212/R3319) to two control genes (RPLP0 and ACTB). Effect estimates for individual cohorts and the pooled data set were calculated using multiple linear regression and mixed models. We also performed a mediation analysis. Pooled estimates indicated that a 10-μg/m3 increment in average NO2 exposure during pregnancy was associated with a 4.9% decrease in placental mtDNA content (95% CI: -9.3, -0.3%) and a 48-g decrease (95% CI: -87, -9 g) in birth weight. However, the association with birth weight was significant for INMA (-66 g; 95% CI: -111, -23 g) but not for ENVIRONAGE (-20 g; 95% CI: -101, 62 g). Placental mtDNA content was associated with significantly higher mean birth weight (pooled analysis, interquartile range increase: 140 g; 95% CI: 43, 237 g). Mediation analysis estimates, which were derived for the INMA cohort only, suggested that 10% (95% CI: 6.6, 13.0 g) of the association between prenatal NO2 and birth weight was mediated by changes in placental mtDNA content. Our results suggest that mtDNA content can be one of the potential mediators of the association between prenatal air pollution exposure and birth weight. Clemente DB, Casas M, Vilahur N, Begiristain H, Bustamante M, Carsin AE, Fernández MF, Fierens F, Gyselaers W, Iñiguez C, Janssen BG, Lefebvre W, Llop S, Olea N, Pedersen M, Pieters N, Santa Marina L, Souto A, Tardón A, Vanpoucke C, Vrijheid M, Sunyer J, Nawrot TS. 2016. Prenatal ambient air pollution, placental mitochondrial DNA content, and birth weight in the INMA (Spain) and ENVIRONAGE (Belgium) birth cohorts. Environ Health Perspect 124:659-665; http://dx.doi.org/10.1289/ehp.1408981.

A Personal Story of Teaching Aboriginal Art as a Non-Aboriginal Person

ERIC Educational Resources Information Center

Fritzlan, Amanda

2017-01-01

This is an autoethnographic reflection of teaching Aboriginal art as a non-Aboriginal person. Over a period of ten months, a class of grade seven students was led through an inquiry into Aboriginal art including research and the creation of individual and group art pieces. The evolving curriculum was shaped by considerations of respect for…

Tertiary Success for the Aboriginal Student: The Numerous Factors Impacting on the Dream.

ERIC Educational Resources Information Center

Eltchelebi, Wadda

This paper presents an overview of Aboriginal education in the state of Victoria, Australia, as a frame for the role of the Aboriginal Tertiary Support Unit (ATSU) at La Trobe University, Bendigo. At the elementary and secondary levels, Aboriginal advocacy and support are provided by the Victorian Aboriginal Education Association, which promotes…

Do baby boomers use more healthcare services than other generations? Longitudinal trajectories of physician service use across five birth cohorts

PubMed Central

Canizares, Mayilee; Gignac, Monique; Hogg-Johnson, Sheilah; Glazier, Richard H; Badley, Elizabeth M

2016-01-01

Objective In light of concerns for meeting the provision of healthcare services given the large numbers of ageing baby boomers, we compared the trajectories of primary care and specialist services use across the lifecourse of 5 birth cohorts and examined factors associated with birth cohort differences. Design Longitudinal panel. Setting Canadian National Population Health Survey (1994–2011). Population Sample of 10 186 individuals aged 20–69 years in 1994–1995 and who were from 5 birth cohorts: Generation X (Gen X; born: 1965–1974), Younger Baby Boomers (born: 1955–1964), Older Baby Boomers (born: 1945–1954), World War II (born: 1935–1944) and pre-World War II (born: 1925–1934). Main outcomes Use of primary care and specialist services. Results Although the overall pattern suggested less use of physician services by each successive recent cohort, this blinded differences in primary and specialist care use by cohort. Multilevel analyses comparing cohorts showed that Gen Xers and younger boomers, particularly those with multimorbidity, were less likely to use primary care than earlier cohorts. In contrast, specialist use was higher in recent cohorts, with Gen Xers having the highest specialist use. These increases were explained by the increasing levels of multimorbidity. Education, income, having a regular source of care, sedentary lifestyle and obesity were significantly associated with physician services use, but only partially contributed to cohort differences. Conclusions The findings suggest a shift from primary care to specialist care among recent cohorts, particularly for those with multimorbidity. This is of concern given policies to promote primary care services to prevent and manage chronic conditions. There is a need for policies to address important generational differences in healthcare preferences and the balance between primary and specialty care to ensure integration and coordination of healthcare delivery. PMID:27687902

Gender and socioeconomic disparities in BMI trajectories in the Seychelles: a cohort analysis based on serial population-based surveys.

PubMed

Rossi, Isabelle A; Rousson, Valentin; Viswanathan, Bharathi; Bovet, Pascal

2011-12-09

The relationship between body mass index (BMI) and socioeconomic status (SES) tends to change over time and across populations. In this study, we examined, separately in men and women, whether the association between BMI and SES changed over successive birth cohorts in the Seychelles (Indian Ocean, African region). We used data from all participants in three surveys conducted in 1989, 1994 and 2004 in independent random samples of the population aged 25-64 years in the Seychelles (N = 3'403). We used linear regression to model mean BMI according to age, cohort, SES and smoking status, allowing for a quadratic term for age to account for a curvilinear relation between BMI and age and interactions between SES and age and between SES and cohorts to test whether the relation between SES and BMI changed across subsequent cohorts. All analyses were performed separately in men and women. BMI increased with age in all birth cohorts. BMI was lower in men of low SES than high SES but was higher in women of low SES than high SES. In all SES categories, BMI increased over successive cohorts (1.24 kg/m2 in men and 1.51 kg/m2 for a 10-year increase in birth cohorts, p < 0.001). The difference in BMI between men or women of high vs. low SES did not change significantly across successive cohorts (the interaction between SES and year of birth of cohort was statistically not significant). Smoking was associated with lower BMI in men and women (respectively -1.55 kg/m2 and 2.46 kg/m2, p < 0.001). Although large differences exist between men and women, social patterning of BMI did not change significantly over successive cohorts in this population of a middle-income country in the African region.

Tracing the cigarette epidemic: an age-period-cohort study of education, gender and smoking using a pseudo-panel approach.

PubMed

Vedøy, Tord F

2014-11-01

This study examined if temporal variations in daily cigarette smoking and never smoking among groups with different levels of education fit the pattern proposed by the theory of diffusion of innovations (TDI), while taking into account the separate effects of age, period and birth cohort (APC). Aggregated data from nationally representative interview surveys from Norway from 1976 to 2010 was used to calculate probabilities of smoking using an APC approach in which the period variable was normalized to pick up short term cyclical effects. Results showed that educational differences in smoking over time were more strongly determined by birth cohort membership than variations in smoking behavior across the life course. The probability of daily smoking decreased faster across cohorts among higher compared to lower educated. In contrast, the change in probability of never having smoked across cohorts was similar in the two education groups, but stronger among men compared to women. Moreover, educational differences in both daily and never smoking increased among early cohorts and leveled off among late cohorts. The results emphasizes the importance of birth cohort for social change and are consistent with TDI, which posits that smoking behavior diffuse through the social structure over time. Copyright © 2014 Elsevier Inc. All rights reserved.

Becoming empowered: a grounded theory study of Aboriginal women's agency.

PubMed

Bainbridge, Roxanne

2011-07-01

The study aim was to identify the process underlying the performance of agency for urban-dwelling Aboriginal women in contemporary Australian society with a view to promoting social change for Aboriginal people. Grounded theory methods were used in the conduct of 20 life history narrative interviews with Aboriginal women from across fourteen different language groups. Analysis identified a specific ecological model of Aboriginal women's empowerment, defined as "becoming empowered". "Performing Aboriginality" was identified as the core category and encompassed the women's concern for carving out a fulfilling life and carrying out their perceived responsibilities as Aboriginal women. While confirming much of the extant literature on empowerment, the analysis also offered unique contributions--a spiritual sensibility, cultural competence and an ethics of care and morality. This sheds new light on the creative ways in which Aboriginal women "disrupt" discourses and create alternate modes of existence. The findings have implications for improving quality of life for Aboriginal people by informing the practical development and delivery of social and health policies and programs.

The changing epidemiology of invasive pneumococcal disease in aboriginal and non-aboriginal western Australians from 1997 through 2007 and emergence of nonvaccine serotypes.

PubMed

Lehmann, Deborah; Willis, Judith; Moore, Hannah C; Giele, Carolien; Murphy, Denise; Keil, Anthony D; Harrison, Catherine; Bayley, Kathy; Watson, Michael; Richmond, Peter

2010-06-01

BACKGROUND. In 2001, Australia introduced a unique 7-valent pneumococcal conjugate vaccine (7vPCV) 2-, 4-, and 6-month schedule with a 23-valent pneumococcal polysaccharide vaccine (23vPPV) booster for Aboriginal children, and in 2005, 7vPCV alone in a 2-, 4-, and 6-month schedule for non-Aboriginal children. Aboriginal adults are offered 23vPPV but coverage is poor. We investigated trends in invasive pneumococcal disease (IPD) in Western Australia (WA). METHODS. Enhanced IPD surveillance has been ongoing since 1996. We calculated IPD incidence rates for Aboriginal and non-Aboriginal Australians before and after introduction of 7vPCV. RESULTS. A total of 1792 cases occurred during the period 1997-2007; the IPD incidence rate was 47 cases per 100,000 population per year among Aboriginal people and 7 cases per 100,000 population per year in non-Aboriginal people. After introduction of 7vPCV, IPD rates among Aboriginal children decreased by 46% for those <2 years of age and by 40% for those 2-4 years of age; rates decreased by 64% and 51% in equivalent age groups for non-Aboriginal children. IPD rates decreased by >30% in non-Aboriginal people 50 years of age but increased among Aboriginal adults (eg, from 59.1 to 109.6 cases per 100,000 population per year among those 30-49 years of age). Although IPD due to 7vPCV serotypes decreased in all age groups, IPD incidence due to non-7vPCV serotypes increased, and it almost doubled among Aboriginal adults 30-49 years of age (from 48.3 to 97.0 cases per 100,000 population per year). Among non-Aboriginal children, 37% of IPD is now due to serotype 19A. CONCLUSIONS. IPD incidence rates have decreased markedly among children and non-Aboriginal adults with a 3-dose infant 7vPCV schedule. However, IPD due to non-7vPCV serotypes has increased and is of particular concern among young Aboriginal adults, for whom an intensive 23vPPV campaign is needed. An immunization register covering all age groups should be established.

Studies on Early Allergic Sensitization in the Lithuanian Birth Cohort

PubMed Central

Dubakiene, Ruta; Rudzeviciene, Odilija; Butiene, Indre; Sezaite, Indre; Petronyte, Malvina; Vaicekauskaite, Dalia; Zvirbliene, Aurelija

2012-01-01

Cohort studies are of great importance in defining the mechanism responsible for the development of allergy-associated diseases, such as atopic dermatitis, allergic asthma, and allergic rhinoconjunctivitis. Although these disorders share genetic and environmental risk factors, it is still under debate whether they are linked or develop sequentially along an atopic pathway. The current study was aimed to determine the pattern of allergy sensitization in the Lithuanian birth cohort “Alergemol” (n = 1558) established as a part of the multicenter European birth cohort “EuroPrevall”. Early sensitization to food allergens in the “Alergemol” birth cohort was analysed. The analysis revealed 1.3% and 2.8% of symptomatic-sensitized subjects at 6 and 12 months of age, respectively. The sensitization pattern in response to different allergens in the group of infants with food allergy symptoms was studied using allergological methods in vivo and in vitro. The impact of maternal and environmental risk factors on the early development of food allergy in at 6 and 12 months of age was evaluated. Our data showed that maternal diet, diseases, the use of antibiotics, and tobacco smoke during pregnancy had no significant impact on the early sensitization to food allergens. However, infants of atopic mothers were significantly more often sensitized to egg as compared to the infants of nonatopic mothers. PMID:22606067

Self-selection and bias in a large prospective pregnancy cohort in Norway.

PubMed

Nilsen, Roy M; Vollset, Stein Emil; Gjessing, Håkon K; Skjaerven, Rolv; Melve, Kari K; Schreuder, Patricia; Alsaker, Elin R; Haug, Kjell; Daltveit, Anne Kjersti; Magnus, Per

2009-11-01

Self-selection in epidemiological studies may introduce selection bias and influence the validity of study results. To evaluate potential bias due to self-selection in a large prospective pregnancy cohort in Norway, the authors studied differences in prevalence estimates and association measures between study participants and all women giving birth in Norway. Women who agreed to participate in the Norwegian Mother and Child Cohort Study (43.5% of invited; n = 73 579) were compared with all women giving birth in Norway (n = 398 849) using data from the population-based Medical Birth Registry of Norway in 2000-2006. Bias in the prevalence of 23 exposure and outcome variables was measured as the ratio of relative frequencies, whereas bias in exposure-outcome associations of eight relationships was measured as the ratio of odds ratios. Statistically significant relative differences in prevalence estimates between the cohort participants and the total population were found for all variables, except for maternal epilepsy, chronic hypertension and pre-eclampsia. There was a strong under-representation of the youngest women (<25 years), those living alone, mothers with more than two previous births and with previous stillbirths (relative deviation 30-45%). In addition, smokers, women with stillbirths and neonatal death were markedly under-represented in the cohort (relative deviation 22-43%), while multivitamin and folic acid supplement users were over-represented (relative deviation 31-43%). Despite this, no statistically relative differences in association measures were found between participants and the total population regarding the eight exposure-outcome associations. Using data from the Medical Birth Registry of Norway, this study suggests that prevalence estimates of exposures and outcomes, but not estimates of exposure-outcome associations are biased due to self-selection in the Norwegian Mother and Child Cohort Study.

Factors relating to high psychological distress in Indigenous Australians and their contribution to Indigenous-non-Indigenous disparities.

PubMed

McNamara, Bridgette J; Banks, Emily; Gubhaju, Lina; Joshy, Grace; Williamson, Anna; Raphael, Beverley; Eades, Sandra

2018-04-01

To explore factors associated with high psychological distress among Aboriginal and non-Aboriginal Australians and their contribution to the elevated distress prevalence among Aboriginal people. Questionnaire data from 1,631 Aboriginal and 233,405 non-Aboriginal 45 and Up Study (NSW, Australia) participants aged ≥45 years were used to calculate adjusted prevalence ratios for high psychological distress (Kessler-10 score ≥22) for socio-demographic, health and disability-related factors, and to quantify contributions to differences in distress prevalence. While high-distress prevalence was increased around three-fold in Aboriginal versus non-Aboriginal participants, distress-related risk factors were similar. Morbidity and physical disability had the strongest associations; high distress affected 43.8% of Aboriginal and 20.9% of non-Aboriginal participants with severe physical limitations and 9.5% and 3.9% of those without limitations, respectively. Differences in distress prevalence between Aboriginal and non-Aboriginal participants were essentially attributable to differences in SES, morbidity, disability/functional limitations and social support (fully-adjusted PR 1.19 [95% 1.08, 1.30]); physical morbidity and disability explained the bulk. The markedly elevated prevalence of high distress among older Aboriginal Australians appears largely attributable to greater physical morbidity and disability. Implications for public health: Addressing upstream determinants of physical morbidity and improved integration of social and emotional wellbeing care into primary care and chronic disease management are essential. © 2018 The Authors.

Brief Report: Estimated Prevalence of a Community Diagnosis of Autism Spectrum Disorder by Age 4 Years in Children from Selected Areas in the United States in 2010--Evaluation of Birth Cohort Effects

ERIC Educational Resources Information Center

Soke, Gnakub N.; Maenner, M. J.; Christensen, D.; Kurzius-Spencer, M.; Schieve, L. A.

2017-01-01

We compared early-diagnosed autism spectrum disorder (ASD) (defined as diagnosis by age 4 years) between the 2002 and 2006 birth cohorts, in five sites of the Autism and Developmental Disabilities Monitoring Network. In the 2002 cohort, the prevalence/1000 of early-diagnosed ASD was half the 8-year-old prevalence (7.2 vs. 14.7, prevalence ratio…

Health Of Americans Who Must Work Longer To Reach Social Security Retirement Age.

PubMed

Choi, HwaJung; Schoeni, Robert F

2017-10-01

To receive full Social Security benefits, Americans born after 1937 must claim those benefits at an older age than earlier birth cohorts. Additionally, proposals to improve the fiscal position of Social Security typically include increasing the age at which workers can receive full benefits. Birth cohorts required to work longer are in worse health at ages 49-60, based on multiple measures of morbidity, than cohorts who could retire earlier. Project HOPE—The People-to-People Health Foundation, Inc.

Stolen from Our Embrace: The Abduction of First Nations Children and the Restoration of Aboriginal Communities.

ERIC Educational Resources Information Center

Fournier, Suzanne; Crey, Ernie

A deliberate policy to separate and forcibly assimilate Aboriginal First Nations children into the mainstream has pervaded every era of Aboriginal history in Canada. Each era saw a new reason to take Aboriginal children away from their homes, placing them in residential schools, foster care, or non-Aboriginal adoptive families. In the words of…

Transformative effects of Aboriginal health placements for medical, nursing, and allied health students: A systematic review.

PubMed

McDonald, Helena; Browne, Jennifer; Perruzza, Julia; Svarc, Ruby; Davis, Corinne; Adams, Karen; Palermo, Claire

2018-06-01

The aim of the present systematic review was to investigate whether placements in Aboriginal health affect the self-perceived skill in working in Aboriginal health settings and career aspirations of health students, and in particular, aspects of the placement that had the greatest impact. The Embase, Cinahl, ProQuest, Scopus, Informit, Ovid MEDLINE, PsychINFO, and PubMed databases were searched in April/May 2016. Placements of at least 1 week duration in an Aboriginal health setting involving Australian students of medical, nursing, dentistry, or allied health disciplines, with outcomes relating to changes in students' knowledge, attitudes, and/or career aspirations, were included. The search retrieved 1351 papers. Fourteen studies were eligible for inclusion in this review. Narrative synthesis found that work placements in Aboriginal health increased understanding and awareness of Aboriginal culture, promoted deeper understanding of Aboriginal health determinant complexity, increased awareness of everyday racism toward Aboriginal Australians, and enhanced desire to work in Aboriginal health. There is a need for improved teaching and learning scholarship to understand whether placements improve students' skill working with Aboriginal people in health care or increase the likelihood of future employment in these settings. © 2018 John Wiley & Sons Australia, Ltd.

Factors associated with pretreatment and treatment dropouts: comparisons between Aboriginal and non-Aboriginal clients admitted to medical withdrawal management

PubMed Central

2013-01-01

Background Addiction treatment faces high pretreatment and treatment dropout rates, especially among Aboriginals. In this study we examined characteristic differences between Aboriginal and non-Aboriginal clients accessing an inpatient medical withdrawal management program, and identified risk factors associated with the probabilities of pretreatment and treatment dropouts, respectively. Methods 2231 unique clients (Aboriginal = 451; 20%) referred to Vancouver Detox over a two-year period were assessed. For both Aboriginal and non-Aboriginal groups, multivariate logistic regression analyses were conducted with pretreatment dropout and treatment dropout as dependent variables, respectively. Results Aboriginal clients had higher pretreatment and treatment dropout rates compared to non-Aboriginal clients (41.0% vs. 32.7% and 25.9% vs. 20.0%, respectively). For Aboriginal people, no fixed address (NFA) was the only predictor of pretreatment dropout. For treatment dropout, significant predictors were: being female, having HCV infection, and being discharged on welfare check issue days or weekends. For non-Aboriginal clients, being male, NFA, alcohol as a preferred substance, and being on methadone maintenance treatment (MMT) at referral were associated with pretreatment dropout. Significant risk factors for treatment dropout were: being younger, having a preferred substance other than alcohol, having opiates as a preferred substance, and being discharged on weekends. Conclusions Our results highlight the importance of social factors for the Aboriginal population compared to substance-specific factors for the non-Aboriginal population. These findings should help clinicians and decision-makers to recognize the importance of social supports especially housing and initiate appropriate services to improve treatment intake and subsequent retention, physical and mental health outcomes and the cost-effectiveness of treatment. PMID:24325629

The community network: an Aboriginal community football club bringing people together.

PubMed

Thorpe, Alister; Anders, Wendy; Rowley, Kevin

2014-01-01

There are few empirical studies about the role of Aboriginal sporting organisations in promoting wellbeing. The aim of the present study was to understand the impact of an Aboriginal community sporting team and its environment on the social, emotional and physical wellbeing of young Aboriginal men, and to identify barriers and motivators for participation. A literature review of the impact of sport on the health and wellbeing of Aboriginal participants was conducted. This informed a qualitative study design with a grounded theory approach. Four semistructured interviews and three focus groups were completed with nine current players and five past players of the Fitzroy Stars Football Club to collect data about the social, emotional and physical wellbeing impact of an Aboriginal football team on its Aboriginal players. Results of the interviews were consistent with the literature, with common concepts emerging around community connection, cultural values and identity, health, values, racism and discrimination. However, the interviews provided further detail around the significance of cultural values and community connection for Aboriginal people. The complex nature of social connections and the strength of Aboriginal community networks in sports settings were also evident. Social reasons were just as important as individual health reasons for participation. Social and community connection is an important mechanism for maintaining and strengthening cultural values and identity. Barriers and motivators for participation in Aboriginal sports teams can be complex and interrelated. Aboriginal sports teams have the potential to have a profound impact on the health of Aboriginal people, especially its players, by fostering a safe and culturally strengthening environment and encompassing a significant positive social hub for the Aboriginal community.

'Stereotypes are reality': addressing stereotyping in Canadian Aboriginal medical education.

PubMed

Ly, Anh; Crowshoe, Lynden

2015-06-01

Efforts are underway in many parts of the world to develop medical education curricula that address the health care issues of indigenous populations. The topic of stereotypes and their impact on such peoples' health, however, has received little attention. An examination of stereotypes will shed light on dominant cultural attitudes toward Aboriginal people that can affect quality of care and health outcomes in Aboriginal patients. This study examines the views of undergraduate medical students regarding Canadian Aboriginal stereotypes and how they potentially affect Aboriginal people's health. The goal of this study was to gain insight into how medical learners perceive issues related to racism, discrimination and social stereotypes and to draw attention to gaps in Aboriginal health curricula. This study involved a convenience sample of medical learners drawn from one undergraduate medical programme in western Canada. Using a semi-structured interview guide, we conducted a total of seven focus group interviews with 38 first- and second-year undergraduate medical students. Data were analysed using a thematic content analysis approach. Medical students recognise that stereotypes are closely related to processes of racism and discrimination. However, they generally feel that stereotypes of Aboriginal people are rooted in reality. Students also identified medical school as one of the environments in which they are commonly exposed to negative views of Aboriginal people. Student responses suggest they see the cultural gap between Aboriginal and non-Aboriginal people as being both a cause and a consequence of discrimination against Aboriginal people. The results of this study suggest that teaching medical students about the realities and impacts of stereotypes on Aboriginal peoples is a good starting point from which to address issues of racism and health inequities affecting the health of Aboriginal people. © 2015 John Wiley & Sons Ltd.

Head Start Participation and School Readiness: Evidence from the Early Childhood Longitudinal Study-Birth Cohort

ERIC Educational Resources Information Center

Lee, RaeHyuck; Zhai, Fuhua; Brooks-Gunn, Jeanne; Han, Wen-Jui; Waldfogel, Jane

2014-01-01

Using data from the Early Childhood Longitudinal Study-Birth Cohort (n ˜ 6,950), a nationally representative sample of children born in 2001, we examined school readiness (academic skills and socioemotional well-being) at kindergarten entry for children who attended Head Start compared with those who experienced other types of child care…

Vision and Intelligence at Age 83 in the Lothian Birth Cohort 1921

ERIC Educational Resources Information Center

Henderson, Ross D.; Allerhand, Michael; Patton, Niall; Pattie, Alison; Gow, Alan J.; Dhillon, Baljean; Starr, John M.; Deary, Ian J.

2011-01-01

The extent to which visual function, measured as near and distant visual acuity and contrast sensitivity, is correlated with concurrently measured cognitive function and prior intellectual ability was investigated in a narrow age range group known as the Lothian Birth Cohort of 1921 (LBC1921). Participants were aged approximately 83 years at the…

Trends in Childspacing: June 1975. Current Population Reports: Population Characteristics.

ERIC Educational Resources Information Center

Moore, Maurice J.; And Others

This report, largely statistical tables, presents data from the June 1975 Current Population Survey, on the timing and spacing of childbearing and discusses how such data is related to annual measures of fertility. By categorizing women according to their year of birth (birth cohort) or period of first marriage (marriage cohort), in addition to…

Opportunistic screening to detect atrial fibrillation in Aboriginal adults in Australia

PubMed Central

Flaskas, Yvonne; O'Brien, Ciaran; Jeffries, Thomas Lee; McCowen, Debbie; Finlayson, Heather; Martin, Tanya; Neubeck, Lis; Freedman, Ben

2016-01-01

Introduction There is a 10-year gap in life expectancy between Aboriginal and non-Aboriginal Australians. The leading cause of death for Aboriginal Australians is cardiovascular disease, including myocardial infarction and stroke. Although atrial fibrillation (AF) is a known precursor to stroke there are no published studies about the prevalence of AF for Aboriginal people and limited evidence about AF in indigenous populations globally. Methods and analysis This mixed methods study will recruit and train Aboriginal health workers to use an iECG device attached to a smartphone to consecutively screen 1500 Aboriginal people aged 45 years and older. The study will quantify the proportion of people who presented for follow-up assessment and/or treatment following a non-normal screening and then estimate the prevalence and age distribution of AF of the Australian Aboriginal population. The study includes semistructured interviews with the Aboriginal health workers about the effectiveness of the iECG device in their practice as well as their perceptions of the acceptability of the device for their patients. Thematic analysis will be undertaken on the qualitative data collected in the study. If the device and approach are acceptable to the Aboriginal people and widely adopted, it may help prevent the effects of untreated AF including ischaemic stroke and early deaths or impairment in Aboriginal people. Ethics and dissemination This mixed methods study received ethics approval from the Aboriginal Health and Medical Research Council (1135/15) and the Australian Health Council of Western Australia (HREC706). Ethics approval is being sought in the Northern Territory. The findings of this study will be shared with Aboriginal communities, in peer reviewed publications and at conferences. There are Aboriginal investigators in each state/territory where the study is being conducted who have been actively involved in the study. They will also be involved in data analysis, dissemination and research translation. Trial registration number ACTRN12616000459426. PMID:27852724

Effect of age, period and birth-cohort on the frequency of glucose-6-phosphate dehydrogenase deficiency in Sardinian adults.

PubMed

Pes, Giovanni Mario; Errigo, Alessandra; Bitti, Angela; Dore, Maria Pina

2018-02-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inherited disorder common in Sardinia. In this study, the frequency variation of G6PD-deficiency across age groups and birth cohorts was investigated using Age-Period-Cohort analysis. Data were collected from the clinical records of 11,252 patients (6975 women, age range 17-94 years) who underwent endoscopy between 2000 and 2016 at a teaching hospital (University of Sassari), Italy. G6PD status was assessed by enzymatic assay based on G6PD/6GPD ratio. A Poisson log-linear regression model was used to identify age and time trend in G6PD deficiency. Enzyme deficiency was detected in 11.4% of the entire cohort (men: 7.9%; women: 13.6%). Age-Period-Cohort analysis showed no inflection points across age groups, especially after age 80. The effects of time period and birth cohorts on G6PD deficiency were negligible (frequencies before and after 1950 were 11.0% and 11.8%, respectively). These findings indicate that the frequency of G6PD deficiency does not vary significantly in oldest subjects. The lack of evidence for selection across the malaria eradication time may be explained by other factors, including somatic cell selection or misclassification of heterozygotes women as G6PD normal in the older birth cohorts. Additional molecular studies may help clarify these issues. Key message The frequency of glucose-6-phosphate dehydrogenase deficiency is stable across age groups and does not vary in generations born before or after malaria eradication.

Protocol: systematic review and meta-analyses of birth outcomes for women who intend at the onset of labour to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital.

PubMed

Hutton, Eileen K; Reitsma, Angela; Thorpe, Julia; Brunton, Ginny; Kaufman, Karyn

2014-05-29

There has been a renewed interest in the place of birth, including intended home birth, for low risk women. In the absence of adequately-sized randomised controlled trials, a recent Cochrane review recommended that a systematic review and meta-analysis, including observational studies, be undertaken to inform this topic. The objective of this review is to determine if women intending at the onset of labour to give birth at home are more or less likely to experience a foetal or neonatal loss compared to a cohort of women who are comparable to the home birth cohort on the absence of risk factors but who intend to give birth in a hospital setting. We will search using Embase, MEDLINE, CINAHL, AMED and the Cochrane Library to find studies published since 1990 that compare foetal, neonatal and maternal outcomes for women who intended at the onset of labour to give birth at home to a comparison cohort of low risk women who intended at the onset of labour to give birth in hospital. We will obtain pooled estimates of effect using Review Manager. Because of the likelihood of differences in outcomes in settings where home birth is integrated into the health care system, we will stratify our results according to jurisdictions that have a health care system that integrates home birth and those where home birth is provided outside the usual health care system. Since parity is known to be associated with birth outcomes, only studies that take parity into account will be included in the meta-analyses. We will provide results by parity to the extent possible. This protocol was registered with PROSPERO at http://www.crd.york.ac.uk/Prospero/ (Registration number: CRD42013004046).

A birth cohort analysis of dental contact among elderly Americans.

PubMed Central

Wolinsky, F D; Arnold, C L

1989-01-01

We applied standard cohort and multiple regression techniques to data on the dental utilization rates of 129,191 elderly individuals taken from the 1972, 1973, 1976, 1977, 1980, and 1981 Health Interview Surveys. The results indicate that the marked variation in dental contact rates is a reflection of cohort succession, and not a function of aging per se. Older cohorts having lower dental contact rates are being replaced by younger cohorts having higher dental contact rates. The dental contact rates of the individual birth cohorts themselves are quite stable over time. The results also indicate that economic barriers (especially liquid assets) have become more important than ever before, especially for the oldest-old. These findings have important implications for public policy about the oral health and health care of elderly Americans. PMID:2783297

Maternal education, birth weight, and infant mortality in the United States.

PubMed

Gage, Timothy B; Fang, Fu; O'Neill, Erin; Dirienzo, Greg

2013-04-01

This research determines whether the observed decline in infant mortality with socioeconomic level, operationalized as maternal education (dichotomized as college or more, versus high school or less), is due to its "indirect" effect (operating through birth weight) and/or to its "direct" effect (independent of birth weight). The data used are the 2001 U.S. national African American, Mexican American, and European American birth cohorts by sex. The analysis explores the birth outcomes of infants undergoing normal and compromised fetal development separately by using covariate density defined mixture of logistic regressions (CDDmlr). Among normal births, mean birth weight increases significantly (by 27-108 g) with higher maternal education. Mortality declines significantly (by a factor of 0.40-0.96) through the direct effect of education. The indirect effect of education among normal births is small but significant in three cohorts. Furthermore, the indirect effect of maternal education tends to increase mortality despite improved birth weight. Among compromised births, education has small and inconsistent effects on birth weight and infant mortality. Overall, our results are consistent with the view that the decrease in infant death by socioeconomic level is not mediated by improved birth weight. Interventions targeting birth weight may not result in lower infant mortality.

Preterm Birth and Adult Wealth: Mathematics Skills Count.

PubMed

Basten, Maartje; Jaekel, Julia; Johnson, Samantha; Gilmore, Camilla; Wolke, Dieter

2015-10-01

Each year, 15 million babies worldwide are born preterm. Preterm birth is associated with adverse neurodevelopmental outcomes across the life span. Recent registry-based studies suggest that preterm birth is associated with decreased wealth in adulthood, but the mediating mechanisms are unknown. This study investigated whether the relationship between preterm birth and low adult wealth is mediated by poor academic abilities and educational qualifications. Participants were members of two British population-based birth cohorts born in 1958 and 1970, respectively. Results showed that preterm birth was associated with decreased wealth at 42 years of age. This association was mediated by decreased intelligence, reading, and, in particular, mathematics attainment in middle childhood, as well as decreased educational qualifications in young adulthood. Findings were similar in both cohorts, which suggests that these mechanisms may be time invariant. Special educational support in childhood may prevent preterm children from becoming less wealthy as adults. © The Author(s) 2015.

Interaction between parental psychosis and risk factors during pregnancy and birth for schizophrenia - the Northern Finland 1966 Birth Cohort study.

PubMed

Keskinen, E; Miettunen, J; Koivumaa-Honkanen, H; Mäki, P; Isohanni, M; Jääskeläinen, E

2013-04-01

Our aim was to investigate the association between parental psychosis and potential risk factors for schizophrenia and their interaction. We evaluated whether the factors during pregnancy and birth have a different effect among subjects with and without a history of parental psychosis and whether parental psychosis may even explain their effects on the risk of schizophrenia. The sample comprised 10,526 individuals from the Northern Finland 1966 Birth Cohort. A total of 150 (1.4%) cohort members had schizophrenia by the age of 44 years, of them 18 (12.0%) had a parent with a history of psychosis. In non-psychotic cohort members, this figure was 495 (4.8%). In the parental psychosis group, significant early biological risk factors for schizophrenia included high birth weight (hazard ratio, HR 11.4; 95% confidence interval 3.3-39.7) and length (HR 4.1; 1.3-12.5), high birth weight in relation to gestational age (HR 3.2; 1.1-9.0), and high maternal age (HR 2.6.; 1.0-6.7). High birth weight and length and high maternal education had a significant interaction with parental psychosis. The presence of any biological risk factor increased the risk of schizophrenia significantly only among the parental psychosis group (HR 4.0; 1.5-10.5), whereas the presence of any psychosocial risk factor had no interaction with parental psychosis. Parental psychosis can act as an effect modifier on early risk factors for schizophrenia. Evaluation of the mechanisms behind the risk factors should, therefore, include consideration of the parental history of psychosis. Copyright © 2013 Elsevier B.V. All rights reserved.

Vector-borne and zoonotic diseases of dogs in North-west New South Wales and the Northern Territory, Australia.

PubMed

Shapiro, Amanda J; Brown, Graeme; Norris, Jacqueline M; Bosward, Katrina L; Marriot, Debbie J; Balakrishnan, Nandhakumar; Breitschwerdt, Edward B; Malik, Richard

2017-08-15

Vector-borne diseases of dogs in Australian Aboriginal communities are relatively unexplored. These dogs represent a unique group with variable ecto- and endo-parasitic burdens, nutritional stresses and a general lack of veterinary intervention. We investigated haemoprotozoal and bacterial pathogen prevalences in relation to erythrocyte and platelet numbers in dogs from North-West New South Wales (N-W NSW) and the Northern Territory (NT; Central Australia). Real-time PCR (qPCR) amplification of Anaplasma platys, Babesia vogeli, Mycoplasma haemocanis, Candidatus Mycoplasma haematoparvum and Bartonella spp., serological screening for Coxiella burnetii, and Bartonella spp. and haematological analyses were performed on dogs from the two cohorts (96 dogs in total). Brucella suis serology was determined additionally for the N-W NSW cohort. Anaplasma platys (n = 26 dogs), Babesia vogeli (n = 7), Candidatus Mycoplasma haematoparvum (n = 10 dogs), and Mycoplasma haemocanis (n = 14) were detected in the sample population (n = 96) using qPCR. There were significant associations between (i) A. platys and anaemia (OR 8.7, CI 2.4-31.7; P < 0.001), thrombocytopenia (OR 12.1, CI 3.4-43.2; P < 0.001) and breed (OR 16.1, CI 2.1-121.5; P = 0.007), and (ii) between B. vogeli and anaemia (OR 11.8, CI 2.3-61.6; P = 0.003). Neither protozoal nor bacterial DNA loads, estimated using qPCR, were positively correlated with anaemia or thrombocytopenia. Haemotropic mycoplasmas were not associated with any haematologic abnormality. Four dogs from the NT were seropositive for Coxiella burnetii, while no dogs were seropositive for Brucella suis or to a panel of Bartonella spp. antigens. Despite directed efforts, Bartonella DNA was not detected in blood from any of the cohorts studied. A sample of dogs from the NT recruited specifically for Bartonella α-proteobacteria growth medium enrichment blood culture were also Bartonella PCR negative. Vector-borne pathogens occur in dogs free ranging near Aboriginal communities, with higher detection rates in NT than N-W NSW. The preponderant haematologic abnormalities were anaemia and thrombocytopenia, likely attributable to A. platys and B. vogeli infections, but also probably affected by nutritional, parasitic, lactational and environmental stressors. The absence of Bartonella spp. is of importance to the Australian setting, and work needs to be extended to tropical coastal communities where fleas are present as well as ticks. Dogs living in and around Aboriginal communities may provide valuable sentinel information on disease infection status of human public health significance.

Cohort profile: cerebral palsy in the Norwegian and Danish birth cohorts (MOBAND-CP)

PubMed Central

Tollånes, Mette C; Strandberg-Larsen, Katrine; Forthun, Ingeborg; Petersen, Tanja Gram; Moster, Dag; Andersen, Anne-Marie Nybo; Stoltenberg, Camilla; Olsen, Jørn; Wilcox, Allen J

2016-01-01

Purpose The purpose of MOthers and BAbies in Norway and Denmark cerebral palsy (MOBAND-CP) was to study CP aetiology in a prospective design. Participants MOBAND-CP is a cohort of more than 210 000 children, created as a collaboration between the world's two largest pregnancy cohorts—the Norwegian Mother and Child Cohort study (MoBa) and the Danish National Birth Cohort. MOBAND-CP includes maternal interview/questionnaire data collected during pregnancy and follow-up, plus linked information from national health registries. Findings to date Initial harmonisation of data from the 2 cohorts has created 140 variables for children and their mothers. In the MOBAND-CP cohort, 438 children with CP have been identified through record linkage with validated national registries, providing by far the largest such sample with prospectively collected detailed pregnancy data. Several studies investigating various hypotheses regarding CP aetiology are currently on-going. Future plans Additional data can be harmonised as necessary to meet requirements of new projects. Biological specimens collected during pregnancy and at delivery are potentially available for assay, as are results from assays conducted on these specimens for other projects. The study size allows consideration of CP subtypes, which is rare in aetiological studies of CP. In addition, MOBAND-CP provides a platform within the context of a merged birth cohort of exceptional size that could, after appropriate permissions have been sought, be used for cohort and case-cohort studies of other relatively rare health conditions of infants and children. PMID:27591025

Supporting Aboriginal Women to Quit Smoking: Antenatal and Postnatal Care Providers' Confidence, Attitudes, and Practices.

PubMed

Tzelepis, Flora; Daly, Justine; Dowe, Sarah; Bourke, Alex; Gillham, Karen; Freund, Megan

2017-05-01

Tobacco use during pregnancy is substantially higher among Aboriginal women compared to non-Aboriginal women in Australia. However, no studies have investigated the amount or type of smoking cessation care that staff from Aboriginal antenatal and postnatal services provide to clients who smoke or staff confidence to do so. This study examined Aboriginal antenatal and postnatal staff confidence, perceived role and delivery of smoking cessation care to Aboriginal women and characteristics associated with provision of such care. Staff from 11 Aboriginal Maternal and Infant Health Services and eight Aboriginal Child and Family Health services in the Hunter New England Local Health District in Australia completed a cross-sectional self-reported survey (n = 67, response rate = 97.1%). Most staff reported they assessed clients' smoking status most or all of the time (92.2%). However, only a minority reported they offered a quitline referral (42.2%), provided follow-up support (28.6%) or provided nicotine replacement therapy (4.7%) to most or all clients who smoked. Few staff felt confident in motivating clients to quit smoking (19.7%) and advising clients about using nicotine replacement therapy (15.6%). Staff confident with talking to clients about how smoking affected their health had significantly higher odds of offering a quitline referral [OR = 4.9 (1.7-14.5)] and quitting assistance [OR = 3.9 (1.3-11.6)] to clients who smoke. Antenatal and postnatal staff delivery of smoking cessation care to pregnant Aboriginal women or mothers with young Aboriginal children could be improved. Programs that support Aboriginal antenatal and postnatal providers to deliver smoking cessation care to clients are needed. Aboriginal antenatal and postnatal service staff have multiple opportunities to assist Aboriginal women to quit smoking during pregnancy and postpartum. However, staff confidence and practices of offering various forms of smoking cessation support to pregnant Aboriginal women is unexplored. This is the first study to examine the amount and type of smoking cessation support Aboriginal antenatal and postnatal service staff provide to Aboriginal women, staff confidence and their perceived role in delivering smoking cessation care. This information is valuable for developing strategies that assist antenatal and postnatal staff to improve their delivery of smoking cessation care to Aboriginal women. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Evaluating Maternity Units: a prospective cohort study of freestanding midwife-led primary maternity units in New Zealand-clinical outcomes.

PubMed

Grigg, Celia P; Tracy, Sally K; Tracy, Mark; Daellenbach, Rea; Kensington, Mary; Monk, Amy; Schmied, Virginia

2017-08-29

To compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in a freestanding primary level midwife-led maternity unit (PMU) or tertiary level obstetric-led maternity hospital (TMH) in Canterbury, Aotearoa/New Zealand. Prospective cohort study. 407 women who intended to give birth in a PMU and 285 women who intended to give birth at the TMH in 2010-2011. All of the women planning a TMH birth were 'low risk', and 29 of the PMU cohort had identified risk factors. Mode of birth, Apgar score of less than 7 at 5 min and neonatal unit admission. labour onset, analgesia, blood loss, third stage of labour management, perineal trauma, non-pharmacological pain relief, neonatal resuscitation, breastfeeding, gestational age at birth, birth weight, severe morbidity and mortality. Women who planned a PMU birth were significantly more likely to have a spontaneous vaginal birth (77.9%vs62.3%, adjusted OR (AOR) 1.61, 95% CI 1.08 to 2.39), and significantly less likely to have an instrumental assisted vaginal birth (10.3%vs20.4%, AOR 0.59, 95% CI 0.37 to 0.93). The emergency and elective caesarean section rates were not significantly different (emergency: PMU 11.6% vs TMH 17.5%, AOR 0.88, 95% CI 0.55 to 1.40; elective: PMU 0.7% vs TMH 2.1%, AOR 0.34, 95% CI 0.08 to 1.41). There were no significant differences between the cohorts in rates of 5 min Apgar score of <7 (2.0%vs2.1%, AOR 0.82, 95% CI 0.27 to 2.52) and neonatal unit admission (5.9%vs4.9%, AOR 1.44, 95% CI 0.70 to 2.96). Planning to give birth in a primary unit was associated with similar or reduced odds of intrapartum interventions and similar odds of all measured neonatal well-being indicators. The results of this study support freestanding midwife-led primary-level maternity units as physically safe places for well women to plan to give birth, with these women having higher rates of spontaneous vaginal births and lower rates of interventions and their associated morbidities than those who planned a tertiary hospital birth, with no differences in neonatal outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluating Maternity Units: a prospective cohort study of freestanding midwife-led primary maternity units in New Zealand—clinical outcomes

PubMed Central

Grigg, Celia P; Tracy, Sally K; Tracy, Mark; Daellenbach, Rea; Kensington, Mary; Monk, Amy; Schmied, Virginia

2017-01-01

Objective To compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in a freestanding primary level midwife-led maternity unit (PMU) or tertiary level obstetric-led maternity hospital (TMH) in Canterbury, Aotearoa/New Zealand. Design Prospective cohort study. Participants 407 women who intended to give birth in a PMU and 285 women who intended to give birth at the TMH in 2010–2011. All of the women planning a TMH birth were ‘low risk’, and 29 of the PMU cohort had identified risk factors. Primary outcomes Mode of birth, Apgar score of less than 7 at 5 min and neonatal unit admission. Secondary outcomes: labour onset, analgesia, blood loss, third stage of labour management, perineal trauma, non-pharmacological pain relief, neonatal resuscitation, breastfeeding, gestational age at birth, birth weight, severe morbidity and mortality. Results Women who planned a PMU birth were significantly more likely to have a spontaneous vaginal birth (77.9%vs62.3%, adjusted OR (AOR) 1.61, 95% CI 1.08 to 2.39), and significantly less likely to have an instrumental assisted vaginal birth (10.3%vs20.4%, AOR 0.59, 95% CI 0.37 to 0.93). The emergency and elective caesarean section rates were not significantly different (emergency: PMU 11.6% vs TMH 17.5%, AOR 0.88, 95% CI 0.55 to 1.40; elective: PMU 0.7% vs TMH 2.1%, AOR 0.34, 95% CI 0.08 to 1.41). There were no significant differences between the cohorts in rates of 5 min Apgar score of <7 (2.0%vs2.1%, AOR 0.82, 95% CI 0.27 to 2.52) and neonatal unit admission (5.9%vs4.9%, AOR 1.44, 95% CI 0.70 to 2.96). Planning to give birth in a primary unit was associated with similar or reduced odds of intrapartum interventions and similar odds of all measured neonatal well-being indicators. Conclusions The results of this study support freestanding midwife-led primary-level maternity units as physically safe places for well women to plan to give birth, with these women having higher rates of spontaneous vaginal births and lower rates of interventions and their associated morbidities than those who planned a tertiary hospital birth, with no differences in neonatal outcomes. PMID:28851782

Rising Rate of Liver Transplantation in the Baby Boomer Generation with Non-alcoholic Steatohepatitis in the United States.

PubMed

Siddique, Osama; Joseph-Talreja, Mairin; Yoo, Eric R; Perumpail, Ryan B; Cholankeril, George; Harrison, Stephen A; Younossi, Zobair M; Wong, Robert J; Ahmed, Aijaz

2017-09-28

Background and Aims: Nonalcoholic steatohepatitis (NASH) is the most rapidly growing indication for liver transplantation (LT) in the United States and is on a trajectory to become the leading indication for LT in the next decade. We aimed to study the trends in NASH-related LT among persons born between 1945 and 1965, the baby boomer (BB) generation. Methods: We performed a retrospective cohort analysis using population-based data from the United Network for Organ Sharing/Organ Procurement and Transplantation Network registry from 2004-2015 to evaluate the birth cohort-specific trends in liver transplant waitlist registrations and liver transplant surgeries in patients with NASH. We stratified our study population into three birth cohorts: 1) birth before 1945, 2) birth between 1945 and 1965, and 3) birth after 1965. Results: The overall rates of NASH-related waitlist registrations and liver transplant surgeries steadily increased from 2004 to 2015 and were reflective of a sharp rise noted in the NASH BB sub-group. From 2004 to 2015, the proportion of BB patients with NASH added to LT waitlist demonstrated an incremental growth, 60.6% in 2004 versus 83.2% in 2015 ( p < 0.01). Among the liver transplant recipients with NASH, the proportion represented by the BB cohort increased from 56.3% in 2004 to 80.0% in 2015 ( p < 0.01). Conclusions: We report rising rates of waitlist registration and LT for the indication of NASH. More importantly, the BB sub-cohort was mainly responsible for these alarming trends.

Rising Rate of Liver Transplantation in the Baby Boomer Generation with Non-alcoholic Steatohepatitis in the United States

PubMed Central

Siddique, Osama; Joseph-Talreja, Mairin; Yoo, Eric R.; Perumpail, Ryan B.; Cholankeril, George; Harrison, Stephen A.; Younossi, Zobair M.; Wong, Robert J.; Ahmed, Aijaz

2017-01-01

Abstract Background and Aims: Nonalcoholic steatohepatitis (NASH) is the most rapidly growing indication for liver transplantation (LT) in the United States and is on a trajectory to become the leading indication for LT in the next decade. We aimed to study the trends in NASH-related LT among persons born between 1945 and 1965, the baby boomer (BB) generation. Methods: We performed a retrospective cohort analysis using population-based data from the United Network for Organ Sharing/Organ Procurement and Transplantation Network registry from 2004–2015 to evaluate the birth cohort-specific trends in liver transplant waitlist registrations and liver transplant surgeries in patients with NASH. We stratified our study population into three birth cohorts: 1) birth before 1945, 2) birth between 1945 and 1965, and 3) birth after 1965. Results: The overall rates of NASH-related waitlist registrations and liver transplant surgeries steadily increased from 2004 to 2015 and were reflective of a sharp rise noted in the NASH BB sub-group. From 2004 to 2015, the proportion of BB patients with NASH added to LT waitlist demonstrated an incremental growth, 60.6% in 2004 versus 83.2% in 2015 (p < 0.01). Among the liver transplant recipients with NASH, the proportion represented by the BB cohort increased from 56.3% in 2004 to 80.0% in 2015 (p < 0.01). Conclusions: We report rising rates of waitlist registration and LT for the indication of NASH. More importantly, the BB sub-cohort was mainly responsible for these alarming trends. PMID:28936399

The Urgency of Postsecondary Education for Aboriginal Peoples

ERIC Educational Resources Information Center

Preston, Jane P.

2008-01-01

Canada has an unprecedented need to increase the number of Aboriginal peoples who undertake and complete postsecondary programs. Endorsing postsecondary education for Aboriginal peoples advocates an invigorating, fortifying future for Aboriginal peoples, their families, and their communities. Additionally, the postsecondary educational…

Improving the health of future generations: the Canadian Institutes of Health Research Institute of Aboriginal Peoples' Health.

PubMed

Reading, Jeff; Nowgesic, Earl

2002-09-01

In the past and in the present, research studies and media reports have focused on pathology and dysfunction in aboriginal communities and have often failed to present a true and complete picture of the aboriginal experience. The Canadian Institutes of Health Research Institute of Aboriginal Peoples' Health is a national strategic research initiative led by both the aboriginal and research communities. This initiative aims to improve aboriginal health information, develop research capacity, better translate research into practice, and inform public health policy with the goal of improving the health of indigenous peoples.

Improving the Health of Future Generations: The Canadian Institutes of Health Research Institute of Aboriginal Peoples’ Health

PubMed Central

Reading, Jeff; Nowgesic, Earl

2002-01-01

In the past and in the present, research studies and media reports have focused on pathology and dysfunction in aboriginal communities and have often failed to present a true and complete picture of the aboriginal experience. The Canadian Institutes of Health Research Institute of Aboriginal Peoples’ Health is a national strategic research initiative led by both the aboriginal and research communities. This initiative aims to improve aboriginal health information, develop research capacity, better translate research into practice, and inform public health policy with the goal of improving the health of indigenous peoples. PMID:12197963

Using policy and workforce development to address Aboriginal mental health and wellbeing.

PubMed

Jones, Carmel; Brideson, Tom

2009-08-01

The aim of this paper is to discuss the New South Wales (NSW) Aboriginal Mental Health and Well Being Policy and its key workforce initiative, the NSW Aboriginal Mental Health Workforce Training Program. The Policy provides a strong framework guiding the development of Aboriginal mental health and wellbeing programs throughout NSW Mental Health Services. However, the effectiveness of the Policy will be determined by the success of its implementation. The NSW Aboriginal Mental Health Workforce Training Program will support implementation of the Policy by growing an Aboriginal mental health workforce in NSW.

Timeliness of antenatal care for mothers of Aboriginal and non-Aboriginal infants in an urban setting.

PubMed

Robinson, Penelope; Comino, Elizabeth; Forbes, Andrew; Webster, Vana; Knight, Jennifer

2012-01-01

To compare the timing of first hospital antenatal care visit by mothers of Aboriginal and non-Aboriginal infants, and to identify the risk and protective factors associated with timeliness of accessing care, mothers who delivered at Campbelltown hospital between October 2005 and November 2006 were surveyed on the maternity ward. This survey was linked to hospital administrative data. Gestational age at first visit to a hospital-based antenatal clinic was compared for mothers of Aboriginal and non-Aboriginal infants. Risks and protective factors associated with timing of antenatal care were also examined using Cox regression and Kaplan-Meier survival curves. Data on 1520 deliveries were included in this study. Mothers of Aboriginal infants presented slightly later to hospital-based antenatal clinics than mothers of non-Aboriginal infants (median 15.6 weeks versus 14.0 weeks). This difference did not remain after adjustment for all risk and protective factors. The three significant factors remaining were: maternal smoking; not in paid employment; and residence in a disadvantaged suburb. The results may reflect the complex associations that exist between the clustering of disadvantage among families of Aboriginal infants. A multifaceted approach is required to improve the timeliness of hospital-based antenatal care for the mothers of Aboriginal infants.

Screening for attention deficit and hyperactivity disorder, autism spectrum disorder, and developmental delay in Taiwanese aboriginal preschool children

PubMed Central

Chan, Hsiang-Lin; Liu, Wen-Sheng; Hsieh, Yi-Hsuan; Lin, Chiao-Fan; Ling, Tiing-Soon; Huang, Yu-Shu

2016-01-01

Objectives This study aimed to estimate the percentages of attention deficit and hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in Taiwanese aboriginal preschool children. Child development level was compared between the two groups. Methods Teachers completed screening questionnaires for ADHD, ASD, and development level for 36- to 72-month-old children in kindergartens in Taiwan. The questionnaire results were compared between the aboriginal and nonaboriginal children. One child psychiatrist then interviewed the aboriginal preschool children to determine if they had ADHD and/or ASD. Results We collected 93 questionnaires from the aboriginal group and 60 from the nonaboriginal group. In the aboriginal group, 5.37% of the children were identified to have ADHD, while 1.08% were identified to have ASD. Significantly fewer aboriginal children had developmental delays for situation comprehension and personal–social development (P=0.012 and 0.002, respectively) than nonaboriginal children. Conclusion Aboriginal children in Taiwan had typical percentages of ADHD and ASD compared to those published in the literature. Aboriginal children showed relative strengths in situation comprehension and personal–social skills. Further studies are required to understand the learning styles of the aboriginal children and to develop effective screening and intervention strategies for ADHD and ASD. PMID:27785028

An Exploration of Underrepresentation of Aboriginal Cancer Patients Attending a Regional Radiotherapy Service in Western Australia

PubMed Central

Baxi, Siddhartha; Cheetham, Shelley; Shahid, Shaouli

2018-01-01

Travel logistics impede Aboriginal patients’ uptake of cancer treatments and is one reason for the poorer outcomes of Aboriginal people with cancer. This research examined benefits of a newly established rurally based radiotherapy unit in southwest Western Australia (WA), and included exploring the experience of Aboriginal patients and possible reasons for Aboriginal people’s underrepresentation in treatment. Semi-structured in-depth interviews with 21 service providers involved in the treatment and care of people with cancer, and 3 Aboriginal patients with cancer who undertook radiotherapy at the Service were undertaken. Data were subject to thematic analysis involving immersion in the data for familiarization, inductive coding, investigator discussion and refining of emerging themes and triangulation of patient and provider interviews. Aboriginal cancer patients were positive about the treatment and support they had received, highlighting the often complex challenges faced by rural Aboriginal cancer patients in accessing and maintaining treatment. Service providers offered suggestions for small numbers presenting to the Service, including late presentation, potential perceptions of cultural insensitivity on the part of service providers, out-of-pocket costs and under-ascertainment of Aboriginal status. The Service has put in place practices and initiatives to support patient health and wellbeing, including making the facility more welcoming towards Aboriginal people and ensuring culturally appropriate care. PMID:29443892

Mortality of breast cancer in Taiwan, 1971–2010: Temporal changes and an age–period–cohort analysis

PubMed Central

Ho, M.-L.; Hsiao, Y.-H.; Su, S.-Y.

2015-01-01

The current paper describes the age, period and cohort effects on breast cancer mortality in Taiwan. Female breast cancer mortality data were collected from the Taiwan death registries for 1971–2010. The annual percentage changes, age- standardised mortality rates (ASMR) and age–period–cohort model were calculated. The mortality rates increased with advancing age groups when fixing the period. The percentage change in the breast cancer mortality rate increased from 54.79% at aged 20–44 years, to 149.78% in those aged 45–64 years (between 1971–75 and 2006–10). The mortality rates in the 45–64 age group increased steadily from 1971 to 1975 and 2006–10. The 1951 birth cohorts (actual birth cohort; 1947–55) showed peak mortalities in both the 50–54 and 45–49 age groups. We found that the 1951 birth cohorts had the greatest mortality risk from breast cancer. This might be attributed to the DDT that was used in large amounts to prevent deaths from malaria in Taiwan. However, future researches require DDT data to evaluate the association between breast cancer and DDT use. PMID:25020211

Famine, third-trimester pregnancy weight gain, and intrauterine growth: the Dutch Famine Birth Cohort Study.

PubMed

Stein, A D; Ravelli, A C; Lumey, L H

1995-02-01

Data from the Dutch Famine Birth Cohort Study were analyzed to assess the influence of acute famine on the relation of maternal weight gain to birth weight, length, and ponderal index. Records were examined for 734 women receiving at least one month of prenatal care and delivering live-born singleton females at the University of Amsterdam Teaching Hospital between August 1944 and April 1946. This period preceded, encompassed, and followed the Hunger Winter, a severe famine. After adjusting for covariates, weight loss or low to moderate (< or = 0.5 kg/week) weight gain was strongly associated with (p < 0.001 for each model) with offspring birth weight, length, and ponderal index and with trimester of famine exposure. At weight gains greater than 0.5 kg/week further weight gain was not associated with birth size. Among women losing weight or gaining < or = 0.5 kg/week the association between third-trimester weight change and birth weight among mother-daughter pairs exposed to famine in early or mid-pregnancy was stronger than the association observed among the unexposed cohort or among those exposed only late in pregnancy. Our results suggest that acute maternal nutritional deprivation affects fetal growth only below a threshold and that, conversely, even after a famine period offspring birth size does not respond in a linear fashion to ad libitum maternal feeding.

Bias from conditioning on live birth in pregnancy cohorts: an illustration based on neurodevelopment in children after prenatal exposure to organic pollutants

PubMed Central

Liew, Zeyan; Olsen, Jørn; Cui, Xin; Ritz, Beate; Arah, Onyebuchi A

2015-01-01

Only 60–70% of fertilized eggs may result in a live birth, and very early fetal loss mainly goes unnoticed. Outcomes that can only be ascertained in live-born children will be missing for those who do not survive till birth. In this article, we illustrate a common bias structure (leading to ‘live-birth bias’) that arises from studying the effects of prenatal exposure to environmental factors on long-term health outcomes among live births only in pregnancy cohorts. To illustrate this we used prenatal exposure to perfluoroalkyl substances (PFAS) and attention-deficit/hyperactivity disorder (ADHD) in school-aged children as an example. PFAS are persistent organic pollutants that may impact human fecundity and be toxic for neurodevelopment. We simulated several hypothetical scenarios based on characteristics from the Danish National Birth Cohort and found that a weak inverse association may appear even if PFAS do not cause ADHD but have a considerable effect on fetal survival. The magnitude of the negative bias was generally small, and adjusting for common causes of the outcome and fetal loss can reduce the bias. Our example highlights the need to identify the determinants of pregnancy loss and the importance of quantifying bias arising from conditioning on live birth in observational studies. PMID:25604449

Social class difference in catch up growth in a national British cohort

PubMed Central

Teranishi, H; Nakagawa, H; Marmot, M

2001-01-01

AIM—To examine the influence of socioeconomic status on growth pattern in height from age 7 to 23years.
METHODS—Prospective cohort study. A total of 10 200 white singleton born children from the 1958 British birth cohort (National Child Development Study) were analysed.
RESULTS—Differences in height by birth weight persisted throughout the follow up period. However, the mean differences in height between low birth weight infants (<2500 g) and adequate birth weight infants (⩾2500 g) were less notable in social classes I and II than in the lower social classes. The catching up of growth in height of low birth weight infants was also more pronounced in social classes I and II than in other social classes. That is, the mean height deficits of low birth weight infants were decreased from 2.9 cm at age 7, to 1.6 cm at age 16, and 2.5 cm at age 23; the significant difference disappeared after age 16 in social classes I and II. Although such improving tendency was more pronounced among the preterm born infants, a similar growth pattern was observed among the term infants. Such improvement was not observed in the other social classes.
CONCLUSION—The growth retardation in height by birth weight can be overcome by improved social conditions and proper health care from childhood to adulthood.

 PMID:11207167

Midwifery: "at the edge of history".

PubMed

Dahlen, H

2006-03-01

The paper focuses on possible future pathways in maternity care for midwives and nations to consider. The paper blends personal and professional experiences to outline priority areas facing midwives in the future. It begins by examining maternal mortality and morbidity in the developing world and considering the potential of the ten high priority action messages (1997) in helping to improve the plight of women and children in the future. The paper then examines major issues facing midwives in the developed world including: the way birth is viewed; the medical-midwifery divide; marketing midwifery; and finally the challenge of dealing with fear around birth. The third part of the paper examines a part of society where the two worlds meet and there are issues from both the developed and developing world to consider. The paper focuses on women from culturally and linguistically diverse communities, Aboriginal and Torres Strait Islander women and women birthing in remote and rural areas. By looking at these three worlds separately the paper examines different concerns facing midwives in the future but also draws on common issues that face us all as citizens of this planet and particularly as predominantly women. The paper challenges midwives to be politically active and dare to change the world.

Incidence of schizophrenia among second-generation immigrants in the jerusalem perinatal cohort.

PubMed

Corcoran, Cheryl; Perrin, Mary; Harlap, Susan; Deutsch, Lisa; Fennig, Shmuel; Manor, Orly; Nahon, Daniella; Kimhy, David; Malaspina, Dolores; Susser, Ezra

2009-05-01

Increased incidence of schizophrenia is observed among some immigrant groups in Europe, with the offspring of immigrants, ie "second-generation" immigrants particularly vulnerable. Few contemporary studies have evaluated the risk of schizophrenia among second-generation immigrants in other parts of the world. We studied the incidence of schizophrenia in relation to parental immigrant status in a population-based cohort of 88 829 offspring born in Jerusalem in 1964-1976. Parental countries of birth were obtained from birth certificates and grouped together as (1) Israel, (2) Other West Asia, (3) North Africa, and (4) Europe and industrialized countries. Cox proportional hazards methods were used in adjusting for sex, parents' ages, maternal education, social class, and birth order. Linkage with Israel's Psychiatric Registry identified 637 people admitted to psychiatric care facilities with schizophrenia-related diagnoses, before 1998. Incidence of schizophrenia was not increased among second-generation immigrants in this birth cohort, neither overall nor by specific group. The difference in risk of schizophrenia among second-generation immigrants in Europe and in this Israeli birth cohort suggests that the nature of the immigration experience may be relevant to risk, including reasons for migration, the nature of entry, and subsequent position in the host country for immigrants and their offspring. Minority status may be of importance as, in later studies, immigrants to Israel from Ethiopia had increased risk of schizophrenia.

Incidence of Schizophrenia Among Second-Generation Immigrants in the Jerusalem Perinatal Cohort

PubMed Central

Corcoran, Cheryl; Perrin, Mary; Harlap, Susan; Deutsch, Lisa; Fennig, Shmuel; Manor, Orly; Nahon, Daniella; Kimhy, David; Malaspina, Dolores; Susser, Ezra

2009-01-01

Objective: Increased incidence of schizophrenia is observed among some immigrant groups in Europe, with the offspring of immigrants, ie “second-generation” immigrants particularly vulnerable. Few contemporary studies have evaluated the risk of schizophrenia among second-generation immigrants in other parts of the world. Methods: We studied the incidence of schizophrenia in relation to parental immigrant status in a population-based cohort of 88 829 offspring born in Jerusalem in 1964–1976. Parental countries of birth were obtained from birth certificates and grouped together as (1) Israel, (2) Other West Asia, (3) North Africa, and (4) Europe and industrialized countries. Cox proportional hazards methods were used in adjusting for sex, parents’ ages, maternal education, social class, and birth order. Results: Linkage with Israel's Psychiatric Registry identified 637 people admitted to psychiatric care facilities with schizophrenia-related diagnoses, before 1998. Incidence of schizophrenia was not increased among second-generation immigrants in this birth cohort, neither overall nor by specific group. Conclusions: The difference in risk of schizophrenia among second-generation immigrants in Europe and in this Israeli birth cohort suggests that the nature of the immigration experience may be relevant to risk, including reasons for migration, the nature of entry, and subsequent position in the host country for immigrants and their offspring. Minority status may be of importance as, in later studies, immigrants to Israel from Ethiopia had increased risk of schizophrenia. PMID:18648022

Gender Differences of Children's Developmental Trajectory from 6 to 60 Months in the Taiwan Birth Cohort Pilot Study

ERIC Educational Resources Information Center

Lung, For-Wey; Chiang, Tung-Liang; Lin, Shio-Jean; Feng, Jui-Ying; Chen, Po-Fei; Shu, Bih-Ching

2011-01-01

The parental report instrument is the most efficient developmental detection method and has shown high validity with professional assessment instruments. The reliability and validity of the Taiwan Birth Cohort Study (TBCS) 6-, 18- and 36-month scales have already been established. In this study, the reliability and validity of the 60-month scale…

Head Start and Urban Children's School Readiness: A Birth Cohort Study in 18 Cities

ERIC Educational Resources Information Center

Zhai, Fuhua; Brooks-Gunn, Jeanne; Waldfogel, Jane

2010-01-01

In this study, the authors used data from a large longitudinal birth cohort study of primarily low-income children in urban areas, the Fragile Families and Child Wellbeing Study (FFCWS), to investigate the effects of Head Start participation on children's school readiness. The fact that their sample was mainly made up of disadvantaged families…

Childhood ADHD Is Strongly Associated with a Broad Range of Psychiatric Disorders during Adolescence: A Population-Based Birth Cohort Study

ERIC Educational Resources Information Center

Yoshimasu, Kouichi; Barbaresi, William J.; Colligan, Robert C.; Voigt, Robert G.; Killian, Jill M.; Weaver, Amy L.; Katusic, Slavica K.

2012-01-01

Background: To evaluate associations between attention-deficit/hyperactivity disorder (ADHD) and comorbid psychiatric disorders using research-identified incident cases of ADHD and population-based controls. Methods: Subjects included a birth cohort of all children born 1976-1982 remaining in Rochester, MN after age five (n = 5,718). Among them we…

Family Structure Transitions and Early Childhood Development in Taiwan: Evidence from a Population-Based Birth Cohort Study

ERIC Educational Resources Information Center

Wu, Jennifer Chun-Li; Chiang, Tung-liang

2015-01-01

Taiwan has over the past three decades been experiencing demographic changes that may pose important concerns for children's quality of life. This study examines the relationships and potential pathways between family structure transitions and early childhood development. Our analysis is based on 19,499 children from the 2005 birth cohort who…

Prenatal Exposure to Organophosphorous Pesticides and Fetal Growth: Pooled Results from Four Longitudinal Birth Cohort Studies.

PubMed

Harley, Kim G; Engel, Stephanie M; Vedar, Michelle G; Eskenazi, Brenda; Whyatt, Robin M; Lanphear, Bruce P; Bradman, Asa; Rauh, Virginia A; Yolton, Kimberly; Hornung, Richard W; Wetmur, James G; Chen, Jia; Holland, Nina T; Barr, Dana Boyd; Perera, Frederica P; Wolff, Mary S

2016-07-01

Organophosphorous (OP) pesticides are associated with reduced fetal growth in animals, but human studies are inconsistent. We pooled data from four cohorts to examine associations of prenatal OP exposure with birth weight (n = 1,169), length (n = 1,152), and head circumference (n = 1,143). Data were from the CHAMACOS, HOME, Columbia, and Mount Sinai birth cohorts. Concentrations of three diethyl phosphate (ΣDEP) and three dimethyl phosphate (ΣDMP) metabolites of OP pesticides [summed to six dialkyl phosphates (ΣDAPs)] were measured in maternal urine. Linear regression and mixed-effects models were used to examine associations with birth outcomes. We found no significant associations of ΣDEP, ΣDMP, or ΣDAPs with birth weight, length, or head circumference overall. However, among non-Hispanic black women, increasing urinary ΣDAP and ΣDMP concentrations were associated with decreased birth length (β = -0.4 cm; 95% CI: -0.9, 0.0 and β = -0.4 cm; 95% CI: -0.8, 0.0, respectively, for each 10-fold increase in metabolite concentration). Among infants with the PON1192RR genotype, ΣDAP and ΣDMP were negatively associated with length (β = -0.4 cm; 95% CI: -0.9, 0.0 and β = -0.5 cm; 95% CI: -0.9, -0.1). This study confirms previously reported associations of prenatal OP exposure among black women with decreased infant size at birth, but finds no evidence of smaller birth weight, length, or head circumference among whites or Hispanics. Contrary to our hypothesis, we found stronger inverse associations of DAPs and birth outcome in infants with the less susceptible PON1192RR genotype. The large pooled data set facilitated exploration of interactions by race/ethnicity and PON1 genotype, but was limited by differences in study populations. Harley KG, Engel SM, Vedar MG, Eskenazi B, Whyatt RM, Lanphear BP, Bradman A, Rauh VA, Yolton K, Hornung RW, Wetmur JG, Chen J, Holland NT, Barr DB, Perera FP, Wolff MS. 2016. Prenatal exposure to organophosphorous pesticides and fetal growth: pooled results from four longitudinal birth cohort studies. Environ Health Perspect 124:1084-1092; http://dx.doi.org/10.1289/ehp.1409362.

Culturally Framing Aboriginal Literacy and Learning.

ERIC Educational Resources Information Center

Antone, Eileen

2003-01-01

More than just the development of reading and writing skills, Aboriginal literacy is a wholistic concept, with spiritual, physical, mental, and emotional aspects, involving relationships between self, community, nation, and creation. Models are presented for incorporating traditional Aboriginal knowledge and methodologies into Aboriginal learning…

The maternal and neonatal outcomes for an urban Indigenous population compared with their non-Indigenous counterparts and a trend analysis over four triennia.

PubMed

Kildea, Sue; Stapleton, Helen; Murphy, Rebecca; Kosiak, Machellee; Gibbons, Kristen

2013-08-30

Indigenous Australians experience significantly disproportionate poorer health outcomes compared to their non-Indigenous counterparts. Despite the recognised importance of maternal infant health (MIH), there is surprisingly little empirical research to guide service redesign that successfully addresses the disparities. This paper reports on a service evaluation that also compared key MIH indicators for Indigenous and non-Indigenous mothers and babies over a 12-year period 1998-2009. Trend analysis with logistic regression, using the independent variables of ethnicity and triennia, explored changes over time (1998-2009) between two cohorts: 1,523 births to Indigenous mothers and 43,693 births to non-Indigenous mothers. We included bivariate and multivariate analysis on key indicators (e.g. teenage births, preterm birth, low birth weight, smoking) and report odds ratios (ORs), 95% CIs and logistic regression adjusting for important confounders. We excluded transfers in from other areas which are identified within the database. Bivariate analysis revealed Indigenous women were statistically more likely to have spontaneous onset of labour and a non-instrumental vaginal birth. They were less likely to take epidurals for pain relief in labour, have assisted births, caesarean sections or perineal trauma. Despite better labour outcomes, Indigenous babies were more likely to be born preterm (< 37 weeks) and be low birth weight (< 2500 g); these differences remained significant in multivariate analysis. The trend analysis revealed relatively stable rates for teenage pregnancy, small for gestational age, low birth weight babies, and perinatal mortality for both cohorts, with the gap between cohorts consistent over time. A statistical widening of the gap in preterm birth and smoking rates was found with preterm birth demonstrating a relative increase of 51% over this period. The comprehensive database from a large urban hospital allowed a thorough examination of outcomes and contributing factors. The gap between both cohorts remains static in several areas but in some cases worsened. Alternative models for delivering care to Indigenous women and their babies have shown improved outcomes, including preterm birth, though not all have been sustained over time and none are available Australia-wide. New models of care, which recognise the heterogeneity of Indigenous communities, incorporate a multiagency approach, and are set within a research framework, are urgently needed.

Association of birth defects with the mode of assisted reproductive technology in a Chinese data-linkage cohort.

PubMed

Yu, Hui-Ting; Yang, Qing; Sun, Xiao-Xi; Chen, Guo-Wu; Qian, Nai-Si; Cai, Ren-Zhi; Guo, Han-Bing; Wang, Chun-Fang

2018-05-01

To evaluate the impact of assisted reproductive technology (ART) on the offspring of Chinese population. Retrospective, data-linkage cohort. Not applicable. Live births resulting from ART or natural conception. None. Birth defects coded according to ICD-10. Births after ART were more likely to be female and multiple births, especially after intracytoplasmic sperm injection (ICSI). ART was associated with a significantly increased risk of birth defects, especially, among singleton births, a significantly increased risk in fresh-embryo cycles after in vitro fertilization (IVF) and frozen-embryo cycles after ICSI. Associations between ART and multiple defects, between ART and gastrointestinal malformation, genital organs malformation, and musculoskeletal malformation among singleton births, and between ART and cardiac septa malformation among multiple births were observed. This study suggests that ART increases the risk of birth defects. Subgroup analyses indicate higher risk for both fresh and frozen embryos, although nonsignificantly for frozen embryos after IVF and for fresh embryos were presented with low power. Larger sample size research is needed to clarify effects from fresh- or frozen-embryo cycles after IVF and ICSI. Copyright © 2018 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Implications of teen birth for overweight and obesity in adulthood.

PubMed

Chang, Tammy; Choi, HwaJung; Richardson, Caroline R; Davis, Matthew M

2013-08-01

The objective of this study was to examine whether teen birth was independently associated with overweight and obesity in a US cohort. We examined whether teen birth is independently associated with overweight and obesity in a multiyear US cohort using the 2001-2010 National Health and Nutrition Examination Survey, a nationally representative cross-sectional survey of the US civilian, noninstitutionalized population. We performed multinomial logistic regression adjusting for survey cohort, age at survey, race, education, and parity. We included women 20-59 years old at the time of survey, with at least 1 live birth, not currently or recently pregnant (unweighted, n = 5220; weighted, n = 48.4 million). Our outcome measure was the effect of teen birth on subsequent overweight and obesity. In bivariate analyses, women with a teen birth were significantly more likely than women without a teen birth to be overweight (relative risk ratios [RRRs], 1.61; 95% confidence interval [CI], 1.37-1.90) or obese (RRR, 1.84; 95% CI, 1.56-2.16) at the time of the survey. In multivariate models, women with a teen birth remained significantly more likely to be overweight (adjusted RRR, 1.33; 95% CI, 1.10-1.62) or obese (adjusted RRR, 1.32; 95% CI, 1.09-1.61) than women without a teen birth. For women in the United States, giving birth as a teen is associated with subsequent overweight/obese status later in life. To inform clinical and policy interventions with the goal to improve the long-term health of teenage mothers, future studies must examine modifiable physiological and sociomedical reasons for early child-bearing and later risk of obesity. Copyright © 2013 Mosby, Inc. All rights reserved.

Antenatal services for Aboriginal women: the relevance of cultural competence.

PubMed

Reibel, Tracy; Walker, Roz

2010-01-01

Due to persistent significantly poorer Aboriginal perinatal outcomes, the Women's and Newborns' Health Network, Western Australian Department of Health, required a comprehensive appraisal of antenatal services available to Aboriginal women as a starting point for future service delivery modelling. A services audit was conducted to ascertain the usage frequency and characteristics of antenatal services used by Aboriginal women in Western Australia (WA). Telephone interviews were undertaken with eligible antenatal services utilising a purpose specific service audit tool comprising questions in five categories: 1) general characteristics; 2) risk assessment; 3) treatment, risk reduction and education; 4) access; and 5) quality of care. Data were analysed according to routine antenatal care (e.g. risk assessment, treatment and risk reduction), service status (Aboriginal specific or non-specific) and application of cultural responsiveness. Significant gaps in appropriate antenatal services for Aboriginal women in metropolitan, rural and remote regions in WA were evident. Approximately 75% of antenatal services used by Aboriginal women have not achieved a model of service delivery consistent with the principles of culturally responsive care, with few services incorporating Aboriginal specific antenatal protocols/programme, maintaining access or employing Aboriginal Health Workers (AHWs). Of 42 audited services, 18 Aboriginal specific and 24 general antenatal services reported utilisation by Aboriginal women. Of these, nine were identified as providing culturally responsive service delivery, incorporating key indicators of cultural security combined with highly consistent delivery of routine antenatal care. One service was located in the metropolitan area and eight in rural or remote locations. The audit of antenatal services in WA represents a significant step towards a detailed understanding of which services are most highly utilised and their defining characteristics. The cultural responsiveness indicators used in the audit establish benchmarks for planning culturally appropriate antenatal services that may encourage Aboriginal women to more frequently attend antenatal visits.

Aboriginal women in rural Australia; a small study of infant feeding behaviour.

PubMed

Helps, Catherine; Barclay, Lesley

2015-06-01

Aboriginal women in rural areas have lower rates of breastfeeding than Australian averages. The reasons for this are poorly understood. Aboriginal people experience higher morbidity and increased rates of chronic disease throughout the life cycle. The protective effects of sustained breastfeeding could benefit rural Aboriginal communities. To explore the factors impacting upon infant feeding choices in a rural Aboriginal Community. Semi-structured interviews were conducted with eight Aboriginal rural dwelling first time mothers. These women received a continuity of midwife and Aboriginal Health Worker model of care. Interviews were also undertaken with five Aboriginal Health Workers and two Aboriginal community breastfeeding champions. The analysis was integrated with a conventional literature review and was further developed and illustrated with historical literature. Indigenist methodology guided the study design, analysis and the dissemination of results. Three key themes were identified. These were "I'm doing the best thing for..." which encompasses the motivations underpinning infant feeding decisions; "this is what I know..." which explores individual and community knowledge regarding infant feeding; and "a safe place to feed" identifying the barriers that negative societal messages pose for women as they make infant feeding decisions. It appears loss of family and community breastfeeding knowledge resulting from colonisation still influences the Aboriginal women of today. Aboriginal women value and trust knowledge which is passed to them from extended family members and women within their Community. Cultural, historical and socioeconomic factors all strongly influence the infant feeding decisions of individuals in this study. Efforts to normalise breastfeeding in the culture of rural dwelling Aboriginal women and their supporting community appear to be necessary and may promote breastfeeding more effectively than optimal professional care of individuals can do. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Factors that drive the gap in diabetes rates between Aboriginal and non-Aboriginal people in non-remote NSW.

PubMed

Reeve, Rebecca; Church, Jody; Haas, Marion; Bradford, Wylie; Viney, Rosalie

2014-10-01

To identify factors underpinning the gap in diabetes rates between Aboriginal and non-Aboriginal people in non-remote NSW. This will indicate appropriate target areas for policy and for monitoring progress towards reducing the gap. Data from the 2004-05 National Health Survey and National Aboriginal and Torres Strait Islander Health Survey were used to estimate differences in self-reported diabetes rates and risk/prevention factors between Aboriginal and non-Aboriginal people in non-remote NSW. Logistic regression models were used to investigate the contribution of each factor to predicting the probability of diabetes. Risk factors for diabetes are more prevalent and diabetes rates 2.5 to 4 times higher in Aboriginal compared to non-Aboriginal adults in non-remote NSW. The odds of (known) diabetes for both groups are significantly higher for older people, those with low levels of education and those who are overweight or obese. In the Aboriginal sample, the odds of diabetes are significantly higher for people reporting forced removal of their relatives. Differences in BMI and education appear to be driving the diabetes gap, together with onset at younger ages in the Aboriginal population. Psychological distress, indicated by removal of relatives, may contribute to increased risk of diabetes in the Aboriginal population. The results imply that improved nutrition and exercise, capacity to access and act upon health care information and early intervention are required to reduce the diabetes gap. Current strategies appear to be appropriately aligned with the evidence; however, further research is required to determine whether implementation methods are effective. © 2014 Public Health Association of Australia.

Changing trends in reproductive/lifestyle factors in UK women: descriptive study within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)

PubMed Central

Gentry-Maharaj, Aleksandra; Glazer, Clara; Burnell, Matthew; Ryan, Andy; Berry, Hannah; Kalsi, Jatinderpal; Woolas, Robert; Skates, Steve J; Campbell, Stuart; Jacobs, Ian

2017-01-01

Objective There has been considerable interest in the impact of reproductive factors on health but there are little data on how these have varied over time. We explore trends in reproductive/lifestyle factors of postmenopausal British women by analysing self-reported data from participants of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Design Prospective birth cohort analysis. Setting Population cohort invited between 2001 and 2005 from age-sex registers of 27 Primary Care Trusts in England, Wales and Northern Ireland and recruited through 13 National Health Service Trusts. Participants 202 638 postmenopausal women aged 50–74 years at randomisation to UKCTOCS between April 2001 and October 2005. Interventions Women were stratified into the following six birth cohorts (1925–1929, 1930–1934, 1935–1939, 1940–1944, 1945–1949, 1950–1955) based on year of birth. Self-reported data on reproductive factors provided at recruitment were explored using tabular and graphical summaries to examine for differences between the birth cohorts. Outcome measures Trends in mean age at menarche and menopause, use of oral contraceptives, change in family size, infertility treatments, tubal ligation and hysterectomy rates. Results Women born between 1935 and 1955 made up 86% of the cohort. Median age at menarche decreased from 13.4 for women born between 1925 and 1929 to 12.8 for women born between 1950 and 1955. Increased use of the oral contraceptives, infertility treatments and smaller family size was observed in the younger birth cohorts. Tubal ligation rates increased for those born between 1925 and 1945, but this increase did not persist in subsequent cohorts. Hysterectomy rates (17–20%) did not change over time. Conclusions The trends seen in this large cohort are likely to reflect the reproductive history of the UK female postmenopausal population of similar age. Since these are risk factors for hormone-related cancers, these trends are important in understanding the changing incidence of these cancers. Trial registration number International Standard Randomised Controlled Trial Number: 22488978. PMID:28264823

Factors associated to leisure-time sedentary lifestyle in adults of 1982 birth cohort, Pelotas, Southern Brazil

PubMed Central

Azevedo, Mario R; Horta, Bernardo L; Gigante, Denise P; Victora, Cesar G; Barros, Fernando C

2009-01-01

OBJECTIVE To assess factors associated to leisure-time physical activity and sedentary lifestyle. METHODS Prospective cohort study of people born in 1982 in the city of Pelotas, southern Brazil. Data were collected at birth and during in a visit in 2004-5 when 77.4% of the cohort were evaluated, making a total of 4,297 people studied. Information about leisure-time physical activity was collected using the International Physical Activity Questionnaire. Sedentary people were defined as those with weekly physical activity below 150 minutes. The following independent variables were studied: gender, skin color, birth weight, family income at birth and income change between birth and 23 years of age. Poisson’s regression with robust adjustment of variance was used for the assessment of risk factors of sedentary lifestyle. RESULTS Men reported 334 min of weekly leisure-time physical activity compared to 112 min among women. The prevalence of sedentary lifestyle was 80.6% in women and 49.2% in men. Scores of physical activity increased as income at birth increased. Those who were currently poor or who became poor during adult life were more sedentary. CONCLUSIONS Leisure-time sedentary lifestyle in young adults was high especially among women. Physical activity during leisure time is determined by current socioeconomic conditions. PMID:19142347

Understanding trends in Australian alcohol consumption-an age-period-cohort model.

PubMed

Livingston, Michael; Raninen, Jonas; Slade, Tim; Swift, Wendy; Lloyd, Belinda; Dietze, Paul

2016-09-01

To decompose Australian trends in alcohol consumption into their age, period (survey year) and cohort (birth year/generation) components. In particular, we aimed to test whether recent declines in overall consumption have been influenced by reductions in drinking among recently born cohorts. Seven cross-sectional waves of the Australian National Drug Strategy Household Survey (1995-2013). Age, period and cohort effects were estimated using a linear and logistic cross-classified random-effects models (CCREMs). Australia A total of 124 440 Australians (69 193 females and 55 257 males), aged 14-79 years. Whether or not respondents consumed alcohol in the 12 months prior to the survey and, for those who did, the estimated volume of pure alcohol consumed, derived using standard quantity-frequency survey questions. Controlling for age and period effects, there was significant variation in drinking participation and drinking volume by birth cohort. In particular, male cohorts born between the 1965 and 1974 and female cohorts born between 1955 and 1974 reported higher rates of drinking participation (P < 0.05), while the most recent cohorts (born in the 1990s) had lower rates of participation (P < 0.01). Among drinkers, the most recently born cohort also had sharply lower average consumption volumes than older cohorts for both men and women (P < 0.01). Recent birth cohorts (born between 1995 and 1999) in Australia report significantly lower rates of both drinking participation and drinking volume than previous cohorts, controlling for their age distribution and overall changes in population drinking. These findings suggest that the recent decline in alcohol consumption in Australia has been driven by declines in drinking among these recently born cohorts. These trends are consistent with international shifts in youth drinking. © 2016 Society for the Study of Addiction.

Closing the gap in Australian Aboriginal infant immunisation rates -- the development and review of a pre-call strategy.

PubMed

Cashman, Patrick M; Allan, Natalie A; Clark, Katrina K; Butler, Michelle T; Massey, Peter D; Durrheim, David N

2016-06-16

Improving timely immunisation is key to closing the inequitable gap in immunisation rates between Aboriginal children and non-Indigenous children. Aboriginal Immunisation Officers were employed in Hunter New England Local Health District (HNELHD), New South Wales (NSW), Australia, to telephone the families of all Aboriginal infants prior to the due date for their first scheduled vaccination. Aboriginal Immunisation Officers contacted the families of Aboriginal children born in the Hunter New England Local Health District (HNELHD) by telephone before their due immunisation date (pre-call) to provide the rationale for timely immunisation, and to facilitate contact with culturally safe local immunisation services if this was required. The impact of this strategy on immunisation coverage rates is reviewed. For the period March 2010 to September 2014 there was a significant increase in immunisation coverage rate for Aboriginal children at 12 months of age in HNELHD (p < 0.0001). The coverage in the rest of NSW Aboriginal children also increased but not significantly (p = 0.218). Over the full study period there was a significant decrease in the immunisation coverage gap between Aboriginal children and non-Indigenous children in HNELHD (p < 0.0001) and the rest of NSW (p = 0.004). The immunisation coverage gap between Aboriginal and non-Indigenous infants decreased at a significantly faster rate in HNELHD than the rest of NSW (p = 0.0001). By the end of the study period in 2014, immunisation coverage in HNELHD Aboriginal infants had surpassed that of non-Indigenous infants by 0.8 %. The employment of Aboriginal immunisation officers may be associated with closing of the gap between Aboriginal and non-Indigenous infants' immunisation coverage in HNELHD and NSW. The pre-call telephone strategy provided accelerated benefit in closing this gap in HNELHD.

Illicit and prescription drug problems among urban Aboriginal adults in Canada: the role of traditional culture in protection and resilience.

PubMed

Currie, Cheryl L; Wild, T Cameron; Schopflocher, Donald P; Laing, Lory; Veugelers, Paul

2013-07-01

Illicit and prescription drug use disorders are two to four times more prevalent among Aboriginal peoples in North America than the general population. Research suggests Aboriginal cultural participation may be protective against substance use problems in rural and remote Aboriginal communities. As Aboriginal peoples continue to urbanize rapidly around the globe, the role traditional Aboriginal beliefs and practices may play in reducing or even preventing substance use problems in cities is becoming increasingly relevant, and is the focus of the present study. Mainstream acculturation was also examined. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Associations were analysed using two sets of bootstrapped linear regression models adjusted for confounders with continuous illicit and prescription drug problem scores as outcomes. Psychological mechanisms that may explain why traditional culture is protective for Aboriginal peoples were examined using the cross-products of coefficients mediation method. The extent to which culture served as a resilience factor was examined via interaction testing. Results indicate Aboriginal enculturation was a protective factor associated with reduced 12-month illicit drug problems and 12-month prescription drug problems among Aboriginal adults in an urban setting. Increased self-esteem partially explained why cultural participation was protective. Cultural participation also promoted resilience by reducing the effects of high school incompletion on drug problems. In contrast, mainstream acculturation was not associated with illicit drug problems and served as a risk factor for prescription drug problems in this urban sample. Findings encourage the growth of programs and services that support Aboriginal peoples who strive to maintain their cultural traditions within cities, and further studies that examine how Aboriginal cultural practices and beliefs may promote and protect Aboriginal health in an urban environment. Copyright © 2013 Elsevier Ltd. All rights reserved.

The prevalence of hookworm infection, iron deficiency and anaemia in an aboriginal community in north-west Australia.

PubMed

Hopkins, R M; Gracey, M S; Hobbs, R P; Spargo, R M; Yates, M; Thompson, R C

1997-03-03

To determine the prevalence of hookworm infections, iron deficiency and anaemia in an Aboriginal community in the north of Western Australia. A cross-sectional survey conducted in 1992, examining faecal specimens and blood samples from Aboriginals and non-Aboriginals in a remote coastal community in the north of Western Australia. All those living in the community at the time of the survey. Parasite status and haematological values for haemoglobin, serum iron, ferritin, transferrin and mean red cell volume. Infections with hookworm were present throughout the Aboriginal population (77%; n = 243), with the highest prevalence in children aged 5-14 years (93%; n = 74). Hookworm was not detected in non-Aboriginals (n = 24). Iron deficiency was common throughout the Aboriginal population, especially in children aged 5-14 years (79%; n = 68) and women aged over 14 years (72%; n = 65). Anaemia was highly prevalent among Aboriginal children aged 5-14 years (84% in hookworm-positive children, 75% in hookworm-negative) and women aged over 14 years (63% in hookworm-positive women, 31% in hookworm-negative). Aboriginals over 14 years of age who had hookworm (n = 82) had significantly lower levels of haemoglobin, serum iron and serum ferritin, a lower mean red cell volume and significantly higher transferrin levels than uninfected Aboriginals (n = 38) and non-Aboriginals (n = 19) in the same age group. Hookworm infections were associated with anaemia (P < 0.01) and iron deficiency (P < 0.01) in people over 14 years of age. The species of hookworm, determined after examining 13 larval cultures and two adult worms, was found to be Ancylostoma duodenale. Infections with A. duodenale are endemic in Aboriginals in this community, and are likely to contribute to the high prevalence of iron deficiency and anaemia observed in the Aboriginal population, particularly in children and women.

A clash of paradigms? Western and indigenous views on health research involving Aboriginal peoples.

PubMed

Campbell, Theresa Diane

2014-07-01

To explore the issues of data management and data ownership with regard to health research conducted in aboriginal or indigenous populations in Canada. Research with aboriginal communities in Canada has often been conducted by researchers who had little or no understanding of the community in which the research was taking place. This led to 'helicopter' research, which benefitted the researcher but not the community. National aboriginal leadership developed the ownership, control, access, and possession (OCAP) principles, which outline how to manage research data regarding aboriginal people and to counteract disrespectful methodologies. However, these principles present their own set of challenges to those who would conduct research with aboriginal populations. Documents from the Assembly of First Nations, the Government of Canada, Aboriginal writers and researchers, and Nursing theorists and researchers. This is a methodology paper that reviews the issues of data ownership when conducting research with Aboriginal populations. The authors explore indigenous and Western views of knowledge development, outline and discuss the OCAP principles, and present the Canadian Institute of Health Research's guidelines for health research involving aboriginal people as a guide for those who want to carry out ethical and culturally competent research, do no harm and produce research that can benefit aboriginal peoples. There are special considerations associated with conducting research with Aboriginal populations. The Assembly of First Nations wants researchers to use the Ownership, Control, Access and Possession (OCAP) principles with First Nations data. These principles are restrictive and need to be discussed with stakeholders before research is undertaken. In Canada, it is imperative that researchers use the Canadian Institute of Health Research Guidelines for Health Research Involving Aboriginal People to ensure culturally sensitive and ethical conduct during the course of the research with Aboriginal populations. However, some communities may also want to use the OCAP principles and these principles will need to be taken into consideration when designing the study.

Advanced parental ages and low birth weight in autism spectrum disorders--rates and effect on functioning.

PubMed

Ben Itzchak, Esther; Lahat, Eli; Zachor, Ditza A

2011-01-01

(1) To assess the distribution of parental age and birth weight in a large cohort with autism spectrum disorder (ASD) and to compare them to Israeli national data. (2) To examine possible relationships between these risk factors and functioning. The study included 529 participants diagnosed with ASD using standardized tests: the Autism Diagnosis Interview-Revised and the Autism Diagnosis Observation Schedule (ADOS). Medical, developmental and familial histories (gender, age, pregnancy and birth information, parental ages) were obtained. Autism severity was assessed using the new ADOS severity scale and adaptive skill using the Vineland Adaptive Behavior Scales. Advanced parental age was associated with ASD. In the older age range the percentages of mothers (35-44 y) and fathers (30-40 y) were significantly higher in the ASD cohort in comparison to the Israeli newborn data. The ASD cohort had significantly higher percentages of low birth weight (<2500 g) and very low birth weight (VLBW<1500 g) in comparison to the Israeli newborn data. Of these risk factors, only VLBW was associated with lower adaptive functioning. The group with VLBW had lower scores in daily living, socialization and motor skills in comparison to the >1500 g group. Autism severity was not associated with advanced parental age or VLBW. The shift in parental age distribution and birth weight in our ASD cohort suggests that the increase in ASD prevalence in recent years might be associated with novel prenatal insults. An adverse fetal course resulting in VLBW may represent a "second hit" phenomenon, causing a poorer outcome. Copyright © 2011 Elsevier Ltd. All rights reserved.

External validation of anti-Müllerian hormone based prediction of live birth in assisted conception

PubMed Central

2013-01-01

Background Chronological age and oocyte yield are independent determinants of live birth in assisted conception. Anti-Müllerian hormone (AMH) is strongly associated with oocyte yield after controlled ovarian stimulation. We have previously assessed the ability of AMH and age to independently predict live birth in an Italian assisted conception cohort. Herein we report the external validation of the nomogram in 822 UK first in vitro fertilization (IVF) cycles. Methods Retrospective cohort consisting of 822 patients undergoing their first IVF treatment cycle at Glasgow Centre for Reproductive Medicine. Analyses were restricted to women aged between 25 and 42 years of age. All women had an AMH measured prior to commencing their first IVF cycle. The performance of the model was assessed; discrimination by the area under the receiver operator curve (ROCAUC) and model calibration by the predicted probability versus observed probability. Results Live births occurred in 29.4% of the cohort. The observed and predicted outcomes showed no evidence of miscalibration (p = 0.188). The ROCAUC was 0.64 (95% CI: 0.60, 0.68), suggesting moderate and similar discrimination to the original model. The ROCAUC for a continuous model of age and AMH was 0.65 (95% CI 0.61, 0.69), suggesting that the original categories of AMH were appropriate. Conclusions We confirm by external validation that AMH and age are independent predictors of live birth. Although the confidence intervals for each category are wide, our results support the assessment of AMH in larger cohorts with detailed baseline phenotyping for live birth prediction. PMID:23294733

Non-Standard Assessment Practices in the Evaluation of Communication in Australian Aboriginal Children

ERIC Educational Resources Information Center

Gould, Judith

2008-01-01

Australian Aboriginal children typically receive communication assessment services from Standard Australian English (SAE) speaking non-Aboriginal speech-language pathologists (SLPs). Educational assessments, including intelligence testing, are also primarily conducted by non-Aboriginal educational professionals. While the current paper will show…

Contextualising the social capital of Australian Aboriginal and non-Aboriginal men in prison.

PubMed

Lafferty, Lise; Treloar, Carla; Chambers, Georgina M; Butler, Tony; Guthrie, Jill

2016-10-01

Social capital is a valuable resource that has received little attention in the prison context. Differences in the construct and accessibility of bonding, bridging, and linking social capital exist for Aboriginal Australians in mainstream society, but were previously unexplored in prison. This study seeks to understand contextual differences of social capital for Australian Aboriginal and non-Aboriginal men in prison. Thirty male inmates participated in qualitative interviews across three New South Wales (NSW) correctional centres. Interviews were completed between November 2014 and March 2015. Experiences of bonding and linking social capital varied among Aboriginal and non-Aboriginal participants. Opportunities for bridging social capital were limited for all participants. There is greater scope for building bonding social capital among male inmates than either bridging or linking social capital. Bonding social capital, particularly among Aboriginal men in prison, should be utilised to promote health and other programs to inmates. Copyright © 2016 Elsevier Ltd. All rights reserved.

Incense Burning during Pregnancy and Birth Weight and Head Circumference among Term Births: The Taiwan Birth Cohort Study.

PubMed

Chen, Le-Yu; Ho, Christine

2016-09-01

Incense burning for rituals or religious purposes is an important tradition in many countries. However, incense smoke contains particulate matter and gas products such as carbon monoxide, sulfur, and nitrogen dioxide, which are potentially harmful to health. We analyzed the relationship between prenatal incense burning and birth weight and head circumference at birth using the Taiwan Birth Cohort Study. We also analyzed whether the associations varied by sex and along the distribution of birth outcomes. We performed ordinary least squares (OLS) and quantile regressions analysis on a sample of 15,773 term births (> 37 gestational weeks; 8,216 boys and 7,557 girls) in Taiwan in 2005. The associations were estimated separately for boys and girls as well as for the population as a whole. We controlled extensively for factors that may be correlated with incense burning and birth weight and head circumference, such as parental religion, demographics, and health characteristics, as well as pregnancy-related variables. Findings from fully adjusted OLS regressions indicated that exposure to incense was associated with lower birth weight in boys (-18 g; 95% CI: -36, -0.94) but not girls (1 g; 95% CI: -17, 19; interaction p-value = 0.31). Associations with head circumference were negative for boys (-0.95 mm; 95% CI: -1.8, -0.16) and girls (-0.71 mm; 95% CI: -1.5, 0.11; interaction p-values = 0.73). Quantile regression results suggested that the negative associations were larger among the lower quantiles of birth outcomes. OLS regressions showed that prenatal incense burning was associated with lower birth weight for boys and smaller head circumference for boys and girls. The associations were more pronounced among the lower quantiles of birth outcomes. Further research is necessary to confirm whether incense burning has differential effects by sex. Chen LY, Ho C. 2016. Incense burning during pregnancy and birth weight and head circumference among term births: The Taiwan Birth Cohort Study. Environ Health Perspect 124:1487-1492; http://dx.doi.org/10.1289/ehp.1509922.

Incense Burning during Pregnancy and Birth Weight and Head Circumference among Term Births: The Taiwan Birth Cohort Study

PubMed Central

Chen, Le-Yu; Ho, Christine

2016-01-01

Background: Incense burning for rituals or religious purposes is an important tradition in many countries. However, incense smoke contains particulate matter and gas products such as carbon monoxide, sulfur, and nitrogen dioxide, which are potentially harmful to health. Objectives: We analyzed the relationship between prenatal incense burning and birth weight and head circumference at birth using the Taiwan Birth Cohort Study. We also analyzed whether the associations varied by sex and along the distribution of birth outcomes. Methods: We performed ordinary least squares (OLS) and quantile regressions analysis on a sample of 15,773 term births (> 37 gestational weeks; 8,216 boys and 7,557 girls) in Taiwan in 2005. The associations were estimated separately for boys and girls as well as for the population as a whole. We controlled extensively for factors that may be correlated with incense burning and birth weight and head circumference, such as parental religion, demographics, and health characteristics, as well as pregnancy-related variables. Results: Findings from fully adjusted OLS regressions indicated that exposure to incense was associated with lower birth weight in boys (–18 g; 95% CI: –36, –0.94) but not girls (1 g; 95% CI: –17, 19; interaction p-value = 0.31). Associations with head circumference were negative for boys (–0.95 mm; 95% CI: –1.8, –0.16) and girls (–0.71 mm; 95% CI: –1.5, 0.11; interaction p-values = 0.73). Quantile regression results suggested that the negative associations were larger among the lower quantiles of birth outcomes. Conclusions: OLS regressions showed that prenatal incense burning was associated with lower birth weight for boys and smaller head circumference for boys and girls. The associations were more pronounced among the lower quantiles of birth outcomes. Further research is necessary to confirm whether incense burning has differential effects by sex. Citation: Chen LY, Ho C. 2016. Incense burning during pregnancy and birth weight and head circumference among term births: The Taiwan Birth Cohort Study. Environ Health Perspect 124:1487–1492; http://dx.doi.org/10.1289/ehp.1509922 PMID:26967367

Developing the rural health workforce to improve Australian Aboriginal and Torres Strait Islander health outcomes: a systematic review.

PubMed

Gwynne, Kylie; Lincoln, Michelle

2017-05-01

Objective The aim of the present study was to identify evidence-based strategies in the literature for developing and maintaining a skilled and qualified rural and remote health workforce in Australia to better meet the health care needs of Australian Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) people. Methods A systematic search strategy was implemented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist. Exclusion and inclusion criteria were applied, and 26 papers were included in the study. These 26 papers were critically evaluated and analysed for common findings about the rural health workforce providing services for Aboriginal people. Results There were four key findings of the study: (1) the experience of Aboriginal people in the health workforce affects their engagement with education, training and employment; (2) particular factors affect the effectiveness and longevity of the non-Aboriginal workforce working in Aboriginal health; (3) attitudes and behaviours of the workforce have a direct effect on service delivery design and models in Aboriginal health; and (4) student placements affect the likelihood of applying for rural and remote health jobs in Aboriginal communities after graduation. Each finding has associated evidence-based strategies including those to promote the engagement and retention of Aboriginal staff; training and support for non-Aboriginal health workers; effective service design; and support strategies for effective student placement. Conclusions Strategies are evidenced in the peer-reviewed literature to improve the rural and remote workforce for health delivery for Australian Aboriginal people and should be considered by policy makers, funders and program managers. What is known about the topic? There is a significant amount of peer-reviewed literature about the recruitment and retention of the rural and remote health workforce. What does this paper add? There is a gap in the literature about strategies to improve recruitment and retention of the rural and remote health workforce for health delivery for Australian Aboriginal people. This paper provides evidence-based strategies in four key areas. What are the implications for practitioners? The findings of the present study are relevant for policy makers, funders and program managers in rural and remote Aboriginal health.

Maternal Residential Exposure to Agricultural Pesticides and Birth Defects in a 2003 to 2005 North Carolina Birth Cohort

EPA Science Inventory

Birth defects are responsible for a large proportion of disability and infant mortality. Exposure to a variety of pesticides have been linked to increased risk of birth defects. We conducted a case-control study to estimate the associations between a residence-based metric of agr...

Birth Weight Ratio as an Alternative to Birth Weight Percentile to Express Infant Weight in Research and Clinical Practice: A Nationwide Cohort Study

PubMed Central

Kazemier, Brenda M.; Schuit, Ewoud; Mol, Ben Willem J.; Pajkrt, Eva; Ganzevoort, Wessel

2014-01-01

Objective. To compare birth weight ratio and birth weight percentile to express infant weight when assessing pregnancy outcome. Study Design. We performed a national cohort study. Birth weight ratio was calculated as the observed birth weight divided by the median birth weight for gestational age. The discriminative ability of birth weight ratio and birth weight percentile to identify infants at risk of perinatal death (fetal death and neonatal death) or adverse pregnancy outcome (perinatal death + severe neonatal morbidity) was compared using the area under the curve. Outcomes were expressed stratified by gestational age at delivery separate for birth weight ratio and birth weight percentile. Results. We studied 1,299,244 pregnant women, with an overall perinatal death rate of 0.62%. Birth weight ratio and birth weight percentile have equivalent overall discriminative performance for perinatal death and adverse perinatal outcome. In late preterm infants (33+0–36+6 weeks), birth weight ratio has better discriminative ability than birth weight percentile for perinatal death (0.68 versus 0.63, P  0.01) or adverse pregnancy outcome (0.67 versus 0.60, P < 0.001). Conclusion. Birth weight ratio is a potentially valuable instrument to identify infants at risk of perinatal death and adverse pregnancy outcome and provides several advantages for use in research and clinical practice. Moreover, it allows comparison of groups with different average birth weights. PMID:25197283

Aurorae in Australian Aboriginal Traditions

NASA Astrophysics Data System (ADS)

Hamacher, Duane W.

2013-07-01

Transient celestial phenomena feature prominently in the astronomical knowledge and traditions of Aboriginal Australians. In this paper, I collect accounts of the Aurora Australis from the literature regarding Aboriginal culture. Using previous studies of meteors, eclipses, and comets in Aboriginal traditions, I anticipate that the physical properties of aurora, such as their generally red colour as seen from southern Australia, will be associated with fire, death, blood, and evil spirits. The survey reveals this to be the case and also explores historical auroral events in Aboriginal cultures, aurorae in rock art, and briefly compares Aboriginal auroral traditions with other global indigenous groups, including the Maori of New Zealand.

Closing the (service) gap: exploring partnerships between Aboriginal and mainstream health services.

PubMed

Taylor, Kate P; Thompson, Sandra C

2011-08-01

Although effective partnerships between Aboriginal and mainstream health services are critical to improve Aboriginal health outcomes, many factors can cause these partnerships to be tenuous and unproductive. Understanding the elements of best practice for successful partnerships is essential. A literature review was conducted in 2009 using keyword searches of electronic databases. Sourced literature was assessed for relevance regarding the benefits, challenges, lessons learnt and factors contributing to successful Aboriginal and mainstream partnerships. Key themes were collated. Although there is much literature regarding general partnerships generally, few specifically examine Aboriginal and mainstream health service partnerships. Twenty-four sources were reviewed in detail. Benefits include broadening service capacity and improving the cultural security of healthcare. Challenges include the legacy of Australia's colonial history, different approaches to servicing clients and resource limitations. Recommendations for success include workshopping tensions early, building trust and leadership. Although successful partnerships are crucial to optimise Aboriginal health outcomes, failed collaborations risk inflaming sensitive Aboriginal-non-Aboriginal relationships. Factors supporting successful partnerships remind us to develop genuine, trusting relationships that are tangibly linked to the Aboriginal community. Failure to invest in this relational process and push forward with 'business as usual' can ultimately have negative ramifications on client outcomes.

Efficient funding: a path to improving Aboriginal healthcare in Australia?

PubMed

Lloyd, Jane E; Wise, Marilyn J

2010-11-01

To identify the factors that contribute to the under-resourcing of Aboriginal health and to explore the impact that funding arrangements have on the implementation of Aboriginal health policy. Qualitative study based on 35 in-depth interviews with a purposive sample of frontline health professionals involved in health policy and service provision in the Northern Territory. Participants described three factors that contributed to the under-resourcing of Aboriginal health: inefficient funding arrangements, mainstream programs being inappropriate for Aboriginal Australians, and competing interests determining the allocation of resources. Insufficient capacity within the healthcare system undermines the multilevel implementation process whereby organisations need to have the capacity to recognise new policy ideas, assess their relevance to their existing work and strategic plan and to be able to incorporate the relevant new ideas into day-to-day practice. Insufficient resources for Aboriginal health were found to be a barrier to implementing Aboriginal health policy. Inadequate resources result from the cumbersome allocation of funding rather than simply the amount of funding provided to Aboriginal healthcare. Monitoring government performance and ensuring the efficient allocation of funds would allow us to develop the delivery system for Aboriginal healthcare and therefore provide greater opportunities to capitalise on current interventions and future efforts.

Understanding practitioner professionalism in Aboriginal and Torres Strait Islander health: lessons from student and registrar placements at an urban Aboriginal and Torres Strait Islander primary healthcare service.

PubMed

Askew, Deborah A; Lyall, Vivian J; Ewen, Shaun C; Paul, David; Wheeler, Melissa

2017-10-01

Aboriginal and Torres Strait Islander peoples continue to be pathologised in medical curriculum, leaving graduates feeling unequipped to effectively work cross-culturally. These factors create barriers to culturally safe health care for Aboriginal and Torres Strait Islander peoples. In this pilot pre-post study, the learning experiences of seven medical students and four medical registrars undertaking clinical placements at an urban Aboriginal and Torres Strait Islander primary healthcare service in 2014 were followed. Through analysis and comparison of pre- and post-placement responses to a paper-based case study of a fictitious Aboriginal patient, four learning principles for medical professionalism were identified: student exposure to nuanced, complex and positive representations of Aboriginal peoples; positive practitioner role modelling; interpersonal skills that build trust and minimise patient-practitioner relational power imbalances; and knowledge, understanding and skills for providing patient-centred, holistic care. Though not exhaustive, these principles can increase the capacity of practitioners to foster culturally safe and optimal health care for Aboriginal peoples. Furthermore, competence and effectiveness in Aboriginal health care is an essential component of medical professionalism.

A comparison of the effectiveness of an adult nutrition education program for Aboriginal and non-Aboriginal Australians.

PubMed

Pettigrew, Simone; Jongenelis, Michelle I; Moore, Sarah; Pratt, Iain S

2015-11-01

Adult nutrition education is an important component of broader societal efforts to address the high prevalence of nutrition-related diseases. In Australia, Aboriginal people are a critical target group for such programs because of their substantially higher rates of these diseases. The aim of this study was to assess the relative effectiveness of an adult nutrition education program for Aboriginal and non-Aboriginal participants. Pre-and post-course evaluation data were used to assess changes in confidence in ability to buy healthy foods on a budget, nutrition knowledge, and dietary behaviours among individuals attending FOODcents nutrition education courses. The total sample of 875 Western Australians included 169 who self-identified as Aboriginal or Torres Strait Islander. Perceptions of course usefulness were very high and comparable between Aboriginal and non-Aboriginal participants. Significantly larger improvements in confidence, nutrition knowledge, and reported consumption behaviours were evident among Aboriginal participants. The findings suggest that adult nutrition education programs that address specific knowledge and skill deficits that are common among disadvantaged groups can be effective for multiple target groups, and may also assist in reducing nutrition-related inequalities. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

'We've fallen into the cracks': Aboriginal women's experiences with breast cancer through photovoice.

PubMed

Poudrier, Jennifer; Mac-Lean, Roanne Thomas

2009-12-01

Despite some recognition that Aboriginal women who have experienced breast cancer may have unique health needs, little research has documented the experiences of Aboriginal women from their perspective. Our main objective was to explore and to begin to make visible Aboriginal women's experiences with breast cancer using the qualitative research technique, photovoice. The research was based in Saskatchewan, Canada and participants were Aboriginal women who had completed breast cancer treatment. Although Aboriginal women cannot be viewed as a homogeneous group, participants indicated two areas of priority for health-care: (i) Aboriginal identity and traditional beliefs, although expressed in diverse ways, are an important dimension of breast cancer experiences and have relevance for health-care; and (ii) there is a need for multidimensional support which addresses larger issues of racism, power and socioeconomic inequality. We draw upon a critical and feminist conception of visuality to interrogate and disrupt the dominant visual terrain (both real and metaphorical) where Aboriginal women are either invisible or visible in disempowering ways. Aboriginal women who have experienced breast cancer must be made visible within health-care in a way that recognizes their experiences situated within the structural context of marginalization through colonial oppression.

Sociodemographic variations in the amount, duration and cost of potentially preventable hospitalisation for chronic conditions among Aboriginal and non-Aboriginal Australians: a period prevalence study of linked public hospital data

PubMed Central

Banham, David; Chen, Tenglong; Karnon, Jonathan; Brown, Alex; Lynch, John

2017-01-01

Objectives To determine disparities in rates, length of stay (LOS) and hospital costs of potentially preventable hospitalisations (PPH) for selected chronic conditions among Aboriginal and non-Aboriginal South Australians (SA), then examine associations with area-level socioeconomic disadvantage and remoteness. Setting Period prevalence study using linked, administrative public hospital records. Participants Participants included all SA residents in 2005–2006 to 2010–2011. Analysis focused on those individuals experiencing chronic PPH as defined by the Australian Institute of Health and Welfare. Primary outcome measures Number and rates (unadjusted, then adjusted for sex and age) of chronic PPH, total LOS and direct hospital costs by Aboriginality. Results Aboriginal SAs experienced higher risk of index chronic PPH compared with non-Aboriginals (11.5 and 6.2 per 1000 persons per year, respectively) and at younger ages (median age 48 vs 70 years). Once hospitalised, Aboriginal people experienced more chronic PPH events, longer total LOS with higher costs than non-Aboriginal people (2.6 vs 1.9 PPH per person; 11.7 vs 9.0 days LOS; at $A17 928 vs $A11 515, respectively). Compared with population average LOS, the standardised rate ratio of LOS among Aboriginal people increased by 0.03 (95% CI 0.00 to 0.07) as disadvantage rank increased and 1.04 (95% CI 0.63 to 1.44) as remoteness increased. Non-Aboriginal LOS also increased as disadvantage increased but at a lower rate (0.01 (95% CI 0.01 to 0.01)). Costs of Aboriginal chronic PPH increased by 0.02 (95% CI 0.00 to 0.06) for each increase in disadvantage and 1.18 (95% CI 0.80 to 1.55) for increased remoteness. Non-Aboriginal costs also increased as disadvantage increased but at lower rates (0.01 (95% CI 0.01 to 0.01)). Conclusion Aboriginal people’s heightened risk of chronic PPH resulted in more time in hospital and greater cost. Systematic disparities in chronic PPH by Aboriginality, area disadvantage and remoteness highlight the need for improved uptake of effective primary care. Routine, regional reporting will help monitor progress in meeting these population needs. PMID:29038183

Sociodemographic variations in the amount, duration and cost of potentially preventable hospitalisation for chronic conditions among Aboriginal and non-Aboriginal Australians: a period prevalence study of linked public hospital data.

PubMed

Banham, David; Chen, Tenglong; Karnon, Jonathan; Brown, Alex; Lynch, John

2017-10-15

To determine disparities in rates, length of stay (LOS) and hospital costs of potentially preventable hospitalisations (PPH) for selected chronic conditions among Aboriginal and non-Aboriginal South Australians (SA), then examine associations with area-level socioeconomic disadvantage and remoteness. Period prevalence study using linked, administrative public hospital records. Participants included all SA residents in 2005-2006 to 2010-2011. Analysis focused on those individuals experiencing chronic PPH as defined by the Australian Institute of Health and Welfare. Number and rates (unadjusted, then adjusted for sex and age) of chronic PPH, total LOS and direct hospital costs by Aboriginality. Aboriginal SAs experienced higher risk of index chronic PPH compared with non-Aboriginals (11.5 and 6.2 per 1000 persons per year, respectively) and at younger ages (median age 48 vs 70 years). Once hospitalised, Aboriginal people experienced more chronic PPH events, longer total LOS with higher costs than non-Aboriginal people (2.6 vs 1.9 PPH per person; 11.7 vs 9.0 days LOS; at $A17 928 vs $A11 515, respectively). Compared with population average LOS, the standardised rate ratio of LOS among Aboriginal people increased by 0.03 (95% CI 0.00 to 0.07) as disadvantage rank increased and 1.04 (95% CI 0.63 to 1.44) as remoteness increased. Non-Aboriginal LOS also increased as disadvantage increased but at a lower rate (0.01 (95% CI 0.01 to 0.01)). Costs of Aboriginal chronic PPH increased by 0.02 (95% CI 0.00 to 0.06) for each increase in disadvantage and 1.18 (95% CI 0.80 to 1.55) for increased remoteness. Non-Aboriginal costs also increased as disadvantage increased but at lower rates (0.01 (95% CI 0.01 to 0.01)). Aboriginal people's heightened risk of chronic PPH resulted in more time in hospital and greater cost. Systematic disparities in chronic PPH by Aboriginality, area disadvantage and remoteness highlight the need for improved uptake of effective primary care. Routine, regional reporting will help monitor progress in meeting these population needs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Prenatal Ambient Air Pollution, Placental Mitochondrial DNA Content, and Birth Weight in the INMA (Spain) and ENVIRONAGE (Belgium) Birth Cohorts

PubMed Central

Clemente, Diana B.P.; Casas, Maribel; Vilahur, Nadia; Begiristain, Haizea; Bustamante, Mariona; Carsin, Anne-Elie; Fernández, Mariana F.; Fierens, Frans; Gyselaers, Wilfried; Iñiguez, Carmen; Janssen, Bram G.; Lefebvre, Wouter; Llop, Sabrina; Olea, Nicolás; Pedersen, Marie; Pieters, Nicky; Santa Marina, Loreto; Souto, Ana; Tardón, Adonina; Vanpoucke, Charlotte; Vrijheid, Martine; Sunyer, Jordi; Nawrot, Tim S.

2015-01-01

Background: Mitochondria are sensitive to environmental toxicants due to their lack of repair capacity. Changes in mitochondrial DNA (mtDNA) content may represent a biologically relevant intermediate outcome in mechanisms linking air pollution and fetal growth restriction. Objective: We investigated whether placental mtDNA content is a possible mediator of the association between prenatal nitrogen dioxide (NO2) exposure and birth weight. Methods: We used data from two independent European cohorts: INMA (n = 376; Spain) and ENVIRONAGE (n = 550; Belgium). Relative placental mtDNA content was determined as the ratio of two mitochondrial genes (MT-ND1 and MTF3212/R3319) to two control genes (RPLP0 and ACTB). Effect estimates for individual cohorts and the pooled data set were calculated using multiple linear regression and mixed models. We also performed a mediation analysis. Results: Pooled estimates indicated that a 10-μg/m3 increment in average NO2 exposure during pregnancy was associated with a 4.9% decrease in placental mtDNA content (95% CI: –9.3, –0.3%) and a 48-g decrease (95% CI: –87, –9 g) in birth weight. However, the association with birth weight was significant for INMA (–66 g; 95% CI: –111, –23 g) but not for ENVIRONAGE (–20 g; 95% CI: –101, 62 g). Placental mtDNA content was associated with significantly higher mean birth weight (pooled analysis, interquartile range increase: 140 g; 95% CI: 43, 237 g). Mediation analysis estimates, which were derived for the INMA cohort only, suggested that 10% (95% CI: 6.6, 13.0 g) of the association between prenatal NO2 and birth weight was mediated by changes in placental mtDNA content. Conclusion: Our results suggest that mtDNA content can be one of the potential mediators of the association between prenatal air pollution exposure and birth weight. Citation: Clemente DB, Casas M, Vilahur N, Begiristain H, Bustamante M, Carsin AE, Fernández MF, Fierens F, Gyselaers W, Iñiguez C, Janssen BG, Lefebvre W, Llop S, Olea N, Pedersen M, Pieters N, Santa Marina L, Souto A, Tardón A, Vanpoucke C, Vrijheid M, Sunyer J, Nawrot TS. 2016. Prenatal ambient air pollution, placental mitochondrial DNA content, and birth weight in the INMA (Spain) and ENVIRONAGE (Belgium) birth cohorts. Environ Health Perspect 124:659–665; http://dx.doi.org/10.1289/ehp.1408981 PMID:26317635

Disparities experienced by Aboriginal compared to non-Aboriginal metropolitan Western Australians in receiving coronary angiography following acute ischaemic heart disease: the impact of age and comorbidities.

PubMed

Lopez, Derrick; Katzenellenbogen, Judith M; Sanfilippo, Frank M; Woods, John A; Hobbs, Michael S T; Knuiman, Matthew W; Briffa, Tom G; Thompson, Peter L; Thompson, Sandra C

2014-10-21

Aboriginal Australians have a substantially higher frequency of ischaemic heart disease (IHD) events than their non-Aboriginal counterparts, together with a higher prevalence of comorbidities. The pattern of health service provision for IHD suggests inequitable delivery of important diagnostic procedures. Published data on disparities in IHD management among Aboriginal Australians are conflicting, and the role of comorbidities has not been adequately delineated. We compared the profiles of Aboriginal and non-Aboriginal patients in the metropolitan area undergoing emergency IHD admissions at Western Australian metropolitan hospitals, and investigated the determinants of receiving coronary angiography. Person-linked administrative hospital and mortality records were used to identify 28-day survivors of IHD emergency admission events (n =20,816) commencing at metropolitan hospitals in 2005-09. The outcome measure was receipt of angiography. The Aboriginal to non-Aboriginal risk ratio (RR) was estimated from a multivariable Poisson log-linear regression model with allowance for multiple IHD events in individuals. The subgroup of myocardial infarction (MI) events was modelled separately. Compared with their non-Aboriginal counterparts, Aboriginal IHD patients were younger and more likely to have comorbidities. In the age- and sex-adjusted model, Aboriginal patients were less likely than others to receive angiography (RRIHD 0.77, 95% CI 0.72-0.83; RRMI 0.81, 95% CI 0.75-0.87) but in the full multivariable model this disparity was accounted for by comorbidities as well as IHD category and MI subtype, and private health insurance (RRIHD 0.95, 95% CI 0.89-1.01; RRMI 0.94, 95% CI 0.88-1.01). When stratified by age groups, this disparity was not significant in the 25-54 year age group (RRMI 0.95, 95% CI 0.88-1.02) but was significant in the 55-84 year age group (RRMI 0.88, 95% CI 0.77-0.99). The disproportionate under-management of older Aboriginal IHD patients is of particular concern. Regardless of age, the disparity between Aboriginal and non-Aboriginal Australians in receiving angiography for acute IHD in a metropolitan setting is mediated substantially by comorbidities. This constellation of health problems is a 'double-whammy' for Aboriginal people, predisposing them to IHD and also adversely impacting on their receipt of angiography. Further research should investigate how older age and comorbidities influence clinical decision making in this context.

'You can drop dead': midwives bullying women.

PubMed

Dietsch, Elaine; Shackleton, Pamela; Davies, Carmel; McLeod, Margaret; Alston, Margaret

2010-06-01

This paper describes how women experienced what came to be labelled as 'bullying' by a small number of midwives when they were evacuated from their rural and remote areas of NSW, Australia to a maternity unit to birth. What is the experience of women who are required to travel away from their NSW rural/remote communities to birth? Forty-two participants together with a number of their partners/support people were interviewed in depth for this qualitative, exploratory study. Upon thematic analysis of the transcribed interviews, an unexpected finding was that four participants (plus one partner) described experiences which were interpreted as bullying, by a small number of midwives working with them. Women identifying as Aboriginal were especially likely to share stories of midwifery bullying. Emotional and cultural safety of women must be a prime consideration of midwives. Strategies to reverse power differentials between midwives and women are urgently required to eradicate bullying by any midwife. 2009. Published by Elsevier Ltd. All rights reserved.

Statistical methods to enhance reporting of Aboriginal Australians in routine hospital records using data linkage affect estimates of health disparities.

PubMed

Randall, Deborah A; Lujic, Sanja; Leyland, Alastair H; Jorm, Louisa R

2013-10-01

To investigate under-recording of Aboriginal people in hospital data from New South Wales (NSW), Australia, define algorithms for enhanced reporting, and examine the impact of these algorithms on estimated disparities in cardiovascular and injury outcomes. NSW Admitted Patient Data were linked with NSW mortality data (2001-2007). Associations with recording of Aboriginal status were investigated using multilevel logistic regression. The number of admissions reported as Aboriginal according to six algorithms was compared with the original (unenhanced) Aboriginal status variable. Age-standardised admission, and 30- and 365-day mortality ratios were estimated for cardiovascular disease and injury. Sixty per cent of the variation in recording of Aboriginal status was due to the hospital of admission, with poorer recording in private and major city hospitals. All enhancement algorithms increased the number of admissions reported as Aboriginal, from between 4.1% and 37.8%. Admission and mortality ratios varied markedly between algorithms, with less strict algorithms resulting in higher admission rate ratios, but generally lower mortality rate ratios, particularly for cardiovascular disease. The choice of enhancement algorithm has an impact on the number of people reported as Aboriginal and on estimated outcome ratios. The influence of the hospital on recording of Aboriginal status highlights the importance of continued efforts to improve data collection. Estimates of Aboriginal health disparity can change depending on how Aboriginal status is reported. Sensitivity analyses using a number of algorithms are recommended. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Prevalence of HIV among Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis.

PubMed

Graham, Simon; O'Connor, Catherine C; Morgan, Stephen; Chamberlain, Catherine; Hocking, Jane

2017-06-01

Background Aboriginal and Torres Strait Islanders (Aboriginal) are Australia's first peoples. Between 2006 and 2015, HIV notifications increased among Aboriginal people; however, among non-Aboriginal people, notifications remained relatively stable. This systematic review and meta-analysis aims to examine the prevalence of HIV among Aboriginal people overall and by subgroups. In November 2015, a search of PubMed and Web of Science, grey literature and abstracts from conferences was conducted. A study was included if it reported the number of Aboriginal people tested and those who tested positive for HIV. The following variables were extracted: gender; Aboriginal status; population group (men who have sex with men, people who inject drugs, adults, youth in detention and pregnant females) and geographical location. An assessment of between study heterogeneity (I 2 test) and within study bias (selection, measurement and sample size) was also conducted. Seven studies were included; all were cross-sectional study designs. The overall sample size was 3772 and the prevalence of HIV was 0.1% (I 2 =38.3%, P=0.136). Five studies included convenient samples of people attending Australian Needle and Syringe Program Centres, clinics, hospitals and a youth detention centre, increasing the potential of selection bias. Four studies had a sample size, thus decreasing the ability to report pooled estimates. The prevalence of HIV among Aboriginal people in Australia is low. Community-based programs that include both prevention messages for those at risk of infection and culturally appropriate clinical management and support for Aboriginal people living with HIV are needed to prevent HIV increasing among Aboriginal people.

Supporting Educational Success for Aboriginal Students: Identifying Key Influences

ERIC Educational Resources Information Center

Whitley, Jessica

2014-01-01

The academic difficulties experienced by many Aboriginal (First Nations, Métis, Inuit) students in Canada have been well-documented. Indicators such as school persistence and post-secondary enrollment are typically far lower for Aboriginal students as a group compared to non-Aboriginal students. Identifying facilitators of success is key to…

Aboriginal Early Childhood Education in Canada: Issues of Context

ERIC Educational Resources Information Center

Preston, Jane P.; Cottrell, Michael; Pelletier, Terrance R.; Pearce, Joseph V.

2012-01-01

Herein we provide a literature synthesis pertaining to the state of Aboriginal early childhood education in Canada. We identify key features of quality Aboriginal early childhood programs. The background and significance of early childhood education for Aboriginal peoples is explicated. Cultural compatibility theory is employed as the…

Food Perceptions and Concerns of Aboriginal Women Coping with Gestational Diabetes in Winnipeg, Manitoba

ERIC Educational Resources Information Center

Neufeld, Hannah Tait

2011-01-01

Objective: To describe how Aboriginal women in an urban setting perceive dietary treatment recommendations associated with gestational diabetes mellitus (GDM). Design: Semi-structured explanatory model interviews explored Aboriginal women's illness experiences with GDM. Setting and Participants: Twenty-nine self-declared Aboriginal women who had…

The Coercive Sterilization of Aboriginal Women in Canada

ERIC Educational Resources Information Center

Stote, Karen

2012-01-01

This paper considers the coercive sterilization of Aboriginal women in legislated and non-legislated form in Canada. I provide an historical and materialist critique of coercive sterilization. I argue for coercive sterilization to be understood as one of many policies employed to undermine Aboriginal women, to separate Aboriginal peoples from…

Aboriginal Students' Achievement in Science Education: The Effect of Teaching Methods

ERIC Educational Resources Information Center

Bourque, Jimmy; Bouchamma, Yamina; Larose, Francois

2010-01-01

Some authors assume that the academic difficulties encountered by Aboriginal students can be partly explained by the discrepancy between teaching methods and Aboriginal learning styles. However, this hypothesis lacks empirical foundations. Using pan-Canadian data, we tried to identify the most efficient teaching methods for Aboriginal students and…

Building Cultural Bridges with Aboriginal Learners and Their "Classmates" for Transformative Environmental Education

ERIC Educational Resources Information Center

Hatcher, Annamarie

2012-01-01

The educational gap between Aboriginal and non-Aboriginal Canadians is the most significant social policy challenge facing Canada (Richards 2008). This gap is particularly evident in the science fields. Educational institutions are still regarded as mechanisms of colonization by many Aboriginal people. Their "foreign" Eurocentric (or…

Urban and Education Disparity for Autism Spectrum Disorders in Taiwan Birth Cohort Study

ERIC Educational Resources Information Center

Lung, For-Wey; Chiang, Tung-Liang; Lin, Shio-Jean; Shu, Bih-Ching

2017-01-01

This study aimed to determine the optimal cut-off for autism spectrum disorder (ASD) screening in 66-month-old children, and to explore the distribution of ASD screening and diagnosis in Taiwan. The Taiwan Birth Cohort Study dataset was used (N = 20,095). The Modified Checklist for Autism in Toddlers (M-CHAT) cut-off point of 13/14 was considered…

An Analysis of Associations between Residential and School Mobility and Educational Outcomes in South African Urban Children: The Birth to Twenty Cohort

ERIC Educational Resources Information Center

Ginsburg, Carren; Richter, Linda M.; Fleisch, Brahm; Norris, Shane A.

2011-01-01

Using data from Birth to Twenty, a cohort of South African urban children, the current paper investigates the relationships between residential and school mobility and a set of educational outcomes. The findings provide some evidence of a positive association between changes in residence and numeracy and literacy scores, and school mobility was…

The Short-Run Effects of the Croatian War on Education, Employment, and Earnings

ERIC Educational Resources Information Center

Kecmanovic, Milica

2013-01-01

The recent war in Croatia (1991-1995) has had numerous adverse affects on the country and the economy as a whole. This article investigates the effect that the war had on the educational, employment, and earnings trajectories of the 1971 birth cohort of men. This birth cohort was very likely to be drafted into the armed forces. Using data from the…

Etiological Survey on Intellectual Disability in the Northern Finland Birth Cohort 1986

ERIC Educational Resources Information Center

Heikura, Ulla; Linna, Sirkka-Liisa; Olsen, Paivi; Hartikainen, Anna-Liisa; Taanila, Anja; Jarvelin, Marjo-Riitta

2005-01-01

The etiology of intellectual disability was studied both in incident (n = 9,432) and prevalent (n = 9,351) populations in a one-year birth cohort born in Northern Finland in 1985-1986. Data from multiple sources were used to follow the children until the age of 11.5 years. Of the incident cases (n = 119) with intellectual disabilities, 66.4% had…

Preschool: First Findings from the Preschool Follow-Up of the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). First Look. NCES 2008-025

ERIC Educational Resources Information Center

Chernoff, Jodi Jacobson; Flanagan, Kristin Denton; McPhee, Cameron; Park, Jennifer

2007-01-01

The Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) is designed to provide detailed information on children's development, health, and early learning experiences in the years leading up to entry into school. The ECLS-B is the first nationally representative study within the United States to directly assess children's early mental and…

Intergenerational Class Mobility in Britain: A Comparative Look across Three Generations in the Lothian Birth Cohort 1936

ERIC Educational Resources Information Center

Johnson, Wendy; Brett, Caroline E.; Deary, Ian J.

2010-01-01

The Lothian Birth Cohort 1936 sample is in a uniquely good position to provide relevant data on social class mobility patterns over most of the last century. These participants, with known ultimate social class attainment, took a validated mental test in the Scottish Mental Survey of 1947 and were followed up at approximately age 70. Then, besides…

IQ in Childhood and the Metabolic Syndrome in Middle Age: Extended Follow-Up of the 1946 British Birth Cohort Study

ERIC Educational Resources Information Center

Richards, Marcus; Black, Stephanie; Mishra, Gita; Gale, Catharine R.; Deary, Ian J.; Batty, David G.

2009-01-01

IQ in early adulthood has been inversely associated with risk of the metabolic syndrome in midlife. We tested this association in the British 1946 birth cohort, which assessed IQ at age eight years and ascertained the metabolic syndrome at age 53 years based on modified (non-fasting blood) ATPIII criteria. Childhood IQ was inversely associated…

Bridging the Millennial Generation Expectation Gap: Perspectives and Strategies for Physician and Interprofessional Faculty.

PubMed

Williams, Valerie N; Medina, Jose; Medina, Andria; Clifton, Shari

2017-02-01

Assigning attributes to a birth cohort is one way we identify society-wide, shared life experiences within a group collectively called a "generation." Such assigned attributes influence society's adoption of generation-based expectations held by and about people from a particular birth cohort. Census data and generational attributes inform perspectives on millennial generation birth cohort experiences and engagement as students. The eldest living generation in U.S. society has given way to 3 subsequent generations, the youngest of which is called the millennial generation. What generational attributes influence the effectiveness of teaching and learning between millennial learners and faculty members from other generations? Understanding the role of life cycle effects, period effects and cohort effects can offer medical and health professions educators' insights into different strategies for learner engagement. Discussion includes specific strategies and teaching tactics faculty members can use to engage millennials across a continuum of learning to bridge the "expectation gap." Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Cohort fertility in Western Europe: comparing fertility trends in recent birth cohorts.

PubMed

Hopflinger, F

1984-01-01

A comparative study of fertility levels among cohorts of women born in 1940, 1945, 1950, 1955, and 1960 in 16 European countries was undertaken using vital statistics data. The average number of live birth/woman for each of the 5 cohorts by age 20, 25, 30, and 35 was computed by cumulating age-specific fertility rates of women born in specific years. Median age at childbirth and completed fertility were estimated for the 3 oldest cohorts (1940, 1945, and 1950). 2 estimations of completed fertility were made. 1 was based on the assumption of a constant age-specific fertility rate, and the other was based on a relational Gompertz model. Where possible cohort fertility was disaggregated by birth order. Since the data for the countries was not fully comparable, it was not possible to use sophisticated analytical techniques. Other limits of the study were that fertility, especially for the more recent cohorts was incomplete, parity specific data was not available for all the countries, and open cohorts rather than closed cohorts were used. The analysis indicated that completed cohort fertility was lower for the 1950 cohort than for the 1940 cohort in all 16 countries. For the 1940 cohort, only Germany's estimated completed fertility was less than 2.00. For the other 15 countries, estimated completed fertility ranged from 2.04 (Finland) to 3.36 (Ireland). For the 1950 cohort, estimated completed fertility was less than 2.00 in 8 of the countries. Estimated completed fertility was lowest in Finland and Switzerland (1.82) and highest in Ireland (3.33). No marked increase in childlessness was observed, and for the 1940 and 1950 cohorts, childlessness did not exceed 20% in any of the countries and was considerably less than 20% in most of the countries. There was a trend toward delayed childbearing in most of the countries. An examination of available parity data for the 1940 and 1950 cohorts lead to the conclusion that the major factor contributing toward the decline in fertility was a decline in 3rd and higher order births. Most countries showed a decline in higher order births, and in some countries the decline was marked. The proportion of 1-child families increased in many countries and was especially high in Germany. The fertility decline may be leveling off in some of the countries. Fertility will probably stablize at a low level in most of the countries. The decline in fertility is due not only to increased contraceptive use but to the growing trend toward secular individualism in European society. The similarities in the fertility declines in all the countries indicates that identical cross national causes are influencing fertility behavior. The 16 countries included iln the study were Austria, Belgium, Denmark, England and Wales, Finland, France, Germany, Greece, Ireland, Italy, Netherlands, Norway, Portugal, Spain, Sweden, and Switzerland.

17-alpha Hydroxyprogesterone Caproate did not reduce the rate of recurrent preterm birth in a prospective cohort study

PubMed Central

Nelson, David B.; McIntire, Donald D.; McDonald, Jeffrey; Gard, John; Turrichi, Paula; Leveno, Kenneth J.

2017-01-01

Background 17-alpha hydroxyprogesterone caproate for prevention of recurrent preterm birth is recommended for use in the United States. Objective To assess the clinical effectiveness of 17-alpha hydroxyprogesterone caproate to prevent recurrent preterm birth ≤ 35 weeks compared to similar births in our obstetric population prior to the implementation of 17-alpha hydroxyprogesterone caproate. Study Design This was a prospective cohort study of 17-alpha hydroxyprogesterone caproate in our obstetric population. The primary outcome was the recurrence of birth ≤ 35 weeks for the entire study cohort compared to a historical referent rate of 16.8% of recurrent preterm birth in our population. There were three secondary outcomes. First, did 17-alpha hydroxyprogesterone caproate modify a woman’s history of preterm birth when taking into account her prior number and sequence of preterm and term births? Second, was recurrence of preterm birth related to 17-alpha hydroxyprogesterone caproate plasma concentration? Third, was duration of pregnancy modified by 17-alpha hydroxyprogesterone caproate treatment compared to a prior preterm birth? Results Between January 2012 and March 2016, 430 consecutive women with prior births ≤ 35 weeks were treated with 17-alpha hydroxyprogesterone caproate. Nearly two-thirds of the women (N=267) began injections ≤ 18 weeks and 394 (92%) received a scheduled weekly injection within 10 days of reaching 35 weeks or delivery. The overall rate of recurrent preterm birth was 25% (N=106) for the entire cohort compared to the 16.8% expected rate (P = 1.0). The three secondary outcomes were also negative. First, 17-alpha hydroxyprogesterone caproate did not significantly reduce the rates of recurrence regardless of prior preterm birth number or sequence. Second, plasma concentrations of 17-alpha hydroxyprogesterone caproate were not different (P=0.17 at 24 weeks; P=0.38 at 32 weeks) between women delivered ≤ 35 weeks and those delivered later in pregnancy. Third, the mean (± standard deviation) interval in weeks of recurrent preterm birth before 17-alpha hydroxyprogesterone caproate use was 0.4 ± 5.3 weeks and the interval of recurrent preterm birth after 17-alpha hydroxyprogesterone caproate treatment was 0.1 ± 4.7 weeks (P=0.63). A side effect of weekly 17-alpha hydroxyprogesterone caproate injections was an increase in gestational diabetes. Specifically, the rate of gestational diabetes was 13.4% in 17-alpha hydroxyprogesterone caproate treated women compared to 8% in case-matched controls (P=0.001). Conclusions 17-alpha hydroxyprogesterone caproate was ineffective for prevention of recurrent preterm birth and was associated with increased rates of gestational diabetes. PMID:28223163

Maternal sleep and small for gestational age infants in the Japan Environment and Children's Study: a cohort study.

PubMed

Morokuma, Seiichi; Shimokawa, Mototsugu; Kato, Kiyoko; Sanefuji, Masafumi; Shibata, Eiji; Tsuji, Mayumi; Senju, Ayako; Kawamoto, Toshihiro; Kusuhara, Koichi

2017-08-11

Small for gestational age infants have an increased risk of immediate complications, short-term morbidity and mortality, and long-term neurologic and metabolic disorders in adulthood. Previous research has shown that reduced sleep duration is a risk factor for SGA birth. However, only a few studies have evaluated maternal sleep as a risk factor for SGA birth. In the present study, we investigated the relationship between the amount and quality of mothers' sleep and infants' birth weight. This cohort study (n = 8631) used data from the Japan Environment and Children's Study, an ongoing cohort study that began in January 2011. Data on sleep status (sleep duration and one indicator of sleep quality) and potential confounding factors were recorded. A log-binomial regression model was used to estimate the risk of small for gestational age birth, and the results were expressed as risk ratios and their respective 95% confidence interval. No significant results were observed for sleep duration or tiredness upon waking. Neither the amount nor the quality of mothers' sleep was associated with the risk of small for gestational age birth.

Effect of early nutritional intake on long-term growth and bone mineralization of former very low birth weight infants.

PubMed

Christmann, V; van der Putten, M E; Rodwell, L; Steiner, K; Gotthardt, M; van Goudoever, J B; van Heijst, A F J

2018-03-01

Preterm infants are at risk for impaired bone mineralization and growth in length later in life due to inadequate nutritional intake in the early postnatal period. To investigate whether increased nutritional supplementation of calcium, phosphate and protein in Very Low Birth Weight (VLBW) infants during the first 14days after birth was associated with improvement in length and bone development until 9-10years of age. Observational follow-up study of VLBW infants (birth weight<1500g or gestational age<32weeks) born in two consecutive years (eligible infants: 2004 n: 63 and 2005: n: 66). Cohort 2005 received higher intake of calcium, phosphate and protein with parenteral nutrition compared to Cohort 2004. Anthropometric data were collected during standard follow-up visits until five years, and additionally at 9-10years of age including measurements of bone mineral content, bone mineral density of the whole body and lumbar spine determined by dual-energy X-ray absorptiometry. Long-term growth trajectories of both cohorts were evaluated separately for participants born appropriate (AGA) and small for gestational age (SGA), stratified by gender. Multivariate linear regression was used to examine the effect of nutritional intake and clinical covariates on length and bone mineralization. Both cohorts achieved a catch-up in length to SDS within the normal range by 6months (length SDS: estimated mean (95% confidence interval (CI): 6months: Cohort 2004: -0.7 (-1.1, -0.3) Cohort 2005: -0.5 (-0.8, -0.2)). Bone mineral content and density were within the normal range and not different between the cohorts. SGA children achieved a catch-up in length at 5years with bone mineralization comparable to AGA children. Only for girls birth weight was significantly associated with length SDS (per gram: β 0.001; 95% CI (0.000, 0.003); p=0.03) There was no evidence of an association between early nutritional intake and bone mineralization. Children born as appropriate or small for gestational age preterm infants are able to catch up in length after the postnatal period, and achieve a normal length and bone mineralization at age nine-ten years. An improvement of calcium and phosphate intake during the first 14days after birth was not associated with improvement in length and bone development. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Head circumference growth among extremely preterm infants in Denmark has improved during the past two decades.

PubMed

Zachariassen, Gitte; Hansen, Bo Mølholm

2015-07-01

Treatment of extremely preterm and low birth weight infants is still evolving and improving. In this study, we evaluated if growth has improved from birth to two years of corrected age (CA) among extremely low birth weight (BW) and preterm born infants in Denmark. This was an observational study with comparison of head circumference (HC), weight and length growth in two Danish cohorts of extremely preterm (gestational age (GA) < 28 weeks) and extremely low birth weight (ELBW with a BW < 1,000 g) infants (A: 1994-1995 and B: 2004-2008). Infants in cohort A (n = 198) and B (n = 64) had a median GA and BW of 27 + 2 weeks and 948 g in A, and 27 + 3 weeks and 934 g in B. At discharge, infants in B compared with A had increased more in HC (p = 0.000), length (p = 0.008) and weight (p = 0.000). At two years CA, HC was still significantly larger in cohort B than A (p = 0.03), while no significant difference was recorded for length or weight. Growth during hospitalisation seems to have improved among extremely preterm and low birth weight infants from 1994-1995 to 2004-2008. This may be a result of improved nutrition in combination with improved intensive care during hospitalisation. Collection of data in the 2004-2008 cohort was supported by the Institute of Regional Health Services Research, the Egmont Foundation and the University of Southern Denmark. Collection of data from birth to two years of age in the 1994-1995 cohort was without financial support. For the 1994-1995 study, all eight regional Research Ethics Committees in Denmark at that time approved the study. The 2004-2008 study was approved by the Danish National Committee on Biomedical Research Ethics, and handling of data and registrations were approved by the Danish Data Protection Agency.

Birth weight, maternal weight and childhood leukaemia

PubMed Central

McLaughlin, C C; Baptiste, M S; Schymura, M J; Nasca, P C; Zdeb, M S

2006-01-01

There is mounting evidence that childhood leukaemia is associated with high birth weight, but few studies have examined the relationship between leukaemia and other perinatal factors that influence birth weight, such as maternal weight or gestational weight gain. This case-cohort study included 916 acute lymphocytic leukaemia (ALL) and 154 acute myeloid leukaemia (AML) cases diagnosed prior to age 10 years between 1985 and 2001 and born in New York State excluding New York City between 1978 and 2001. Controls (n=9686) were selected from the birth cohorts for the same years. Moderate increased risk of both ALL and AML was associated with birth weight 3500 g or more. For ALL, however, there was evidence of effect modification with birth weight and maternal prepregnancy weight. High birth weight was associated with ALL only when the mother was not overweight while heavier maternal weight was associated with ALL only when the infant was not high birth weight. Increased pregnancy-related weight gain was associated with ALL. For AML, birth weight under 3000 g and higher prepregnancy weight were both associated with increased risk. These findings suggest childhood leukaemia may be related to factors influencing abnormal fetal growth patterns. PMID:16736025

Early pregnancy vaginal microbiome trends and preterm birth.

PubMed

Stout, Molly J; Zhou, Yanjiao; Wylie, Kristine M; Tarr, Phillip I; Macones, George A; Tuuli, Methodius G

2017-09-01

Despite decades of attempts to link infectious agents to preterm birth, an exact causative microbe or community of microbes remains elusive. Nonculture 16S ribosomal RNA gene sequencing suggests important racial differences and pregnancy specific changes in the vaginal microbial communities. A recent study examining the association of the vaginal microbiome and preterm birth documented important findings but was performed in a predominantly white cohort. Given the important racial differences in bacterial communities within the vagina as well as persistent racial disparities in preterm birth, it is important to examine cohorts with varied demographic compositions. To characterize vaginal microbial community characteristics in a large, predominantly African-American, longitudinal cohort of pregnant women and test whether particular vaginal microbial community characteristics are associated with the risk for subsequent preterm birth. This is a nested case-control study within a prospective cohort study of women with singleton pregnancies, not on supplemental progesterone, and without cervical cerclage in situ. Serial mid-vaginal swabs were obtained by speculum exam at their routine prenatal visits. Sequencing of the V1V3 region of the 16S rRNA gene was performed on the Roche 454 platform. Alpha diversity community characteristics including richness, Shannon diversity, and evenness as well as beta diversity metrics including Bray Curtis Dissimilarity and specific taxon abundance were compared longitudinally in women who delivered preterm to those who delivered at term. A total of 77 subjects contributed 149 vaginal swabs longitudinally across pregnancy. Participants were predominantly African-American (69%) and had a preterm birth rate of 31%. In subjects with subsequent term delivery, the vaginal microbiome demonstrated stable community richness and Shannon diversity, whereas subjects with subsequent preterm delivery had significantly decreased vaginal richness, diversity, and evenness during pregnancy (P < .01). This change occurred between the first and second trimesters. Within-subject comparisons across pregnancy showed that preterm birth is associated with increased vaginal microbiome instability compared to term birth. No distinct taxa were associated with preterm birth. In a predominantly African-American population, a significant decrease of vaginal microbial community richness and diversity is associated with preterm birth. The timing of this suppression appears early in pregnancy, between the first and second trimesters, suggesting that early gestation may be an ecologically important time for events that ordain subsequent term and preterm birth outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Global patterns and trends in stomach cancer incidence: Age, period and birth cohort analysis.

PubMed

Luo, Ganfeng; Zhang, Yanting; Guo, Pi; Wang, Li; Huang, Yuanwei; Li, Ke

2017-10-01

The cases of stomach cancer (SC) incidence are increasing per year and the SC burden has remained very high in some countries. We aimed to evaluate the global geographical variation in SC incidence and temporal trends from 1978 to 2007, with an emphasis on the effect of birth cohort. Joinpoint regression and age-period-cohort model were applied. From 2003 to 2007, male rate were 1.5- to 3-fold higher than female in all countries. Rates were highest in Eastern Asian and South American countries. Except for Uganda, all countries showed favorable trends. Pronounced cohort-specific increases in risk for recent birth cohorts were seen in Brazil, Colombia, Iceland, New Zealand, Norway, Uganda and US white people for males and in Australia, Brazil, Colombia, Costa Rica, Czech Republic, Ecuador, Iceland, India, Malta, New Zealand, Norway, Switzerland, United Kingdom, Uganda, US black and white people for females. The cohort-specific ratio for male significantly decreased in Japan, Malta and Spain for cohorts born since 1950 and in Austria, China, Croatia, Ecuador, Russia, Switzerland and Thailand for cohorts born since 1960 and for female in Japan for cohorts born since 1950 and in Canada, China, Croatia, Latvia, Russia and Thailand for cohorts born since 1960. Disparities in incidence and carcinogenic risk persist worldwide. The favorable trends may be due to changes in environmental exposure and lifestyle, including decreased Helicobacter pylori prevalence, increased intake of fresh fruits and vegetables, the availability of refrigeration and decreased intake of salted and preserved food and smoking prevalence. © 2017 UICC.

Genetic anticipation in BRCA1/2 families after controlling for ascertainment bias and cohort effect

PubMed Central

Guindalini, Rodrigo Santa Cruz; Song, Andrew; Fackenthal, James D.; Olopade, Olufunmilayo I.; Huo, Dezheng

2016-01-01

Background Genetic anticipation, the earlier onset of disease in successive generations, has been reported in hereditary breast and ovarian cancer syndrome (HBOC), but little is known about its underlying mechanisms. Ascertainment bias is a reason that has been suggested in previous studies. Likewise, cohort effect, which may be due to environmental factors, can be misinterpreted as genetic anticipation. Methods We conducted a review of pedigrees in 176 kindreds segregating deleterious mutations in BRCA1/2 genes who had at least two consecutive generations of the same cancer (breast or ovarian). Using mutation probabilities as analytical weights in weighted random-effect models, we calculated generational differences in age of onset of breast/ovarian cancer. Then we further controlled for ascertainment bias by excluding probands and adjusted for birth cohort effect in the anticipation models. Results The mean age of breast cancer for the probands’ generation was 41.9 years, which was 6.8 years and 9.8 years earlier than the parents’ and grandparents’ generations, respectively. The anticipation effect for breast cancer remained significant after excluding probands. There was a birth cohort effect: patients born in 1930s and 1940s had breast cancer 5.0 and 7.6 years earlier than patients born before 1920. The difference in breast cancer age of onset across generations was no longer significant after adjusting for birth cohort effect. Conclusions The observed anticipation effect was mainly driven by a decrease in age of onset across birth cohorts, underscoring the need for risk reducing interventions that target changing environmental/lifestyle factors in BRCA1/2 carriers. PMID:26992017

Testicular cancer: marked birth cohort effects on incidence and a decline in mortality in southern Netherlands since 1970.

PubMed

Verhoeven, Rob; Houterman, Saskia; Kiemeney, Bart; Koldewijn, Evert; Coebergh, Jan Willem

2008-02-01

The aim of our study was to interpret the changing incidence, and to describe the mortality of patients with testicular cancer in the south of the Netherlands between 1970 and 2004. On the basis of data from the Eindhoven Cancer Registry and Statistics Netherlands, 5-year moving average standardised incidence and mortality rates were calculated. An age-period-cohort (APC) Poisson regression analysis was performed to disentangle time and birth cohort effects on incidence. The incidence rate remained stable for all ages at about 3 per 100,000 person-years until 1989 but increased annually thereafter by 4% to 6 in 2004. This increase can almost completely be attributed to an increase in localised tumours. The largest increase was found for seminoma testicular cancer (TC) patients aged 35-39 and non-seminoma TC patients aged 20-24 years. Relatively more localised and tumours with lymph node metastases were detected in the later periods. APC analysis showed the best fit with an age-cohort model. An increase in incidence of TC was found for birth cohorts since 1950. The mortality rate dropped from 1.0 per 100,000 person-years in 1970 to 0.3 in 2005, with a steep annual decline of 12% in the period 1979-1986. In conclusion, the increase in incidence of TC was strongly correlated with birth cohorts since 1945. The increase in incidence is possibly caused by in utero or early life exposure to a yet unknown risk factor. There was a steep decline in mortality in the period 1979-1986. (c) 2007 Wiley-Liss, Inc.

Evaluating the Aboriginal child's mind: assimilation and cross-cultural psychology in Australia.

PubMed

Robertson, David

2018-06-01

This article examines two psychological interventions with Australian Aboriginal children in the late 1960s and early 1970s. The first involved evaluating the cognitive maturation of Aboriginal adolescents using a series of Piagetian interviews. The second, a more extensive educational intervention, used a variety of quantitative tests to measure and intervene in the intellectual performance of Aboriginal preschoolers. In both of these interventions the viability of the psychological instruments in the cross-cultural encounter created ongoing ambiguity as to the value of the research outcomes. Ultimately, the resolution of this ambiguity in favour of notions of Aboriginal 'cultural deprivation' reflected the broader political context of debates over Aboriginal self-governance during this period.

Eclipses in Australian Aboriginal Astronomy

NASA Astrophysics Data System (ADS)

Hamacher, Duane W.; Norris, Ray P.

2011-07-01

We explore about fifty different Australian Aboriginal accounts of lunar and solar eclipses to determine how Aboriginal groups understood this phenomenon. We summarize the literature on Aboriginal references to eclipses. We show that many Aboriginal groups viewed eclipses negatively, frequently associating them with bad omens, evil magic, disease, blood and death. In many communities, elders or medicine men claimed to be able to control or avert eclipses by magical means, solidifying their roles as providers and protectors within their communities. We also show that some Aboriginal groups seem to have understood the motions of the Sun-Earth-Moon system, the connection between the lunar phases and tides, and acknowledged that solar eclipses were caused by the Moon blocking the Sun.

Gender equality and smoking: a theory-driven approach to smoking gender differences in Spain.

PubMed

Bilal, Usama; Beltrán, Paula; Fernández, Esteve; Navas-Acien, Ana; Bolumar, Francisco; Franco, Manuel

2016-05-01

The intersection between gender and class can aid in understanding gender differences in smoking. To analyse how changes in gender inequality relate to differences in smoking prevalence by gender, education and birth cohort in Spain over the past five decades (1960-2010). The Gender Inequality Index (GII) was calculated in 5-year intervals from 1960 to 2010. GII ranges from 0 to 1 (1=highest inequality) and encompasses three dimensions: reproductive health, empowerment and labour market. Estimates of female and male smoking prevalence were reconstructed from representative National Health Surveys and stratified by birth cohort and level of education. We calculated female-to-male smoking ratios from 1960 to 2010 stratified by education and birth cohort. Gender inequality in Spain decreased from 0.65 to 0.09 over the past 50 years. This rapid decline was inversely correlated (r=-0.99) to a rising female-to-male smoking ratio. The youngest birth cohort of the study (born 1980-1990) and women with high education levels had similar smoking prevalences compared with men. Women with high levels of education were also the first to show a reduction in smoking prevalence, compared with less educated women. Gender inequality fell significantly in Spain over the past 50 years. This process was accompanied by converging trends in smoking prevalence for men and women. Smoking prevalence patterns varied greatly by birth cohort and education levels. Countries in earlier stages of the tobacco epidemic should consider gender-sensitive tobacco control measures and policies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Academic achievement of twins and singletons in early adulthood: Taiwanese cohort study.

PubMed

Tsou, Meng-Ting; Tsou, Meng-Wen; Wu, Ming-Ping; Liu, Jin-Tan

2008-07-21

To examine the long term effects of low birth weight on academic achievements in twins and singletons and to determine whether the academic achievement of twins in early adulthood is inferior to that of singletons. Cohort study. Taiwanese nationwide register of academic outcome. A cohort of 218 972 singletons and 1687 twins born in Taiwan, 1983-5. College attendance and test scores in the college joint entrance examinations. After adjustment for birth weight, gestational age, birth order, and sex and the sociodemographic characteristics of the parents, twins were found to have significantly lower mean test scores than singletons in Chinese, mathematics, and natural science, as well as a 2.2% lower probability of attending college. Low birthweight twins had an 8.5% lower probability of college attendance than normal weight twins, while low birthweight singletons had only a 3.2% lower probability. The negative effects of low birth weight on the test scores in English and mathematics were substantially greater for twins than for singletons. The twin pair analysis showed that the association between birth weight and academic achievement scores, which existed for opposite sex twin pairs, was not discernible for same sex twin pairs, indicating that birth weight might partly reflect other underlying genetic variations. These data support the proposition that twins perform less well academically than singletons. Low birth weight has a negative association with subsequent academic achievement in early adulthood, with the effect being stronger for twins than for singletons. The association between birth weight and academic performance might be partly attributable to genetic factors.

Clinical outcomes of the first midwife-led normal birth unit in China: a retrospective cohort study.

PubMed

Cheung, Ngai Fen; Mander, Rosemary; Wang, Xiaoli; Fu, Wei; Zhou, Hong; Zhang, Liping

2011-10-01

to report the clinical outcomes of the first six months of operation of an innovative midwife-led normal birth unit (MNBU) in China in 2008, aiming to facilitate normal birth and enhance midwifery practice. an urban hospital with 2000-3000 deliveries per year. this study was part of a major action research project that led to implementation of the MNBU. A retrospective cohort and a questionnaire survey were used. The data were analysed thematically. the outcomes of the first 226 women accessing the MNBU were compared with a matched retrospective cohort of 226 women accessing standard care. In total, 128 participants completed a satisfaction questionnaire before discharge. mode of birth and model of care. the vaginal birth rate was 87.6% in the MNBU compared with 58.8% in the standard care unit. All women who accessed the MNBU were supported by both a midwife and a birth companion, referred to as 'two-to-one' care. None of the women labouring in the standard care unit were identified as having a birth companion. the concept of 'two-to-one' care emerged as fundamental to women's experiences and utilisation of midwives' skills to promote normal birth and decrease the likelihood of a caesarean section. the MNBU provides an environment where midwives can practice to the full extent of their role. The high vaginal birth rate in the MNBU indicates the potential of this model of care to reduce obstetric intervention and increase women's satisfaction with care within a context of extraordinary high caesarean section rates. midwife-led care implies a separation of obstetric care from maternity care, which has been advocated in many European countries. Copyright © 2010 Elsevier Ltd. All rights reserved.

Physical activity during pregnancy and infant's birth weight: results from the 3D Birth Cohort.

PubMed

Bisson, Michèle; Croteau, Jordie; Guinhouya, Benjamin C; Bujold, Emmanuel; Audibert, François; Fraser, William D; Marc, Isabelle

2017-01-01

To evaluate the association between maternal physical activity and infant's birth weight or risk of inappropriate weight for gestational age (GA), and whether this association differs by infant's sex, maternal body mass index (BMI) or pregnancy complications in a prospective cohort study. 1913 pregnant women from the 3D Birth Cohort (Québec, Canada) completed the Pregnancy Physical Activity Questionnaire at each trimester. Energy expenditure (metabolic equivalent of task (MET)*hours/week) for total activity, sports and exercise and vigorous intensity activities was calculated. The associations with birth weight and risk of inappropriate weight for GA were evaluated by regression modelling. Interactions were tested with infant's sex, maternal prepregnancy BMI, gestational diabetes, hypertensive disorders and prematurity. Each 1 MET/hours/week increase in sports and exercise in the first trimester was associated with a 2.5 g reduction in infant's birth weight (95% CI -4.8 to -0.3) but was not associated with the risk of small weight for GA. In contrast, although not significant, a 17% reduction in the risk of large weight for GA was observed with increasing sports and exercise. Furthermore, in women with subsequent pre-eclampsia (but not normotensive or hypertensive women), each 1 MET/hours/week increment spent in any vigorous exercise in the first trimester reduced the infant's birth weight by 19.8 g (95% CI -35.2 to -4.3). Pregnant women with higher sports and exercise levels in the first trimester delivered infants with a lower birth weight. The risk of reducing infant's birth weight with vigorous exercise in women who develop pre-eclampsia later in pregnancy requires evaluation.

Low birthweight and preterm birth: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982-2015.

PubMed

Silveira, Mariangela F; Victora, Cesar G; Horta, Bernardo L; da Silva, Bruna G C; Matijasevich, Alicia; Barros, Fernando C

2018-06-22

Despite positive changes in most maternal risk factors in Brazil, previous studies did not show reductions in preterm birth and low birthweight. We analysed trends and inequalities in these outcomes over a 33-year period in a Brazilian city. Four population-based birth cohort studies were carried out in the city of Pelotas in 1982, 1993, 2004 and 2015, with samples ranging from 4231 to 5914 liveborn children. Low birthweight (LBW) was defined as <2500 g, and preterm birth as less than 37 weeks of gestation. Information was collected on family income, maternal skin colour and other risk factors for low birthweight. Multivariable linear regression was used to estimate the contribution of risk factors to time trends in birthweight. Preterm births increased from 5.8% (1982) to 13.8% (2015), and LBW prevalence increased from 9.0% to 10.1%, being higher for boys and for children born to mothers with low income and brown or black skin colour. Mean birthweight remained stable, around 3200 g, but increased from 3058 to 3146 g in the poorest quintile and decreased from 3307 to 3227 g in the richest quintile. After adjustment for risk factors for LBW, mean birthweight was estimated to have declined by 160 g over 1982-2015 (reductions of 103 g in the poorest and 213 g in the richest quintiles). Data from four birth cohorts show that preterm births increased markedly. Mean birthweights remained stable over a 33-year period. Increased prevalence of preterm and early term births, associated with high levels of obstetric interventions, has offset the expected improvements due to reduction in risk factors for low birthweight.

Complicated grief in Aboriginal populations

PubMed Central

Spiwak, Rae; Sareen, Jitender; Elias, Brenda; Martens, Patricia; Munro, Garry; Bolton, James

2012-01-01

To date there have been no studies examining complicated grief (CG) in Aboriginal populations. Although this research gap exists, it can be hypothesized that Aboriginal populations may be at increased risk for CG, given a variety of factors, including increased rates of all-cause mortality and death by suicide. Aboriginal people also have a past history of multiple stressors resulting from the effects of colonization and forced assimilation, a significant example being residential school placement. This loss of culture and high rates of traumatic events may place Aboriginal individuals at increased risk for suicide, as well as CG resulting from traumatic loss and suicide bereavement. Studies are needed to examine CG in Aboriginal populations. These studies must include cooperation with Aboriginal communities to help identify risk factors for CG, understand the role of culture among these communities, and identify interventions to reduce poor health outcomes such as suicidal behavior. PMID:22754293

Knowing, Being, and Doing: Aboriginal and Non-Aboriginal Collaboration in Cancer Services

PubMed Central

Zubrzycki, Joanna; Shipp, Rick; Jones, Victoria

2017-01-01

This qualitative inquiry explored the processes and practices of collaboration as experienced by a group of Australian multidisciplinary Aboriginal and non-Aboriginal health workers. Each worker had participated, for a period of 2 to 5 years, in an Australian Government–funded project in which a range of health initiatives led to improved access to cancer services by Aboriginal communities in a rural region of South Eastern Australia. Initiatives which addressed high rates of mortality from cancer, poor access to cancer screening, and engagement with cancer treatment were developed through the formation of close working relationships between Aboriginal and non-Aboriginal health workers. These relationships were regarded as personally and professionally transformative. Through the sharing of knowledge, skills, and experiences, new ways of knowing, being, and doing emerged. Developing a deeper understanding of cross-cultural collaboration is one way of addressing complex health problems and building the capacity of the health workforce. PMID:28682709

Planning, implementing, and evaluating a program to address the oral health needs of aboriginal children in port augusta, australia.

PubMed

Parker, E J; Misan, G; Shearer, M; Richards, L; Russell, A; Mills, H; Jamieson, L M

2012-01-01

Aboriginal Australian children experience profound oral health disparities relative to their non-Aboriginal counterparts. In response to community concerns regarding Aboriginal child oral health in the regional town of Port Augusta, South Australia, a child dental health service was established within a Community Controlled Aboriginal Health Service. A partnership approach was employed with the key aims of (1) quantifying rates of dental service utilisation, (2) identifying factors influencing participation, and (3) planning and establishing a program for delivery of Aboriginal children's dental services that would increase participation and adapt to community needs. In planning the program, levels of participation were quantified and key issues identified through semistructured interviews. After 3.5 years, the participation rate for dental care among the target population increased from 53 to 70 percent. Key areas were identified to encourage further improvements and ensure sustainability in Aboriginal child oral health in this regional location.

A genomic history of Aboriginal Australia.

PubMed

Malaspinas, Anna-Sapfo; Westaway, Michael C; Muller, Craig; Sousa, Vitor C; Lao, Oscar; Alves, Isabel; Bergström, Anders; Athanasiadis, Georgios; Cheng, Jade Y; Crawford, Jacob E; Heupink, Tim H; Macholdt, Enrico; Peischl, Stephan; Rasmussen, Simon; Schiffels, Stephan; Subramanian, Sankar; Wright, Joanne L; Albrechtsen, Anders; Barbieri, Chiara; Dupanloup, Isabelle; Eriksson, Anders; Margaryan, Ashot; Moltke, Ida; Pugach, Irina; Korneliussen, Thorfinn S; Levkivskyi, Ivan P; Moreno-Mayar, J Víctor; Ni, Shengyu; Racimo, Fernando; Sikora, Martin; Xue, Yali; Aghakhanian, Farhang A; Brucato, Nicolas; Brunak, Søren; Campos, Paula F; Clark, Warren; Ellingvåg, Sturla; Fourmile, Gudjugudju; Gerbault, Pascale; Injie, Darren; Koki, George; Leavesley, Matthew; Logan, Betty; Lynch, Aubrey; Matisoo-Smith, Elizabeth A; McAllister, Peter J; Mentzer, Alexander J; Metspalu, Mait; Migliano, Andrea B; Murgha, Les; Phipps, Maude E; Pomat, William; Reynolds, Doc; Ricaut, Francois-Xavier; Siba, Peter; Thomas, Mark G; Wales, Thomas; Wall, Colleen Ma'run; Oppenheimer, Stephen J; Tyler-Smith, Chris; Durbin, Richard; Dortch, Joe; Manica, Andrea; Schierup, Mikkel H; Foley, Robert A; Lahr, Marta Mirazón; Bowern, Claire; Wall, Jeffrey D; Mailund, Thomas; Stoneking, Mark; Nielsen, Rasmus; Sandhu, Manjinder S; Excoffier, Laurent; Lambert, David M; Willerslev, Eske

2016-10-13

The population history of Aboriginal Australians remains largely uncharacterized. Here we generate high-coverage genomes for 83 Aboriginal Australians (speakers of Pama-Nyungan languages) and 25 Papuans from the New Guinea Highlands. We find that Papuan and Aboriginal Australian ancestors diversified 25-40 thousand years ago (kya), suggesting pre-Holocene population structure in the ancient continent of Sahul (Australia, New Guinea and Tasmania). However, all of the studied Aboriginal Australians descend from a single founding population that differentiated ~10-32 kya. We infer a population expansion in northeast Australia during the Holocene epoch (past 10,000 years) associated with limited gene flow from this region to the rest of Australia, consistent with the spread of the Pama-Nyungan languages. We estimate that Aboriginal Australians and Papuans diverged from Eurasians 51-72 kya, following a single out-of-Africa dispersal, and subsequently admixed with archaic populations. Finally, we report evidence of selection in Aboriginal Australians potentially associated with living in the desert.

Aboriginal Student Stories, the Missing Voice to Guide Us towards Change

ERIC Educational Resources Information Center

Donovan, Michael J.

2015-01-01

Despite decades of policy and practice oriented at improving educational outcomes for Aboriginal students in Australia, achievements on most measures indicate that there is a long way to go in this endeavour. One avenue for improving Aboriginal education that has received little attention is accessing the views of Aboriginal students themselves…

Aboriginal Students' Perspectives on the Factors Influencing High School Completion

ERIC Educational Resources Information Center

MacIver, Marion

2012-01-01

The Canadian education system is failing its Aboriginal students as evidenced by the significant proportion not completing high school. The Aboriginal population has experienced a significantly greater proportion of people living in poverty and higher rates of unemployment than has the non-Aboriginal population. These factors can be linked to the…

Non-timber forest products and Aboriginal traditional knowledge

Treesearch

Robin J. Marles

2001-01-01

Ethnobotanical research was conducted in over 30 Aboriginal communities within Canada's boreal forest region. Specific methods for the research were developed that involved a high degree of participation by Aboriginal people in every stage of the project, with the result that well over 100 Aboriginal elders contributed information on the uses of more that 200...

Intellectual Property and Aboriginal People: A Working Paper = Propriete intellectuelle et Autochtones: Document de travail.

ERIC Educational Resources Information Center

Brascoupe, Simon; Endemann, Karin

Written in English and French, this paper outlines current Canadian intellectual property legislation as it relates to Aboriginal people in Canada, and provides a general review of the implications and limitations of this legislation for protecting the traditional knowledge of Aboriginal people. An initial discussion of Aboriginal perspectives…

The Process of Coping with Changes: A Study of Learning Experiences for the Aboriginal Nursing Freshmen

ERIC Educational Resources Information Center

Liu, Ruo Lan

2012-01-01

Background: Given the increasing presence of aborigines in Taiwan higher education, especially in nursing institutes, the retention and adaptation of aboriginal students is a critical issue for research. Understanding the adjustment and transformation process of aboriginal nursing freshmen is very important for improving their learning, but very…

School Sport Self-Concept of Urban Aboriginal School Children: Teacher Influences.

ERIC Educational Resources Information Center

Kickett-Tucker, Cheryl S.

This paper examines the self-concept of urban Western Australian Aboriginal school children, aged 11-12, in school sports settings. Most students were from the Nyoongar Aboriginal community of southwestern Western Australia. Data were collected from interviews with Aboriginal students and parents, class teachers, and sports teachers, and from…

National Aboriginal and Torres Strait Islander Education Strategy 2015

ERIC Educational Resources Information Center

Education Council, 2015

2015-01-01

Despite determined effort much more needs to be done to close the gap in Aboriginal and Torres Strait Islander education outcomes. Aboriginal and Torres Strait Islander people are the first Australians with the oldest continuing cultures in human history. Governments across Australia affirm the right of Aboriginal and Torres Islander people to…

How Aboriginal Peer Interactions in Upper Primary School Sport Support Aboriginal Identity

ERIC Educational Resources Information Center

Kickett-Tucker, Cheryl S.

2008-01-01

This ethnographic study tested the hypothesis that positive social interactions in sport will contribute positively to the Aboriginal identity of urban, Australian Aboriginal children. Nine male and female children aged 11-12 years were observed and interviewed. Significant responses were extracted and meanings were identified and grouped into…

Aborigines of the Imaginary: Applying Lacan to Aboriginal Education

ERIC Educational Resources Information Center

Harrison, Neil

2012-01-01

This paper applies the work of Jacques Lacan, a French psychoanalyst, to decipher the desire of the teacher in Aboriginal education. It argues that the images of Aboriginal people represented in Australian classrooms are effects of the teacher's Imaginary, the Imaginary being one of the three psychoanalytic domains theorised by Lacan over a period…

A Four-Stage Method for Developing Early Interventions for Alcohol among Aboriginal Adolescents

ERIC Educational Resources Information Center

Mushquash, Christopher J.; Comeau, M. Nancy; McLeod, Brian D.; Stewart, Sherry H.

2010-01-01

This paper details a four-stage methodology for developing early alcohol interventions for at-risk Aboriginal youth. Stage 1 was an integrative approach to Aboriginal education that upholds Aboriginal traditional wisdom supporting respectful relationships to the Creator, to the land and to each other. Stage 2 used quantitative methods to…

A Study of Aboriginal Teachers' Professional Knowledge and Experience in Canadian Schools

ERIC Educational Resources Information Center

St. Denis, Verna

2010-01-01

This qualitative study, initiated by the Canadian Teachers' Federation and its Advisory Committee on Aboriginal Education, explored the professional knowledge and experiences of Aboriginal (First Nations, Mets and Inuit) teachers. The rationale for the study was to address the urgent need to improve and promote Aboriginal education in public…

The Rainbow/Holistic Approach to Aboriginal Literacy.

ERIC Educational Resources Information Center

George, Ningwakwe Priscilla

2003-01-01

Aboriginal literacy programs in Canada are using literacy as a means of reclaiming Aboriginal languages and a positive cultural identity. The Rainbow/Holistic Approach to Aboriginal literacy uses seven ways of knowing, each corresponding to a color. The approach recognizes that spirit, heart, mind, and body equally contribute to a life of balance,…

Identifying Multi-Level Culturally Appropriate Smoking Cessation Strategies for Aboriginal Health Staff: A Concept Mapping Approach

ERIC Educational Resources Information Center

Dawson, Anna P.; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

2013-01-01

Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco…

Aboriginal Digital Opportunities: Addressing Aboriginal Learning Needs through the Use of Learning Technologies. 328-01 Detailed Findings.

ERIC Educational Resources Information Center

Greenall, David; Loizides, Stelios

Aboriginal educators and economic development practitioners in Canada are developing and implementing initiatives to promote the achievement of "digital opportunities" so that Aboriginal communities can both develop and be in a position to take advantage of economic opportunities without falling deeper into the "digital…

Aboriginal Students and School Mobility in British Columbia Public Schools

ERIC Educational Resources Information Center

Aman, Cheryl

2008-01-01

In British Columbia, K-12 school Aboriginal students' completion rates are far from equivalent to those of their non-Aboriginal peers. In addition, there is a high degree of variability in Aboriginal students' school completion rates across schools and communities. Administrative data associating approximately 1.5 million school census records of…

Early life determinants of frailty in old age: the Helsinki Birth Cohort Study.

PubMed

Haapanen, M J; Perälä, M M; Salonen, M K; Kajantie, E; Simonen, M; Pohjolainen, P; Eriksson, J G; von Bonsdorff, M B

2018-04-12

there is evidence suggesting that several chronic diseases have their origins in utero and that development taking place during sensitive periods may affect the aging process. We investigated whether early life determinants would be associated with frailty in old age. at a mean age of 71 years, 1,078 participants belonging to the Helsinki Birth Cohort Study were assessed for frailty according to the Fried frailty criteria. Early life measurements (birth weight, length, mother body mass index [BMI] and parity) were obtained from birth, child welfare and school health records. Multinomial regression analysis was used to assess the association between early life determinants and frailty in old age. weight, length and BMI at birth were all inversely associated with frailty in old age. A 1 kg increase in birth weight was associated with a lower relative risk ratio (RRR) of frailty (age and sex-adjusted RRR = 0.40, 95% CI: 0.19, 0.82) compared to non-frailty. Associations persisted after adjusting for several confounding factors. Compared to cohort members in the upper middle class, those who as adults worked as manual workers or belonged to the lower middle class, were at an increased risk of frailty. those who were small at birth were at an increased risk of developing frailty in old age, suggesting that frailty is at least partly programmed in early life. A less privileged socioeconomic status in adulthood was associated with an increased risk of frailty in old age.

Altered Growth Trajectory of Head Circumference During Infancy and Schizophrenia in a National Birth Cohort

PubMed Central

Brown, Alan S.; Gyllenberg, David; Hinkka-Yli-Salomäki, Susanna; Sourander, Andre; McKeague, Ian W.

2016-01-01

Identification of abnormalities in the developmental trajectory during infancy of future schizophrenia cases offers the potential to reveal pathogenic mechanisms of this disorder. Previous studies of head circumference in pre-schizophrenia were limited to measures at birth. The use of growth acceleration of head circumference (defined as the rate of change in head circumference) provides a more informative representation of the maturational landscape of this measure compared to studies based on static head circumference measures. To date, however, no study has examined whether HC growth acceleration differs between pre-schizophrenia cases and controls. In the present study, we employed a nested case control design of a national birth cohort in Finland. Cases with schizophrenia or schizoaffective disorder (N=375) and controls (N=375) drawn from the birth cohort were matched 1:1 on date of birth (within 1 month), sex, and residence in Finland at case diagnosis. Longitudinal data were obtained on head circumference from birth through age 1. Data were analyzed using a new nonparametric Bayesian inversion method which allows for a detailed understanding of growth dynamics. Adjusting for growth velocity of height and weight, and gestational age, there was significantly accelerated growth of head circumference in females with schizophrenia from birth to 2 months; the findings remained significant following Bonferroni correction (p < 0.0125). This is the first study to report abnormal HC growth acceleration, a more sensitive measure of somatic developmental deviation of this measure, in schizophrenia. PMID:27818077

Syphilis epidemiology and public health interventions in Western Australia from 1991 to 2009.

PubMed

Kwan, Kellie S H; Giele, Carolien M; Greville, Heath S; Reeve, Carole A; Lyttle, P Heather; Mak, Donna B

2012-07-01

To describe the epidemiology of congenital and infectious syphilis during 1991-2009, examine the impact of public health interventions and discuss the feasibility of syphilis elimination among Aboriginal people in Western Australia (WA). WA congenital and infectious syphilis notification data in 1991-2009 and national infectious syphilis notification data in 2005-2009 were analysed by Aboriginality, region of residence, and demographic and behavioural characteristics. Syphilis public health interventions in WA from 1991-2009 were also reviewed. During 1991-2009, there were six notifications of congenital syphilis (50% Aboriginal) and 1441 infectious syphilis notifications (61% Aboriginal). During 1991-2005, 88% of notifications were Aboriginal, with several outbreaks identified in remote WA. During 2006-2009, 62% of notifications were non-Aboriginal, with an outbreak in metropolitan men who have sex with men. The Aboriginal:non-Aboriginal rate ratio decreased from 173:1 (1991-2005) to 15:1 (2006-2009). These data demonstrate that although the epidemiology of syphilis in WA has changed over time, the infection has remained endemic among Aboriginal people in non-metropolitan areas. Given the continued public health interventions targeted at this population, the limited success in eliminating syphilis in the United States and the unique geographical and socioeconomic features of WA, the elimination of syphilis seems unlikely in this state.

Kick the habit: a social marketing campaign by Aboriginal communities in NSW.

PubMed

Campbell, M A; Finlay, S; Lucas, K; Neal, N; Williams, R

2014-01-01

Tackling smoking is an integral component of efforts to improve health outcomes in Aboriginal communities. Social marketing is an effective strategy for promoting healthy attitudes and influencing behaviours; however, there is little evidence for its success in reducing smoking rates in Aboriginal communities. This paper outlines the development, implementation and evaluation of Kick the Habit Phase 2, an innovative tobacco control social marketing campaign in Aboriginal communities in New South Wales (NSW). The Aboriginal Health & Medical Research Council worked with three Aboriginal communities and a creative agency to develop locally tailored, culturally relevant social marketing campaigns. Each community determined the target audience and main messages, and identified appropriate local champions and marketing tools. Mixed methods were used to evaluate the campaign, including surveys and interviews with community members and Aboriginal Community Controlled Health Service staff. Community survey participants demonstrated high recall of smoking cessation messages, particularly for messages and images specific to the Kick the Habit campaign. Staff participating in interviews reported an increased level of interest from community members in smoking cessation programs, as well as increased confidence and skills in developing further social marketing campaigns. Aboriginal community-driven social marketing campaigns in tobacco control can build capacity, are culturally relevant and lead to high rates of recall in Aboriginal communities.

Health information system linkage and coordination are critical for increasing access to secondary prevention in Aboriginal health: a qualitative study.

PubMed

Digiacomo, Michelle; Davidson, Patricia M; Taylor, Kate P; Smith, Julie S; Dimer, Lyn; Ali, Mohammed; Wood, Marianne M; Leahy, Timothy G; Thompson, Sandra C

2010-01-01

Aboriginal Australians have low rates of participation in cardiac rehabilitation (CR), despite having high rates of cardiovascular disease. Barriers to CR participation reflect multiple patient-related issues. However, an examination of the broader context of health service delivery design and implementation is needed. To identify health professionals' perspectives of systems related barriers to implementation of the National Health and Medical Research Council (NHMRC) guidelines Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander Peoples. Semi-structured interviews were conducted with health professionals involved in CR within mainstream and Aboriginal Community Controlled Health Services in Western Australia (WA). Thirty-eight health professionals from 17 services (ten rural, seven metropolitan) listed in the WA Directory of CR services and seven Aboriginal Medical Services in WA were interviewed. Respondents reported barriers encountered in health information management and the impact of access to CR services for Aboriginal people. Crucial issues identified by participants were: poor communication across the health care sector and between providers, inconsistent and insufficient data collection processes (particularly relating to Aboriginal ethnicity identification), and challenges resulting from multiple clinical information systems and incompatible technologies. This study has demonstrated that inadequate information systems and communication strategies, particularly those representing the interface between primary and secondary care, contribute to the low participation rates of Aboriginal Australians in CR. Although these challenges are shared by non-Aboriginal Australians, the needs are greater for Aboriginal Australians and innovative solutions are required.

Cultural safety and midwifery care for Aboriginal women - A phenomenological study.

PubMed

Brown, Angela E; Middleton, Philippa F; Fereday, Jennifer A; Pincombe, Jan I

2016-04-01

Aboriginal and Torres Strait islander(1) women face considerable health disparity in relation to their maternity health outcomes when compared to non-Aboriginal women. Culture and culturally appropriate care can contribute to positive health outcomes for Aboriginal women. How midwives provide culturally appropriate care and how the care is experienced by the women is central to this study. To explore the lived experiences of midwives providing care in the standard hospital care system to Aboriginal women at a large tertiary teaching hospital. An interpretive Heideggerian phenomenological approach was used. Semi-structured interviews were conducted with thirteen volunteer midwives which were transcribed, analysed and presented informed by van Manen's approach. Thematic analysis revealed six main themes: "Finding ways to connect with the women", "building support networks - supporting with and through Aboriginal cultural knowledge", "managing the perceived barriers to effective care", "perceived equity is treating women the same", "understanding culture" and "assessing cultural needs - urban versus rural/remote Aboriginal cultural needs". The midwives in this study have shared their stories of caring for Aboriginal women. They have identified communication and building support with Aboriginal health workers and families as important. They have identified perceived barriers to the provision of care, and misunderstanding around the interpretation of cultural safety in practice was found. Suggestions are made to support midwives in their practice and improve the experiences for Aboriginal women. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Association of Modality with Mortality among Canadian Aboriginals

PubMed Central

Hemmelgarn, Brenda; Rigatto, Claudio; Komenda, Paul; Yeates, Karen; Promislow, Steven; Mojica, Julie; Tangri, Navdeep

2012-01-01

Summary Background and objectives Previous studies have shown that Aboriginals and Caucasians experience similar outcome on dialysis in Canada. Using the Canadian Organ Replacement Registry, this study examined whether dialysis modality (peritoneal or hemodialysis) impacted mortality in Aboriginal patients. Design, setting, participants, & measurements This study identified 31,576 adult patients (hemodialysis: Aboriginal=1839, Caucasian=21,430; peritoneal dialysis: Aboriginal=554, Caucasian=6769) who initiated dialysis between January of 2000 and December of 2009. Aboriginal status was identified by self-report. Dialysis modality was determined 90 days after dialysis initiation. Multivariate Cox proportional hazards and competing risk models were constructed to determine the association between race and mortality by dialysis modality. Results During the study period, 939 (51.1%) Aboriginals and 12,798 (53.3%) Caucasians initiating hemodialysis died, whereas 166 (30.0%) and 2037 (30.1%), respectively, initiating peritoneal dialysis died. Compared with Caucasians, Aboriginals on hemodialysis had a comparable risk of mortality (adjusted hazards ratio=1.04, 95% confidence interval=0.96–1.11, P=0.37). However, on peritoneal dialysis, Aboriginals experienced a higher risk of mortality (adjusted hazards ratio=1.36, 95% confidence interval=1.13–1.62, P=0.001) and technique failure (adjusted hazards ratio=1.29, 95% confidence interval=1.03–1.60, P=0.03) than Caucasians. The risk of technique failure varied by patient age, with younger Aboriginals (<50 years old) more likely to develop technique failure than Caucasians (adjusted hazards ratio=1.76, 95% confidence interval=1.23–2.52, P=0.002). Conclusions Aboriginals on peritoneal dialysis experience higher mortality and technique failure relative to Caucasians. Reasons for this race disparity in peritoneal dialysis outcomes are unclear. PMID:22997343

Risk of Hospitalization Due to Unintentional Fall Injury in British Columbia, Canada, 1999-2008: Ecological Associations with Socioeconomic Status, Geographic Place, and Aboriginal Ethnicity.

PubMed

Jin, Andrew; Brussoni, Mariana; George, M Anne; Lalonde, Christopher E; McCormick, Rod

2017-08-01

Aboriginal people in British Columbia (BC), especially those residing on Indian reserves, have higher risk of unintentional fall injury than the general population. We test the hypothesis that the disparities are attributable to a combination of socioeconomic status, geographic place, and Aboriginal ethnicity. Within each of 16 Health Service Delivery Areas in BC, we identified three population groups: total population, Aboriginal off-reserve, and Aboriginal on-reserve. We calculated age and gender-standardized relative risks (SRR) of hospitalization due to unintentional fall injury (relative to the total population of BC), during time periods 1999-2003 and 2004-2008, and we obtained custom data from the 2001 and 2006 censuses (long form), describing income, education, employment, housing, proportions of urban and rural dwellers, and prevalence of Aboriginal ethnicity. We studied association of census characteristics with SRR of fall injury, by multivariable linear regression. The best-fitting model was an excellent fit (R 2  = 0.854, p < 0.001) and predicted SRRs very close to observed values for the total, Aboriginal off-reserve, and Aboriginal on-reserve populations of BC. After stepwise regression, the following terms remained: population per room, urban residence, labor force participation, income per capita, and multiplicative interactions of Aboriginal ethnicity with population per room and labor force participation. The disparities are predictable by the hypothesized risk markers. Aboriginal ethnicity is not an independent risk marker: it modifies the effects of socioeconomic factors. Closing the gap in fall injury risk between the general and Aboriginal populations is likely achievable by closing the gaps in socioeconomic conditions.

Transfers to metropolitan hospitals and coronary angiography for rural Aboriginal and non-Aboriginal patients with acute ischaemic heart disease in Western Australia.

PubMed

Lopez, Derrick; Katzenellenbogen, Judith M; Sanfilippo, Frank M; Woods, John A; Hobbs, Michael S T; Knuiman, Matthew W; Briffa, Tom G; Thompson, Peter L; Thompson, Sandra C

2014-05-01

Aboriginal people have a disproportionately higher incidence rate of ischaemic heart disease (IHD) than non-Aboriginal people. The findings on Aboriginal disparity in receiving coronary artery procedures are inconclusive. We describe the profile and transfers of IHD patients admitted to rural hospitals as emergency admissions and investigate determinants of transfers and coronary angiography. Person-linked hospital and mortality records were used to identify 28-day survivors of IHD events commencing at rural hospitals in Western Australia. Outcome measures were receipt of coronary angiography, transfer to a metropolitan hospital, and coronary angiography if transferred to a metropolitan hospital. Compared to non-Aboriginal patients, Aboriginal patients with IHD were more likely to be younger, have more co-morbidities, reside remotely, but less likely to have private insurance. After adjusting for demographic characteristics, Aboriginal people with MI were less likely to be transferred to a metropolitan hospital, and if transferred were less likely to receive coronary angiography. These disparities were not significant after adjusting for comorbidities and private insurance. In the full multivariate model age, comorbidities and private insurance were adversely associated with transfer to a metropolitan hospital and coronary angiography. Disparity in receiving coronary angiography following emergency admission for IHD to rural hospitals is mediated through the lower likelihood of being transferred to metropolitan hospitals where this procedure is performed. The likelihood of a transfer is increased if the patient has private insurance, however, rural Aboriginal people have a lower rate of private insurance than their non-Aboriginal counterparts. Health practitioners and policy makers can continue to claim that they treat Aboriginal and non-Aboriginal people alike based upon clinical indications, as private insurance is acting as a filter to reduce rural residents accessing interventional cardiology. If health practitioners and policy makers are truly committed to reducing health disparities, they must reflect upon the broader systems in which disparity is perpetuated and work towards a systems improvement.

Improving palliative care outcomes for Aboriginal Australians: service providers' perspectives.

PubMed

Shahid, Shaouli; Bessarab, Dawn; van Schaik, Katherine D; Aoun, Samar M; Thompson, Sandra C

2013-07-23

Aboriginal Australians have a lower rate of utilisation of palliative care services than the general population. This study aimed to explore care providers' experiences and concerns in providing palliative care for Aboriginal people, and to identify opportunities for overcoming gaps in understanding between them and their Aboriginal patients and families. In-depth, qualitative interviews with urban, rural and remote palliative care providers were undertaken in inpatient and community settings in Western Australia. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers with QSR NVivo 10 software used to help manage data. Data analysis was informed by multiple theoretical standpoints, including the social ecological model, critical cultural theories and the 'cultural security' framework. Thematic analysis was carried out that identified patterns within data. Fifteen palliative care providers were interviewed. Overall they reported lack of understanding of Aboriginal culture and being uncertain of the needs and priorities of Aboriginal people during end-of-life care. According to several participants, very few Aboriginal people had an understanding of palliative care. Managing issues such as anger, denial, the need for non-medical support due to socioeconomic disadvantage, and dealing with crises and conflicts over funeral arrangements were reported as some of the tensions between Aboriginal patients and families and the service providers. Early referral to palliative care is important in demonstrating and maintaining a caring therapeutic relationship. Paramount to meeting the needs for Aboriginal patients was access to appropriate information and logistical, psychological and emotional support. These were often seen as essential but additional to standard palliative care services. The broader context of Aboriginal history and historical distrust of mainstream services was seen to impinge on Aboriginal people's willingness and ability to accept care and support from these services. This context needs to be understood and acknowledged at the system level. More cultural safety training was requested by care providers but it was not seen as replacing the need for an Aboriginal worker in the palliative care team.

Improving delivery of health care to Aboriginal and Torres Strait Islander children.

PubMed

Attwood, Lucy; Rodrigues, Sarah; Winsor, Josephine; Warren, Shirley; Biviano, Lyn; Gunasekera, Hasantha

2015-05-01

To identify opportunities to improve health-care delivery for urban Aboriginal and Torres Strait Islander children requiring hospital admission and to determine their characteristics. We analysed all documentation of admissions of Aboriginal and/or Torres Strait Islander children to a tertiary paediatric hospital in 2010. We reviewed the medical records to determine whether the Aboriginal status of patients was known, whether Aboriginal and/or Torres Strait Islander children and their families were reviewed by Aboriginal staff during admission and whether basic health-care quality indicators were met, including documentation of anthropometry, ear examination findings, immunisation status and catch-up immunisation delivery. In 2010, 543 (2%) patients admitted to the institution were identified as Aboriginal and/or Torres Strait Islander: 140/538 (26.0%) were from the first decile (most disadvantaged) on Socio-Economic Indexes for Areas index. Of all admitted children, 148/543 (27.3%) were referred to Aboriginal health professionals during admission, more when length of stay was greater than 7 days (61% vs. 23%, P < 0.001). There was documentation of weight in 533/543 (98.2%), ear examinations in 64/543 (11.8%), immunisations being not up to date in 126/543 (23%), catch-up immunisation given in 7/126 (5.6%), Aboriginal and/or Torres Strait Islander status in 8/543 (1.5%) medical and 1/543 (0.2%) nursing discharge summaries. We have identified several opportunities to improve culturally appropriate health-care delivery for Aboriginal and Torres Strait Islander children admitted to hospital, including improved recognition of Aboriginal and/or Torres Strait Islander status of patients, improved access to Aboriginal health professionals and increased performance and documentation of basic anthropometry, ear examination and immunisation catch-up. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Blending Aboriginal and Western healing methods to treat intergenerational trauma with substance use disorder in Aboriginal peoples who live in northeastern Ontario, Canada.

PubMed

Marsh, Teresa Naseba; Coholic, Diana; Cote-Meek, Sheila; Najavits, Lisa M

2015-05-20

As with many Indigenous groups around the world, Aboriginal communities in Canada face significant challenges with trauma and substance use. The complexity of symptoms that accompany intergenerational trauma and substance use disorders represents major challenges in the treatment of both disorders. There appears to be an underutilization of substance use and mental health services, substantial client dropout rates, and an increase in HIV infections in Aboriginal communities in Canada. The aim of this paper is to explore and evaluate current literature on how traditional Aboriginal healing methods and the Western treatment model "Seeking Safety" could be blended to help Aboriginal peoples heal from intergenerational trauma and substance use disorders. A literature search was conducted using the keywords: intergenerational trauma, historical trauma, Seeking Safety, substance use, Two-Eyed Seeing, Aboriginal spirituality, and Aboriginal traditional healing. Through a literature review of Indigenous knowledge, most Indigenous scholars proposed that the wellness of an Aboriginal community can only be adequately measured from within an Indigenous knowledge framework that is holistic, inclusive, and respectful of the balance between the spiritual, emotional, physical, and social realms of life. Their findings indicate that treatment interventions must honour the historical context and history of Indigenous peoples. Furthermore, there appears to be strong evidence that strengthening cultural identity, community integration, and political empowerment can enhance and improve mental health and substance use disorders in Aboriginal populations. In addition, Seeking Safety was highlighted as a well-studied model with most populations, resulting in healing. The provided recommendations seek to improve the treatment and healing of Aboriginal peoples presenting with intergenerational trauma and addiction. Other recommendations include the input of qualitative and quantitative research as well as studies encouraging Aboriginal peoples to explore treatments that could specifically enhance health in their respective communities.

Culturally appropriate methodology in obtaining a representative sample of South Australian Aboriginal adults for a cross-sectional population health study: challenges and resolutions.

PubMed

Marin, Tania; Taylor, Anne Winifred; Grande, Eleonora Dal; Avery, Jodie; Tucker, Graeme; Morey, Kim

2015-05-19

The considerably lower average life expectancy of Aboriginal and Torres Strait Islander Australians, compared with non-Aboriginal and non-Torres Strait Islander Australians, has been widely reported. Prevalence data for chronic disease and health risk factors are needed to provide evidence based estimates for Australian Aboriginal and Torres Strait Islanders population health planning. Representative surveys for these populations are difficult due to complex methodology. The focus of this paper is to describe in detail the methodological challenges and resolutions of a representative South Australian Aboriginal population-based health survey. Using a stratified multi-stage sampling methodology based on the Australian Bureau of Statistics 2006 Census with culturally appropriate and epidemiological rigorous methods, 11,428 randomly selected dwellings were approached from a total of 209 census collection districts. All persons eligible for the survey identified as Aboriginal and/or Torres Strait Islander and were selected from dwellings identified as having one or more Aboriginal person(s) living there at the time of the survey. Overall, the 399 interviews from an eligible sample of 691 SA Aboriginal adults yielded a response rate of 57.7%. These face-to-face interviews were conducted by ten interviewers retained from a total of 27 trained Aboriginal interviewers. Challenges were found in three main areas: identification and recruitment of participants; interviewer recruitment and retainment; and using appropriate engagement with communities. These challenges were resolved, or at least mainly overcome, by following local protocols with communities and their representatives, and reaching agreement on the process of research for Aboriginal people. Obtaining a representative sample of Aboriginal participants in a culturally appropriate way was methodologically challenging and required high levels of commitment and resources. Adhering to these principles has resulted in a rich and unique data set that provides an overview of the self-reported health status for Aboriginal people living in South Australia. This process provides some important principles to be followed when engaging with Aboriginal people and their communities for the purpose of health research.

Estimating secular changes in longitudinal growth patterns underlying adult height with the QEPS model: the Grow Up Gothenburg cohorts.

PubMed

Holmgren, Anton; Niklasson, Aimon; Nierop, Andreas F M; Gelander, Lars; Aronson, A Stefan; Sjöberg, Agneta; Lissner, Lauren; Albertsson-Wikland, Kerstin

2018-05-23

Over the past 150 years, humans have become taller, and puberty has begun earlier. It is unclear if these changes are continuing in Sweden, and how longitudinal growth patterns are involved. We aimed to evaluate the underlying changes in growth patterns from birth to adulthood by QEPS estimates in two Swedish cohorts born in 1974 and 1990. Growth characteristics of the longitudinal 1974 and 1990-birth cohorts (n = 4181) were compared using the QEPS model together with adult heights. There was more rapid fetal/infancy growth in girls/boys born in 1990 compared to 1974, as shown by a faster Etimescale and they were heavier at birth. The laterborn were taller also in childhood as shown by a higher Q-function. Girls born in 1990 had earlier and more pronounced growth during puberty than girls born in 1974. Individuals in the 1990 cohort attained greater adult heights than those in the 1974 cohort; 6 mm taller for females and 10 mm for males. A positive change in adult height was attributed to more growth during childhood in both sexes and during puberty for girls. The QEPS model proved to be effective detecting small changes of growth patterns, between two longitudinal growth cohorts born only 16 years apart.

Parental Separation and Cardiometabolic Risk Factors in Late Adolescence: A Cross-Cohort Comparison

PubMed Central

Soares, Ana Luiza Gonçalves; Gonçalves, Helen; Matijasevich, Alicia; Sequeira, Maija; Smith, George Davey; Menezes, Ana M. B.; Assunção, Maria Cecília; Wehrmeister, Fernando C.; Fraser, Abigail; Howe, Laura D.

2017-01-01

Abstract The aim of this study was to explore the association between parental separation during childhood (up to 18 years of age) and cardiometabolic risk factors (body mass index, fat mass index, blood pressure, physical activity, smoking, and alcohol consumption) in late adolescence using a cross-cohort comparison and to explore whether associations differ according to the age at which the parental separation occurred and the presence or absence of parental conflict prior to separation. Data from the Avon Longitudinal Study of Parents and Children (ALSPAC, United Kingdom) (1991–2011) and the 1993 Pelotas Birth Cohort (Brazil) (1993–2011) were used. The associations of parental separation with children's cardiometabolic risk factors were largely null. Higher odds of daily smoking were observed in both cohorts for those adolescents whose parents separated (for ALSPAC, odds ratio = 1.46; for Pelotas Birth Cohort, odds ratio = 1.98). Some additional associations were observed in the Pelotas Birth Cohort but were generally in the opposite direction to our a priori hypothesis: Parental separation was associated with lower blood pressure and fat mass index, and with more physical activity. No consistent differences were observed when analyses were stratified by child's age at parental separation or parental conflict. PMID:28444145

Cohort profile: cerebral palsy in the Norwegian and Danish birth cohorts (MOBAND-CP).

PubMed

Tollånes, Mette C; Strandberg-Larsen, Katrine; Forthun, Ingeborg; Petersen, Tanja Gram; Moster, Dag; Andersen, Anne-Marie Nybo; Stoltenberg, Camilla; Olsen, Jørn; Wilcox, Allen J

2016-09-02

The purpose of MOthers and BAbies in Norway and Denmark cerebral palsy (MOBAND-CP) was to study CP aetiology in a prospective design. MOBAND-CP is a cohort of more than 210 000 children, created as a collaboration between the world's two largest pregnancy cohorts-the Norwegian Mother and Child Cohort study (MoBa) and the Danish National Birth Cohort. MOBAND-CP includes maternal interview/questionnaire data collected during pregnancy and follow-up, plus linked information from national health registries. Initial harmonisation of data from the 2 cohorts has created 140 variables for children and their mothers. In the MOBAND-CP cohort, 438 children with CP have been identified through record linkage with validated national registries, providing by far the largest such sample with prospectively collected detailed pregnancy data. Several studies investigating various hypotheses regarding CP aetiology are currently on-going. Additional data can be harmonised as necessary to meet requirements of new projects. Biological specimens collected during pregnancy and at delivery are potentially available for assay, as are results from assays conducted on these specimens for other projects. The study size allows consideration of CP subtypes, which is rare in aetiological studies of CP. In addition, MOBAND-CP provides a platform within the context of a merged birth cohort of exceptional size that could, after appropriate permissions have been sought, be used for cohort and case-cohort studies of other relatively rare health conditions of infants and children. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Intellectual disability in young people in custody in New South Wales, Australia - prevalence and markers.

PubMed

Haysom, L; Indig, D; Moore, E; Gaskin, C

2014-11-01

Intellectual disability (ID) is known to be more common in incarcerated groups, especially incarcerated youth. Aboriginal young people have higher rates of ID, and make up half of all youth in juvenile custody in New South Wales (NSW), Australia. We aimed to describe the prevalence of possible ID and borderline intellectual functioning (BIF) in young people in NSW custody, and to describe the association between possible ID and Aboriginality after adjusting for the inequalities in social disadvantage. Baseline study of all youth in NSW Custodial Centres between August and October 2009, with 18-month follow-up. Using Wechsler Intelligence Scale for Children - Fourth Edition (WISC-IV) and Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV) cognitive assessments, possible ID was defined as Extremely Low Intellectual Quotient range (Full Scale Intellectual Quotient, FSIQ < 70), and possible BIF was defined as Borderline IQ range (FSIQ < 80). Risk factors for possible ID and BIF included age, gender, Aboriginality, socio-economic disadvantage, offending history and psychological disorders. N = 295 (65%) of all young people in NSW custody completed cognitive and psychological assessments (87% male, 50% Aboriginal, average age 17 years). Almost one half (45.8%) of young people had borderline or lower intellectual functioning (by IQ assessment), and 14% had an IQ in the extremely low range (FSIQ < 70), indicating a possible ID. Aboriginal participants were three times more likely than non-Aboriginal participants to have a possible ID, but after accounting for the excess disadvantage in the Aboriginal group, Aboriginality was no longer a marker of ID. Incarceration from a young age and psychosis were significantly associated with possible ID in Aboriginal participants, compared with Aboriginal participants first incarcerated at a later age, and Aboriginal participants without psychosis. The inequalities in criminal justice between Aboriginal and non-Aboriginal youth may exacerbate or contribute to the intellectual impairment of those incarcerated from a young age. Aboriginal young people with psychosis are also at high risk of cognitive impairments that might indicate a possible co-morbid ID, and these patients should be diverted at court into community assessment services, rather than incarcerated. These results highlight a need for better and earlier identification of young people (particularly Aboriginal youth) at risk of ID and other co-morbidities in the juvenile justice system. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Physical Functional Limitations among Aboriginal and Non-Aboriginal Older Adults: Associations with Socio-Demographic Factors and Health

PubMed Central

Gubhaju, Lina; Banks, Emily; MacNiven, Rona; McNamara, Bridgette J.; Joshy, Grace; Bauman, Adrian; Eades, Sandra J.

2015-01-01

Background Australian Aboriginal people are disproportionately affected by physical disability; the reasons for this are unclear. This study aimed to quantify associations between severe physical functional limitations and socio-demographic and health-related factors among older Aboriginal and non-Aboriginal adults. Methods Questionnaire data from 1,563 Aboriginal and 226,802 non-Aboriginal participants aged ≥45 years from the Sax Institute’s 45 and Up Study (New South Wales, Australia) were used to calculate age- and sex-adjusted prevalence ratios (aPRs) for severe limitation [MOS-PF score <60] according to socio-demographic and health-related factors. Results Overall, 26% (410/1563) of Aboriginal participants and 13% (29,569/226,802) of non-Aboriginal participants had severe limitations (aPR 2.8, 95%CI 2.5–3.0). In both Aboriginal and non-Aboriginal participants, severe limitation was significantly associated with: being ≥70 vs <70 years old (aPRs 1.8, 1.3–2.4 and 5.3, 5.0–5.5, within Aboriginal and non-Aboriginal participants, respectively), none vs tertiary educational qualifications (aPRs 2.4, 1.7–3.3 and 3.1, 3.0–3.2), lower vs higher income (aPRs 6.6, 4.2–10.5 and 5.5, 5.2–5.8), current vs never-smoking (aPRs 2.0, 1.6–2.5 and 2.2, 2.1–2.3), obese vs normal weight (aPRs 1.7, 1.3–2.2 and 2.7, 2.7–2.8) and sitting for ≥7 vs <7 hours/day (aPRs 1.6, 1.2–2.0 and 1.6, 1.6–1.7). Severe limitations increased with increasing ill-health, with aPRs rising to 5–6 for ≥5 versus no chronic conditions. It was significantly higher in those with few vs many social contacts (aPRs 1.7, 1.4–2.0 and 1.4, 1.4–1.4) and with very high vs low psychological distress (aPRs 4.4, 3.6–5.4 and 5.7, 5.5–5.9). Conclusions Although the prevalence of severe physical limitation among Aboriginal people in this study is around three-fold that of non-Aboriginal people, the factors related to it are similar, indicating that Aboriginal people have higher levels of risk factors for and consequences of severe limitations. Effective management of chronic disease and reducing the prevalence of obesity and smoking are important areas for attention. PMID:26422239

Increasing mumps incidence rates among children and adolescents in the Republic of Korea: age-period-cohort analysis.

PubMed

Choe, Young-June; Lee, Young Hwa; Cho, Sung-Il

2017-04-01

To characterize the temporal dynamics of mumps epidemiology according to the different vaccine strains used, sex-specific trends were decomposed in an age-period-cohort (APC) analysis for mumps cases reported in South Korea. National surveillance data were used to describe the epidemiology of mumps cases from 2001 to 2015. An APC model was used to break down the reported mumps cases into the effects of age, period, and birth cohort. From 2001 to 2015, the incidence started to increase from fewer than 10 cases to more than 100 cases per 100 000. The incidence rate was highest among males aged 15-17 years during 2013-2015, reaching 508.7 per 100 000 persons. There was an increased incidence during the late teenage years in the 1998-2000 cohort. An age shift towards the earlier teenage years was observed across the 2001-2003 and 2004-2006 cohorts. The risk of mumps increased according to the birth cohort; the net drift from 2001 to 2015 was 27.67 (95% confidence interval 27.5.47-29.90) for males and 27.25 (95% confidence interval 24.91-29.65) for females. The increase in mumps seen in Korea may have been affected by the birth cohort exposed to the Rubini strain; however other factors may have contributed to the increase in non-exposed cohorts. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Gender Repetition: School Access, Transitions and Equity in the "Birth-to-Twenty" Cohort Panel Study in Urban South Africa

ERIC Educational Resources Information Center

Fleisch, Brahm; Shindler, Jennifer

2009-01-01

Using data collected by the Birth-to-Twenty child cohort study in urban South Africa, this paper describes the patterns of schooling of a population of children born in the Greater Johannesburg area in April to June 1990. This paper examines the patterns of initial enrolment in Grade 1, transitions through grades, and trends in primary school…

Increased Burden of Respiratory Disease in the First Six Months of Life Due to Prenatal Environmental Tobacco Smoke: Krakow Birth Cohort Study

ERIC Educational Resources Information Center

Jedrychowski, Wieslaw; Galas, Alek Sander; Flak, Elzbieta; Jacek, Ryszard; Penar, Agnieszka; Spengler, John; Perera, Frederica P.

2007-01-01

The main purpose of our study was to assess the effects of prenatal tobacco smoke on respiratory symptoms and on doctor consultations in a birth cohort of 445 infants who had no smoking mothers and who had no postnatal exposure to environmental tobacco smoke (ETS). Before and after delivery, questionnaires and interviews with mothers were…

The Association between Cognitive Ability across the Lifespan and Health Literacy in Old Age: The Lothian Birth Cohort 1936

ERIC Educational Resources Information Center

Murray, Catherine; Johnson, Wendy; Wolf, Michael S.; Deary, Ian J.

2011-01-01

Three hundred and four participants in the Lothian Birth Cohort 1936 study took a validated IQ-type test at age 11 years and a battery of cognitive tests at age 70 years. Three tests of health literacy were completed at age 72 years; the Rapid Estimate of Adult Literacy in Medicine (REALM), the Test of Functional Health Literacy in Adults…

African American Fathers' Contributions to Children's Early Academic Achievement: Evidence from Two-Parent Families from the Early Childhood Longitudinal Study-Birth Cohort

ERIC Educational Resources Information Center

Baker, Claire E.

2014-01-01

Research Findings: This study utilized a large sample ("N" = 750) of 2-parent families from the Early Childhood Longitudinal Study-Birth Cohort to examine the contributions of African American fathers' home literacy involvement, play activities, and caregiving at 24 months to children's reading and math achievement in…

Intelligence in Childhood and Risk of Psychological Distress in Adulthood: The 1958 National Child Development Survey and the 1970 British Cohort Study

ERIC Educational Resources Information Center

Gale, Catharine R.; Hatch, Stephani L.; Batty, G. David; Deary, Ian J.

2009-01-01

Lower cognitive ability is a risk factor for some forms of severe psychiatric disorder, but it is unclear whether it influences risk of psychological distress due to anxiety or the milder forms of depression. The participants in the present study were members of two British birth national birth cohorts, the 1958 National Child Development Survey…

Failure to Thrive in the Term and Preterm Infants of Mothers Depressed in the Postnatal Period: A Population-Based Birth Cohort Study

ERIC Educational Resources Information Center

Drewett, Robert; Blair, Peter; Emmett, Pauline; Emond, Alan

2004-01-01

Aims: To examine the relationship between failure to thrive in preterm and term infants and postnatal depression in their mothers. Method: In a whole population birth cohort of 12,391 infants (excluding those born after term or with major congenital abnormalities) failure to thrive over the first nine months was identified using a conditional…

[Growth in terms of length of Chilean infants of low socioeconomic status: 1978-1992].

PubMed

Pizarro, F; Olivares, M; Hertrampf, E; Walter, T

1996-06-01

In Chile infant malnutrition is better reflected by the length/age indicator than by weight/length. In this study we will present the progression of length during the first year of life from the year 1978 through 1992 of infants of low socioeconomic status. We selected healthy infants with > 3000 g birth weight and birth length > 0.5 z. According to type of milk feedings they were defined as CM (cow milk) those who were weaned before 4 months of life and EM (exclusive breast milk) those who continued exclusive breast milk (as only source of milk solids permitted) past 6 months. Infants CM of the 1978-80 cohort had a length at birth z +0.21 reaching 1 year with z -0.65, a loss of 0.86 z. Infants from the cohorts of 1982-86 and 1988-92 fell from z +0.15 to z -0.37 (a loss of -0.52 z) and +0.16 to -0.19 (a loss of -0.45 z) between birth and 12 months respectively. EBM infants length also fell significantly (delta z: -1.12, -0.69 and 0.59 respectively). Proteincalorie nutrition was adequate confirmed with weight/age or length/weight curves with means of +0.52 throughout the first year. Analysis of the length curves by regression shows that the slopes of the 3 cohorts are significantly different (< 0.01) for CM and EBM favoring the most recent cohorts. Multiple regression analysis identified association of length at 1 year with birth weight (p < 0.05), birth length (p < 0.01) and socioeconomic index (p < 0.01). We suggest that there is an improvement in the trend of Chilean infants growth in length for the past 20 years, likely due to improvement in socioeconomic level.

Biological sex and the risk of cerebral palsy in Victoria, Australia.

PubMed

Reid, Susan M; Meehan, Elaine; Gibson, Catherine S; Scott, Heather; Delacy, Michael J

2016-02-01

Males typically outnumber females in cerebral palsy (CP) cohorts. To better understand this 'male disadvantage' and provide insight into causal pathways to CP, this study used 1983 to 2009 Australian CP and population birth cohorts to identify associations and trends with respect to biological sex and CP. Within birth gestation groups, sex ratios were calculated to evaluate any male excess in the CP cohort compared with livebirths, neonatal deaths, neonatal mortality and survival rates, neonatal survivors, and CP rates in survivors. Sex- and gestation-specific trends in neonatal mortality, CP rates, and CP sex ratios were assessed by plotting their annual frequencies and fitting quadratic curves. Over-representation of males in preterm live births partly explained the male excess in the CP cohort after preterm birth, especially at 28 to 31 weeks. Higher CP rates in male neonatal survivors also contributed to the male excess in CP, particularly at <28 and 37+ weeks. Higher neonatal mortality rates in males at all gestations had little impact on the CP sex ratio. There was no clearly discernible change over time in the CP sex ratio. Gestation-specific associations between sex and CP provide insight into causal pathways to CP and suggest sex-specific differences in response to neuroprotective strategies. © 2016 The Authors. Developmental Medicine & Child Neurology © 2016 Mac Keith Press.

No Differences in Achieving Hepatitis C Virus Care Milestones Between Patients Identified by Birth Cohort or Risk-Based Screening.

PubMed

Norton, Brianna L; Southern, William N; Steinman, Meredith; Smith, Bryce D; Deluca, Joseph; Rosner, Zachary; Litwin, Alain H

2016-09-01

National hepatitis C virus (HCV) screening guidelines recommended 1-time testing of persons born between 1945 and 1965. We performed a retrospective study to compare care milestones achieved by HCV-infected patients identified by birth cohort versus risk-based screens. We determined the proportions of patients newly identified with HCV infection who met care milestones (viral load, referral to and evaluation by a specialist, offer of treatment, initiation of treatment, and sustained viral response) and the time it took to reach them. We found no differences in HCV care milestones for patients identified via birth cohort testing versus risk-based screening. Overall, only 43% of HCV antibody-positive patients were referred to care, and less than 4% started treatment. The time to each care milestone was lengthy and varied greatly; treatment was initiated in a median of 308 days. Although birth cohort testing will likely increase identification of patients with HCV infection, it does not seem to increase the number of patients that meet management milestones. New methods are needed to increase access to care and establish efficient models of health care delivery. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Data on education: from population statistics to epidemiological research.

PubMed

Pallesen, Palle Bo; Tverborgvik, Torill; Rasmussen, Hanna Barbara; Lynge, Elsebeth

2010-03-01

Level of education is in many fields of research used as an indicator of social status. Using Statistics Denmark's register for education and employment of the population, we examined highest completed education with a birth-cohort perspective focusing on people born between 1930 and 1974. Irregularities in the educational data were found for both men and women born from 1951 to 1957. For the birth cohorts born from 1951 to 1954, a sudden increase in the proportion of persons with basic school education only was seen, and a following decrease in this proportion was seen for the birth cohorts born from 1955 to 1957. For the same birth cohorts, a reverse curve was found for the proportion with vocational training as highest completed education. Using proportion of women with at least one child at the age of 30, our analysis illustrated that spurious patterns may emerge when other social phenomena are analysed by partly misclassified educational groups. Our findings showed that register data are not always to be taken at face value and that thorough analysis may unravel unexpected irregularities. Although such data errors may be remedied in analyses of population trends by use of extrapolated values, solutions are less obvious in epidemiological research using individual level data.

Oral health of schoolchildren in Western Australia.

PubMed

Arrow, P

2016-09-01

The West Australian School Dental Service (SDS) provides free, statewide, primary dental care to schoolchildren aged 5-17 years. This study reports on an evaluation of the oral health of children examined during the 2014 calendar year. Children were sampled, based on their date of birth, and SDS clinicians collected the clinical information. Weighted mean values of caries experience were presented. Negative binomial regression modelling was undertaken to test for factors of significance in the rate of caries occurrence. Data from children aged 5-15 years were used (girls = 4616, boys = 4900). Mean dmft (5-10-year-olds), 1.42 SE 0.03; mean DMFT (6-15-year-olds), 0.51 SE 0.01. Negative binomial regression model of permanent tooth caries found higher rates of caries in children who were from non-fluoridated areas (RR 2.1); Aboriginal (RR 2.4); had gingival inflammation (RR 1.5); lower ICSEA level (RR 1.4); and recalled at more than 24-month interval (RR 1.8). The study highlighted poor dental health associated with living in non-fluoridated areas, Aboriginal identity, poor oral hygiene, lower socioeconomic level and having extended intervals between dental checkups. Timely assessments and preventive measures targeted at groups, including extending community water fluoridation, may assist in further improving the oral health of children in Western Australia. © 2015 Australian Dental Association.

Breast feeding practices as cultural interventions for early childhood caries in Cree communities.

PubMed

Cidro, Jaime; Zahayko, Lynelle; Lawrence, Herenia P; Folster, Samantha; McGregor, Margaret; McKay, Kristen

2015-04-09

Breastfeeding is a gift from mother to child and has a wide range of positive health, social and cultural impacts on infants. The link between bottle feeding and the prevalence of early childhood caries (ECC) is well documented. In Aboriginal communities, the higher rates of ECC are linked with low rates of breast feeding and inappropriate infant feeding of high sugar content liquids. The Baby Teeth Talk Study (BTT) is one project that is exploring the use of four interventions (motivational interviewing, anticipatory guidance, fluoride varnish and dental care to expectant mothers) for reducing the prevalence of ECC in infants within Aboriginal communities. This research explored cultural based practices through individual interviews and focus groups with older First Nations women in the community. Participants in a First Nations community identified cultural based practices that have also been used to promote healthy infant feeding and good oral health. A wide range of themes related to oral health and infant feeding emerged. However, this paper focuses on three themes including: breastfeeding attitudes, social support for mothers and birthing and supporting healthy infant feeding through community programs. The importance of understanding cultural health traditions is essential for those working in oral public health capacities to ensure there is community acceptance of the interventions.

Elevated risk of adverse obstetric outcomes in pregnant women with depression.

PubMed

Kim, Deborah R; Sockol, Laura E; Sammel, Mary D; Kelly, Caroline; Moseley, Marian; Epperson, C Neill

2013-12-01

In this study, we evaluated the association between prenatal depression symptoms adverse birth outcomes in African-American women. We conducted a retrospective cohort study of 261 pregnant African-American women who were screened with the Edinburgh Postnatal Depression Scale (EPDS) at their initial prenatal visit. Medical records were reviewed to assess pregnancy and neonatal outcomes, specifically preeclampsia, preterm birth, intrauterine growth retardation, and low birth weight. Using multivariable logistic regression models, an EPDS score ≥10 was associated with increased risk for preeclampsia, preterm birth, and low birth weight. An EPDS score ≥10 was associated with increased risk for intrauterine growth retardation, but after controlling for behavioral risk factors, this association was no longer significant. Patients who screen positive for depression symptoms during pregnancy are at increased risk for multiple adverse birth outcomes. In a positive, patient-rated depression screening at the initial obstetrics visit, depression is associated with increased risk for multiple adverse birth outcomes. Given the retrospective study design and small sample size, these findings should be confirmed in a prospective cohort study.

Better Indigenous Risk stratification for Cardiac Health study (BIRCH) protocol: rationale and design of a cross-sectional and prospective cohort study to identify novel cardiovascular risk indicators in Aboriginal Australian and Torres Strait Islander adults.

PubMed

Rémond, Marc G W; Stewart, Simon; Carrington, Melinda J; Marwick, Thomas H; Kingwell, Bronwyn A; Meikle, Peter; O'Brien, Darren; Marshall, Nathaniel S; Maguire, Graeme P

2017-08-23

Of the estimated 10-11 year life expectancy gap between Indigenous (Aboriginal and Torres Strait Islander people) and non-Indigenous Australians, approximately one quarter is attributable to cardiovascular disease (CVD). Risk prediction of CVD is imperfect, but particularly limited for Indigenous Australians. The BIRCH (Better Indigenous Risk stratification for Cardiac Health) project aims to identify and assess existing and novel markers of early disease and risk in Indigenous Australians to optimise health outcomes in this disadvantaged population. It further aims to determine whether these markers are relevant in non-Indigenous Australians. BIRCH is a cross-sectional and prospective cohort study of Indigenous and non-Indigenous Australian adults (≥ 18 years) living in remote, regional and urban locations. Participants will be assessed for CVD risk factors, left ventricular mass and strain via echocardiography, sleep disordered breathing and quality via home-based polysomnography or actigraphy respectively, and plasma lipidomic profiles via mass spectrometry. Outcome data will comprise CVD events and death over a period of five years. Results of BIRCH may increase understanding regarding the factors underlying the increased burden of CVD in Indigenous Australians in this setting. Further, it may identify novel markers of early disease and risk to inform the development of more accurate prediction equations. Better identification of at-risk individuals will promote more effective primary and secondary preventive initiatives to reduce Indigenous Australian health disadvantage.

Enough Bad News! Remote Social Health & Aboriginal Action in a Harsh Environment--Coober Pedy in South Australia's "Outback."

ERIC Educational Resources Information Center

Brice, G.; And Others

This paper focuses on the complexities of health care in Coober Pedy (South Australia) and the nearby Umoona Aboriginal community, and highlights the vital role of Aboriginal health workers in the implementation of primary health care principles. The Aboriginal population in this "outback" area is characterized by considerable economic…

Aboriginal Self-Determination in Australia: The Effects of Minority-Majority Frames and Target Universalism on Majority Collective Guilt and Compensation Attitudes

ERIC Educational Resources Information Center

Reid, Scott A.; Gunter, Helen N.; Smith, Joanne R.

2005-01-01

In the context of Aboriginal-Anglo Australian relations, we tested the effect of framing (multiculturalism versus separatism) and majority group members' social values (universalism) on the persuasiveness of Aboriginal group rhetoric, majority collective guilt, attitudes toward compensation, and reparations for Aboriginals. As predicted, Anglo…

Aboriginal Identity in Education Settings: Privileging Our Stories as a Way of Deconstructing the Past and Re-Imagining the Future

ERIC Educational Resources Information Center

Shay, Marnee; Wickes, Judi

2017-01-01

From Aboriginal Australian perspectives and experiences, Aunty Judi Wickes and Marnee Shay bring a cross-generational, critical race analysis of Aboriginal identities and how they are implicated in the schooling experiences of Aboriginal young people. Using autoethnography, Aunty Judi and Marnee discuss their educational experiences in the…

Best Practice in Aboriginal and Torres Strait Islander Education. Proceedings of the Conference (Canberra, Australian Capital Territory, Australia, November 17-18, 1993).

ERIC Educational Resources Information Center

Australian National Languages and Literacy Inst., Deakin.

Papers from the conference on the education of Australian Aborigines and Torres Strait Islanders include: "English Language and Numeracy Program for Aboriginal Students" (Alison Jarred); "The Aboriginal Identity Course: A Midstream Evaluation" (Simon Vaughan); "Making the Curriculum Your Own: The Senior Girls at Lajamanu…

Linguistic Aspects of Australian Aboriginal English

ERIC Educational Resources Information Center

Butcher, Andrew

2008-01-01

It is probable that the majority of the 455 000 strong Aboriginal population of Australia speak some form of Australian Aboriginal English (AAE) at least some of the time and that it is the first (and only) language of many Aboriginal children. This means their language is somewhere on a continuum ranging from something very close to Standard…

Reconciling Mixed Methods Approaches with a Community Narrative Model for Educational Research Involving Aboriginal and Torres Strait Islander Families

ERIC Educational Resources Information Center

Dakich, Eva; Watt, Tony; Hooley, Neil

2016-01-01

Researching the education of Aboriginal and Torres Strait Islander children in Australian schools is an exceedingly difficult and uncompromising task. Working respectfully with local Aboriginal and Torres Strait Islander communities must remain top priority with any research project regarding Aboriginal and Torres Strait Islander viewpoints of…

Health and Quality of Life of Aboriginal Residential School Survivors, Bella Coola Valley, 2001

ERIC Educational Resources Information Center

Barton, Sylvia S.; Thommasen, Harvey V.; Tallio, Bill; Zhang, William; Michalos, Alex C.

2005-01-01

The purpose of this study was to make comparisons between Aboriginal residential school survivors' perceptions of health status and overall quality of life, and Aboriginal non-residential school attendees, as well as between non-Aboriginals. Data were obtained from thirty-three questions derived from the 2001 Determinants of Health and Quality of…

Knowledge of an Aboriginal Language and School Outcomes for Children and Adults

ERIC Educational Resources Information Center

Guevremont, Anne; Kohen, Dafna E.

2012-01-01

This study uses data from the child and adult components of the 2001 Canadian Aboriginal Peoples Survey to examine what factors are related to speaking an Aboriginal language and how speaking an Aboriginal language is related to school outcomes. Even after controlling for child and family factors (age, sex, health status, household income, number…

Translanguaging on Facebook: Exploring Australian Aboriginal Multilingual Competence in Technology-Enhanced Environments and Its Pedagogical Implications

ERIC Educational Resources Information Center

Oliver, Rhonda; Nguyen, Bich

2017-01-01

In this study, we explore how Aboriginal multilingual speakers use technology-enhanced environments, specifically Facebook, for their translanguaging practices. Using data collected from Facebook posts written by seven Aboriginal youth over a period of 18 months, we investigate how the participants move between Aboriginal English (AE) and Standard…

Reconstructing the star knowledge of Aboriginal Tasmanians

NASA Astrophysics Data System (ADS)

Gantevoort, Michelle; Hamacher, Duane W.; Lischick, Savannah

2016-12-01

The canopy of stars is a central presence in the daily and spiritual lives of Aboriginal Tasmanians. With the arrival of European colonists, Tasmanian astronomical knowledge and traditions were interrupted and dispersed. Fragments can be found scattered in the ethnographic and historical record throughout the nineteenth century. We draw from these ethnohistorical documents to analyse and reconstruct Aboriginal astronomical knowledge in Tasmania. This analysis demonstrates that stars, the Milky Way, constellations, dark nebula, the Sun, Moon, meteors and aurorae held cultural, spiritual and subsistence significance for the Aboriginal cultures of Tasmania. We move beyond a monolithic view of Aboriginal astronomical knowledge in Tasmania, commonly portrayed in previous research, to lay the groundwork for future ethnographic and archaeological fieldwork with Aboriginal elders and communities.

Contraindications in planned home birth in Iceland: A retrospective cohort study.

PubMed

Halfdansdottir, Berglind; Hildingsson, Ingegerd; Smarason, Alexander Kr; Sveinsdottir, Herdis; Olafsdottir, Olof A

2018-03-01

Icelandic national guidelines on place of birth list contraindications for home birth. Few studies have examined the effect of contraindication on home birth, and none have done so in Iceland. The aim of this study was to examine whether contraindications affect the outcome of planned home birth or have a different effect at home than in hospital. The study is a retrospective cohort study on the effect of contraindications for home birth on the outcome of planned home (n = 307) and hospital (n = 921) birth in 2005-2009. Outcomes were described for four different groups of women, by exposure to contraindications (unexposed vs. exposed) and planned place of birth (hospital vs. home). Linear and logistic regression analysis was used to evaluate the effect of the contraindications under study and to detect interactions between contraindications and planned place of birth. The key findings of the study were that contraindications were related to higher rates of adverse maternal and neonatal outcomes, regardless of place of birth; women exposed to contraindications had higher rates of adverse outcomes in planned home birth; and healthy, unexposed women had higher rates of adverse outcomes in planned hospital birth. Contraindications significantly increased the risk of transfer in labour and postpartum haemorrhage in planned home births. The defined contraindications for home birth had a negative effect on maternal and neonatal outcomes in Iceland, regardless of place of birth. The study results do not contradict the current national guidelines on place of birth. Copyright © 2017 Elsevier B.V. All rights reserved.

Remote midwifery in Nunavik, Québec, Canada: outcomes of perinatal care for the Inuulitsivik health centre, 2000-2007.

PubMed

Van Wagner, Vicki; Osepchook, Claire; Harney, Evelyn; Crosbie, Colleen; Tulugak, Mina

2012-09-01

The Inuulitsivik midwifery service is a community-based, Inuit-led initiative serving the Hudson coast of the Nunavik region of northern Québec. This study of outcomes for the Inuulitsivik birth centers, aims to improve understanding of maternity services in remote communities. We used a retrospective review of perinatal outcome data collected at each birth at the Inuulitsivik birth centers to examine outcomes for 1,372 labors and 1,382 babies from 2000 to 2007. Data were incomplete for some indicators, particularly for transfers to Montreal. Findings revealed low rates of intervention with safe outcomes in this young, largely multiparous "all risk" Inuit population. Ninety-seven percent of births were documented as spontaneous vaginal deliveries, and 85 percent of births were attended by midwives. Eighty-six percent of the labors occurred in Nunavik, whereas 13.7 percent occurred outside Nunavik. The preterm birth rate was found to be 10.6 percent. Postpartum hemorrhage was documented in 15.4 percent of women; of these cases, 6.9 percent had blood loss greater than 1,000 mL. Four fetal deaths (2.9 per 1,000) and five neonatal deaths (< 3.6 per 1,000) were documented. Nine percent (9%) of births involved urgent transfers of mother or baby. The most common reasons for medical evacuation were preterm labor and preeclampsia, and preterm birth was the most common reason for urgent neonatal transfer. The success of the Innulitsivik midwifery service rests on the knowledge and skills of the Inuit midwives, and support of an interprofessional health team. Our study points to the potential for safe, culturally competent local care in remote communities without cesarean section capacity. Our findings support recommendations for integration of midwifery services and Aboriginal midwifery education programs in remote communities. © 2012, Copyright the Authors, Journal compilation © 2012, Wiley Periodicals, Inc.

The predictive role of support in the birth experience: A longitudinal cohort study.

PubMed

Sigurdardottir, Valgerdur Lisa; Gamble, Jennifer; Gudmundsdottir, Berglind; Kristjansdottir, Hildur; Sveinsdottir, Herdis; Gottfredsdottir, Helga

2017-12-01

Several risk factors for negative birth experience have been identified, but little is known regarding the influence of social and midwifery support on the birth experience over time. The aim of this study was to describe women's birth experience up to two years after birth and to detect the predictive role of satisfaction with social and midwifery support in the birth experience. A longitudinal cohort study was conducted with a convenience sample of pregnant women from 26 community health care centres. Data was gathered using questionnaires at 11-16 weeks of pregnancy (T1, n=1111), at five to six months (T2, n=765), and at 18-24 months after birth (T3, n=657). Data about sociodemographic factors, reproductive history, birth outcomes, social and midwifery support, depressive symptoms, and birth experience were collected. The predictive role of midwifery support in the birth experience was examined using binary logistic regression. The prevalence of negative birth experience was 5% at T2 and 5.7% at T3. Women who were not satisfied with midwifery support during pregnancy and birth were more likely to have negative birth experience at T2 than women who were satisfied with midwifery support. Operative birth, perception of prolonged birth and being a student predicted negative birth experience at both T2 and T3. Perception of negative birth experience was relatively consistent during the study period and the role of support from midwives during pregnancy and birth had a significant impact on women's perception of birth experience. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Perinatal and familial risk factors for acute lymphoblastic leukemia in a Swedish national cohort.

PubMed

Crump, Casey; Sundquist, Jan; Sieh, Weiva; Winkleby, Marilyn A; Sundquist, Kristina

2015-04-01

Perinatal factors including high birth weight have been found to be associated with acute lymphoblastic leukemia (ALL) in case-control studies. However, to the best of our knowledge, these findings have seldom been examined in large population-based cohort studies, and the specific contributions of gestational age and fetal growth remain unknown. The authors conducted a national cohort study of 3,569,333 individuals without Down syndrome who were born in Sweden between 1973 and 2008 and followed for the incidence of ALL through 2010 (maximum age, 38 years) to examine perinatal and familial risk factors. There were 1960 ALL cases with 69.7 million person-years of follow-up. After adjusting for potential confounders, risk factors for ALL included high fetal growth (incidence rate ratio [IRR] per additional 1 standard deviation, 1.07; 95% confidence interval [95% CI], 1.02-1.11 [P =.002]; and IRR for large vs appropriate for gestational age, 1.22; 95% CI, 1.06-1.40 [P =.005]), first-degree family history of ALL (IRR, 7.41; 95% CI, 4.60-11.95 [P<.001]), male sex (IRR, 1.20; 95% CI, 1.10-1.31 [P<.001]), and parental country of birth (IRR for both parents born in Sweden vs other countries, 1.13; 95% CI, 1.00-1.27 [P =.045]). These risk factors did not appear to vary by patient age at the time of diagnosis of ALL. Gestational age at birth, season of birth, birth order, multiple birth, parental age, and parental education level were not found to be associated with ALL. In this large cohort study, high fetal growth was found to be associated with an increased risk of ALL in childhood through young adulthood, independent of gestational age at birth, suggesting that growth factor pathways may play an important long-term role in the etiology of ALL. © 2014 American Cancer Society.

IndEcho study: cohort study investigating birth size, childhood growth and young adult cardiovascular risk factors as predictors of midlife myocardial structure and function in South Asians

PubMed Central

Vasan, Senthil K; Roy, Ambuj; Samuel, Viji Thomson; Antonisamy, Belavendra; Bhargava, Santosh K; Alex, Anoop George; Singh, Bhaskar; Osmond, Clive; Geethanjali, Finney S; Karpe, Fredrik; Sachdev, Harshpal; Agrawal, Kanhaiya; Ramakrishnan, Lakshmy; Tandon, Nikhil; Thomas, Nihal; Premkumar, Prasanna S; Asaithambi, Prrathepa; Princy, Sneha F X; Sinha, Sikha; Paul, Thomas Vizhalil; Prabhakaran, Dorairaj; Fall, Caroline H D

2018-01-01

Introduction South Asians have high rates of cardiovascular disease (CVD) and its risk factors (hypertension, diabetes, dyslipidaemia and central obesity). Left ventricular (LV) hypertrophy and dysfunction are features of these disorders and important predictors of CVD mortality. Lower birth and infant weight and greater childhood weight gain are associated with increased adult CVD mortality, but there are few data on their relationship to LV function. The IndEcho study will examine associations of birth size, growth during infancy, childhood and adolescence and CVD risk factors in young adulthood with midlife cardiac structure and function in South Asian Indians. Methods and analysis We propose to study approximately 3000 men and women aged 43–50 years from two birth cohorts established in 1969–1973: the New Delhi Birth Cohort (n=1508) and Vellore Birth Cohort (n=2156). They had serial measurements of weight and height from birth to early adulthood. CVD risk markers (body composition, blood pressure, glucose tolerance and lipids) and lifestyle characteristics (tobacco and alcohol consumption, physical activity, socioeconomic status) were assessed at age ~30 years. Clinical measurements in IndEcho will include anthropometry, blood pressure, biochemistry (glucose, fasting insulin and lipids, urinary albumin/creatinine ratio) and body composition by dual energy X-ray absorptiometry and bioelectrical impedance. Outcomes are LV mass and indices of LV systolic and diastolic function assessed by two-dimensional and Doppler echocardiography, carotid intimal-media thickness and ECG indicators of ischaemia. Regression and conditional growth models, adjusted for potential confounders, will be used to study associations of childhood and young adult exposures with these cardiovascular outcomes. Ethics and dissemination The study has been approved by the Health Ministry Steering Committee, Government of India and institutional ethics committees of participating centres in India and the University of Southampton, UK. Results will be disseminated through scientific meetings and peer-reviewed journals. Trial registration number ISRCTN13432279; Pre-results. PMID:29643156

"Unwell while Aboriginal": iatrogenesis in Australian medical education and clinical case management.

PubMed

Ewen, Shaun C; Hollinsworth, David

2016-01-01

Attention to Aboriginal health has become mandatory in Australian medical education. In parallel, clinical management has increasingly used Aboriginality as an identifier in both decision making and reporting of morbidity and mortality. This focus is applauded in light of the gross inequalities in health outcomes between indigenous people and other Australians. A purposive survey of relevant Australian and international literature was conducted to map the current state of play and identify concerns with efforts to teach cultural competence with Aboriginal people in medical schools and to provide "culturally appropriate" clinical care. The authors critically analyzed this literature in light of their experiences in teaching Aboriginal studies over six decades in many universities to generate examples of iatrogenic effects and possible responses. Understanding how to most effectively embed Aboriginal content and perspectives in curriculum and how to best teach and assess these remains contested. This review canvasses these debates, arguing that well-intentioned efforts in medical education and clinical management can have iatrogenic impacts. Given the long history of racialization of Aboriginal people in Australian medicine and the relatively low levels of routine contact with Aboriginal people among students and clinicians, the review urges caution in compounding these iatrogenic effects and proposes strategies to combat or reduce them. Long overdue efforts to recognize gaps and inadequacies in medical education about Aboriginal people and their health and to provide equitable health services and improved health outcomes are needed and welcome. Such efforts need to be critically examined and rigorously evaluated to avoid the reproduction of pathologizing stereotypes and reductionist explanations for persistent poor outcomes for Aboriginal people.

A comparison of socioeconomic status and mental health among inner-city Aboriginal and non-Aboriginal women.

PubMed

Hamdullahpur, Kevin; Jacobs, Kahá Wi J; Gill, Kathryn J

2017-01-01

Aboriginal women in urban areas have been reported to experience high rates of poverty, homelessness, interpersonal violence, and health problems. However, there are few prior ethnocultural comparisons of urban women from similar socioeconomic backgrounds. The current study explored the mental and physical health of Aboriginal and non-Aboriginal women accessing social services agencies and shelters. Half of the sample (n=172) was Aboriginal (48.3%). The lifetime rate of physical abuse was significantly higher in Aboriginal women, and they were more likely to have been victims of violence or crime in the past year (A=50.6%, NA=35.6%, p<0.05). Rates of teenage pregnancy (<18 years of age) were significantly higher among Aboriginals (A=51.3%, NA=30.6%, p<0.05) and they reported more parental drug/alcohol problems (A=79.2%, NA=56.5%, p<0.05). Aboriginal women were also more likely to have previously received treatment for a drug or alcohol problem. There were no differences in self-reported physical health, medication use, hospitalisations, and current substance misuse. Irrespective of ethnicity, lifetime rates of anxiety, depression and suicide attempts were extremely high. Future research should explore the effects of individual resources (e.g. social support, family relations) and cultural beliefs on women's ability to cope with the stress of living with adverse events, particularly among low SES women with children.

Variable effects of prevalence correction of population denominators on differentials in myocardial infarction incidence: a record linkage study in Aboriginal and non-Aboriginal Western Australians.

PubMed

Katzenellenbogen, Judith M; Sanfilippo, Frank M; Hobbs, Michael S T; Briffa, Tom G; Ridout, Steve C; Knuiman, Matthew W; Dimer, Lyn; Taylor, Kate P; Thompson, Peter L; Thompson, Sandra C

2011-06-01

To investigate the impact of prevalence correction of population denominators on myocardial infarction (MI) incidence rates, rate ratios, and rate differences in Aboriginal vs. non-Aboriginal Western Australians aged 25-74 years during the study period 2000-2004. Person-based linked hospital and mortality data sets were used to estimate the number of prevalent and first-ever MI cases each year from 2000 to 2004 using a 15-year look-back period. Age-specific and -standardized MI incidence rates were calculated using both prevalence-corrected and -uncorrected population denominators, by sex and Aboriginality. The impact of prevalence correction on rates increased with age, was higher for men than women, and substantially greater for Aboriginal than non-Aboriginal people. Despite the systematic underestimation of incidence, prevalence correction had little impact on the Aboriginal to non-Aboriginal age-standardized rate ratios (6% and 4% underestimate in men and women, respectively), although the impact on rate differences was more marked (12% and 6%, respectively). The percentage underestimate of differentials was greater at older ages. Prevalence correction of denominators, while more accurate, is difficult to apply and may add modestly to the quantification of relative disparities in MI incidence between populations. Absolute incidence disparities using uncorrected denominators may have an error >10%. Copyright © 2011 Elsevier Inc. All rights reserved.

Racial discrimination experienced by aboriginal university students in Canada.

PubMed

Currie, Cheryl L; Wild, T Cameron; Schopflocher, Donald P; Laing, Lory; Veugelers, Paul

2012-10-01

Racial discrimination is an established life course social determinant of health associated with adverse psychological outcomes among minority populations. However, little is known about the extent to which Aboriginal people in Canada may experience racial discrimination and consequent adverse psychological effects. This study sought to measure the extent to which Aboriginal university students living in an urban area of Canada experienced racism, to triangulate this evidence with US data and qualitative findings, and to examine the impact of these experiences on mental health. Data for this mixed method study were collected via in-person surveys with a volunteer sample of Aboriginal university students (n = 60) living in a mid-sized city in central Canada in 2008-2009. Results indicate Aboriginal university students experienced more frequent racism across a greater number of life situations than African- and Latino-American adults in the United States. Student reactions to these experiences were symptomatic of what has been termed racial battle fatigue in the United States. Students who considered themselves traditional or cultural Aboriginal persons were significantly more likely to experience discrimination. Results underline the need for policies aimed at reducing racism directed at Aboriginal people in urban areas and the growth of services to help Aboriginal people cope with these experiences. Results highlight the need for further research to determine the potential pathogenic consequences of racial discrimination for Aboriginal people in Canada.

A Social History of the Manitoba Metis. The Development and Loss of Aboriginal Rights.

ERIC Educational Resources Information Center

Pelletier, Emile

The concept of aboriginal rights has been interpreted in various ways. Too often the general public does not understand fully what is meant by aboriginal rights. This topic has been debated in Parliament since Confederation and the general attitude of the news media has been to overlook it as unimportant. By definition, an aboriginal right is what…

Does the EDI Equivalently Measure Facets of School Readiness for Aboriginal and Non-Aboriginal Children?

ERIC Educational Resources Information Center

Muhajarine, Nazeem; Puchala, Chassidy; Janus, Magdalena

2011-01-01

The aim of the current paper was to examine the equivalence of the Early Development Instrument (EDI), a teacher rating measure of school readiness, for Aboriginal and non-Aboriginal children. The current study used an approach, which analyzes the structure and properties of the EDI at the subdomain level. Similar subdomain score distributions…

Aboriginal Title and Sustainable Development: A Case Study

ERIC Educational Resources Information Center

Allen, Derek

2016-01-01

In June 2014, the Supreme Court of Canada held that Aboriginal title should be granted to the Tsilhqo'tin Nation over a portion of its traditional territory in British Columbia.1 This was the first time that a Canadian court had granted Aboriginal title to a specific land area. The court noted that Aboriginal title is collective title held for…

Dancing with Ethnic Identities: An Aboriginal Dance Club in a Taiwanese Middle School

ERIC Educational Resources Information Center

Chen, Shwu-Meei; Lee, Young Ah

2015-01-01

Research in Taiwan has shown that aboriginal students often have low self-esteem and a negative view of their life due to their heritage. This research studied 14 Taiwan aboriginal students to understand how the experience of an aboriginal dance club influenced the development of their ethnic identity. The results showed that the experiences of…

Role, Impacts and Implications of Dedicated Aboriginal Student Space at a Canadian University

ERIC Educational Resources Information Center

Smith, Natasha L.; Varghese, Jeji

2016-01-01

This article draws on a case study of the University of Guelph's Aboriginal Resource Centre (ARC) to identify the role that dedicated spaces have in the lives of Aboriginal students. Three roles that were identified include how these spaces build a sense of community, foster and enhance Aboriginal identity, and provide a safe space for Aboriginal…

The Structural and Predictive Properties of the Psychopathy Checklist-Revised in Canadian Aboriginal and Non-Aboriginal Offenders

ERIC Educational Resources Information Center

Olver, Mark E.; Neumann, Craig S.; Wong, Stephen C. P.; Hare, Robert D.

2013-01-01

We examined the structural and predictive properties of the Psychopathy Checklist-Revised (PCL-R) in large samples of Canadian male Aboriginal and non-Aboriginal offenders. The PCL-R ratings were part of a risk assessment for criminal recidivism, with a mean follow-up of 26 months postrelease. Using multigroup confirmatory factor analysis, we were…

"We Learn A Lot from Mr. Hart": A Qualitative Study of an Effective Teacher of Aboriginal Students.

ERIC Educational Resources Information Center

Harslett, Mort; Godfrey, John; Harrison, Bernard; Partington, Gary; Richer, Kaye

A profile of an effective teacher of Aboriginal Australian students was constructed based on research on the teaching of Aboriginal students. Using the profile as a framework, this paper reports on an ethnographic study of an effective teacher in action with Aboriginal students. The study consisted of semi-participative observation of a teacher of…

Aboriginal Education as Cultural Brokerage: New Aboriginal Teachers Reflect on Language and Culture in the Classroom

ERIC Educational Resources Information Center

Kitchen, Julian; Cherubini, Lorenzo; Trudeau, Lyn; Hodson, Janie M.

2009-01-01

This paper reports on a Talking Circle of six beginning Aboriginal teachers who discussed their roles as teachers. Participants criticized teacher education programs for not preparing them to teach in ways that are respectful of Aboriginal languages and culture. They discussed the importance of coming to know themselves and their culture. The…

A post-colonial analysis of healthcare discourses addressing aboriginal women.

PubMed

Browne, Annette J; Smye, Vicki

2002-01-01

Annette Browne and Vicki Smye use post-colonial theoretical perspectives to inform a critical analysis of healthcare discourses related to cervical cancer among Canadian aboriginal women. They also examine how decontextualised discourses addressing aboriginal women's risks for cervical cancer can perpetuate negative stereotypical images of aboriginal women while downplaying or ignoring the historical, social and economic context of women's health risks.

Raising Awareness of Australian Aboriginal Peoples Reality: Embedding Aboriginal Knowledge in Social Work Education through the Use of Field Experiences

ERIC Educational Resources Information Center

Duthie, Deb; King, Julie; Mays, Jenni

2013-01-01

Effective social work practice with Aboriginal peoples and communities requires knowledge of operational communication skills and practice methods. In addition, there is also a need for practitioners to be aware of the history surrounding white engagement with Aboriginal communities and their cultures. Indeed, the Australian Association of Social…

Is Aboriginal nutrition a priority for local government? A policy analysis.

PubMed

Helson, Catherine; Walker, Ruth; Palermo, Claire; Rounsefell, Kim; Aron, Yudit; MacDonald, Catherine; Atkinson, Petah; Browne, Jennifer

2017-11-01

The present study aimed to explore how Australian local governments prioritise the health and well-being of Aboriginal populations and the extent to which nutrition is addressed by local government health policy. In the state of Victoria, Australia, all seventy-nine local governments' public health policy documents were retrieved. Inclusion of Aboriginal health and nutrition in policy documents was analysed using quantitative content analysis. Representation of Aboriginal nutrition 'problems' and 'solutions' was examined using qualitative framing analysis. The socio-ecological framework was used to classify the types of Aboriginal nutrition issues and strategies within policy documents. Victoria, Australia. Local governments' public health policy documents (n 79). A small proportion (14 %, n 11) of local governments addressed Aboriginal health and well-being in terms of nutrition. Where strategies aimed at nutrition existed, they mostly focused on individual factors rather than the broader macroenvironment. A limited number of Victorian local governments address nutrition as a health issue for their Aboriginal populations in policy documents. Nutrition needs to be addressed as a community and social responsibility rather than merely an individual 'behaviour'. Partnerships are required to ensure Aboriginal people lead government policy development.