Healthy ageing has been unattainable for many of Australia’s First Nation people, driven by an earlier onset of chronic disease when compared to the general Australian population. Our objective was ...to examine the perspectives of Australian First Nation people about healthy ageing.
We used a conversational method to gather knowledge from older First Nation people from established communities in New South Wales, Australia. Discussions were audio recorded and transcribed and analysed using an Indigenous research standpoint methodology. Eight yarning circles were held in six locations with 76 participants aged 45 years and over.
Key issues around healthy ageing were identified; particularly, what the impact of chronic disease means to individuals. Study participants reported that healthy ageing is essential to continue to share knowledge of their history and culture.
This article highlights the need for culturally appropriate healthy ageing programs addressing issues related to chronic disease among First Nation communities.
Research into what constitutes healthy ageing for older First Nation people is necessary for the development of culturally appropriate chronic disease interventions.
Bangladesh has one of the highest drowning mortality rates in the world. The use of unregulated water transportation may contribute to this burden, with 38% of all passenger traffic occurring by ...water. The present study aims to identify provider and end user perception on water transport related drowning risk, and barriers and facilitators for improving water safety practices.
A qualitative study was conducted in a riverine area of Bangladesh, the Barishal division. Data was collected through 18 in-depth interviews, two small group discussions and six observations in February-March 2016. Content analysis was conducted, guided by domains of Haddon's matrix for injury prevention.
A range of unsafe behaviours, practices and conditions were identified at pre event, event and post event stages of water transport related drownings. It was also recognised it is not only the regulation of water transport but other factors such as occupational insecurities, poor access to rescue services and healthcare, migration and capacity for skill development among providers that contribute to unsafe water transport practices and drowning risk.
There are some immediate measures that can be implemented, with some monitoring and accountability processes for water transport safety. However, there is need for robust data to quantify transport related drowning, making a case for prioritization and action by relevant stakeholder such as government and transport providers.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Fall related injury is an emerging issue for older Indigenous people worldwide, yet few targeted fall prevention programs are currently available for Indigenous populations. In order to inform the ...development of a new Aboriginal-specific fall prevention program in Australia, we conducted community consultation with older Aboriginal people to identify perceptions and beliefs about falls, and to identify desired program elements.
Yarning Circles were held with Aboriginal and Torres Strait Islander people aged 45 years and over. Each Yarning Circle was facilitated by an Aboriginal researcher who incorporated six indicative questions into each discussion. Questions explored the impact of falls on Yarning Circle participants, their current use of fall prevention services and investigated Yarning Circle participant's preferences regarding the design and mode of delivery of a fall prevention program.
A total of 76 older Aboriginal people participated in ten Yarning Circles across six sites in the state of New South Wales. Participants associated falls with physical disability, a loss of emotional well-being and loss of connection to family and community. Many participants did not use existing fall prevention services due to a lack of availability in their area, having no referral provided by their GP and/or being unaware of fall prevention programs in general. Program elements identified as important by participants were that it be Aboriginal-specific, group-based, and on-going, with the flexibility to be tailored to specific communities, with free transport provided to and from the program.
Older Aboriginal people reported falls to be a priority health issue, with a significant impact on their health and well-being. Few older Aboriginal people accessed prevention programs, suggesting there is an important need for targeted Aboriginal-specific programs. A number of important program elements were identified which if incorporated into prevention programs, may help to address the rising burden of falls.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Culturally-specific services are central to efforts to improve the health of Aboriginal Australians. Few empirical studies have demonstrated the value of such services relative to mainstream ...alternatives.
To assess the preferences and willingness to pay (WTP) of participants for attending a class and the relative importance of transport, cost and cultural-appropriateness in the choices made by participants.
A discrete choice experiment (DCE) was conducted alongside a study of a culturally-specific fall-prevention service. Attributes that were assessed were out-of-pocket costs, whether transport was provided and whether the class was Aboriginal-specific. Choices of participants were modelled using panel-mixed logit methods.
60 patients completed the DCE. Attending a service was strongly preferred over no service (selected 99% of the time). Assuming equivalent efficacy of fall-prevention programs, participants indicated a preference for services that were culturally-specific (OR 1.25 95% CI: 1.00-1.55) and incurred lower out-of-pocket participant costs (OR 1.19 95% CI 1.11-1.27). The provision of transport did not have a statistically significant influence on service choice (p = 0.57).
This represents the first published DCE in the health field examining preferences amongst an Aboriginal population. The results empirically demonstrate the value of the culturally-specific element of a program has to this cohort and the potential that stated-preference methods can have in incorporating the preferences of Aboriginal Australians and valuing cultural components of health services.
As the majority of the NSW Aboriginal and Torres Strait Islander population is Aboriginal (97.2%), this population will be referred to as 'Aboriginal' in this manuscript.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To examine the risk factors, incidence, consequences and existing prevention strategies for falls and fall‐related injury in older indigenous people.
Relevant literature was identified through ...searching 14 electronic databases, a range of institutional websites, online search engines and government databases, using search terms pertaining to indigenous status, injury and ageing.
Thirteen studies from Australia, the United States, Central America and Canada were identified. Few studies reported on fall rates but two reported that around 30% of indigenous people aged 45 years and above experienced at least one fall during the past year. The most common hospitalised fall injuries among older indigenous people were hip fracture and head injury. Risk factors significantly associated with falls within indigenous populations included poor mobility, a history of stroke, epilepsy, head injury, poor hearing and urinary incontinence. No formally evaluated, indigenous‐specific fall prevention interventions were identified.
Falls are a significant and growing health issue for older indigenous people worldwide that can lead to severe health consequences and even death. No fully‐evaluated, indigenous‐specific fall prevention programs were identified.
Research into fall patterns and fall‐related injury among indigenous people is necessary for the development of appropriate fall prevention interventions.
Aim: To document the implementation and investigate within-group impact of The Ironbark Program: a community-based, Aboriginal-specific fall prevention program, in New South Wales, Australia.
...Methods: The Ironbark Program was trialled in six Aboriginal communities over a three- to six-month period. A mixed methods approach was used for program evaluation: strength, balance and gait were assessed to measure participant physical function and BMI was monitored. Semi-structured participant interviews investigated program suitability, relevance and impact.
Results: Ninety-eight Aboriginal people aged 40+ years registered for the pilot program, 77 (79%) of whom were present at all assessment time points. There were significant improvements in participant leg strength (average time to complete five repetition sit-to-stand: 14 seconds to 11 seconds), balance (timed single-leg stance: 5.6 seconds to 7.8 seconds), gait (timed 4 m walk: 0.51 m/s to 0.94 m/s) and a significant decrease in BMI (32.0 to 31.6) was observed. Participants reported enjoying the program and stated they would recommend it to others. Conclusion: The evaluation of the Ironbark Program demonstrated acceptability, and showed significant improvements in physical function. If proven to be effective in a definitive trial, this program could be used widely to prevent falls in older Aboriginal people.
Implications: Key features of the Ironbark Program were local Aboriginal management, culturally relevant resources, ongoing availability and enabling program use for people aged less than 65 years. These features should be retained on the program's upscale, and may be incorporated into other healthy ageing programs developed for the Aboriginal population.
To examine the burden and risk factors for fatal and non-fatal drowning in India.
Relevant literature was identified through a systematic search of 19 electronic databases and 19 national and global, ...institutional, organisational and government sources of injury data. Search terms used pertained to drowning, injury, trauma, morbidity and mortality in India.
A total of 16 research articles and five data sources were included in the review. Three national data sources provided counts of drowning deaths, reporting a range of 1348-62 569 drowning deaths per year. A further three national data sources provided information on drowning-related morbidity; however, each source presented different outcome measures making comparison difficult. Ten research studies investigated risk factors associated with drowning in India. Key risk factors reported were male gender, young age (0-5 years) and individuals residing in the North-Eastern part of the country who have high exposure to water sources within community settings.
Drowning-related morbidity and mortality have a significant impact on India, with risk factors identified for this setting similar to those within other low-income and middle-income countries. Regional data which look beyond routinely collected data are required to accurately investigate the burden and impact of drowning, to inform targeted, context-specific approaches for drowning reduction initiatives.
Mandatory standard regulation is used within Australia to ensure the safety of consumer products, preventing product-related injury. Standard regulation is particularly important for products ...designed for use by children, who are highly vulnerable to sustaining product-related injuries due to their small size and inability to identify product hazards. This project aims to investigate how effectively information regarding product-related injuries is able to be captured within Australian health and coronial data. Further, it aims to investigate the extent to which child injury occurs for products for which mandatory safety standards exist through the review of available data. This study highlights significant limitations in injury surveillance data for identification and monitoring of child product-related injuries. This in turn limits the evidence base to assess the efficacy of existing regulations. Available data show baby walkers, cots, prams, nightwear, and bunk beds to be associated with a considerable number of child hospital presentations, admissions, and deaths. A significant scope for improvement in current product injury recording practices in the health sector exists.
Aim
Our aim was to improve our understanding of the contextual factors contributing to child drowning in rural West Bengal, India.
Methods
This 2017 study used interviews, focus groups and ...observations and the participants included community leaders, household heads, parents and children aged 7–17 years from three remote villages. They included adults and children who had been directly affected by the loss of family members or friends.
Results
We conducted 19 in‐depth interviews, six focus groups and three informal observations in public locations where people were exposed to water. The area contained a high number of natural open areas of water, which increased the drowning risk. Participants reported that children frequently played unsupervised near potentially hazardous water, as their parents worked long hours and there was a lack of safe recreational spaces. Suggested approaches to reducing the drowning risk included parental education to improve child supervision and establishing village committees to effectively communicate the drowning risks to local government. Low‐cost, community‐based approaches to improving child water safety need to be developed.
Conclusion
Drowning was clearly a complex issue in rural West Bengal, with a significant impact on children and their families. Community‐based approaches are clearly needed.
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