ORCID Profile
0000-0002-6233-3439
Current Organisations
Flinders University
,
UNSW Australia
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Publisher: CSIRO Publishing
Date: 29-05-2023
DOI: 10.1071/AH23105
Publisher: Wiley
Date: 12-2018
DOI: 10.1002/HPJA.215
Development and Evaluation of a Prediction Model for Ascertaining Rheumatic Heart Disease Status in Administrative Data
Publisher: Informa UK Limited
Date: 07-2020
DOI: 10.2147/CLEP.S241588
Publisher: Springer Science and Business Media LLC
Date: 23-10-2021
DOI: 10.1186/S12889-021-11957-5
Abstract: The Northern Territory (NT) has the highest levels of alcohol consumption and harms in Australia. Since the creation of the NT Liquor Act 1978, which came into effect in 1979, numerous legislated alcohol policies have been introduced to attempt to address these harms. We present a narrative historical overview of alcohol policies implemented in the NT from 1979 to 2021. Using scoping review methodology, databases were searched from 1979 to 2021. Of 506 articles screened, 34 met inclusion criteria. Reference lists of all included articles were searched, resulting in the inclusion of another 41 articles and reports, totalling 75 final documents. Policies were organised using Babor and colleagues (2010) established framework: 1. pricing/ taxation 2. regulating physical availability 3. modifying drinking environments 4. drink-driving countermeasures 5. restrictions on marketing 6. education ersuasion 7. treatment/early intervention. Two pricing/taxation policies have been implemented, Living With Alcohol (LWA) and Minimum Unit Price, both demonstrating evidence of positive effects on health and consumption outcomes. Eight policies approaches have focused on regulating physical availability, implemented at both in idual and local area levels. Several of these policies have varied by location and been amended over time. There is some evidence demonstrating reduction in harms attributable to Liquor Supply Plans, localised restrictions, and General Restricted Areas, although these have been site specific. Of the three policies which targeted modifying the drinking environment one was evaluated, finding a relocation of social harms, rather than a reduction. The literature outlines a range of controversies, particularly regarding policies in domain 2–3, including racial discrimination and a lack of policy stability. No policies relating to restricting marketing or education ersuasion programs were found. The only drink-driving legislated policy was considered to have contributed to the success of the LWA program. Three policies relating to treatment were described two were not evaluated and evidence showed no ongoing benefits of Alcohol Mandatory Treatment. The NT has implemented a large number of alcohol policies, several of which have evidence of positive effects. However, these policies have often existed in a context of clear politicisation of alcohol policy, frequently with an implicit focus on Aboriginal people’s consumption.
Publisher: Springer Science and Business Media LLC
Date: 06-06-2023
DOI: 10.1007/S11113-023-09801-2
Abstract: Investigating in idual level-Indigenous identification change by Aboriginal and Torres Strait Islander Australians has been enabled through the linkage of census data across time. This study focusses on the population who moved from an identification of Indigenous in the 2011 census to not Indigenous in the 2016 census. We calculated transition probabilities for a range of personal characteristics to investigate the influence of broad life-course transitions on the pattern of identification change. In addition to age, we found that sex, employment, mixed ancestry, interstate migration, and living arrangements had the strongest associations with the risk of a transition to not Indigenous. The highest transition probabilities were at each end of the adult life-course and the role of “not stated” was implicated, destabilising assumptions that decisions to identify as Indigenous, or not, always reflect personal agency. Finally, the paper challenges the adequacy of an origin-based identity question to define the increasingly complex ethnic histories of Aboriginal and/or Torres Strait Islander people. Both improved definition and enumeration of Indigenous Australians are fundamental to current national conversations about constitutional recognition and continuing gaps in measured health and wellbeing.
Publisher: Wiley
Date: 04-2020
DOI: 10.1002/HPJA.340
Publisher: Springer Science and Business Media LLC
Date: 12-04-2021
DOI: 10.1186/S12939-021-01433-2
Abstract: Measurement of patients’ healthcare experiences is increasingly used as an indicator of quality of care, but there are concerns that existing measures omit information that is meaningful to patients and that results may not be used systematically to inform service improvement. Further, current approaches may be inadequate for some population groups, such as Indigenous people in Australia, whose healthcare experience is impacted by the context of colonisation and discordance between Indigenous understandings of health and the Western biomedical health system. This study aimed to assess the extent to which existing patient experience measures used in Australia collect information about critical aspects of cancer care, as previously identified by Indigenous people affected by cancer and their health care providers. A two-stage process was used to examine the adequacy of existing patient experience measures for Indigenous people in Australia: (1) relevant tools and measures were identified and assessed, and four measures selected as suitable comparators (2) comparators were examined in detail and mapped against topics identified in earlier research as important to Indigenous people with cancer. Gaps in topic coverage in comparators were identified. No comparators completely captured the critical aspects of cancer care identified by Indigenous people affected by cancer and their health care providers. The number of topics ‘partially’ captured by the four comparators ranged from 4 to 7 out of 9. While most topics were partially covered, the lack of questions around culture and cultural safety was notable. Existing tools are likely to miss key aspects of Indigenous peoples’ experiences of cancer care in Australia. Failure to adequately assess care experiences related to cultural safety may compromise efforts to improve health outcomes. Addressing gaps requires development of experience measures that are strengths-based, reflect an Indigenous worldview and measure aspects of experience relevant to Indigenous people.
Publisher: Elsevier BV
Date: 03-2022
Publisher: Springer Science and Business Media LLC
Date: 31-01-2014
Publisher: MDPI AG
Date: 30-09-2021
Abstract: There is increasing potential to improve the research and reporting on the health and wellbeing of Indigenous and Tribal peoples through the collection and (re)use of population-level data. As the data economy grows and the value of data increases, the optimization of data pertaining to Indigenous peoples requires governance that defines who makes decisions on behalf of whom and how these data can and should be used. An international a priori PROSPERO (#CRD42020170033) systematic review was undertaken to examine the health research literature to (1) identify, describe, and synthesize definitions and principles (2) identify and describe data governance frameworks and (3) identify, describe, and synthesize processes, policies and practices used in Indigenous Data Governance (ID-GOV). Sixty-eight articles were included in the review that found five components that require consideration in the governance of health research data pertaining to Indigenous people. This included (1) Indigenous governance (2) institutional ethics (3) socio-political dynamics (4) data management and data stewardship and (5) overarching influences. This review provides the first systematic international review of ID-GOV that could potentially be used in a range of governance strategies moving forward in health research.
Publisher: Wiley
Date: 04-2018
DOI: 10.1002/HPJA.48
Publisher: MDPI AG
Date: 27-12-2021
Abstract: Indigenous and Tribal peoples account for approximately 6 [...]
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 18-03-2014
Publisher: Wiley
Date: 02-2021
DOI: 10.1002/HPJA.446
Publisher: Center for Open Science
Date: 16-09-2021
Abstract: The Doherty Model is being used in Australia to justify partial reopening with 70% of adults vaccinated. However, we have identified six critical failures of the model: failure to model uncertainties failure to use appropriate premises failure to model subgroup vaccine takeup failure to correctly model child transmission failure to include relevant outcomes and failure to consider longer time-frames. These failures result in missing over 200,000 cases of long covid in children, underestimating death counts by a factor of up to ten, underestimating the severity of the delta variant by a factor of two, and greatly underestimating the potential downside risk.
Publisher: Wiley
Date: 09-2020
DOI: 10.1002/HPJA.422
Publisher: MDPI AG
Date: 29-09-2021
Abstract: Despite significant developments in Aboriginal and Torres Strait Islander Health information over the last 25 years, many challenges remain. There are still uncertainties about the accuracy of estimates of the summary measure of life expectancy, and methods to estimate changes in life expectancy over time are unreliable because of changing patterns of identification. Far too little use is made of the wealth of information that is available, and formal systems for systematically using that information are often vestigial to non-existent. Available information has focussed largely on traditional biomedical topics and too little on access to, expenditure on, and availability of services required to improve health outcomes, and on the underpinning issues of social and emotional wellbeing. It is of concern that statistical artefacts may have been misrepresented as indicating real progress in key health indices. Challenges and opportunities for the future include improving the accuracy of estimation of life expectancy, provision of community level data, information on the availability and effectiveness of health services, measurement of the underpinning issues of racism, culture and social and emotional wellbeing (SEWB), enhancing the interoperability of data systems, and capacity building and mechanisms for Indigenous data governance. There is little point in having information unless it is used, and formal mechanisms for making full use of information in a proper policy lanning cycle are urgently required.
Publisher: Oxford University Press (OUP)
Date: 11-2021
Abstract: Rheumatic heart disease (RHD) is a major contributor to cardiac morbidity and mortality globally. This study aims to estimate the probability and predictors of progressing to non-fatal cardiovascular complications and death in young Australians after their first RHD diagnosis. This retrospective cohort study used linked RHD register, hospital, and death data from five Australian states and territories (covering 70% of the whole population and 86% of the Indigenous population). Progression from uncomplicated RHD to all-cause death and non-fatal cardiovascular complications (surgical intervention, heart failure, atrial fibrillation, infective endocarditis, and stroke) was estimated for people aged & years with first-ever RHD diagnosis between 2010 and 2018, identified from register and hospital data. The study cohort comprised 1718 initially uncomplicated RHD cases (84.6% Indigenous 10.9% migrant 63.2% women 40.3% aged 5–14 years 76.4% non-metropolitan). The composite outcome of death/cardiovascular complication was experienced by 23.3% (95% confidence interval: 19.5–26.9) within 8 years. Older age and metropolitan residence were independent positive predictors of the composite outcome history of acute rheumatic fever was a negative predictor. Population group (Indigenous/migrant/other Australian) and sex were not predictive of outcome after multivariable adjustment. This study provides the most definitive and contemporary estimates of progression to major cardiovascular complication or death in young Australians with RHD. Despite access to the publically funded universal Australian healthcare system, one-fifth of initially uncomplicated RHD cases will experience one of the major complications of RHD within 8 years supporting the need for programmes to eradicate RHD.
Publisher: Wiley
Date: 2019
DOI: 10.1002/HPJA.222
Publisher: BMJ
Date: 02-2023
DOI: 10.1136/BMJOPEN-2022-067054
Abstract: Conducting ethical and high-quality health research is crucial for informing public health policy and service delivery to reduce the high and inequitable burden of disease experienced by Aboriginal and Torres Strait Islander people. Ethical guidelines and principles specifically for health research with Aboriginal and Torres Strait Islander people have been developed for use since 1987. However, there has been limited examination of how these are being applied to the conduct of research. Murru Minya will be a large-scale national study to examine the implementation of ethical processes in Aboriginal and Torres Strait Islander health research. A mixed-methods design will be used in four baarra (steps). The first three baarra will collect knowledge, experiences and wisdom from three key groups: Aboriginal and Torres Strait Islander communities, research academics, and Human Research Ethics Committees using online surveys, yarning, and semistructured interviews. This knowledge will inform the final baarra of developing a set of practical recommendations to support ethical conduct in Aboriginal and Torres Strait Islander health research into the future. Ethical approval for this research project has been granted by National, State and Territory Human Research Ethics Committees. This research has been developed in collaboration with Aboriginal and Torres Strait Islander researchers, Aboriginal Community Controlled Health Organisation representatives, Aboriginal community members, the National Health Leadership Forum, and Aboriginal and Torres Strait Islander research team. The knowledge translation plan will be integrated and revised throughout the project as partnerships and engagement with Aboriginal and Torres Strait Islander communities continue. All findings will be shared with peak Aboriginal research bodies and Aboriginal and Torres Strait Islander communities in ways that are meaningful to them.
Publisher: Wiley
Date: 04-2019
DOI: 10.1002/HPJA.242
Publisher: AMPCo
Date: 13-03-2020
DOI: 10.5694/MJA2.50543
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 30-07-2013
DOI: 10.1161/CIRCULATIONAHA.113.001477
Abstract: Although acute rheumatic fever (ARF) and its sequel, rheumatic heart disease (RHD), continue to cause a large burden of morbidity and mortality in disadvantaged populations, most studies investigating the effectiveness of control programs date from the 1950s. A control program, including a disease register, in the Northern Territory of Australia where the Indigenous population has high rates of ARF and RHD allowed us to examine current disease incidence and progression. ARF and RHD incidence rates, ARF recurrence rates, progression rates from ARF to RHD to heart failure, and RHD survival and mortality rates were calculated for Northern Territory residents from 1997 to 2010. For Indigenous people, ARF incidence was highest in the 5- to 14-year age group (males, 162 per 100 000 females, 228 per 100 000). There was little evidence that the incidence of ARF or RHD had declined. The ARF recurrence rate declined by 9% per year after diagnosis. After a first ARF diagnosis, 61% developed RHD within 10 years. After RHD diagnosis, 27% developed heart failure within 5 years. For Indigenous RHD patients, the relative survival rate was 88.4% at 10 years after diagnosis and the standardized mortality ratio was 1.56 (95% confidence interval, 1.23–1.96). For Indigenous Australians in the Northern Territory, ARF and RHD incidence and associated mortality remain very high. The reduction in ARF recurrence indicates that the RHD control program has improved secondary prophylaxis a decline in RHD incidence is expected to follow.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.ANNEPIDEM.2018.02.005
Abstract: It is estimated that there are 370 million indigenous peoples in 90 countries globally. Indigenous peoples generally face substantial disadvantage and poorer health status compared with nonindigenous peoples. Population-level cancer surveillance provides data to set priorities, inform policies, and monitor progress over time. Measuring the cancer burden of vulnerable subpopulations, particularly indigenous peoples, is problematic. There are a number of practical and methodological issues potentially resulting in substantial underestimation of cancer incidence and mortality rates, and biased survival rates, among indigenous peoples. This, in turn, may result in a deprioritization of cancer-related programs and policies among these populations. This commentary describes key issues relating to cancer surveillance among indigenous populations including 1) suboptimal identification of indigenous populations, 2) numerator-denominator bias, 3) problems with data linkage in survival analysis, and 4) statistical analytic considerations. We suggest solutions that can be implemented to strengthen the visibility of indigenous peoples around the world. These include acknowledgment of the central importance of full engagement of indigenous peoples with all data-related processes, encouraging the use of indigenous identifiers in national and regional data sets and mitigation and/or careful assessment of biases inherent in cancer surveillance methods for indigenous peoples.
Publisher: Springer Science and Business Media LLC
Date: 12-2018
Location: Australia
Start Date: 2012
End Date: 2014
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2019
End Date: 2019
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2019
End Date: 2022
Funder: Australian Research Council
View Funded ActivityStart Date: 2020
End Date: 2021
Funder: Lowitja Institute
View Funded ActivityStart Date: 2019
End Date: 2023
Funder: The Clive and Vera Ramaciotti Foundation
View Funded Activity