Social and emotional outcomes of Australian children from Indigenous and culturally and linguistically diverse backgrounds

Objectives: 1) profile the living environments and 2) examine the social and emotional outcomes of Australian children from Indigenous and cultural and linguistically diverse (CALD) backgrounds at school entry. Method: Secondary analysis of cross- sectional data collected in Wave 1 of the Longitudinal Study of Australian Children (n=4,735). Child mental-health outcomes were measured using parent report of the Strengths and Difficulties Questionnaire (SDQ). Results: Significant differences in family and neighbourhood characteristics, including parental income, maternal education, maternal parenting quality and neighbourhood safety, were found in children of Indigenous and CALD backgrounds compared to the reference group of Australian-born, English-speaking children. After controlling for family and neighbourhood characteristics, significant differences in parent-reported SDQ total difficulties were found for Indigenous children. Significant differences in emotional difficulties and peer problems subscales were found for children with overseas-born mothers regardless of English proficiency. Conclusions: Children from Indigenous and CALD backgrounds experience poorer mental health outcomes at school entry than their Australian-born English- speaking peers. They are also more likely to be exposed to risk factors for poor child mental-health outcomes within their family and neighbourhood environments

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

Background: 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. Methods: 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. Results: 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. Conclusions: 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

Trials and tribulations : the 'use' (and 'misuse') of evidence in public policy

Randomized controlled trials (RCTs) are increasingly playing a central role in shaping policy for development. By comparison, social experimentation has not driven the great transformation of welfare within the developed world. This introduces a range of issues for those interested in the nature of research evidence for making policy. In this article we will seek a greater understanding of why the RCT is increasingly seen as the ‘gold standard’ for policy experiments in low- and middle-income countries (LMICs), but not in the more advanced liberal democracies, and we will explore the implications of this. One objection to the use of RCTs, however can be cost, but implementing policies and programmes without good evidence or a good understanding of their effectiveness is unlikely to be a good use of resources either. Other issues arise. Trials are often complex to run and ethical concerns often arise in social ‘experiments’ with human subjects. However, rolling out untested policies may also be morally objectionable. This article sheds new light on the relationship between evidence and evaluation in public policy in both the global north and developing south. It also tackles emerging issues concerning the ‘use’ and ‘misuse’ of evidence and evaluation within public policy

Conventionally accepted risk factors do not explain higher rates of middle ear disease in remote Indigenous children: an ecological study

No abstract is available for this article

Ensuring Indigenous Australians with acquired brain injuries have equitable access to the National Disability Insurance Scheme

[Extract] The National Disability Insurance Scheme (NDIS) has the potential to change the lives of Indigenous Australians living with an acquired brain injury (ABI) by providing much needed services and support. We believe it is imperative that greater effort and resources be focused on ensuring that Indigenous Australians with an ABI can access accurate and culturally acceptable cognitive assessment of a similar standard to that available for non-Indigenous Australians. While there is little data on incidence of ABI in Indigenous Australians, the prevalence of risk factors for ABI is high. For example, head trauma accounts for 30% of injuries requiring hospitalisation in Indigenous Australians, compared to 18% in non-Indigenous Australians. Between 2005 and 2008, Indigenous Australians were 21 times more likely to suffer a head injury due to assault. Indigenous Australians are 1.5 times more likely to drink alcohol at risky levels, although rates of risky drinking and alcohol-related head trauma appear to be much higher in regions such as the Northern Territory. Data suggest the burden of ABI is high in this population