Indigenous families and the welfare system: The Yuendumu community case study, Stage Two

In 1998, CAEPR commenced research for the Children and Welfare Project, as negotiated with the Indigenous Policy Unit (IPU) of the Department of Family and Community Services (DFACS). The project aims to provide a longitudinal study into the factors influencing the service delivery of social security income support payments to Indigenous families for the care of their children. The results of the first stage community surveys undertaken at Kuranda, Queensland, and Yuendumu, Northern Territory, focused on a sample of households in the two communities and were published in 1999 and 2000. This Discussion Paper presents the findings of the first follow-up survey (referred to as Stage Two) undertaken at Yuendumu, in August and September 2000. In line with issues raised in the original terms of reference and the earlier stages of the project, the focus is on mobility and consequent changes in membership and composition of households, and the related policy and service delivery issues. The paper presents an ethnographic and statistical exploration of intra-community mobility based on the comparative data available from the two consecutive surveys in 1999 and 2000. It relates mobility to factors underlying everyday life in Yuendumu-the sharing of food, money and other resources within social networks-and the implications of these for policy and the delivery of welfare services. The paper concludes with further consideration of the recommendations made in the earlier stage of the project. It provides a more detailed elaboration of particular issues related to policy and more appropriate payment structures for Indigenous welfare recipients, and formulates relevant ideas for future action

Skin infection, housing and social circumstances in children living in remote Indigenous communities: testing conceptual and methodological approaches

BACKGROUND: Poor housing conditions in remote Indigenous communities in Australia are a major underlying factor in poor child health, including high rates of skin infections. The aim of this study is to test approaches to data collection, analysis and feedback for a follow-up study of the impact of housing conditions on child health. METHODS: Participation was negotiated in three communities with community councils and individual participants. Data were collected by survey of dwelling condition, interviews, and audit health centre records of children aged under seven years. Community feedback comprised immediate report of items requiring urgent repair followed by a summary descriptive report. Multivariate models were developed to calculate adjusted incidence rate ratios (IRR) for skin infections and their association with aspects of household infrastructure. RESULTS: There was a high level of participation in all communities. Health centre records were inadequate for audit in one community. The records of 138 children were available for development of multivariate analytic models. Rates of skin infection in dwellings that lacked functioning facilities for removing faeces or which had concrete floors may be up to twice as high as for other dwellings, and the latter association appears to be exacerbated by crowding. Younger children living in older dwellings may also be at approximately two-fold higher risk. A number of socioeconomic and socio-demographic variables also appear to be directly associated with high rates of skin infections. CONCLUSION: The methods used in the pilot study were generally feasible, and the analytic approach provides meaningful results. The study provides some evidence that new and modern housing is contributing to a reduction in skin infections in Aboriginal children in remote communities, particularly when this housing leads to a reduction in crowding and the effective removal of human waste

Application of Electrochemical Impedance Spectroscopy for assessing inhibition efficiency of triptamine on iron corrosion in acidic media

P28 - ISSN

Exploring Yamatji perceptions and use of palliative care: an ethnographic study.

BACKGROUND: The Yamatji people comprise several Aboriginal groups living in the Midwest region of Western Australia. Palliative care remains underutilised among Aboriginal groups, but little is known about Yamatji people's thoughts about and experiences of accessing services. AIM: As part of a broader study focusing on Yamatji's lived experiences of breast cancer, this study analysed their perceptions and use of palliative care services. METHODS: The study used grounded theory and 28 in-depth interviews with Aboriginal and non-Aboriginal health-care providers as well as Yamatji patients, carers, and families. RESULTS: Palliative care services are underutilised by Yamatji breast cancer patients. The reasons for this include misperceptions about what palliative care entails, cultural and structural barriers to adequate service provision, and the inflexibility of institutionalised death. CONCLUSIONS: Efforts to raise awareness among Yamatji that palliative care is broader than end-of-life care would be a step in the right direction, but would not be sufficient to significantly increase uptake among Yamatji if culturally specific perceptions of death and dying are not included in the dialogue

Molecular correlates of cerebellar mutism syndrome in medulloblastoma

Background: Cerebellar Mutism Syndrome (CMS) is a common complication following resection of posterior fossa tumors, most commonly after surgery for medulloblastoma. Medulloblastoma subgroups have historically been treated as a single entity when assessing CMS risk; however, recent studies highlighting their clinical heterogeneity suggest the need for subgroup-specific analysis. Here, we examine a large international multicenter cohort of molecularly characterized medulloblastoma patients to assess predictors of CMS. / Methods: We assembled a cohort of 370 molecularly characterized medulloblastoma subjects with available neuroimaging from five sites globally including Great Ormond Street Hospital, Christian Medical College and Hospital, Hospital for Sick Children, King Hussein Cancer Center, and Lucile Packard Children’s Hospital. Age at diagnosis, sex, tumour volume, and CMS development were assessed in addition to molecular subgroup. / Results: Overall, 23.8% of patients developed CMS. CMS patients were younger (mean difference -2.05 years ± 0.50, P=0.0218) and had larger tumours (mean difference 10.25 cm3 ± 4.60, P=0.0010) that were more often midline (OR=5.72, P<0.0001). In a multivariable analysis adjusting for age, sex, midline location, and tumour volume, WNT (Wingless) (adjusted OR=4.91, p=0.0063), Group 3 (adjusted OR=5.56, p=0.0022) and Group 4 (adjusted OR=8.57 p=9.1x10-5) tumours were found to be independently associated with higher risk of CMS compared with SHH (Sonic Hedgehog) tumours. / Conclusions: Medulloblastoma subgroup is a very strong predictor of CMS development, independent of tumour volume and midline location. These findings have significant implications for management of both the tumour and CMS