Intrinsic capacity and ageing well for Aboriginal people in remote Western Australia: a longitudinal cohort study.

Objective: To assess intrinsic capacity, an important component of ageing well, in older Aboriginal people living in remote Western Australia.

Study Design: Longitudinal cohort study; secondary analysis of survey and clinical assessment data.

Setting: Kimberley region of Western Australia (six remote communities, and the town of Derby).

Real-world screening for diabetes in early pregnancy: Improved screening uptake using universal glycated haemoglobin.

Aims: To improve perinatal outcomes, screening for hyperglycaemia using 75 g oral glucose tolerance test (OGTT) is recommended for all pregnant women at 24-28 weeks gestation (routine), and earlier if high-risk. Screening coverage for remote and Aboriginal Australian women is less than ideal. This study examined OGTT completion (early and routine) by women from rural and remote Western Australia compared with early glycated haemoglobin (HbA).

Prediabetes and pregnancy: Early pregnancy HbA identifies Australian Aboriginal women with high-risk of gestational diabetes mellitus and adverse perinatal outcomes.

Aims: To assess whether early pregnancy HbA can predict gestational diabetes mellitus (GDM) and adverse birth outcomes in Australian women.

Methods: Prospective study of 466 women without diabetes, aged ≥16-years at first antenatal presentation. Recruitment was from 27 primary healthcare sites in rural and remote Australia from 9-January 2015 to 31-May 2018.

Underestimation of risk for large babies in rural and remote Australia: Time to change plasma glucose collection protocols.

Aims: Preanalytical glycolysis in oral glucose tolerance tests (OGTT) leads to substantial underestimation of gestational diabetes mellitus (GDM) and hence risk for large-for-gestational-age (LGA) babies. This paper quantified the impact of glycolysis on identification of LGA risk in a prospective rural and remote Australian cohort.

Methods: For 495 women, OGTT results from room temperature fluoride-oxalate (FLOX) tubes were algorithmically corrected for estimated glycolysis compared to 1) the Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) study protocol (FLOX tubes in ice-slurry); and 2) room temperature fluoride-citrate (FC) tubes.

Aboriginal women's experiences of strengths and challenges of antenatal care in the Kimberley: A qualitative study.

Background: High-quality, culturally safe antenatal care has an important role in improving health outcomes of Aboriginal and Torres Strait Islander people. We sought to describe Aboriginal women's experiences of antenatal care in the Kimberley region of Western Australia, to better understand current systems and opportunities for enhancing antenatal care.

Methods: Throughout the Kimberley, 124 Aboriginal women who had accessed antenatal care in 2015-2018 were recruited.

Maboo wirriya, be healthy: Community-directed development of an evidence-based diabetes prevention program for young Aboriginal people in a remote Australian town.

Supporting healthy lifestyle behaviours is a key aspect of preventing type 2 diabetes which disproportionately affects disadvantaged groups from a younger age. Formative participatory research was undertaken to design a program for young Aboriginal people in a remote town in North West Australia with a high level of health needs and relatively few prevention initiatives. Focus groups and advisory discussions with Aboriginal community members were used to determine the nature of the program.

Real-World Gestational Diabetes Screening: Problems with the Oral Glucose Tolerance Test in Rural and Remote Australia.

Gestational diabetes mellitus (GDM) is the most common antenatal complication in Australia. All pregnant women are recommended for screening by 75 g oral glucose tolerance test (OGTT). As part of a study to improve screening, 694 women from 27 regional, rural and remote clinics were recruited from 2015-2018 into the Optimisation of Rural Clinical and Haematological Indicators for Diabetes in pregnancy (ORCHID) study.

Piloting a culturally appropriate, localised diabetes prevention program for young Aboriginal people in a remote town.

Lifestyle changes are central to preventing type 2 diabetes. Embarking upon and sustaining change is challenging, and translation of prevention approaches into a wider range of real-world settings is needed. In this study, a locally adapted community-led diabetes prevention program with local young Aboriginal facilitators was created and trialled through the Derby Aboriginal Health Service (DAHS).

Potentially suboptimal prescribing of medicines for older Aboriginal Australians in remote areas.

Objectives: To investigate the prevalence of polypharmacy, under-prescribing and potentially inappropriate medicine use among Aboriginal Australians living in remote Western Australia.

Design: Cross-sectional study.

Setting: Six remote communities and the town of Derby in the Kimberley, Western Australia.

'It's Important to Make Changes.' Insights about Motivators and Enablers of Healthy Lifestyle Modification from Young Aboriginal Men in Western Australia.

Lifestyle modification can improve the health of people with or at risk of non-communicable diseases; however, initiating and maintaining positive health behaviours including healthy eating and physical activity is challenging. Young remote Aboriginal people who had successfully made significant healthy lifestyle changes were sought out to explore how they achieved this success. Four Aboriginal men aged 20⁻35 years were identified and consented to participate.

Acute kidney injury in Indigenous Australians in the Kimberley: age distribution and associated diagnoses.

Objective: To describe the frequencies of acute kidney injury (AKI) and of associated diagnoses in Indigenous people in a remote Western Australian region.

Design: Retrospective population-based study of AKI events confirmed by changes in serum creatinine levels.

Setting, Participants: Aboriginal and Torres Strait Islander residents of the Kimberley region of Western Australia, aged 15 years or more and without end-stage kidney disease, for whom AKI between 1 June 2009 and 30 May 2016 was confirmed by an acute rise in serum creatinine levels.

Uptake of long-acting, reversible contraception in three remote Aboriginal communities: a population-based study.

Objective: To assess the use, effectiveness and acceptance of prescribed contraception in three remote Western Australian Aboriginal communities.

Participants And Design: Mixed method study, including retrospective file review of contraception methods for 566 regular female Aboriginal patients, 1 November 2010 - 1 September 2014, and semi-structured interviews with 20 Aboriginal women.

Setting: Primary care clinics in three remote Aboriginal communities.

Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia, Prospective Population Based Data Linkage Study.

Background: Indigenous infants (infants aged under 12 months) have the highest hospital admission and emergency department presentation risks in Australia. However, there have been no recent reports comparing hospital utilisation between Indigenous and non-Indigenous infants.

Methods: Our primary objective was to use a large prospective population-based linked dataset to assess the risk of all-cause hospital admission and emergency department presentation in Indigenous compared to non-Indigenous infants in Western Australia (WA).

Rheumatic heart disease in Indigenous children in northern Australia: differences in prevalence and the challenges of screening.

Objectives: To compare regional differences in the prevalence of rheumatic heart disease (RHD) detected by echocardiographic screening in high-risk Indigenous Australian children, and to describe the logistical and other practical challenges of RHD screening.

Design: Cross-sectional screening survey performed between September 2008 and November 2010.

Setting: Thirty-two remote communities in four regions of northern and central Australia.

Using glycated haemoglobin testing to simplify diabetes screening in remote Aboriginal Australian health care settings.

Objectives: To determine whether a combination of point-of-care (POC) and laboratory glycated haemoglobin A (HbA1c) testing (HbA1c algorithm) is more effective in testing for diabetes in everyday practice in remote Australian Aboriginal primary health care, by providing a more rapid definitive result and diagnosing more cases than the standard glucose algorithm.

Design: Cross-sectional study that independently classified participants using both diagnostic algorithms and compared their outcomes.

Participants: Two hundred and fifty-five Aboriginal Australians aged 15 years or more without confirmed diabetes and due for diabetes testing at participating clinics.

Impact of the Rural Clinical School of Western Australia on work location of medical graduates.

Objective: To determine whether completing a year of the Rural Clinical School of Western Australia (RCSWA) program is associated with entering the rural medical workforce.

Design And Setting: Cohort study of graduates from the University of Western Australia who completed Year 5 of medical school between 2002 and 2009, comparing work location (identified from the Australian Health Practitioner Regulation Agency database in March-June 2013) between those who participated in the RCSWA (RCSWA graduates) and those who did not (controls).

Main Outcome Measure: Rural or urban work location of graduates.

Utility of auscultatory screening for detecting rheumatic heart disease in high-risk children in Australia's Northern Territory.

Objectives: To evaluate the utility of auscultatory screening for detecting echocardiographically confirmed rheumatic heart disease (RHD) in high-risk children in the Northern Territory, Australia.

Design: Cross-sectional screening survey.

Setting: Twelve rural and remote communities in the NT between September 2008 and June 2010.

Respiratory symptoms and illness in older Australians: the Burden of Obstructive Lung Disease (BOLD) study.

Objective: To measure the prevalence of chronic obstructive pulmonary disease (COPD) among people aged 40 years or older in Australia.

Design, Setting And Participants: A cross-sectional study of people in the community aged ≥ 40 years, selected at random using electoral rolls, in six sites chosen to reflect the sociodemographic and geographic diversity of Australia, conducted between 2006 and 2010. Standardised questionnaires were administered by interview.