Looking back in time: conducting a cohort study of the long-term effects of treatment of adolescent tall girls with synthetic hormones.

Objective: Public health research is an endeavour that often involves multiple relationships, far-reaching collaborations, divergent expectations and various outcomes. Using the Tall Girls Study as a case study, this paper will present and discuss a number of methodological, ethical and legal challenges that have implications for other public health research.

Approach: The Tall Girls Study was the first study to examine the long-term health and psychosocial effects of oestrogen treatment for tall stature.

Successful chronic disease care for Aboriginal Australians requires cultural competence.

Objective: To review the literature to determine the attributes of culturally appropriate healthcare to inform the design of chronic disease management (CDM) models for Aboriginal patients in urban general practice.

Methods: A comprehensive conceptual framework, drawing on the Access to Care, Pathway to Care, Chronic Care, Level of Connectedness, and Cultural Security, Cultural Competency and Cultural Respect models, was developed to define the search strategy, inclusion criteria and appraisal methods for the literature review. Selected papers were reviewed in detail if they examined a chronic disease intervention for an Aboriginal population and reported on its evaluation, impacts or outcomes.

The medicalisation of 'tall' girls: A discourse analysis of medical literature on the use of synthetic oestrogen to reduce female height.

Endocrine research in the 1930s increased and extended the use of sex hormones as medical therapies in an unprecedented way, especially for female ailments. In the 1950s the therapeutic use of sex hormones extended to the treatment of 'tall' girls. Ambiguity in the definition of the 'tall' girl, the arbitrary nature of the treatment decision, and diversity in the therapeutic regimes highlight the problematic nature of this medical practice.

Barriers and facilitators to the utilization of adult mental health services by Australia's Indigenous people: seeking a way forward.

Mental disorders are the second leading cause of disease burden among Australia's Indigenous people after cardiovascular disease. Yet Indigenous people do not access mental health services in proportion to their need. This paper explores the barriers and facilitators for Indigenous people seeking mental health services in Australia and identifies key elements in the development and maintenance of partnerships for improved service delivery and future research.

Was it good for you too? Impediments to conducting university-based collaborative research with communities experiencing disadvantage.

Objective: Collaborative and participatory research (CPR) models are increasingly recognised as methodologically, ethically and practically appropriate to conducting health and welfare research involving disadvantaged communities. This paper identifies impediments to CPR and proposes measures to support and encourage future CPR in Australian universities.

Methods: This paper draws on a small qualitative study of university-based CPR projects in Melbourne.

Engaging with Aboriginal communities in an urban context: some practical suggestions for public health researchers.

Objective: In this paper, one Indigenous and two non-Indigenous public health researchers reflect on our combined experience of over thirty years in Aboriginal health, in order to develop some practical guidelines, particularly for researchers working with urban Indigenous population groups.

Approach: Public health research is important not only to address the health inequities experienced by Australia's Indigenous populations, but also to build knowledge and confidence and to inform practice in Aboriginal community-controlled health organisations. Ethical guidelines and previous research experience demonstrate that researchers need to engage with the communities that may be involved in or affected by the research they propose.

Challenging our own practices in Indigenous health promotion and research.

At the 2006 National Conference of the Australian Health Promotion, Māori academic and public health physician Dr Papaarangi Reid challenged us to critique our own practice and asked whether health promotion needs to be de-colonised. In this paper, one Indigenous and two non-Indigenous researchers working within the Aboriginal community controlled health sector reflect on ways in which research and health promotion interventions with Indigenous populations challenge or reinforce the very values that have led to the disadvantage, neglect and apathy experienced by Indigenous populations in the first place. While our practice is framed by the principles of Aboriginal self-determination and community control, we suggest that de-colonising is not so much about the need to invent new research methods nor to search for research methods in traditional Aboriginal culture; it is much more about values, processes and relationships.

Oestrogen treatment for tall stature in girls: estimating the effect on height and the error in height prediction.

Objective: To determine the effect of oestrogen treatment on attenuating the growth of tall girls after adjusting for error in height prediction.

Design: Retrospective cohort study.

Patients: Tall girls assessed by Australian paediatric endocrinologists between 1959 and 1993.

Concern about tall stature during adolescence and depression in later life.

Objective: This retrospective cohort study aimed to examine the long-term psychosocial outcomes for women assessed or treated during adolescence for tall stature.

Method: Women assessed or treated for tall stature identified from the records of Australian paediatricians were eligible to participate. Psychosocial outcomes were measured using the depression, mania and eating disorders modules of the Composite International Diagnostic Interview (CIDI), the SF-36, and an index of social support.

Towards reconciliation in Indigenous health research: the responsibilities of the non-Indigenous researcher.

This paper discusses the benefits of a collaborative participatory approach to Indigenous health research and the responsibilities of the non-Indigenous researcher. Principles to guide non-Indigenous researchers and to facilitate the empowerment of Indigenous Communities are outlined. These include: accountability to the Indigenous Community; the cultural safety of Indigenous participants; and establishing a meaningful role for Indigenous co-workers.

Using hormone treatment to reduce the adult height of tall girls: are women satisfied with the decision in later years?

Treatment with synthetic oestrogens to reduce adult height has been available for tall girls since the 1950s. Treatment aims to reduce psychosocial problems associated with tall stature that might occur in adolescence or adulthood, but little is known about the long-term outcomes. This retrospective cohort study identified 1248 eligible women from the medical records of Australian paediatricians who assessed or treated tall girls between 1959 and 1993, and 184 women from self-referrals.

Oestrogen treatment to reduce the adult height of tall girls: long-term effects on fertility.

Background: Treatment with oestrogen to reduce the adult height of tall girls has been available since the 1950s. We undertook a retrospective cohort study to assess the long-term effects of this treatment on fertility.

Methods: Eligible participants were identified from the records of Australian paediatric endocrinologists who assessed tall girls from 1959 to 1993, and from self-referrals.

A commentary on the NH&MRC Draft Values and Ethics in Aboriginal and Torres Strait Islander Health Research.

In this paper, we discuss and critically evaluate the National Health and Medical Research Council's recently released document entitled 'Draft Values and Ethics in Aboriginal and Torres Strait Islander Health Research'. We provide a brief account of its development, philosophy and contents, and then consider how the document could be used by HRECs. We recommend that three specially targeted documents be developed from this one document, to meet the particular needs of HRECs, Indigenous people and researchers.

Validation of qualitative research in the "real world".

In this article, the author takes up the debate about the usefulness of the concept of validity in qualitative research and acknowledges the critical role of the researcher as an "instrument" in the research process. Qualitative research, and the process of analysis in particular, involves continuous reflexivity and self-scrutiny. Balancing the need for creativity and rigor, the qualitative researcher can experience uncertainty, particularly in relation to small numbers.

Working together to reduce health inequalities: reflections on a collaborative participatory approach to health research.

With mounting evidence that health problems are related to social inequalities, health researchers increasingly need to engage with disadvantaged and marginalised groups. These groups can present specific challenges to conventional research method. This paper reflects on the need for health researchers to meet these challenges in order to gain a deeper understanding of the ways in which social disadvantage affects people's health, and to develop appropriate interventions for those groups.