Cancer among Indigenous Australians: time for decisive action. Cancers in Indigenous people are largely preventable.
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Australia↗
Biomedical subjects
N J Thomson
Publications and source records attributed to N J Thomson.
Psychiatric presentations to primary care.
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Family Practice↗
Sudden death due to ischaemic heart disease in young aboriginal sportsmen in the Northern Territory, 1982-1996.
OBJECTIVE: To estimate the incidence of sport-related sudden cardiac death due to ischaemic heart disease (IHD) in competitive young Aboriginal sportsmen. SETTING: Northern Territory (NT), 1982-1996. DESIGN: Retrospective case series with cases identified from Australian Bureau of Statistics cause-of-death listings and NT coronial autopsy records. MAIN OUTCOME MEASURES: Circumstances and incidence of sport-related sudden cardiac deaths due to IHD; autopsy findings. RESULTS: Between 1982 and 1996, there were eight sudden cardiac deaths due to IHD and related to sporting activity among Aboriginal sportsmen aged 15-37 years in the NT. Six were associated with games of Australian (rules) football. All occurred in the Top End of the NT in the wet season, and all occurred after the first half, or within an hour of, a game. Four of the players had macrosopic myocardial abnormalities (hypertrophy or previous infarcts) on autopsy. The estimated incidence of IHD-related sudden cardiac death among Aboriginal Australian football players in the NT was 19-24 per 100,000 player-years, compared with 0.54 per 100,000 player-years among Australian rules footballers of similar ages in Victoria. CONCLUSIONS: Incidence of sudden cardiac death attributable to underlying IHD was extremely high among young NT Aboriginal Australian footballers. Prevention will best be achieved by funding culturally appropriate long-term strategies to reduce the incidence of IHD. However, in the short-term, community-controlled programs with education of athletes, heat-stress reduction strategies, and cardiovascular screening should reduce the incidence of sudden cardiac death in sport.
Adult↗
The impact of tobacco smoking and alcohol consumption on aboriginal mortality in Western Australia, 1989-1991.
OBJECTIVES: To compare the estimated death rates associated with alcohol and tobacco use for Australian Aboriginals in Western Australia with those for non-Aboriginals. METHOD: Deaths attributable to tobacco smoking and alcohol consumption were estimated for 1989-1991 with the aetiological fractions method, using data from the Health Department of Western Australia's mortality database. RESULTS: Tobacco smoking was responsible for 15.4% of all deaths and 13.9% of Aboriginal deaths, and alcohol consumption for 5% and 9.2%, respectively. The age-standardised death rates per 100,000 person-years for tobacco and alcohol were: Aboriginal males, 271 and 152; other males, 113 and 29; Aboriginal females, 118 and 56; and other females, 32 and 15. Of those who died as a result of tobacco use, 49% of Aboriginal males and 48% of Aboriginal females died before 55 years of age, compared with 11% and 10%, respectively, in non-Aboriginal males. For alcohol-related deaths, 62% of Aboriginal males and 70% of Aboriginal females died before 55 years of age, compared with 35% and 23%, respectively, in non-Aboriginals. CONCLUSION: During 1989-1991 tobacco smoking and alcohol consumption were responsible for much higher death rates among Aboriginals than among non-Aboriginals in Western Australia.
Adult↗
Australian deaths in custody, 1980-1989. 1. Relative risks of aborigines and non-aborigines.
OBJECTIVE: To assess the risks of death in police or prison custody in Australia for Aborigines and non-Aborigines. DESIGN, SETTING AND PARTICIPANTS: Retrospective collection and analysis of data about deaths occurring in police or prison custody in Australia in the 10-year period 1980-1989. RESULTS: For the period 1980-1989, Aboriginal and non-Aboriginal people in prison had risks of death similar to those of the total Australian population, but the risks of death in police custody for both Aborigines and non-Aborigines were between 10 and 20 times the risks of death experienced by the general population. Within each type of custody, there were no significant differences in the risks of death experienced by Aboriginal and non-Aboriginal people. CONCLUSION: Although some deaths in custody are inevitable, the very much higher risks of death in police custody for both Aborigines and non-Aborigines has implications for custodial authorities in terms of preventive and remedial action. Reduction of the excess of Aboriginal over non-Aboriginal deaths in police and prison custody relative to general population figures requires action to reduce the over-representation of Aboriginal people in custody and to improve the general well-being and health status of Aboriginal people in the community.
Adolescent↗
Australian deaths in custody, 1980-1989. 2. Causes.
OBJECTIVE: To assess the causes of death for people in police or prison custody in Australia, with particular attention to the differences between Aboriginal and non-Aboriginal deaths. DESIGN, SETTING AND PARTICIPANTS: Retrospective collection and analysis of data about deaths occurring in police or prison custody in Australia in the 10-year period 1980-1989. RESULTS: In the period 1980-1989, 527 deaths are known to have occurred in police or prison custody. About half these deaths were due to self-harmful behaviour, including hanging. The next most frequent causes of death were diseases of the circulatory system, injuries and diseases of the respiratory system. CONCLUSION: The high number of deaths in custody resulting from self-harmful behaviour has important implications for the criminal justice and corrections systems. Minimisation of the number of people held in police and prison custody is important in preventing such deaths. Close attention needs to be paid to ensuring the safety of lock-ups and prisons and to the screening of people likely to be at risk of death from self-harmful behaviour. Custodial authorities have a clear responsibility to provide quality preventive and clinical health services to all people in custody. Special attention needs to be directed to the specific health needs of Aborigines, many of whom are at much greater health risk than are non-Aborigines.
Australia↗
Recent trends in aboriginal mortality.
Mortality is an important measure of the extent of the health disadvantages experienced by Australia's Aborigines. In the absence of routinely available data on Aboriginal deaths, this paper has collated information from a number of sources. In addition to published reports and theses, it also includes unpublished data provided to the Australian Institute of Health by State and Territory health authorities. The review also draws on data on maternal deaths, collated on a triennial basis and published by the National Health and Medical Research Council. Despite improvements in some indices of mortality, the death rates of Aborigines, particularly for young and middle-aged adults, are unacceptably higher than those of non-Aboriginal Australians. Without substantial reductions in death rates, the expectation of life of Aborigines will remain comparable with that of people living in developing countries.
Australia↗
Bromhexine in the treatment of otitis media with effusion.
In a double blind randomised trial of 95 children aged 3-8 years with otitis media with effusion (OME), the efficacy of the mucolytic agent bromhexine hydrochloride (Bisolvon) was compared with a placebo. Each child received two 4 week courses of either bromhexine or placebo in a random fashion. One hundred and ninety ears were available for analysis, i.e. 380 'ear treatments'. There were 198 ears in the placebo group and 182 ears in the bromhexine group. The resolution rate in the placebo treated group was 19% and in the bromhexine treated group 16%. Bromhexine does not appear to be a useful drug for the treatment of OME in children.
Bromhexine↗