Indigenous Health Assignment

MBBS I

Last updated May 2012 by Mick Draper

Part 1
Discuss one health condition (eg. an illness or an infectious disease in Indigenous children or adults) in which there has been a health improvement and outline some of the key factors which have assisted in this improvement. In your analysis, look at broad-based determinants – e.g. social, economic, political factors, as well as clinical factors

Start by reading
Overview of Australian indigenous health status 2011

You should look at the sections on Selected Health Conditions and the Concluding comments to find health conditions where there have been improvements. Read the literature cited for more detail on particular conditions.

You might also like to read Closing the Gap Prime Minister's Report 2012
But note that this report is aimed at broad topics not particular health conditions

Statistics
To find the Australian Bureau of Statistics online website use Summon on the Library home.

Enter

"australian bureau of statistics" "statistics section"

into Summon for the easiest passage to the part of the ABS site that you need.

Click on the ABS Statistics section link.
This should be the top link that comes up on Summon.

On the next screen you have a couple of possible routes for finding indigenous health stats.
Scroll down to find the Indigenous section under the Popular Statistics heading.

Alternatively click on the Topic button.

Scroll down to find Population/People
Click on Aboriginal and Torres Strait Islander Peoples.

Click on the link to Indigenous Health.

Here you'll find a range of statistics.

To find the actual stats click on the Downloads tab.
The colour of the tab starts off as grey but will change to green when you point at it with your cursor.

Click on the pdf icon.

You'll need to compare stats from different times to see if there is really any significant difference. Warning: Definitions of some diseases might change, and the ability of health workers to make an accurate diagnosis might also change. The way stats are collected and analysed might also vary and will make it harder to compare different years.

Part 2
Chronic kidney disease is one area in which the gap is still great. Discuss the underlying reasons for the disproportionate numbers of Indigenous people with chronic kidney disease, and discuss some approaches (national, states or Northern Territory or local) which have been implemented since the framework was announced, to attempt to reduce the problem.

Searching for Journal Articles
Logic Grids

Write down the concepts that you are looking for.
Underneath each concept write down any synonyms or alternative terms.
You saw this approach in the Library Health Sciences Tutorial

Here the * is the truncation symbol.
A search for aborigin* would find aboriginal OR aboriginality OR aboriginals etc

Are there other terms for chronic kidney disease?

Databases
There are lots of databases that might have useful information.
Below are some simple instructions for using a couple of those that are most likely to be useful.

Informit Health Databases
On the Library home, click on Databases.

Click on Health Sciences.

Scroll down the list of databases on the Health Sciences site and click on Informit Health Databases.

Click in the box next to Health in the blue bar on the next screen.

Click on the continue button.
The search screen of Informit appears.
Now you can enter the terms from your logic grid.

This is an Australian database and most of the articles are about Australian subjects. There shouldn't be any need to include Australia in your searches in this database.

Type in the terms from your first logic grid column into the first search box.
Remember that terms in the same column are joined by or.

Next type the terms from the second column of your logic grid into the second search box.
Type in as many terms as you think are appropriate to your search.
Phrases have to be in double quotes to be searched as a phrase, and can't be truncated.

I limited the search period to 2007 to 2011.

Notice that you can limit your search to Full Text Records Only.

The full text here only applies to the full text that comes as part of the Informit Health databases.
If you don't click in Full Text Records Only you might find more fulltext articles.
You mustn't assume that by clicking in the Full Text Records Only that you will find all the articles for which the Barr Smith Library has full text!

My search found 52 citations (3rd May 2012)

Notice that the first citation doesn't have a link to the full text.
However a few seconds on an internet search engine reveals that the full text document is available at

http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737420068

The second document has a link to full text.
Click on this link if you want to view this doc.

Some of the citations may be duplicates. You are searching several databases.

If you want to make your search more specific, click on the link Add more terms

This is so you can add extra terms such as terms for prevention, control and therapy.

These results will be a subset of the previous search.
If you don't find the sort of articles you want try changing your search terms.

Peer Review
It can be tricky to find out if an article is peer reviewed.
First it's probably not peer reviewed if it's an editorial, a letter, a comment, or a review article.
You'll probably have to find the title of the journal and use an internet search engine to find out if articles submitted to the journal go through a peer review process.

PubMed
The PubMed database finds articles published in higher profile journals.

PubMed is available from the Library Home

Click on the link to the MeSH database.

MeSH stands for Medical Subject Headings.
MeSH are added to most citations of articles in PubMed to describe their topical contents and make them easier to find.
If you can find the MeSH that correspond to the concepts you want to search, then you should find most of the citations in PubMed that are of interest.

The main concepts are Australian aboriginals, and chronic kidney disease.

Try entering the first of these concepts into the MeSH Database search box.
Click on Search.

The MeSH database claims to know nothing about Australian Aboriginals but takes you to the MeSH Oceanic Ancestry Group.

While this subject heading will work, it also includes people groups other than Australian Aboriginals.
Nevertheless we want to incorporate this subject heading into our search.
Click in the Add to search builder box on the right of the screen.

The subject heading appears in the PubMed search builder.

Now we have to restrict the search to Australia instead of all the Oceanic groups.
Clear the MeSH search box and type australia.
Click on Search.

Click in the box to the left of the subject heading Australia.

Click on Add to search builder.
Now you have both terms included in the search builder.

Now search for chronic kidney disease in the MeSH Search box.

Click on the Add to Search Builder button.
Now you should have 3 search terms in the search builder.
Click on the Search PubMed button.

Your results will appear.
In May 2012 this search found 62 citations.

Click on the Display Settings link or the down arrow to its right.
Click in the radio button to the left of Abstract, but not Abstract (text).
Click on the Apply button.

Most of the citations will now appear with abstracts, and many of them will have Uni of Adelaide Online icons.
Click on a Uni of Adelaide icon to read the full text of the article.

If there isn't a Uni of Adelaide online icon and you really want to look at the article contact me.

To find similar citations to the one you are looking at click on the Related citations link.

This will usually find about 100+ citations that PubMed thinks are similar to the one found by your search.

What about Prevention or Control?

In PubMed when you get to the point where you are adding kidney failure, chronic to the PubMed Search Builder, click in the box to the left of prevention and control (and/or any of the other subheadings you want to search).

Click on Add to search builder.

Now PubMed will search for article citations that have the subject heading Kidney Failure, Chronic but only if they also have the subheading prevention and control.
Click on Search PubMed to see the results of your search.

This time there will be fewer citations.

Summon (on the Library home)

Go back to your logic grid and look at the terms you have there in light of what you have found already.

You might like to add terms for aspects of the search you haven't yet found that relate to the social problems that are involved.
You can probably think of more terms than I've included in my grid below.

From the logic grid you can generate a Summon search like the one below, remembering to keep terms that you OR together inside round brackets

australia* AND (aborigin* OR indigenous) AND ("chronic kidney disease" OR "end stage kidney disease" OR "chronic kidney failure" OR "chronic renal disease" OR "chronic renal failure") AND (barrier* OR access* OR attitude* OR inequ*)

Remember you can use the boxes and other tools on the left of the result screen to reduce the number of items found.

Please feel free to contact me if you are having trouble with any part of this assignment.