Uncharted Territory Conference Wrap Up · Uncharted Territory Conference Wrap Up Meredith Neilson...

The Chronicle May 2003 1

Volume 6 , Issue 7

May 2003 Ci rcula t ion 850

Uncharted Territory Conference Wrap Up Meredith Neilson The 7th Annual Chronic Disease Network Workshop was bigger than ever this year! A truly collaborative event, the Network combined with several other Department of Health programs – Alcohol and Other Drugs, Health Promotion and Mental Health, as well as the Cooperative Research Centre for Aboriginal and Tropical Health (CRCATH), Australian Health Promotion Association and the General Practice

Divisions of the N o r t h e r n Territory. The focus of the “Uncharted T e r r i t o r y ” Conference was to explore the links between chronic disease, mental health, and alcohol and other drugs.

The Conference resulted in hours of intense discussion, thought provocation, and fruitful sharing of ideas and experiences. Media interest was high with stories from the Conference presented on both television and radio forums. What happened? A larger number of participants than ever attended at approximately 230 people per day. Inspiring keynote speakers, in particular, Tracey Westerman, Professor Ian Hickie, Professor George Patton, Dr Malcolm Battersby and the Hon Marion Scrymgour commenced each day of the three day program. The concurrent abstract sessions enabled local and inter-state speakers an opportunity to demonstrate their projects and outcomes in the area of co-morbidity, provoking comments such as “fantastic diversity of material”, and “great practical value”. A highlight of the Conference for many participants was the Workshop sessions on Saturday. The Indigenous Yarning session facilitated by Lyn

(Continued on page 2)

Attendees Glen Norris and Jane Puantjimi

The May 2003 edition of the Chronicle has a focus on health centres and programs occurring in the Alice Springs region. Central Australians have a range of services available with dynamic projects occurring at many centres including the Centre for Remote Health and Tangentyere Council. The Chronicle visits the Alice Springs

Community Health Centre, hears from Trish Morrow at the Centre for Appropriate Technology, and discusses the Community Perception of Injury with Jeff Hulcombe. What’s the agenda for the 38th CARPA Conference and what’s the Male Healthy Lifestyle Forum? Read on.

STORIES FROM THE SOUTH

A Focus on Alice Springs What’s Happening Where you work?

Your story is

valuable too. Why not share it?

Contact the Chronic

Diseases Network


THE CHRONICLE EDITOR: Meredith Neilson, Chronic Diseases & Injury Prevention Project Officer DEPARTMENT OF HEALTH & COMMUNITY SERVICES PO BOX 40596 CASUARINA NT 0811 PHONE: (08) 89228280 FAX: (08) 89228310 E-MAIL: [email protected] Contributions appearing in The Chronicle do not necessarily reflect the views of the editor or DHCS. Contributions are consistent with the aims of the Chronic Diseases Network and are intended to : • Inform and stimulate thought and action; • encourage discussion and comment; • promote communication, co-ordination and collaboration.

Uncharted Territory Conference Wrap Up 1-3

Food Chemicals and Asthma 1-8

What’s Happening at Alice Springs Community Health Centre? 4-5

Benchtops May be Linked to Chronic Disease 6

Lifesavers in Remote Communities 9

Health Prmoting Schools Grants 10

What is the Community Perception of Injury? 10-12

New Group Sessions in Evenings at Palmerston 12

“Stress” and Coronary Heart Disease: Psychosocial Factors 13

38th CARPA Conference Draft 14-15

Healthy Families, Healthy Men 15-16

What goes on at Darwin Withdrawal Services? 17

Healthy Living NT Alice Springs Branch Opening 17

Fit Kids 19

Snapshots for the Uncharted Territory Conference 20

Inside this issue:

(Continued from page 1) O’Donoghue was extremely well received with many requesting more of these sessions in future Chronic Disease Network Workshops. Many also enjoyed the session on “Existentialism, Optimism and Addiction” by Chris Wurm which offered an alternative approach to the Conference focus. Comments Despite many comments on the lower than standard room temperature, the Committee received an abundance of positive feedback. “Indigenous speakers with innovative ideas, intelligently and powerfully expressed”, “I think the Chronic Disease Network is improving every year”, “tremendous goodwill and friendliness”, were some of the comments received. Other comments included altering the Panel Discussion to a debate between Panel experts, conducting region-based discussions, a request for more Indigenous speakers, fewer concurrent sessions, and larger plate sizes for lunch! All will be considered for the next Workshop. Thankyou A big thankyou to all who helped organise the Conference for your tireless efforts, in particular – Bev Hayhurst, Lanny Hoskin, Alby Sullivan, Bronwyn Russell, Janine Weston, Jeanette Boland, Justine Glover, Paula Convery, David Moorcroft, Marie Hughes, Michel Burgum. Also the Program Sub-Committee, in particular Anthea Duquemin, Christine Connors, Michael Smith, and Yin Paradies who produced the “stimulating and high quality” program content. Top End Sounds provided a professional and excellent service considering the high number of presenters. Thanks also to Peter Thomsen from Menzies School of Health Research for videotaping the Keynote Speakers presentations.

(Continued on page 3) Attendees at their Display

The Chronicle ONLINE www.nt.gov.au/health/cdc/preventable/

chronicle If you would prefer to receive The Chronicle on-

line, please contact Meredith on 8922 8280 or Email: [email protected]


Sue Dengate is a Darwin based food intolerance counsellor who is well respected world-wide. She became interested in asthma through her work on dietary management of children's behaviour problems. Sue's meticulous research into the effects of food intolerance on children's health and behaviour has resulted in the publication of four bestselling books on the topic. Her most recent publication “Fed up with Asthma” was written in collaboration with Asthma NT. Sue Dengate According to the prevailing wisdom, food chemicals are a rare trigger of asthma. In the course of their treatment, asthmatics may be asked if they have noticed any foods which affect their asthma. If so, they may be invited to undergo food additive challenge testing. Otherwise, it is assumed that their asthma is not related to foods. However, observations during my work with difficult children suggested that food chemicals may be more commonly associated with asthma than is currently thought. When families undertake a low chemical elimination diet for a child's behaviour problems, I noticed that any asthmatics in the family are likely to improve. This was despite initial parental claims such as 'his asthma isn't related to foods. He only gets it after he has a cold'. Why don't asthmatics notice the

connection between their asthma and foods? When thousands of asthmatics were tested for the effects of food chemicals at Duke University Medical Centre, researchers found that the majority had not seen a connection. 'Exposure to [food chemicals] is sufficiently frequent to mask any relationship between

i n g e s t i o n a n d s y m p t o m s i n susceptible people,' concluded researchers Elizabeth Corder and C. Edward Buckley III. Their research was published in the Journal of Clinical

Epidemiology in 1995. Sulphites (preservatives 220-228) are widely acknowledged as the food additives most likely to affect asthmatics. Drs Corder and Buckley identified two groups of sulphite-sensitive asthmatics. • A small group of very sulphite-

sensitive asthmatics. They see a connection between foods and their asthma because they react quickly, often within 15 minutes of ingesting sulphites. This group will choose to avoid sulphite-containing foods, drinks and medications.

• The second - and much larger -

group of asthmatics are less sensitive to sulphites. They will not have an obvious reaction to a single exposure. In this group, repeated exposure to sulphites w i l l c a u s e s u b c l i n i c a l

inflammation of the lungs. This group may develop chronically inflamed lungs over the long term and are at greater risk of lung function impairment because they are unaware of the effects of sulphites and therefore do not choose to avoid them.

When asthmatics with inflamed l u n g s a re e x p osed to an environmental trigger such as a virus or pollen, the result may be asthma for which the trigger will be blamed. However, these patients can avoid lung inflammation by avoiding sulphites and subsequent exposure to the trigger will not result in asthma. How many asthmatics are

affected by sulphites? T h e U S F o o d a n d Dr u g Administration estimates that about 5 per cent of asthmatics are sensitive to sulphites. This low figure probably represents the group of very sulphite sensitive


Food Chemicals and Asthma

(Continued from page 2) Available The next edition of the Chronicle will feature a report on the major outcomes from the Small Group work. A list of registrants and their addresses is available, as well as copies of Speakers Presentations

which can be sent via email. The video of the Keynote Speakers presentations will also be available to borrow in the near future. Please contact us if you are interested in receiving any of this material on Email: Meredith.

[email protected] or call on 08 8922 8280. For more photos of the Conference see the back page!

Author: Sue Dengate

“Over 70% were shown to react to

the sulphite challenge”


Emma Corcoran (Community Nurse) and Peg Garner (client)

What’s Happening at Alice Springs Community Health Centre?

FALLS PREVENTION EXERCISE PROGRAM

Adolescent and Adult Health Unit

The Community Health Nurses and Allied Health staff at the Community Health Centre in Alice Springs have developed a Falls Prevention and Exercise Program. The program was formulated following examination of the recent literature describing the benefits of exercise for reducing the rate and impact of falls in the elderly. The program was conceived in 2001 and has now been developed to the pilot stage by Emma Corcoran (Community Health Nurse) and Karen Van de Hoef (Occupational Therapist). The pilot program will assess, manage and evaluate ten clients and, if successful, then be incorporated into the Adolescent and Adult Health Service. What does the program involve? Clients who are currently accessing Community Health Services are offered the 6 week Falls Prevention and Exercise Program. The program targets people aged 65 and over who live alone at home. The steps involved in the program are: 1. Assessment

• Home environment • Falls history • Medication and health review

2. Baseline Measures • Postural control tests including ‘timed single

leg standing balance’, ‘timed unsupported steady standing’ and ‘timed get up and go’

• Attitudes to falling

3. Intervention • Education for clients about fall prevention

techniques, modifying the home environment, how to get off the floor

• Simple three point exercise program for strengthening the lower limbs

• Exercise program recorded in a diary • Follow-up visits by staff

4. Post Exercise Review • Postural control tests repeated

(quantitative data) • Attitudes to falling reviewed (qualitative

data)

5. Evaluation Benefits Emma and Karen report that early findings from the program support the results found in the falls prevention literature with clients reporting increase in balance, self reported reduced depression rates, improved environmental conditions, greater self-confidence, and improved independence. For more details on the program contact Emma Corcoran on 89516744, or email [email protected]

Alice Springs Community Health Centre offers many services to Central Australians. The following is a sample of their current programs and activities.


AWARD WINNING Maternal and Child Health Unit

According to Josie Probin the Maternal and Child Health unit has a very strong Primary Health Care focus. The unit has a keen interest and emphasis on education and health promotion, particularly for post-natal women. Current programs include the Family and Baby (FAB) Program, Toddler Topics, Breastfeeding discussions, Introduction to Solids and Settling and Sleep Management. The programs are a collaborative approach involving a multidisciplinary team including a physiotherapist, occupational therapist, nutritionist, and registered nurses. Josie reports that “you can really see the difference in parents” following completion of these programs. Congratulations to the Maternal and Child Health team who also recently received the National Immunisation Award for Recognition of Significant Achievement by a Public Immunisation Provider in the Northern Territory. For further details contact Josie Probin on 8951 6711, or Email: [email protected]

Anna Lennie, physiotherapist for the Aged and Disability Services, has a multifactoral approach to her role in the management of chronic conditions. Much of Anna’s work involves health promotion through education, exercise classes, as well as individual physiotherapy case management. In an effort to reduce the impact of chronic conditions such as obesity, diabetes, and immobility, Anna conducts regular exercise classes. These include classes at the Irrkerlantye Indigenous Learning Facility which is a joint initiative of the Community Health Centre and Amoonguna Community. Anna is also about to commence classes at the Alice Springs Hospital in

conjuction with the Old Timers Nursing Home, the Alice Springs Hospital Rehabilitation Unit, Central Australian Aboriginal Congress (Congress), and the Community Health Nurses to assist with chronic disease management. Anna reports that her classes are gaining in popularity and hopes that they will encourage a healthy lifestyle in this at risk group. Amongst her other roles in a job offering marked variability, Anna has a regular physiotherapy clinic at Congress, a women’s health workshop for education on pelvic

floor problems, and attends individual patients at town camps and Alice Springs urban areas. For further details contact Anna on 8951 6744 or Email [email protected]

GET MOVING WITH PHYSIOTHERAPY Adult and Adolescent Health Team

Renal Dialysis Unit

Andrea Rolfe, Manager of the Renal Dialysis Unit, presides over a busy team at the Community Health Centre. Currently the team tends to 80 people on haemodialysis three times per week, and 21 on peritoneal dialysis. Andrea reports a marked increase in peritoneal dialysis in comparison to haemodialysis, over the past 18 months. Peritoneal dialysis is a more manageable means of dialysis in a home or community environment. Home Haemodialysis for patients is a major aim for the unit, however a limit in resources and staff has hampered this process. August 2002 saw the opening of a renal clinic in Tennant Creek allowing three patients to return to their community. Three more patients will be accommodated in Tennant Creek in June of this year. Currently the team is working on developing culturally appropriate educational tools. They also provide both urban and remote services including education to both patients and community based staff. For further details contact Andrea Rolfe on 8951 6750, or email: [email protected]

Alice Springs Community Health Centre

Exercise Class with Anna Lennie


Trish Morrow, Technology Researcher/Analyst, Centre for Appropriate Technology Late last year a staff member from the Centre for Appropriate Technology (CAT) was visiting a remote Indigenous community and discovered that galvanised iron was being used for benchtops in indoor kitchens. CAT staff have previously seen galvanised iron being used for b e n c h t op s i n t h e Ana n g u Pitjantjatjara lands of South Australia, where it was found that zinc was flaking off the benchtop surface (1), resulting in possible contamination of food. After carrying out a review of the literature, CAT researchers have found that there is some potential for adverse health effects resulting from the use of galvanised iron for food preparation areas. A material safety data sheet (2) obtained from the manufac tu r e r , r evea l s t ha t galvanised steel contains between 1 and 20% zinc, as well as small amounts of aluminium, iron, and lead, which can cause or exacerbate chronic diseases such as cancer, heart disease or respiratory illness. Toxic Metals When galvanised iron comes into contact with acidic foodstuffs, stibine gas may be formed (3) w h i c h c a n c a u s e haemoglobinaemia, laboured breathing, weak and irregular pulse, weakness, nausea and headaches (4). Aluminium does not usually have a pronounced effect on normal

healthy individuals, however people who are prone to kidney failure may suffer from toxic effects. There have also been claims that aluminium ingestion is a risk factor for Alzheimer’s disease (8). Lead affects the central nervous system, blood and kidneys (9). Children are particularly susceptible a n d ma y b e a f f e c t ed b y developmental difficulties, reduced intelligence and hearing loss.

Zinc Ingestion of high levels of zinc over long periods of time can lead to pancreas damage, anaemia, abnormal cholesterol levels, and heart problems (5+7). Short term exposure to zinc can cause vomiting, nausea and

stomach cramps (6). Depending on the quality of the galvanising process, galvanised steel may corrode and crack and flakes of zinc may peel away from the surface (10+11). The zinc coating’s ability to withstand corrosion is a f fec ted by i t s thickness (12), as well as plating operations such as cleaning and degreasing. A study of materials for ecotourist accommodation (13) comments that zinc coatings tend to dissipate into the environment. It is this flaking of zinc from the galvanising layer that poses a health risk to the residents of

remote communities. The Council of Europe’s Policy Statements Concerning Materials and Articles Intended to Come into Contact with Foodstuffs (14) have noted that high levels of zinc increase an individual’s cancer risk, as well as commenting that galvanised containers holding acidic foods or drinks (15) have resulted in zinc poisoning (16). They state quite unequivocally, “Zinc should not be used in contact with wet or humid acidic foodstuffs.”

Many foods eaten by people in remote communities, such as emu, camel, beef, fish, kidneys, oysters and seafood, mutton and lamb, may contain high levels of zinc or lead(17+18), regardless of what type of kitchen benchtop surface is used for their preparation. Preparing them on a galvanised iron benchtop could cause these high levels to rise further. Many remote communities in the Northern Territory have corrosive water (19) which can easily


BENCHTOPS MAY BE LINKED TO ILL HEALTH

CATs outside kitchen benchtop that does not use galvanised iron.

“there is some potential for

adverse health effects resulting from the use of

galvanised iron for food preparation

areas”.


(Continued from page 6) dissolve galvanised coatings (20). Zinc or galvanised steel should therefore not be used in the wet areas of houses such as kitchens. Recommendation Considering the likelihood of corrosion of galvanised steel kitchen benchtops, the fact that many foods commonly eaten by Indigenous people are already high in zinc and that zinc is known to be toxic, the Centre for Appropriate Technology recommends that the use of galvanised iron is not specified for use in benchtops and should not be used as a material on which food preparation is undertaken. REFERENCES: 1. Benjamin, Ian, personal communication, November 2002. 2. Williams, Scott, BHP, personal fax communication, 23 January 2003. 3. Williams, Scott, BHP, personal fax communication, 23 January 2003. 4. URL: http://www.ilo.org/public/english/protection/safework/cis/products/icsc/dtasht/_icsc07/icsc0776.pdf Stibine Material Safety Data Sheet 5. URL: http://www.unsystem.org/scn/Publications/scnnews/scnnews21.pdf United Nations Sub-Committee on Nutrition, Nutrition and the Environment, Number 21, December 2000. 6. URL: http://www.atsdr.cdc.gov/tfacts60.html ATSDR: ToxFAQs: Zinc 7. URL:http://www.epa.gov/iris/subst/0426.htm USEPA Integrated Risk Information System – Zinc and Compounds 8. URL: http://www.alfed.org.uk/health.htm ALFED Health Factsheet 9. URL: http://www.tec.nccnsw.org.au/member/tec/projects/tcye/detail/Household/Lead_healt_38.html Lead: Health Effects and Sources of Exposure 10. URL: www.key-to-metals.com/ViewArticle.asp?ID=40 Key to Metals Article – Corrosion of Zinc 11. URL: http://www.matcoinc.com/tech/failureanalysis1.php Some Failure Analysis Case Histories in Galvanised Steel Products – Abstract 12. URL: http://www.finishing.com/3000-3199/3170.html

Galvanizing thickness/coating relationship 13. URL: http://twinshare.crctourism.com.au/metals.htm Twinshare: Tourism accomodation and the environment 14. URL: http://www.coe.fr/soc-sp/sante/pack/metals.zip Council of Europe’s Policy Statements Concerning Materials and Articles Intended to Come into Contact with Foodstuffs – Technical Document – Guidelines on Metals and Alloys used as Food Contact Materials 15. Elinder, c. –G. (1986) Zinc. In: Friberg, L., Nordberg, G.F., Vouk, V.B. Handbook on the toxicology of metals. Second edition. Elsevier, Amnsterdam, New York, Oxford, cited in URL: http://www.coe.fr/soc-sp/sante/pack/metals.zip Council of Europe’s Policy Statements Concerning Materials and Articles Intended to Come into Contact with Foodstuffs – Technical Document – Guidelines on Metals and Alloys used as Food Contact Materials 16. Beliles, R.P. (1994). The metals. In: Patty’s Industrial Hygiene and Toxicology, Fourth edition, Volume 2, Part C. Edited by Clayton, G. D., and Clayton, F.E. John Wiley & Sons, Inc. cited in URL: http://www.coe.fr/soc-sp/sante/pack/metals.zip Council of Europe’s Policy Statements Concerning Materials and Articles Intended to Come into Contact with Foodstuffs – Technical Document – Guidelines on Metals and Alloys used as Food Contact Materials 17. URL: http://www.affa.gov.au/corporate.docs/publications/pdf/product_integrity/residues/spmetal4.pdf Australian National Residue Survey Metals in Meat Survey, 1997 18. URL:http://www.affa.gov.au/corporate_docs/publications/pdf/product_integrity/residues/nrsres0102.pdf Report on the Australian National Residue Survey Results 2001-2002 19. URL: http://www.nt.gov.au/health/healthdev/environ_health/eh_standards/Environmental_Health_Standards_Remote_NT.pdf Environmental Health Standards for Remote Communities in the Northern Territory 20. URL: http://www.moh.govt.nz/moh.nsf/Files/pvol4no11/$file/pvol4no11.pdf The New Zealand Public Health Report Volume 4 No. 11/12 For further information please contact Trish on: 08 8951 4337 or email [email protected]

6th APS NT Branch Annual Conference Provisional Notice

“Anxiety – Psychology Making a Difference”

1 – 2 August 2003

Darwin, Northern Territory

Keynote Speaker : Michael D. Yapko, Ph.D.

For further information at this time contact :

Dianne Mayo by email : [email protected]

Capacity Building in Indigenous Communities Workshops

Presented by the Aboriginal Resource and

Development Services Inc

Topics include: Communication Across Cultures, The

Importance of Language, Understanding World-view, Traditional Law and Politics

9-10 September, Darwin

Contact Alice on 8987 3910 or Email: [email protected]


(Continued from page 3) asthmatics identified in the Duke University research, above. Standard challenge testing is likely to miss the much larger second group of sulphite responders, as demonstrated in a sophisticated study at Sydney's Royal Prince Alfred Hospi tal and published in Thorax in 1996. The study compared standard challenge testing with a protocol in which challenge testing was preceded by the use of a comprehensive elimination diet. Using the standard method (no elimination diet), only 20 per cent of asthmatic patients were identified as sulphite-sensitive, but when the elimination diet method was used with the same patients, over 70 per cent were shown to react to the sulphite challenge. Similarly, a study published in Pediatrics in 1984 used a comprehensive elimination diet with children who were selected for the severity of their asthma. More than 65 per cent of the children were found to react to sulphites. Should asthmatics be advised to avoid sulphites? This strategy is unlikely to be successful for two reasons: • Avoiding all sulphites in foods

and medications is not easy. For young children, cordial, sausages, instant mashed potato and dried fruit including fruit and muesli bars are common - but not the only - sources of sulphites. Although the use of sulphites in minced meat is illegal in Australia, a small Food Intolerance Network survey of butchers in the Northern Territory found 3 butchers out of 4 admitted to using preservatives in their mince. Furthermore, one of the butchers will supply sulphite-free mince if you phone and place your order the day before

it is required. Duke University researchers complained about the abundance of small amounts of unlabelled sulphites in US foods. The situation is similar in Australia. Small amounts of sulphites do not have to be labelled. Cornflour labelled '100% pure' may contain

e n ou g h u n l a be l l ed sulphite residues from processing to affect sensitive asthmatics. It is possible to avoid all sulphi tes, but the knowledge required far exceeds simple label reading. • Asthmatics may be

affected by other food chemicals. Avoiding sulphites will be useless if another frequently consumed food additive is causing the problem. A case history reported in the F ren ch medica l journa l Archives de Pédiatrie in 1996 describes a child diagnosed with asthma around her first birthday and treated with continuous medication for almost six years. At that time her condit ion worsened, requiring hospitalisation about once a month. Oral challenges with sulphites and benzoates, both additives abundantly ingested by the patient, revealed benzoate sensitivity. After 12 months of avoiding this additive in foods and medications, the patient remained asthma free.

Other food chemicals As well as sulphites, food additives which have been associated with asthma include artificial colours, nitrates (249-252), benzoates (210-212), antioxidants BHA (320) and BHT (321), and MSG (621). For some as thmat ics , natural ly occurring salicylates in some fruits and vegetables, and salicylates in medications, can also be a problem. Some asthmatics need to make only

minor modifications to their diet. One woman noticed that her diagnosis of adult-onset asthma coincided with a switch to diet cola. The diet cola was preserved with benzoates, the regular cola was not. When she reverted to regular cola, her asthma disappeared. Most asthmatics will react to only one or two food chemicals, but which ones? For asthmatics who would like to find out exactly which food chemicals are associated with their asthma, the best way to remove the guesswork is to carry out a trial of the Royal Prince Alfred Hospital elimination diet with challenges, supervised by an experienced dietitian. Asthmatics should consult their doctor about any reduction in the use of their asthma medication, and also about the suitability of carrying out food challenges at home. For mot iva t ed adul t s , the elimination diet is considered easy. It is also an excellent way to learn about which additives are in our foods. For difficult children, the elimination diet requires more effort. Parents report that they need support, recipes and access to safe foods. The Food Intolerance Network provides a support website and email support groups including a group for the Northern Territory. Suitable foods such as preservative-free low salicylate sausages are available from butchers in both Darwin and Alice Springs. More information • The Food Intolerance Network:

www.fedupwithfoodadditives.info.

• Fed Up with Asthma by Sue Dengate, published by Random House, 2003.

• Asthma NT: phone 8922 8817

“ S o m e a s t h m a t i c s need to make only minor modifications to their diet”


Tanya Williamson NT Corporates have risen to the challenge and provided much needed lifesaving defibrillators for remote communities. An initiative of the National Heart Foundation (NT Division) (NHF), money raised through corporate donations has provided the Department of Health and Community Services with a cheque for $34,701 to provide state of the art Automatic External Defibrillators (AEDs) to 9 remote communities. NHF Board member and cardiologist, Dr Marcus Ilton, knows first hand how important AEDs are to these communities. “90% of heart attack victims can be saved by an AED if treated with the first minute, every minute after decreases the chances of survival by 10%. Almost anyone can use one of these machines to deliver a shock to the heart and hopefully, save someone’s life”. “The response from NT companies has been fantastic,” said Graham Opie, NT Division Executive Director, “to generate nearly $40,000 in such a short period of time, solely through corporate sponsorship, shows a true community spirit.” The National Heart Foundation (NT Division) would like to thank; Ngukurr General Store NT Cardiac Services Northpharm Pharmacy – Darwin Private Hospital Mr Amin Islam Ernst and Young ANZ Bank Quota International Royal Darwin Hospital Specialist Trust Fund The communities initially identified by DHCS are Ali Curung, Kings Canyon, Hermannsburg, Oenpelli, Bickerton Island, Mataranka, Barunga, Daguragu, Ngukurr and a Tiwi Island community. Quota International also donated a defibrillator to Healthy Living NT. For further information, call Graham Opie at the Heart Foundation on 8981 1966.

Lifesavers in Remote Communities

An Invitation from Katherine West Health Board Aboriginal

Corporation to

Chronic Disease Self-Management Training

Three hour session

Presented by Mignon Markwick

Flinders University of South Australia

Human Behaviour and Health Research Unit

with a second trainer

Katherine, NT Thursday 29 May, 2003

1pm

This workshop will introduce the theory of behaviour change and the self-management tools

developed by Flinders to facilitate chronic disease self-management communication with clients in the community,

and in health care centres.

To book a place, contact Wendy Wood on

8971 9300


13th May 2003, Media Release, Hon Jane Aagaard The Minister for Health and Community Services, Jane Aagaard, today announced grants to Territory schools aimed at discouraging young people from smoking. Mrs Aagaard said the grants of $500 will be used to promote the harmful effects of smoking as well as encouraging young people to stay or become smoke free. " All schools in the Territory are encouraged to choose any activity that they think will promote these two objectives to the school and the wider community, including art, sports, recreation and the purchase of health promoting resources."" This year’s applications for Health Promoting School Grants demonstrates the dedication of schools, staff and students, toward the well being of young people." "The variety of applications received reflects the diverse range of schools applying. Applications have come from bush and town schools, government and non-government schools and from both primary and secondary." Some of the activities included in this year’s successful applications have included: • Holding an open day at the school to raise awareness

in the broader school community about the school’s new "smoke-free" status. Students artwork on the dangers of smoking will also be displayed for parents to see.

• A QUIT marathon • Students recording a song encouraging the members

of their community to stop smoking • A fitness and exercise program for adolescent girls

focusing on a healthy body image . Successful applicants for the 2003 Health Promoting Schools Grants were: Nightcliff High School, Tennant Creek High School , Adelaide River School, Wagaman Primary School, Centralian College, St John’s College (1), Borooloola CEC, Anzac Hill High School, Sheperdson College, Nemarluk School, Darwin High School, St John’s College (2), Taminmin High School, O’Loughlin College, Sanderson High School.

Health Promoting Schools Grants

Jeff Hulcombe as told by Meredith Neilson To reduce the impact of injury in Central Australian Indigenous populations, an Aboriginal Community perception of injury must first be understood. A National Health and Medical Research Council funded ‘action’ research project in Central Australia is endeavouring to achieve this understanding. This research project is a collaborative exercise between Tangentyere Council, Centre for Remote Health Alice Springs, and the Centre for Injury Studies, Flinders University.

Who’s Involved? Jeff Hulcombe has been employed as part of the research team, through Flinders University in Adelaide to undertake the qualitative field research. Jeff has had a long relationship with Central Australian communities having worked in education, community development and management at Papunya, Mt Liebig and Kintore since 1980. Alexis Wright, author of ‘Grog Wars’ and ‘Plains of Promise’ was initially employed as the researcher and completed a literature review. Donna Campbell is an Indigenous research trainee and is employed through Tangentyere Council and has been with the research project since it commenced. The methodology of this research has proven a vexing issue given the history of injury to Indigenous Australians. Having an Indigenous research trainee and the guidance of Tangentyere Council, have been necessary factors in supporting and promoting the perspective of injury.


What is the Community Perception of Injury?

Injury Prevention Workshop participants


(Continued from page 10) How to determine injury perception? Thi s research p ro jec t has undertaken several methods to determine injury perception in Indigenous populations. These have included fieldwork, the many years of experience and prior knowledge brought to the project by those invo lved, a comprehensive literature review undertaken by Ms Alexis Wright and an NHMRC Injury Prevention Workshop in December 2002. Injury Prevention Workshop The Workshop was a collaborative approach between Tangentyere Council and the Centre for Remote H e a l t h , A l i c e S p r i n g s i n conjunction with The Centre for Injury Studies, Flinders University Adelaide. The theme was to “Understand the Past – to Make Sense of the Present – so as to Work for the Future”. It brought together a number of remote communities who have been researching these issues for many years, and Alice Springs based p ro j e c t s a d d ress ing in ju ry prevention. The Workshop involved several stages: • An overview of current injury

statistics • An analysis of past research

undertaken by communities • A review of current strategies

being undertaken by Aboriginal organisations and communities within the Central Australian context. These included the Tangentyere Council’s, Night Patrol, Warden’s and Family Well Being programs

• A presentation of the concerns and strategies in relation to the prevention of injury from remote communities. These included Remote Area Night P a t r o l s , S a f e H o u s e s , programmes addressing Family Violence, Substance Abuse

Programmes, Law and Justice Strategies.

Discussion was centred upon a determination of the ingredients for success of these initiatives, including the political and financial imperatives involved. A story was then outlined to determine future directions and how these goals may be achieved. Outcomes/How to limit injury

This research project considers it has realised a number of important understandings in the perception of injury to Aboriginal people of Central Australia. An essential awareness in the perception of injury, which this project has achieved, is that for Aboriginal people, injury has both an internal and external dimension. Moreover it is recognised that there exists, between these aspects of injury, an intrinsic relationship, each having the capability to reproduce the other in a cycle of injury. Another fundamental component, of the perception of injury held by Aboriginal people in Central Australia, is that injury occurs due to damage to the construct of self. This self is an intricate and at times ritualised system of identification, which occurs through a process of

l e a r n i n g a n d b e c o m i n g knowledgeable in ones relationship with land, family and spiritual articulation. When and where either of these components is negatively affected i.e. injured, so is ones’ self. While the statistics of injury, for research analysis, are determined at the individual level, for Aboriginal people of Central Australia they are realised and felt keenly at the family level. All individuals are part of family and family are part of oneself. Moreover injury to family is not statistically separated, all loss and hurt is part of ongoing injury. For instance, the levels of chronic disease, which afflict Aboriginal people in Central Australia, are a part of the gamut of injury, which compound injury upon injury. Thus having gained such a realisation of injury enables a further understanding of the phenomena of injury within Aboriginal peoples lives. This knowledge permits an identification of the perceived major source of injury afflicting Aboriginal people today. A tracing back from the present, via the trans-generational transmission of injury, clearly associates past policies and actions, directed at Aboriginal people, as c ruc ia l ingred ien ts in the continuance of injury today. Perhaps more importantly, this perception of injury also identifies current policies and practises, which maintain a negative impact upon those values of self-identity, as compounding the initial injury at the current inter and intra-generational levels. To ignore or avoid either one of these points of injury would therefore negate any strategy proposed for the treatment and prevention of injury. Where to from here? Important to the negation of injury, from this perception, is to have those elements critical to the well


A painting created at the Workshop to depict injury


Chrissy Inglis, Healthy Living NT from Territory Way Diabetes Australia NT(DANT) is a community based organization. While we are growing in size and expanding our services it is important that our directions and practices are determined by you, the community members, DANT’s reason for existing. Throughout the last 12 months, and in response to our members surveys last year, it has become apparent that people require better access to DANT services after hours and in other locations. So DANT and Healthy Living NT (the education arm of DANT) are working on this by:

☺ Recruiting sub-agencies (pharmacies who are able to supply diabetes medical products).

☺ Continuing to visit Palmerston Health Precinct fortnightly to conduct individual education consultations.

☺ Opening the new office in Alice Springs. ☺ Remaining available to answer questions over

the phone (or phoning back as soon as possible).

☺ Taking phone orders for products and mailing them out.

☺ Commencing evening group education sessions for people newly diagnosed with Type 2 diabetes or impaired glucose tolerance at Palmerston Health Precinct.

☺ Commencing late afternoon cardiac rehabilitation groups at Palmerston Health Precinct.

Diabetes Education sessions As many of you will know, group education sessions for people who are diagnosed with Type 2 diabetes or impaired glucose tolerance (IGT) have been provided at our Tiwi office for many years. We strongly recommend that anyone diagnosed with Type 2 or IGT attend education with a diabetes nurse educator and a nutrition educator. If you have been diagnosed for sometime, but never received education, or you received education a while ago and would like an update or refresher, you are most welcome to attend. You will find it very useful and informative. As of February, these group sessions are now provided monthly at Palmerston, from 5:45-8:15pm, usually on a Thursday. A doctor’s referral is required. For more information or to make an appointment phone Healthy Living NT (Diabetes Australia NT) on 8927 8488. Palmerston Healthy Heart Program The Healthy Heart program is a 4 week cardiac rehabilitation program which has been running at our Tiwi offices every Tuesday morning. We are now expanding this service to cater for clients living in the Palmerston and outer Darwin region with classes being held on Mondays at the Multi purpose room of the Palmerston Health Precinct. This service will also cater for people who have returned to work, by being offered after hours, between 4:30 pm and 6:30 pm. The Healthy Heart Program is the same as what is currently being offered in Tiwi and includes physical activity and an education program designed for people who have had a cardiac event. If you feel that this 4 week program may be suitable for you but are unsure, please contact Chrissie Inglis at Healthy Living NT on ph 8927 8488.

New Group Sessions in Evenings at Palmerston

(Continued from page 11) being of self, back within the grasp of ones own hands. Central to the achievement of this position is having this recognised by non-Aboriginal people and their institutions of authority. Recognition of the person, as they identify themselves, is vital to the health and safety of Aboriginal people of Central Australia. This recognition is not only critical as a strategy to address the injury to Aboriginal people but is also essential for the development and implementation of effective strategies to address injury amongst Aboriginal people. An outcome of this workshop was the production of a number of paintings by the workshop representatives. These paintings outlined the need to inform as much

of the broader community and government at all levels, of the workshop and research findings. This article is part of that process. For more information contact Jeff Hulcombe on 8951 4265 or Email [email protected]


A National Heart Foundation of Australia Position Statement Update (The Medical Journal of Australia, 17 March 2003) INFORMATION SHEET There has always been a great deal of public interest in possible links between “stress” and coronary heart disease. A National Heart Foundation of Australia expert group recently reviewed and assessed the scientific evidence on this topic. Although the term “stress” is in general use, there has never been any agreement about what it actually means. Therefore the expert group was only able to examine the factors that are commonly regarded as components of “stress”. These include: • Depression, anxiety, panic

disorder; • Social isolation and lack of

quality social support; • Life events such as bereavement,

earthquakes and terrorist attacks • Work-related “stressors” • Anger and hostility. Main findings

1. There is strong and consistent evidence that people who experience depression or are socially isolated or do not have quality social support are at greater risk of developing coronary heart disease.

2. These three factors can have as great an effect on a person’s risk of coronary heart disease as other, better-known risk factors s u c h a s smo k i ng , h i g h cholesterol levels or high blood pressure.

3. For people who already have c o r o n a r y h e a r t d i sea se , depression or social isolation or lack of quality social support can affect their recovery and future health.

4. At this time there is no strong or

consistent evidence that life events, work-related “stressors”, anger , host i l i ty , anxie ty disorders or panic disorders are linked to the development of coronary heart disease. The Foundation will continue to monitor and assess the evidence in this area in order to update its position as necessary.

What is meant by depression? How is it different to just feeling sad? It is normal for anyone to feel sad or down from time to time. However, depression is an illness, that leads a person to feel sad, down or miserable most of the time and makes it harder for them to function from day to day. As a result, depression can have a significant impact on a person’s everyday life, affecting their work, personal relationships and overall well being. What do the terms ‘social isolation’ and ‘quality social support’ mean? Social isolation refers to situations in which people live alone or who are lonely for other reasons. Some people who live alone may not be socially isolated because they still have a supportive network of family or friends. Social support means having a variety of contacts with people who are available for emotional support, for example someone to confide in such as friends and family, as well as opportunities to participate in formal or informal social activities. This is often referred to as a person’s ‘social network’. It is important to recognise that it is the nature and quality of social relationships that is important -– not the actual number. For example, a person may have many social contacts but they may involve interpersonal conflict and relationship problems.

What does the Heart Foundation recommend? The National Heart Foundation of Australia recommends that health p ro fess iona l s a l so consider depression and a person’s social environment during assessment and management of a person’s risk of heart disease. The Foundation is working with medical and other health professions to increase awareness of the additional risk to heart health posed by these factors. All Australians should be aware of the importance to heart health of these additional factors. Anyone who appears to be at increased risk should be encouraged and supported by friends or family to seek help from their general practitioner or other health professional. For further information Beyondblue – the nat ional depression initiative www.beyondblue.org.au A full copy of “Stress” and co ro na ry hear t d i sease – psychosocial risk factors: National Heart Foundation of Australia Position Statement Update is available on the Medical Journal of Australia website: ht tp:/ /www.mja.com.au/public/i s s u e s / 1 7 8 _ 0 6 _ 1 7 0 3 0 3 /contents_170303.html A full copy of tables of supporting evidence is available on the Heart F o u nd a t i o n web s i t e : www.heartfoundation.com.au For general heart health information please contact Heartline, the Heart Foundation’s national telephone information service, on 1300 36 27 87 (local call cost).

“Stress” and Coronary Heart Disease: Psychosocial Factors


38th CARPA CONFERENCE DRAFT

Alcohol & Drugs in Remote PHC Practice & Launch 4th Edition CARPA STM

Friday 20th June 2003

Saturday 21st June 2003

12:00 Conference registration & Lunch

12:30 Indigenous alcohol and other drug use. Dennis Gray, Sherry Saggers & Anna Sterne

1:10 Clinical management of alcohol withdrawal and cannabis withdrawal. Steven Skov

1:45 Reflecting on the petrol sniffing interventions in Central Australia. Craig San Roque

2:15 Emerging issues of IV drug use. Nick Williams

3:00-3:30 Afternoon Tea

3:30 Foetal Alcohol, the Canadian experience. Margaret Clarke tbc

4:15 Self screening of alcohol risk using touch screen kiosks. Helen Travers

4:35 Nicotine replacement therapy. Dan Ewald

5:00 Snippets

5:30 CARPA Launch: 4th Edition STM

6:30 CARPA BBQ 28 Chewings St. BYO

8:30 Identification and clinical issues of foetal alcohol affect and syndrome. John Be-thall, Andrew White & Nigel Stewart

9:30 Discussion 9:45 Strategy to address substance misuse amoung young Aboriginal and Torres Strait

Islander peoples. Ted Wilkes

10:30 Morning tea 10:50 Talking about alcohol with Indigenous patients. Ernest Hunter tbc

11:15 Different aspects of Indigenous Cannabis use in the Top End and Centre: Cannabis psychosis Marcus Tabart, Perspectives of young urban people David Parfitt, Pat-terns of remote community use Robert Assan

12:30-1:15 Lunch 1:15 The expansion of Tangentyere Council’s night patrol activities. Sharon Forrester tbc

1:45 Young fellas choosing wisely. Ushma Scales. Nganampa Health 2:25 The Alcohol Education and Rehabilitation Foundation and Funding for alcohol and

other substance misuse interventions. Scott Wilson

3:00-3:15 Afternoon Tea 3:15- CARPA AGM & business session


CARPA CONFERENCE Alice Springs

Registration payable on the day. -Conference and BBQ $70 Session only $35

Contact: Sabina Knight, Convener. Email [email protected]

Phone 89514709 0417823933

Child Care is available, but must be booked 6th June. Phone & book childcare with Lindy, Remote Health Workforce Agency on 89504809

A Male Healthy Lifestyle Forum for Community Men Roy Price, DHCS A Male Healthy Lifestyle Forum is being conducted at Haarts Range, a remote Aboriginal community 180kms North-East of Alice Springs on the Plenty Highway, on 20-22nd May, 2003. The forum aims to provide an opportunity for community men to engage with male service providers from a wide variety of organisations in a gender a n d c u l t u r a l l y s a f e environment. The forum will provide a smorgasbord of activities a n d i n f o r m a t i o n s h a r i n g experiences, and it is believed that by working in this way it will assist better communication between community men, service providers, and service providers' respective departments. History The need for male-only facilities to help Indigenous men access health services was highlighted during the landmark 1st National Indigenous Male Health Convention held in 1999 at Ross River, via Alice Springs. At the convention, Indigenous men from all over Australia clearly enunciated their preference, nay need, for gender

specific health and information services. With less than 10% of the health work force being male, accessing health services is very uncomfortable for Aboriginal men. Although four years have elapsed since the Ross River Convention, health departments Australia-wide are yet to adequately respond to this health service access inequity. A coalition of the ready, willing and able The concept of bringing male service providers from a wide variety of organisations together in one place at one time to participate in a male healthy lifestyle forum is a strategy to help redress this inequity. By necessity, the organisers have intentionally sought out male service providers, and Aboriginal male service providers in particular, to participate in this forum. There are several potential a d v a n t ag es i n wo rk i n g i n t e r s e c t o r a l l y a n d collaboratively with male service providers from a variety of organisations and disciplines, not least of which is that it helps offset the perpetual problem of g ender b ias in ind iv idua l

o r g a n i s a t i o n s . W o r k i n g collaboratively means that the group can offer a smorgasbord of i n t e r e s t i n g a c t i v i t i e s a n d information over a relatively short period of time, allowing the community men to chose what activities they wish to engage in, where and when. Service providers involved in the forum will have a better opportunity to develop partnerships with community men and other service providers on c o m m u n i t y d e v e l o p m e n t projects. Most importantly, the forums have the potential to be an efficient use of manpower, resources and funds.

Organisation Ideas for the forums were


HEALTHY FAMILIES, HEALTHY MEN


In Erratum “The Chronicle” would like to amend points made in the March 2003 Edition of the story “Chronic Disease Self-Management Project – Creating Community Ownership”. Doris Lewis is a Board Member of the KWHB, not a Community Support Worker. There are 8 National Demonstration sites of the Sharing Health Care Initiative, not 6. At the time of writing there were six Community Support Workers, (CSWs) not 12. The project is a community empowerment and health promotion approach to facilitate self-management. There is no formal trial of other methods and models. The project was conceived by Dr Andrew Bell. Robin Mobbs has been with the project since the beginning of its implementation. The CSW orientation intensive is not based on the Flinders University tools. The Flinders tools have been adapted in Stage 1. Care planning is a major part of chronic disease self-management. Our apologies to those involved in the CDSM project.

(Continued from page 15) formulated and in April 2002 the organising committee were successful in gaining a grant for $15,000 for two male health forums in Indigenous Communities. Waltja Tjutangku Palyapayi is the primary non-Government organising group, with members of the Department of Health and Community Services as partners providing a proportion of the expertise. The Organising Committee includes DHCS staff from Health Promotion, Nutrition, Preventable Chronic Disease Strategy, and Aboriginal Health Workers, most of who are indigenous males. Contributions to the forum have also been made by male service providers from the Department of Sport and Recreation, the Mental Health Association, the Centre for Appropriate Technology, Batchelor College, the Education Department, Alice Springs Youth Accommodation and Support Services, NT AFL AusKick, ATSIC, and the Department of Community Development, Sport and Cultural Affairs. The program The first forum will occur at Harts Range on 20-22nd May 2003. The organising committee has worked closely with the Community Council Chairman who is very supportive and enthusiastic about the event. To engage the male population, the Forum has been marketed with a sporting, healthy lifestyle focus “Play better Football”, “Eat Sport Food”, “Fitness Information”. As well as these topics, the forum will address issues such as looking after family, heart and body health, and career options. What happens later? The men of Titjikala Community, 100kms south of

Alice Springs, have expressed an interest in the next forum being held in their community. However, for more than two such forums to occur, the support - financial, work force and in kind varieties - will need to come from all of the organisations involved. Despite intense lobbying over the past 4 years, there is still no recurrent funding allocated for activities to address men's health. For further details contact Roy Price on 8921 7094, or Email: [email protected] Roy Price DIET @VICE INTERACTIVE Alice Springs Australia 0870 mailto:[email protected] http://welcome.to/dietinfo

ARTHRITIS AND OSTEOPOROSIS

FOUNDATION NT Welcome visitors to the

FUN AND FITNESS EXERCISE

CLASSES Classes are land and water based

When: Tuesday and Thursdays

Where: Tropicus Centre, 6 Caryota Crt

Coconut Grove Ph: 8948 5232


What Goes on at Darwin Withdrawal Services?

Jane Whitehead, Outreach Registered Nurse Darwin Withdrawal Services (p rev iously known as the detoxification unit) has been in place since July 2002. Outpatient and outreach withdrawal services are avai lab le for individuals who wish to withdraw from alcohol, opiates, cannabis, a m p h e t a m i n e s a n d benzodiazepines. Clients are assessed by a medical team to identify the best withdrawal option. Where possible clients are encouraged to use their own GP to arrange medications and the withdrawal services team then provides support, including daily home visits by nurses. What is the service? An experienced nurse works closely with you and your local doctor to help you withdraw from drug or alcohol in your own home, or Residential Support Service. Can I do a home based withdrawal? For some people it would be unsafe to stop their drug or alcohol use at home. If you have a medical or psychiatric condition it must be stable, and you need to be in the care of someone who can manage that condition. In most cases you will need a family member or friend to be a support person. As everyone is different, a nurse will always discuss this with you when you first contact the service. What will it cost? The cost of the service, excluding medications, is free. What do I need to do to start? Contact us on 89480087.

We will ask you some questions about your drug and alcohol use to help us to understand your situation and ensure your safety. It is wise to cut down the use of drug of choice prior to starting detox. This will make your home detox easier for you. The admission needs to be planned and a waiting list may apply. An appointment will be made for you to come in and plan your withdrawal with a nurse. We will contact your GP and discuss your withdrawal. Withdrawal starts. It may take 5-14 days depending on the severity of the withdrawal and what substances you are stopping. Darwin Withdrawal Services provide an individually tailored outreach withdrawal service for those people choosing to withdraw from alcohol or other drugs. Referral is not essential but planning is necessary. We offer assured confidentiality and referral to a wide range of agencies and services throughout the Territory and interstate. For further information on the services we offer clients, families and others you are encouraged to ring Darwin Withdrawal Services: 89480087.

Healthy Living NT opened its Alice Springs Branch in March this year. The new service is located at 9 Parsons Street across the road from the Commonwealth Bank. It is ideally located due to good access to parking, full disabled access, and close vicinity to the main shopping area. The Branch will provide diabetes education and cardiac rehabilitation services to the Alice Springs community under the auspices of Diabetes Australia NT (DANT). In a separate development the National Heart Foundation will be placing a Health Promotion Officer in the same office which will create some exciting opportunities. Attending the function were many auspicious guests including Diabetes Australia NT board members, the National, Victorian and NT Presidents of Diabetes Australia, Graham Opie, Executive Director of the National Heart Foundation NT Division, Alice Springs members, and health staff. The Branch was opened by the Honorable Jane Aagaard. Penny Fielding the Vice President of the DANT board, read a poem written by Aboriginal poet and DANT board member, Luke Morcom, about the new service in Alice Springs. The Centre is staffed by Kareen Stewart - the Diabetes Nurse Educator, Moira-Jane Conahan - the cardiac educator, and Julie D’Bras continues as the customer service officer. Contact details for the Alice Springs office are as follows: Ph) 08 8952 8000 Email: [email protected] Shop 1/9 Parsons St

Healthy Living NT Alice Springs Branch

Opening


National Chronic Disease Self-Management Workshop

Sharing Health Care Initiative 12th, 13th & 14th November, 2003 Venue: Hilton on the Park, Melbourne

Purpose of the Workshop This Workshop is designed to promote chronic disease self-management activity both here in Australia and overseas by examining the progress, learnings and successes of the 12 National Sharing Health Care Initiative demonstration projects along with a range of other Australian

and international chronic condition self-management projects and research activity. The Workshop will explore the challenges and enablers for the integration of chronic condi-

tion self-management more broadly within the Australian health care system.

Who should attend? The broad range of presentations and workshops will be of special interest to GPs and Divi-sions of GP, nurses, allied health professionals, Aboriginal Health Workers, health provider

organisations, consumer groups and organisations, Commonwealth, State/Territory health pol-icy makers and administrators, private health insurance policy makers and administrators, and

health trainers and educationists.

Call for papers All nominations including a brief ½ page abstract should be e-mailed to Ms Daphne Shakespear

on [email protected] by 30 June 2003 or contact (02) 6289 8689. Acceptances will be notified by 31 July 2003.

Please watch our website www.chronicdisease.health.gov.au for more details

Mental Health and Alcohol and Other Drugs

TARGET:Community based health professionals interested in improving their knowledge and skills to assist clients with mental health, substance misuse and domestic violence is-sues including Aboriginal health workers, nurses and allied health professionals.

AIM: Improve skills & share information to assist health practitioners to address these com-plex issues in their daily work

TOPICS:● Current information on the major substances misused, mental disorders commonly seen and domestic violence issues

● Strategies to assist clients including Brief Intervention, motivational interviewing ● 2 Days training including dual disorders education delivered by Northern Nexus

(Dual Diagnosis Services) DATE: 28th July – 1st August 2003 TIME: 0830 – 1630 daily VENUE: NARU (North Australian Research Unit, Ellengowen Drive Brinkin – next to NTU) CONTACT: Jeanette Boland 8922 7820 or Bernadette Eaton 8922 7898 Workforce Support


Media release, DHCS 30 April 2003 Australia has the second highest rate of childhood overweight and obesity in the world, affecting between 20 - 25% of our children (AIHW - Australia's Health and Welfare 2000). The Department of Health and Community Services will be running an NT-first program, "Fit Kids", to try and combat this growing problem. Being overweight or obese has both immediate and long-term health impacts on children. Overweight children are more likely to have psychological problems such as low self esteem and physical effects such as orthopaedic problems, sleep apnoea and type 2 diabetes. There is some genetic component to obesity, but the dramatic increase over the past decade is thought to be due to significant changes in lifestyle influencing children and their families. Traditional therapies focussing on the child have been shown to have a negative impact and include an increase in stress and anxiety and higher rates of withdrawal of the family from therapy. An information session on the new "Fit Kids" program will be held at Flynn Drive Community Health Centre, Alice Springs, 7pm Wednesday 30 April. A 6 week program will follow, running from 14 May to 18 June, facilitated by a dietitian and a child psychologist from DHCS. The program is based on one developed by the Children's Hospital at Westmead in Sydney and has been run successfully in other centres across Australia and New Zealand. The program covers the following topics; factors influencing weight, the need to avoid 'diets', healthy eating, family food habits, becoming more active, overeating versus hunger and understanding self image and building self confidence. It is a 'hands on' course providing parents with practical solutions to take home for their families. Contacts: Liz Conway, DHCS Media Liaison, Ph: 8999 2749, Alison McLay, DHCS Urban Nutritionist Ph: 8951 6731

Fit Kids

A new program for families of overweight and obese children

National Respiratory and Asthma Educators

Symposium

August 7 and 8, 2003 University House

Canberra The ACT Asthma Educators Group and AEA (NSW), on behalf of the Australian Asthma and Respiratory Educators Alliance, invites all health professionals to participate in a

national first; a conference designed specifically for health professionals who work

in the specialised area of respiratory and asthma education.

We are arranging for speakers who have

access to current and important information to impart (such as Janice McKay and her work

on asthma and sexual relationships) as well as internationally recognised speakers who can

give us all an insight into the future for respiratory management (Dr Christine Jenkins

of the National Asthma Reference Group).

Other topics include: Adherence, allergies, evaluation of education, pulmonary rehabilitation, competencies, poster

presentations

Contact: Lyndall Finn on (02) 6205 5207 or Ken Langbridge on (02) 4320

3410

Cost :$250.00 (Includes dinner on Thursday night).

Positions are extremely limited. Please register your interest in

attending or presenting a poster as soon as possible.


Snapshots from the Uncharted Territory Conference

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