Ear microbiota and middle ear disease: a longitudinal pilot study of Aboriginal children in a remote south Australian setting

Background Otitis media (OM) is a major disease burden in Australian Aboriginal children, contributing to serious long-term health outcomes. We report a pilot analysis of OM in children attending an outreach ear and hearing clinic in a remote south Australian community over a two-year period. Our study focuses on longitudinal relationships between ear canal microbiota characteristics with nasopharyngeal microbiota, and clinical and treatment variables. Results Middle ear health status were assessed in 19 children (aged 3 months to 8 years) presenting in remote western South Australia and medical interventions were recorded. Over the two-year study period, chronic suppurative OM was diagnosed at least once in 7 children (37%), acute OM with perforation in 4 children (21%), OM with effusion in 11 children (58%), while only 1 child had no ear disease. Microbiota analysis of 19 children (51 sets of left and right ear canal swabs and nasopharyngeal swabs) revealed a core group of bacterial taxa that included Corynebacterium, Alloiococcus, Staphylococcus, Haemophilus, Turicella, Streptococcus, and Pseudomonas. Within-subject microbiota similarity (between ears) was significantly greater than inter-subject similarity, regardless of differences in ear disease (p = 0.0006). Longitudinal analysis revealed changes in diagnosis to be associated with more pronounced changes in microbiota characteristics, irrespective of time interval. Ear microbiota characteristics differed significantly according to diagnosis (P (perm) = 0.0001). Diagnoses featuring inflammation with tympanic membrane perforation clustering separately to those in which the tympanic membrane was intact, and characterised by increased Proteobacteria, particularly Haemophilus influenzae, Moraxella catarrhalis, and Oligella. While nasopharyngeal microbiota differed significantly in composition to ear microbiota (P (perm) = 0.0001), inter-site similarity was significantly greater in subjects with perforated tympanic membranes, a relationship that was associated with the relative abundance of H. influenzae in ear samples (rs = − 0.71, p = 0.0003). Longitudinal changes in ear microbiology reflected changes in clinical signs and treatment. Conclusions Children attending the ear and hearing clinic in a remote Aboriginal community present with a broad spectrum of OM conditions and severities, consistent with other remote Aboriginal communities. Ear microbiota characteristics align with OM diagnosis and change with disease course. Nasopharyngeal microbiota characteristics are consistent with the contribution of acute upper respiratory infection to OM aetiology.

Respect, Relationships and “Just Spending Time with Them”: Critical Elements for Engaging Aboriginal Students in Primary School Education

While disparities in educational outcomes for Aboriginal children have narrowed in early childhood education and for Year 12 completions, these positive trends are not replicated in the intervening years where attendance, reading, writing, and numeracy targets have been missed. Erratic attendance in the primary years has the greatest impact on achievement; literacy and numeracy scores decline as absences increase. Family functioning and health, caregiver expectations, past encounters with the education system and socio-economic disadvantage are all implicated in poorer rates of attendance. In response to community concerns, an Aboriginal/mainstream partnership was forged in 2011 and began work in 2016 to address patterns of attendance and achievement among Aboriginal primary students in a regional city in Western Australia. This paper describes the innovative, community-led “More Than Talk” program and presents findings from teaching and support staff interviews two years after implementation. Qualitative methods were employed to analyse the data, develop themes, and ensure rigour. Findings highlighted the cascading impact of erratic attendance and the role of strong relationships, respect, and investment of time with children as critical elements in student engagement and wellbeing. Community-led, collaborative educational programs have the potential to positively impact Aboriginal students’ engagement and contribute to culturally responsive environments. If sustained, such efforts can enable learning to flourish.

Introduction: International Issues and Debates Concerning Adoption

A history of systemic injustices and a lack of transparency have influenced public perceptions of domestic adoption. This book aims to introduce more empirical evidence into the debate by exploring the value of open adoption, as practised in Australia, as a route to permanence for abused and neglected children in out-of-home care who cannot safely return to their birth families. International evidence about the outcomes of adoption and foster care is discussed. The chapter introduces the Barnardos Australia Find-a-Family programme which has been finding adoptive homes since 1986 for non-Aboriginal children in care who are identified as ‘hard to place’. Regular post-adoption face-to-face contact with birth family members is an integral part of the adoption plan. The methodology for evaluating the outcomes for 210 children placed through the programme included case and court file analysis, a follow-up survey and interviews with adoptive parents and adult adoptees.

Law, Justice, and Indigenous Intergenerational Trauma—A Genealogy

Aboriginal Australians experience trauma that is linked to continuing colonising practices in the present, and which are also reproduced throughout the more than 230 years of colonisation. Intergeneration trauma intersects with the over-representation of Aboriginal people in the welfare and justice systems. This paper examines evidence of the relations between trauma and colonialising practices imposed on Indigenous peoples, as past and present conditions leading to intergenerational trauma. Historical and present-day conditions affecting Aboriginal children and families are shown to set in place the conditions producing trauma over time.

Pathways to school success: Self-regulation and executive function, preschool attendance and early academic achievement of Aboriginal and non-Aboriginal children in Australia’s Northern Territory

Background With the pending implementation of the Closing the Gap 2020 recommendations, there is an urgent need to better understand the contributing factors of, and pathways to positive educational outcomes for both Aboriginal and non-Aboriginal children. This deeper understanding is particularly important in the Northern Territory (NT) of Australia, in which the majority of Aboriginal children lived in remote communities and have language backgrounds other than English (i.e. 75%). Methods This study linked the Australian Early Development Census (AEDC) to the attendance data (i.e. government preschool and primary schools) and Year 3 National Assessment Program for Literacy and Numeracy (NAPLAN). Structural equation modelling was used to investigate the pathway from self-regulation and executive function (SR-EF) at age 5 to early academic achievement (i.e. Year 3 reading/numeracy at age 8) for 3,199 NT children. Result The study confirms the expected importance of SR-EF for all children but suggests the different pathways for Aboriginal and non-Aboriginal children. For non-Aboriginal children, there was a significant indirect effect of SR-EF (β = 0.38, p<0.001) on early academic achievement, mediated by early literacy/numeracy skills (at age 5). For Aboriginal children, there were significant indirect effects of SR-EF (β = 0.19, p<0.001) and preschool attendance (β = 0.20, p<0.001), mediated by early literacy/numeracy skills and early primary school attendance (i.e. Transition Years to Year 2 (age 5–7)). Conclusion This study highlights the need for further investigation and development of culturally, linguistically and contextually responsive programs and policies to support SR-EF skills in the current Australian education context. There is a pressing need to better understand how current policies and programs enhance children and their families’ sense of safety and support to nurture these skills. This study also confirms the critical importance of school attendance for improved educational outcomes of Aboriginal children. However, the factors contributing to non-attendance are complex, hence the solutions require multi-sectoral collaboration in place-based design for effective implementation.

The knowledge, attitudes and beliefs of midwives on the vaccination coverage rates in Perth’s Aboriginal children

Background Midwives are well placed to promote vaccination awareness throughout a women’s pregnancy and strengthen childhood vaccination demand following hospital discharge. In Perth, Western Australia, Aboriginal children experience some of the lowest vaccination coverage rates across the nation. To identify factors preventing greater vaccination uptake amongst the target population, a theory-based study was conducted with midwives across two Perth maternity hospitals to explore behavioural attributes, knowledge, attitudes and beliefs surrounding vaccination provision and the vaccines administered to Aboriginal children. Methods A purpose-designed questionnaire was distributed to midwives working in two Perth public maternity hospitals. The proximal constructs of The Theory of Planned Behavior were used to frame the questionnaire to enable the barriers to greater vaccination coverage to be identified and behaviourally situated. Descriptive statistics described the demographics of the study sample. Chi-square and the Fisher’s exact test were used to identify associations between midwife characteristics and awareness of the coverage rates. Significance was set at α = 0.05. Results Of the 58 midwives who completed the study questionnaire, 77.2% were unaware of the sub-optimal vaccination coverage in Perth’s Aboriginal children. Level of education (p = 0.53) and years worked as a practising midwife (p = 0.47) were not found to be associated with an awareness of the coverage rates. Approximately, 50% of midwives reported some concern over the efficacy of childhood vaccines, 44.4% did not feel confident with their knowledge of vaccines, while 33.3% do not routinely discuss childhood vaccinations with parents prior to hospital discharge. Conclusions Key findings in the study identified that a range of educational, leadership and system-based issues are affecting midwives’ capacity to play a more substantial role in influencing vaccination coverage in Perth’s Aboriginal children.

Association between dietary quality and growth of the aboriginal primary school children in Negeri Sembilan

PurposeThis study aims to determine the association between dietary quality and growth of the aboriginal primary school children in Negeri Sembilan, Malaysia.Design/methodology/approachThe cross-sectional study was carried out in Negeri Sembilan. A total of 194 school-aged aboriginal children participated in the study. The dietary intake and socioeconomic status data were collected from the parents using an interviewer-administrated structured questionnaire comprised of sociodemographic questions and three days of dietary recall. The Malaysian Healthy Eating Index was used to determine the diet quality of children. WHO Anthro Plus software was used to determine the z-score of weight-for-age (WAZ), height-for-age (HAZ) and body mass index (BMI)-for-age (BAZ).FindingsAmong all children, 15, 9 and 5% of them were stunted, underweight and thin, respectively. On the other hand, 16 and 12% of the children were overweight and obese, respectively. The aboriginal children were at risk of poor diet quality (37.19 ± 12.07) and had high dietary protein and fat intake than national recommended nutrient intake. The children achieved micronutrients intake, except for calcium. There was no significant association between total diet quality scores with growth indices among the aboriginal children. There is significant negative correlation between dietary vitamin A intake with HAZ (r = −0.168, p < 0.05) and WAZ (r = −0.219, p < 0.05) z-score of the aboriginal children.Originality/valueAlthough there was a reduction in under-nutrition among the aborigines, an increasing over-nutrition status among aborigines should be considered, especially in terms of poor dietary quality and intake.