Anthony Dillon

Increasing rates of surgical treatment and preventing comorbidities may increase breast cancer survival for Aboriginal women

BackgroundLower breast cancer survival has been reported for Australian Aboriginal women compared to non-Aboriginal women, however the reasons for this disparity have not been fully explored. We compared the surgical treatment and survival of Aboriginal and non-Aboriginal women diagnosed with breast cancer in New South Wales (NSW), Australia.MethodsWe analysed NSW cancer registry records of breast cancers diagnosed in 2001–2007, linked to hospital inpatient episodes and deaths. We used unconditional logistic regression to compare the odds of Aboriginal and non-Aboriginal women receiving surgical treatment. Breast cancer-specific survival was examined using cumulative mortality curves and Cox proportional hazards regression models.ResultsOf the 27 850 eligible women, 288 (1.03%) identified as Aboriginal. The Aboriginal women were younger and more likely to have advanced spread of disease when diagnosed than non-Aboriginal women. Aboriginal women were less likely than non-Aboriginal women to receive surgical treatment (odds ratio 0.59, 95% confidence interval (CI) 0.42-0.86). The five-year crude breast cancer-specific mortality was 6.1% higher for Aboriginal women (17.7%, 95% CI 12.9-23.2) compared with non-Aboriginal women (11.6%, 95% CI 11.2-12.0). After accounting for differences in age at diagnosis, year of diagnosis, spread of disease and surgical treatment received the risk of death from breast cancer was 39% higher in Aboriginal women (HR 1.39, 95% CI 1.01-1.86). Finally after also accounting for differences in comorbidities, socioeconomic disadvantage and place of residence the hazard ratio was reduced to 1.30 (95% CI 0.94-1.75).ConclusionPreventing comorbidities and increasing rates of surgical treatment may increase breast cancer survival for NSW Aboriginal women.

Are Aboriginal people more likely to be diagnosed with more advanced cancer

Objective: To determine whether Aboriginal people in New South Wales were diagnosed with more advanced cancer than non‐Aboriginal people.

Prostate cancer mortality outcomes and patterns of primary treatment for Aboriginal men in New South Wales, Australia

To compare prostate cancer mortality for Aboriginal and non‐Aboriginal men and to describe prostate cancer treatments received by Aboriginal men.

Seeding success in indigenous Australian higher education: Indigenous Australian students' participation in higher education and potential ways forward

Abstract Purpose This chapter critically analyses the current participation of Indigenous Australian students in higher education and identifies new directions for seeding success and enabling Indigenous students to flourish in higher education contexts. Methodology Statistical reports, government reports and the scholarly literature were analysed to elucidate the nature of participation of Indigenous students in higher education, identify strategies that are succeeding, identify issues that need addressing and explicate potentially potent ways forward. Findings The findings have important implications for theory, research and practice. The results of this study demonstrate, that while increasing numbers of Indigenous Australian students are accessing higher education, they still are not participating at a rate commensurate with their representation in the Australian population. The findings also suggest new ways to enable Indigenous Australians to not only succeed in higher education, but flourish. Research implications The findings imply that more needs to be done to seed success in increasing the numbers of Indigenous Australian students in higher education to be representative of the population and ensuring participation in higher education enables Indigenous students to succeed and flourish. The findings also imply that there is a dire need for further research to identify key drivers of success. Implications The study supports the need for increasing the number of Indigenous Australians participating in higher education and enhancing higher education strategies to enable Indigenous students to succeed and flourish. Social implications Enhancing the participation of Indigenous students in higher education internationally can help to contribute to the well-being of individuals, Indigenous communities and nations. Originality/value This chapter provides an up to date analysis of the nature of Indigenous Australian participation in higher education and identifies potentially potent new ways forward to seed success that have international implications.

Engaging the disengaged? A longitudinal analysis of the relations between indigenous and non-indigenous Australian students’ academic self-concept and disengagement

Academic disengagement among disadvantaged minority groups has received considerable attention within the psychological literature, and such research has attempted to identify variables that may reduce the risk of disengagement. With regard to this investigation, longitudinal structural equation modeling techniques were used across a sample of secondary school students to test whether Aboriginality (being Indigenous or non-Indigenous Australian), academic self-concept, and academic disengagement were causally related (once the effects of prior measures had been accounted for). The results suggest that although Aboriginality held a significant correlation with disengagement (suggesting that Indigenous students are more likely to disengage from school), the causal impact of this variable seems to be negated when the causal impact of academic self-concept is also considered. These results suggest that enhancing academic self-concept may be a useful strategy for addressing patterns of school disengagement that have been repeatedly noted for Indigenous Australian students.

Examining the Genetic Contribution to ADHD

The scientific status of attention deficit hyperactivity disorder (ADHD) is highly controversial. Much of the controversy hinges on whether ADHD is a biological disorder. Advocates of biological causation often argue that it has a genetic basis. Etiology of ADHD has implications for treatment options, which is also a source of controversy. Given the ongoing interest in establishing the genetic basis of ADHD, this article critically examines the claims of a genetic basis to ADHD. We conclude that although genes may have a role to play in the expression of ADHD behaviors, available evidence suggests that the effect size of a genetic contribution is likely to be small.

i Had a Little Bit of a Bloke Meltdown…but the Next Day, I Was Up: Understanding Cancer Experiences Among Aboriginal Men.

Background: Although cancer in indigenous populations is receiving increased research attention, there is a gap in understanding the particular experiences of Aboriginal men. Objective: The aim of this study is to integrate a range of primary and secondary accounts of the experiences of Aboriginal men in engaging with a cancer diagnosis and treatment in Australia. Methods: Secondary analysis of qualitative interviews (n = 54) conducted between 2008 and 2011 revealed recurrent themes regarding the cancer experiences of Aboriginal men in a subset of participant interviews (n = 23). The analysis reports themes that spanned the accounts of Aboriginal men with cancer (n = 6) and those of their carers (n = 12) and clinicians (n = 5). Results: Recurrent beliefs about the cancer experiences of Aboriginal men included that they “avoid seeking help” for health matters, including cancer symptoms, and to “get on with it,” “not talk about it,” and “manage without fuss” after a cancer diagnosis. Although some men described having to “accept vulnerability,” emphasis was placed on appreciating men’s desire to “protect cultural roles” and “connect with family and culture” throughout care and treatment, including through humor. Conclusions: Men’s accounts of the experiences of cancer diagnosis and care reveal more than simply individual challenge, extending to encompass the very real social and economic implications of illness and vulnerability for Aboriginal men today. Implications for Practice: Aboriginal men could be better engaged with cancer diagnosis and treatment if greater attention was paid to recognizing preferred approaches, including pragmatism and humor, and supporting connections to family and culture throughout the cancer journey.

Comparing colorectal cancer treatment and survival for Aboriginal and non-Aboriginal people in New South Wales

Objectives: Our aim was to compare surgical treatment rates and survival rates for Aboriginal and non‐Aboriginal people in New South Wales with colorectal cancer, and to describe the medical treatment received by a sample of Aboriginal people with colorectal cancer.