In this study, urban soundscapes containing combined noise sources were evaluated through field surveys and laboratory experiments. The effect of water sounds on masking urban noises was then examined in order to enhance the soundscape perception. Field surveys in 16 urban spaces were conducted through soundwalking to evaluate the annoyance of combined noise sources. Synthesis curves were derived for the relationships between noise levels and the percentage of highly annoyed (%HA) and the percentage of annoyed (%A) for the combined noise sources. Qualitative analysis was also made using semantic scales for evaluating the quality of the soundscape, and it was shown that the perception of acoustic comfort and loudness was strongly related to the annoyance. A laboratory auditory experiment was then conducted in order to quantify the total annoyance caused by road traffic noise and four types of construction noise. It was shown that the annoyance ratings were related to the types of construction noise in combination with road traffic noise and the level of the road traffic noise. Finally, water sounds were determined to be the best sounds to use for enhancing the urban soundscape. The level of the water sounds should be similar to or not less than 3 dB below the level of the urban noises.

IntroductionUnderstanding health inequity is necessary for addressing the disparities in health outcomes in many populations, including the health gap between Indigenous and non-Indigenous Australians. This report investigates the links between Indigenous health outcomes and socioeconomic disadvantage in the Northern Territory of Australia (NT).MethodsData sources include deaths, public hospital admissions between 2005 and 2007, and Socio-Economic Indexes for Areas from the 2006 Census. Age-sex standardisation, standardised rate ratio, concentration index and Poisson regression model are used for statistical analysis.ResultsThere was a strong inverse association between socioeconomic status (SES) and both mortality and morbidity rates. Mortality and morbidity rates in the low SES group were approximately twice those in the medium SES group, which were, in turn, 50% higher than those in the high SES group. The gradient was present for most disease categories for both deaths and hospital admissions. Residents in remote and very remote areas experienced higher mortality and hospital morbidity than non-remote areas. Approximately 25-30% of the NT Indigenous health disparity may be explained by socioeconomic disadvantage.ConclusionsSocioeconomic disadvantage is a shared common denominator for the main causes of deaths and principal diagnoses of hospitalisations for the NT population. Closing the gap in health outcomes between Indigenous and non-Indigenous populations will require improving the socioeconomic conditions of Indigenous Australians.

In the Northern Territory, as elsewhere in Australia, Indigenous Australians are more likely than other Australians to suffer a stroke. Lack of falling in incidence in the Northern Territory population highlights the importance for ongoing comprehensive primary and acute care in reducing risk factors and managing stroke patients.

Objective: To estimate the incidence and survival rates of acute myocardial infarction (AMI) for Northern Territory Indigenous and non‐Indigenous populations. Design and participants: Retrospective cohort study for all new AMI cases recorded in hospital inpatient data or registered as an ischaemic heart disease (IHD) death between 1992 and 2004. Main outcome measures: Population‐based incidence and survival rates by age, sex, Indigenous status, remoteness of residence and year of diagnosis. Results: Over the 13‐year study period, the incidence of AMI increased 60% in the NT Indigenous population (incidence rate ratio [IRR], 1.04; 95% CI, 1.02–1.06), but decreased 20% in the non‐Indigenous population (IRR, 0.98; 95% CI, 0.97–1.00). Over the same period, there was an improvement in all‐cases survival (ie, survival with and without hospital admission) for the NT Indigenous population due to a reduction in deaths both pre‐hospital and after hospital admission (death rates reduced by 56% and 50%, respectively). The non‐Indigenous all‐cases death rate was reduced by 29% as a consequence of improved survival after hospital admission; there was no significant change in pre‐hospital survival in this population. Important factors that affected outcome in all people after AMI were sex (better survival for women), age (survival declined with increasing age), remoteness (worse outcomes for non‐Indigenous residents of remote areas), year of diagnosis and Indigenous status (hazard ratio, 1.44; 95% CI, 1.21–1.70). Conclusions: Our results show that the increasing IHD mortality in the NT Indigenous population is a consequence of a rise in AMI incidence, while at the same time there has been some improvement in Indigenous AMI survival rates. The simultaneous decrease in IHD mortality in NT non‐Indigenous people was a result of reduced AMI incidence and improved survival after AMI in those admitted to hospital. Our results inform population‐specific strategies for a systemwide response to AMI management.

Objective:To compare hospital costs of Aboriginal and non-Aboriginal patients having haemodialysis treatment and forecast the future treatment cost. Methods:The costs of patients with HD in the "Top End" of Australia's Northern Territory were estimated for the financial years 1996/97 and 1997/98 using a hospital costing model. We used an Autoregression Integrated Moving Average model to predict future demand.Results: 165 patients (101 Aboriginal and 64 non-Aboriginal) were treated at a total cost of $12.4 million in this two-year period. These 165 patients represented 0.7% of inpatients, 8.8% of total inpatient costs and 31.6% of total inpatient episodes of care in the Top End region. $9.5 million (77%) was spent on routine haemodialysis treatment and $2.9m (23%) on other hospitalisations. The average cost per routine haemodialysis treatment over the two-year period was $527, or $78 600 per patient treatment year. Hospitalisations for comorbidities occurred in 86% of Aboriginal and 39% of non-Aboriginal patients. Average cost per patient, number of admissions and length of hospital stays were all significantly greater for Aboriginals. We predict an average increase in the number of treatments of 12% each year over the next five years and a five-year cost of $49.8m. Conclusions:A multipronged strategy designed to reduce the prevalence and MJA 2002; 176: 461-465 costs of renal failure is required.