Australian and New Zealand journal of public health
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Culturally safe service delivery is critical in enhancing personal empowerment and, as a result, should promote more effective and meaningful pathways to self determination for Indigenous people. Little has been said about encouraging people from Indigenous groups into the health and education discipline(s) to help provide a safe environment which includes cultural safety. This is a phrase originally coined by Maori nurses which means that there is no assault on a person's identity. ⋯ To genuinely address the challenges of Indigenous health and education, the issue of cultural safety cannot be avoided. Critical reflection on experiential knowledge and defining or framing a debate on cultural safety is essential. This paper briefly examines some considerations for work practice.
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This report analysed data on opioid overdose mortality between 1988 and 1996 to: examine differences between jurisdictions in the rate of fatal opioid overdose and the rate of increase in overdose; and estimate the proportion of all deaths which were attributed to opioid overdose. Australian Bureau of Statistics (ABS) data were obtained on the number of deaths attributed to opioid dependence (ICD 9 codes 304.0, 304.7) and accidental opioid poisoning (ICD 9 codes E850.0, E850.1). The highest rate of fatal overdose occurred in NSW, followed by Victoria. ⋯ During the interval from 1988 to 1996, the proportion of deaths attributed to opioid overdose increased. From 1988 to 1996, the proportion of deaths attributed to opioid overdose among individuals aged 25-34 years was approximately one-third that attributed to suicide, but this proportion had increased to approximately one-half by 1996. The rate of increase in the proportion of deaths attributed to opioid overdose was higher than the rate of increase in the proportion of deaths attributed to suicide.
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Aust N Z J Public Health · Oct 1998
Hospital use for potentially preventable conditions in aboriginal and Torres Strait Islander and other Australian populations.
The poor state of Aboriginal and Torres Strait Islander health has been documented in many ways, most obviously by comparing the relatively higher age-specific mortality and morbidity rates. This paper demonstrates the use of acute hospital separation data as a way to identify potential deficiencies in providing appropriate primary health care services for Aboriginal and Torres Strait Islander populations. It does so by using 'ambulatory sensitive conditions': those conditions (and procedures) for which high-quality appropriate primary health services deliverable under ideal circumstances are though to potentially reduce or eliminate the need for hospitalisation. ⋯ In this study, 1993-94 acute hospital separation data from NSW, Queensland, South Australia, Western Australia and the Northern Territory were used to calculate separation rates and odds ratios for Aboriginal and Torres Strait Islander and non-Aboriginal and Torres Strait Islander populations. Age-specific acute hospital separation rates for ambulatory sensitive conditions were 1.7 to 11 times higher for the Aboriginal and Torres Strait Islander populations studied. This supports clinical contentions that much Aboriginal and Torres Strait Islander morbidity and mortality is preventable and that further consideration is needed to service delivery reform at all levels in the health system and the distribution of funding.
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Improved cervical screening has been identified as a priority in reducing the incidence of cervical cancer among Aboriginal women. This paper discusses the cervical screening recommendations of a women's health project developed by Nganampa Health Council (NHC), the Aboriginal-controlled medical service meeting the health needs of the people of the Anangu Pitjantjatjara (AP) Lands. A community participation public health model was used in program development. ⋯ Strategies aimed at maximising patient participation, improving patient satisfaction, running an effective call and recall system, improving quality of cervical smears, improving management of women with abnormal smears and evaluating the program are suggested. The involvement of the community in a scientifically sound, public health approach may increase the likelihood that the strategies suggested will be effective in this community. Both the model of program development and the cervical screening strategies derived are likely to be of relevance for other Aboriginal communities.