scholarly journals Lung cancer in rural and remote Aboriginal and Torres Strait Islander communities in Queensland: awareness and identifying health needs in a cultural context

2015 ◽  
Author(s):  
Barbara Page
Keyword(s):  
Lung Cancer ◽  
Cultural Context ◽  
Torres Strait Islander ◽  
Health Needs ◽  
Rural And Remote ◽  
Torres Strait

The use of clozapine in a rural and remote region of Australia

2020 ◽  
pp. 103985622097527
Author(s):  
Bridson Tahnee ◽  
Abeysundera Hesitha ◽  
Arunachalam Arulmathy ◽  
Lam Anthea ◽  
Mora Linda ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Torres Strait Islander ◽  
Psychotic Disorders ◽  
Clinical Information ◽  
Antipsychotic Treatment ◽  
Rural And Remote ◽  
Access To Treatment ◽  
Regional Area ◽  
The Mean ◽  
Torres Strait

Objective: Clozapine is the most effective antipsychotic available for treatment-resistant schizophrenia. Unfortunately, it is often underutilised or administered late in the treatment course, if at all. This issue is further augmented in rural and remote regions where access to treatment is sparse. This study is the first of its kind to investigate the use of clozapine in a remote and regional area of Australia with a high proportion of Aboriginal and/or Torres Strait Islander individuals. Methods: This study includes all individuals who were commenced on clozapine between June 2013 and June 2018. Relevant clinical information was sourced from electronic medical records and descriptive statistical analysis performed. Results: A total of 3850 patients with psychotic disorders were reviewed over 5 years, of whom 63 were commenced on clozapine. The majority were male ( n = 50, 79.4%) with a mean age of 33.9 years (standard deviation 11.0). A total of 34.9% ( n = 22) identified as Aboriginal and/or Torres Strait Islander. The mean length of time between diagnosis and commencement of clozapine was 7.2 years (standard deviation ±4.6 years), while the mean number of antipsychotic medications tried prior to clozapine was 4.2 (standard deviation ±1.6 antipsychotics). Clozapine was discontinued in 57.1% of the individuals in this study (41% within the first 12 months). The most common cause for cessation was poor compliance ( n = 19, 30.2%). Conclusion: While clozapine remains the most effective antipsychotic treatment, it is often commenced late in the treatment or ceased prematurely. Further work is required, particularly in remote and regional populations, to ensure treatment adherence for optimal patient outcomes.

Cancer outcomes for Aboriginal and Torres Strait Islander Australians in rural and remote areas

2015 ◽  
Vol 23 (1) ◽  
pp. 4-18 ◽  
Author(s):  
Abbey Diaz ◽  
Lisa J. Whop ◽  
Patricia C. Valery ◽  
Suzanne P. Moore ◽  
Joan Cunningham ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Cancer Outcomes ◽  
Rural And Remote ◽  
Remote Areas ◽  
Rural And Remote Areas ◽  
Torres Strait

scholarly journals Working Well: Strategies to Strengthen the Workforce of the Indigenous Primary Healthcare Sector

2019 ◽  
Author(s):  
Crystal Jongen ◽  
Janya McCalman ◽  
Sandy Campbell ◽  
Ruth Fagan
Keyword(s):  
Workforce Development ◽  
Primary Healthcare ◽  
Torres Strait Islander ◽  
Positive Impact ◽  
Health Needs ◽  
Healthcare Sector ◽  
Enabling Factors ◽  
Aboriginal Community ◽  
Torres Strait ◽  
Structural Levels

Abstract Background: The capacity of the Indigenous primary healthcare (PHC) sector to continue playing a crucial role in meeting the health needs of Aboriginal and Torres Strait Islander Australians is in large part reliant on the skills, motivation and experience of its workforce. While exhibiting many workforce strengths, the sector faces significant challenges in building and maintaining a strong and stable workforce. Drawing on data from one Aboriginal Community Controlled Health Service (ACCHS), this study reports what is working well and what could be improved to strengthen the Indigenous PHC sector workforce. Methods: Using grounded theory methods, interviews with 17 ACCHS staff from a range of organisational positions were transcribed, coded and analysed. This paper focuses on the strategies identified that contribute towards strengthening the Indigenous PHC workforce. Results: Four overarching strategies for Indigenous PHC workforce strengthening were identified. These were Strengthening Workforce Stability, Having Strong Leadership, Growing Capacity, and Working Well Together. A range of enabling factors at the macro, community, organisational and individual levels were also identified. Conclusion: Indigenous PHC services are already implementing many important workforce-development strategies that are having a positive impact on the sector. There are also several persistent challenges which need to be addressed through action at organisational and structural levels. Approaches to workforce strengthening in Indigenous PHC should be tailored to local needs to ensure they address the unique workforce challenges experienced in different contexts.

Sustainability Concepts in Indigenous and Non-Indigenous Cultures

2016 ◽  
Vol 23 (2) ◽  
pp. 119-140 ◽  
Author(s):  
David Throsby ◽  
Ekaterina Petetskaya
Keyword(s):  
Sustainable Development ◽  
Cultural Context ◽  
Policy Making ◽  
Torres Strait Islander ◽  
Indigenous Communities ◽  
Knowledge Systems ◽  
International Policy ◽  
Indigenous Cultures ◽  
Indigenous Knowledge Systems ◽  
Torres Strait

Abstract:The concepts of sustainability, and of the more specific notion of sustainable development, have become entrenched in national and international policy making over the last half century. However, little attention has been paid to sustainability as it relates to indigenous communities. This article discusses sustainability concepts as understood in indigenous and non-indigenous societies, drawing a number of illustrations from the experiences and practices of the Aboriginal and Torres Strait Islander peoples of Australia. We point out that the two approaches to sustainability share many common concerns, although significant differences are evident. While the paradigm of sustainability can be seen as a universal concept that can be applied irrespective of social, political, or cultural context, it is argued that a fully realized model of sustainability for application in non-indigenous societies will only be possible if it acknowledges the importance of culture and incorporates the insights that have been accumulated over generations in indigenous knowledge systems.

scholarly journals ‘At the grass roots level it’s about sitting down and talking’: exploring quality improvement through case studies with high-improving Aboriginal and Torres Strait Islander primary healthcare services

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027568 ◽  
Author(s):  
Sarah Larkins ◽  
Karen Carlisle ◽  
Nalita Turner ◽  
Judy Taylor ◽  
Kerry Copley ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Community Engagement ◽  
Primary Healthcare ◽  
Cultural Context ◽  
Torres Strait Islander ◽  
Indigenous Communities ◽  
Community Context ◽  
Health Improvement ◽  
Successful Implementation ◽  
Torres Strait

ObjectivesImproving the quality of primary care is an important strategy to improve health outcomes. However, responses to continuous quality improvement (CQI) initiatives are variable, likely due in part to a mismatch between interventions and context. This project aimed to understand the successful implementation of CQI initiatives in Aboriginal and Torres Strait Islander health services in Australia through exploring the strategies used by ‘high-improving’ Indigenous primary healthcare (PHC) services.Design, settings and participantsThis strengths-based participatory observational study used a multiple case study method with six Indigenous PHC services in northern Australia that had improved their performance in CQI audits. Interviews with healthcare providers, service users and managers (n=134), documentary review and non-participant observation were used to explore implementation of CQI and the enablers of quality improvement in these contexts.ResultsServices approached the implementation of CQI differently according to their contexts. Common themes previously reported included CQI systems, teamwork, collaboration, a stable workforce and community engagement. Novel themes included embeddedness in the local historical and cultural contexts, two-way learning about CQI and the community ‘driving’ health improvement. These novel themes were implicit in the descriptions of stakeholders about why the services were improving. Embeddedness in the local historical and cultural context resulted in ‘two-way’ learning between communities and health system personnel.ConclusionsPractical interventions to strengthen responses to CQI in Indigenous PHC services require recruitment and support of an appropriate and well prepared workforce, training in leadership and joint decision-making, regional CQI collaboratives and workable mechanisms for genuine community engagement. A ‘toolkit’ of strategies for service support might address each of these components, although strategies need to be implemented through a two-way learning process and adapted to the historical and cultural community context. Such approaches have the potential to assist health service personnel strengthen the PHC provided to Indigenous communities.

scholarly journals Pregnancy-related aeromedical retrievals in rural and remote Australia: national evidence from the Royal Flying Doctor Service

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Gonzalez-Chica ◽  
Marianne Gillam ◽  
Susan Williams ◽  
Pritish Sharma ◽  
Matthew Leach ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Age Groups ◽  
South Australia ◽  
International Classification Of Diseases ◽  
Cross Sectional Study ◽  
Rural And Remote ◽  
Cross Sectional ◽  
Unintended Pregnancies ◽  
Torres Strait ◽  
The Impact

Abstract Background Inequalities in the availability of maternity health services in rural Australia have been documented, but not the impact on aeromedical retrievals. This study aims to examine the prevalence of pregnancy-related aeromedical retrievals, the most common conditions (overall and in specific age groups), and their distribution according to operation area and demographic characteristics. Methods Cross-sectional study using administrative data from the Royal Flying Doctors Service (RFDS) including all pregnant women aged 15–49 years retrieved by the RFDS between 2015 and 2019. All pregnancy-related aeromedical retrievals were classified according to the International Classification of Diseases, Tenth Revision (ICD-10, chapter XV). The distribution of pregnancy-related conditions was presented overall and stratified by age group (i.e. < 20 years, 20–34 years and 35+ years). Retrieval and receiving sites were geographically mapped with Tableau mapping software® based on postcode numbers of origin and destination. Results A total of 4653 pregnancy-related retrievals were identified (mean age 27.8 ± 6.1 years), representing 3.1% of all RFDS transfers between 2015 and 18 and 3.5% in 2018–19 (p-value 0.01). The highest proportion of pregnancy-related retrievals (4.8%) occurred in Western operation. There was an apparent increase in pregnancy-related retrievals in South Australia and the Northern Territory (Central Operation) in 2018–19. Preterm labour/delivery was responsible for 36.4% of all retrievals (40.7% among women aged 15–19 years) and premature rupture of membranes for 14.9% (19.4% among women aged 35–49 years). Inter-hospital transfers represented 87.9% of all retrievals, with most patients relocated from rural and remote regions to urban hospitals; most retrievals occurred during the day, with a median distance of 300 km. Adolescents and Aboriginal and Torres Strait Islander were overrepresented in the sample (four and eight times higher than their metropolitan counterparts, respectively). Conclusions The proportion of pregnancy-related aeromedical retrievals varies geographically across Australia. Overall, one-third of retrievals were related to preterm/delivery complications, especially among adolescents. Most retrievals performed by the RFDS are susceptible to public health strategies aimed at improving antenatal care and preventing unintended pregnancies among adolescents and Aboriginal and Torres Strait Islander women. Greater capacity to manage pregnancy conditions in rural hospitals could reduce the requirement for aeromedical inter-hospital transfers.

scholarly journals Working Well: Strategies to Strengthen the Workforce of the Indigenous Primary Healthcare Sector

2019 ◽  
Author(s):  
Crystal Jongen ◽  
Janya McCalman ◽  
Sandy Campbell ◽  
Ruth Fagan
Keyword(s):  
Workforce Development ◽  
Primary Healthcare ◽  
Torres Strait Islander ◽  
Positive Impact ◽  
Health Needs ◽  
Healthcare Sector ◽  
Enabling Factors ◽  
Aboriginal Community ◽  
Torres Strait ◽  
Structural Levels

Abstract Background The capacity of the Indigenous primary healthcare (PHC) sector to continue playing a crucial role in meeting the health needs of Aboriginal and Torres Strait Islander Australians is in large part reliant on the skills, motivation and experience of its workforce. While exhibiting many workforce strengths, the sector faces significant challenges in building and maintaining a strong and stable workforce. Drawing on data from one Aboriginal Community Controlled Health Service (ACCHS), this study reports what is working well and what could be improved to strengthen the Indigenous PHC sector workforce.Methods Using grounded theory methods, interviews with 17 ACCHS staff from a range of organisational positions were transcribed, coded and analysed. This paper focuses on the strategies identified that contribute towards strengthening the Indigenous PHC workforce.Results Four overarching strategies for Indigenous PHC workforce strengthening were identified. These were Strengthening Workforce Stability, Having Strong Leadership, Growing Capacity, and Working Well Together . A range of enabling factors at the macro, community, organisational and individual levels were also identified.Conclusion Indigenous PHC services are already implementing many important workforce-development strategies that are having a positive impact on the sector. There are also several persistent challenges which need to be addressed through action at organisational and structural levels. Approaches to workforce strengthening in Indigenous PHC should be tailored to local needs to ensure they address the unique workforce challenges experienced in different contexts.

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