Recent Reading on Indigenous Affairs and Health

I haven’t been posting much but I have tried to keep up my reading.

An article from a 2011 edition of the Australian Prescriber on the prescribing cascade. This is where a new medication is prescribed to cover a side effect of a previously prescribed medication, where this adverse effect is not recognised as a side effect. It happens more than you think. I remember a presentation with a number of prescribing cascades presented to a bunch of remote practitioners eight years ago. The cry was “we want pharmacists in remote”. Sadly there are still only a few of us.

There’s a lot of research showing those with low health literacy have worse health outcomes in a number of disease states. Recently there’s been a look at those with Chronic Obstructive Pulmonary Disease (COPD). An article has been published recently in the Journal of General Internal Medicine with the brief title “Lower Health Literacy is Associated with Poorer Health Status and Outcomes in Chronic Obstructive Pulmonary Disease“. The title gives away the conclusion. If you have poorer health literacy you have worse outcomes. If you can’t access the article Reuters has a summary.

The CSIRO in 2011 released a report Indigenous socio-economic values and river flows (large PDF) looking at the Fitzroy and Daly Rivers. I’m a bit of a desert sort of bloke but it is interesting if dry reading (see what I did there). The conclusion notes that the percentage of Indigenous Australians over the age of 15 who participate in the harvesting of natural resources in remote Australia was 72% and 60% for all Australia. That is a remarkably high number and to me highlights the still strong connection to land by Indigenous Australians.
Late Addition: Late Night Live on ABC’s Radio National has a segment discussing the management of the 20% of Australia that is Indigenous owned. Caring for country

A recent post in one of the pharmacy online forums I frequent asked where they could send returned or unused drugs to be sent overseas. I am a little perturbed by the number of pharmacists who still ask that question. It hasn’t been recommended since 1996 when the Australian Pharmaceutical Advisory Council endorsed the Australian guidelines for drug donations to developing countries. Page two describes several examples highlighting why guidelines are required. The WHO also has a 52 page document Drug Donations in Post-Emergency Situations

To finish up Australian Medicine Online tells how researchers from The University of Melbourne found that medical tribunals are more likely to deregister doctors for character flaws and lack of insight rather than errors or poor clinical knowledge.

Recent Reading

Here are some articles I have been reading that sort of fit in with the blog.

I’ve discovered TechNet21 – the technical network for strengthening immunisation services. There are two articles in particular that I have been reading. Cool Innovations for Vaccine Transportation and Storage is looking at a range of innovative cool storage and transfer containers. Solar is getting hotter looks at alternative ways to keep the drug fridges going where there is unreliable or no power.

The Atlantic’s article What Americans Keep Ignoring About Finland’s School Success looks at Finland’s school system and finds Equity in Education is what has led Finland to top world scores in education. Something to think about in the context of remote Australia

One of my favourite blogs from Nyaya Health, a health service in a remote area of Nepal looks at how they worked to improve how their patient xrays are read to improve patient care.

I’ve yet to read the actual study but this release describing how using copper door handles and bench tops to reduce the spread of infections in hospital by 40%. Yes, a big claim.

The US Department of Housing can predict your life expectancy just on where you live. And it ain’t those who live in a good neighbourhood who get sick the most. Just moving poor people to safer neighbourhoods improves health outcomes.

An article by the SkepticLawyer looks at the current actions of the incorrectly named Australian Vaccination Network and the tripe they spread and argues a major campaign to shock people into vaccinating their children is required.

Recent Reading

I hope you find something interesting in this selection.

The Overcoming Indigenous Disadvantage Key Indicators 2011 is a long and very sad read.

Across virtually all the indicators in this report, there are wide gaps in outcomes between Indigenous and other Australians. The report shows that the challenge is not impossible — in a few areas, the gaps are narrowing. However, many indicators show that outcomes are not improving, or are even deteriorating. There is still a considerable way to go to achieve COAG’s commitment to close the gap in Indigenous disadvantage.

Aboriginal to non-Aboriginal differentials in 2-year outcomes following non-fatal first-ever acute MI persist after adjustment for co-morbidity you have probably guessed is a very dry research article. It looked at death rates from heart attacks from 2000-2004. Aboriginal people were much more likely to have a heart attack and were younger when they occurred. Sadly, even when adjusting for the increased disease rate (e.g. renal) in Aboriginal Australians it found that Aboriginality is a significant independent risk factor.

The Australian reported that the committee set up to review the constitution, looking at a preamble recognising Indigenous Australians seem to have surprised with suggesting Section 51(xxvi) of the Constitution – the “race power” that allows the Commonwealth to legislate in regard to “any race for whom it is deemed necessary to make special laws” – be removed.

We are fast running out of antibiotics with bacterial resistance developing to many. The Antimicrobial Stewardship in Australian Hospitals by the Australian Commission on Safety and Quality in Health Care looks at ways to minimise the spread of resistance.

The publication provides guidance on developing and introducing a hospital Antimicrobial Stewardship program. It describes the structure, governance and resources needed for an effective program, along with those strategies shown to influence antimicrobial prescribing and reduce inappropriate use.

The Oxford League Table of Analgesic Efficacy looks at various pain relievers and the numbers needed to treat for at least 50% pain relief compared to placebo.

Recent Reading

If there is one article you read from this list make it this one. The Brutal Truth: What Happened in the Gulf Country. Published in The Monthly in November 2009 it presents details of the massacres that occurred in the Top end up until the 1930s. It is a despairing but necessary read.

Drink, death and dollars looked at the “rivers of grog in Alice Springs. It was heard on ABC Radio’s The World Today in December 2010. Following its recent Walkley Award I went and listened to it again. Still relevant.

A read of Three Must-Haves for Using Twitter in a Crisis reminded me of the excellent Croakey Blog post The role of social media in flood response and recovery efforts. Which then led me to the United Nations Foundation report New Technologies in Emergencies and Conflict: The Role of Information and Social Networks. The last two are certainly worth a read.

The National Health and Medical Research Foundation ran its 75th anniversary Scientific Symposium at the end of November. All presentations are on the website but a must watch is that of Indigenous public health medical researcher Alex Brown Voices from the Centre of the Fringe: Chronic Disease in Indigenous Australians

“What scientists hold stock in, is only what they can measure. But you can’t measure the mind or the spirit. You can’t weigh it, you can’t deconstruct it. But only if we do will they see that Aboriginal people are spectators to the death of their culture, their lives….

We watch as our culture dies.

How are you going to measure that?”

His presentation high lighted several areas in chronic disease that we need to be approaching differently

I hope you find something you like from this week’s selection

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