Australian Family Physician October 2005 - Health Inequalities
Vol 34, (10): 805 - 896
The theme for the October issue of AFP is Health
Inequalities. Articles include encounters with Indigenous patients in
Australian general practice, Indigenous male health disadvantage,
prevention and socioeconomic disadvantage and refugee health..
Tackling health inequalities - General practitioners and physicians working together
Jill Sewell and Michael Kidd
The dramatic increase in life expectancy of the Australian population during the early twentieth century was largely due to improved management of infectious diseases, while the improvement in the second half was largely due to a decrease in rates of chronic diseases including heart disease and stroke; and in more recent years, lung, colorectal and breast cancer.
Letters to the Editor
The opinions expressed by correspondents in this column are in no way endorsed by either the Editors or The Royal Australian College of General Practitioners
Encounters with indigenous patients in Australian general practice
Janice Charles, Helena Britt, Stephanie Knox
The BEACH program, a continuous national study of general practice activity in Australia, gives an overview of consultations with indigenous patients.
Indigenous male health disadvantage - Linking the heart and mind
Alex Brown and Grant Blashk
Aboriginal men experience unacceptably high morbidity and mortality rates for almost all medical conditions. Heart disease and depression in particular are common, inter-linked, and potentially amendable to interventions delivered through primary care.
Prevention and socioeconomic disadvantage
John Furler and Doris Young
Counselling in behavioural risk factors links chronic disease prevention and chronic disease care in the day-to-day work of general practice. This is particularly so in diabetes and cardiovascular disease.
Refugee health
Mark Harris and Nicholas Zwar
Refugees and asylum seekers in Australia come from many countries. They present a significant challenge for general practice.
Concordance - An alternative term to compliance in the Aboriginal population
Jill Benson
Compliance is an important issue for the health of the Aboriginal people. The word implies that patients are not following the doctors rules.
Inequities in Aboriginal health - Access to the Asthma 3+ Visit Plan
Sophie Couzos and Scott Davis
The prevalence of asthma is higher in Aboriginal and Torres Strait Islander adults than in non-Indigenous Australian adults in all age groups, and hospitalisation rates for acute asthma episodes are much higher, indicating suboptimal prevention.
PBS medications - Improving access for Aboriginal and Torres Strait Islander peoples
Sophie Couzos
Expenditure through major commonwealth funded health programs such as the Pharmaceutical Benefits Scheme (PBS) is much lower for Aboriginal and Torres Strait Islander peoples than other Australians.
The RACGP - Supporting GPs to work better in Aboriginal and Torres Strait Islander health
Jenny Reath
The Royal Australian College of General Practitioners (RACGP) has worked with funding from the Australian government to improve support and training for general practitioners working in Aboriginal and Torres Strait Islander communities.
NACCHO GP Network - Enhancing communication in Aboriginal health
Robert N Starling, Chris O'Connellis and Sophie Couzos
Communication between general practitioners, information sharing, and GP support are important issues, especially for those in rural and remote areas.
Breast cancer in young women
Meagan Brennan, James French, Nehmat Houssami, Judy Kirk and John Boyages
This eighth article in our series on breast disease focusses on breast cancer in young women. There are several challenges in the diagnosis of breast cancer in young women, and special consideration must be given to the woman’s fertility and body image issues.
Ear examination - A practical guide
Phillip Chang and Kesley Pedler
Ear problems represent a significant proportion of cases seen in primary practice – both in paediatric and adult patients. The majority of these ear problems can be diagnosed on the basis of clinical examination of the ear alone.
Re-entry adjustment of cross cultural workers - The role of the GP
Susan Selby, Alison Jones, Teresa Burgess and Justin Beilby
Re-entry adjustment affects Australian cross cultural workers returning home; and for many, loss and grief issues arise. General practitioners are often the first point of contact in the health care system and are well placed to deal with these issues.
Diabetes and the skin - Part 1 Tender skin lumps
Pat Phillips and Warren Weightman
Sarah has poorly controlled type 2 diabetes (A1c consistently over 10%, also known as glycosylated haemoglobin, glycated haemoglobin or HbA1c; target levels <7%) associated with hypertension and dyslipidaemia.
Contraception and sexually transmitted infections
Belinda Sheary and Linda Dayan
Many women seek contraceptive advice from general practitioners. These consultations provide an opportunity to discuss the prevention of sexually transmitted infections (STIs) including human immunodeficiency virus (HIV).
A GP's duty of confidentiality
Sara Bird
Case histories are based on actual medical negligence claims, however certain facts have been omitted or changed by the author to ensure the anonymity of the parties involved.
Do we need USPs?
Martin Halperin
Australia is lacking the vital data relating to current practices needed to perform a meaningful evaluation of the quality of care in general practice.
Research and development in Central Australia - an indigenous perspective
Ricky Mentha
I have lived in Alice Springs for the past 14 years with my partner and her relatives. I am proud to call them my family and want to acknowledge their support and guidance for teaching me their laws and cultural protocols.
Indigenous research - a personal perspective
Anita Curtis
To date there are not many indigenous people working in medical research. To be employed in a position where you can still work with your own people at a level where learning is mutually beneficial is worthwhile and rewarding for the community and yourself.
Facial rash - Brain teaser
Jerzy K Pawlak
Case history: A boy, 10 years of age, presented with a rash on his chin. The rash is a scaling papular lesion with peripheral enlargement and central clearing.
Clinical Challenge
Jenni Parsons
Questions for this month's clinical challenge are based on articles in this issue.
Self directed learning and continuing medical education
Navaz Hiramanek
Self directed learning (SDL) for continuing medical education (CME) is the most effective approach for improving physician performance and patient care outcomes.
Consent before testing men for prostate cancer - a challenge?
Geoffrey Hirst
Advocacy for and against the screening of men for prostate cancer has engendered a wide ranging, and at times acrimonious, debate in both the medical and lay press.
An educational workshop on the early detection of prostate cancer - A before -after evaluation
Suzanne K Steginga, Carole Pinnock, Peter D Baade, Claire Jackson, Anita Green, John Preston, Peter Heathcote and Brian McAvoy
Australian population based screening for prostate cancer with prostate specific antigen (PSA) testing is not recommended because of lack of evidence that it reduces its death rate.
Early management of meningococcal disease - Do attitudes of GPs influence practice?
Kari Jarvinen, Linda Selvey, Chris Del Mar, Michael Tilse and Robyn Pugh
Survival from early meningococcal disease might be improved if general practitioners followed guidelines by immediately administering parenteral antibiotics (before hospital referral).
What factors facilitate a GP survey high response rate?
James Fielding, Hazel Clothier, Nigel Stocks and Heath Kelly
General practitioners are inundated with surveys seeking information about their beliefs and practices by a range of health researchers, policy makers and marketers.