Australian Family Physician December 2008 - Indigenous Health

Vol 37, (12) 977 - 1056

Australian Family 
Physician December 2008 - Indigenous HealthThe theme for the December issue of AFP is Indigenous Health. This month's articles include Indigenous Patients, Beyond the mainstream - health gains in remote Aboriginal communities, Patient centred care - cultural safety in indigenous health & Motivational care planning - self management in indigenous mental health.


Working toward a goal

Aleeta Fejo
I thought that this story started when I was 28 years of age, but actually, it started before I was born. I am a Larrakia Traditional Owner, inherited from my father, and I am a Warramunga woman from my mother.

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.

Closing the indigenous health gap

Ian PS Anderson
On 24 March 2008, Prime Minister Kevin Rudd, the leader of the Federal Opposition, and health sector leaders signed a pledge to close the indigenous health gap by 2030 and the equity gap in health service provision by 2018.

Indigenous patients

Salma Fahridin, Helena Britt, Janice Charles
In the BEACH program (Bettering the Evaluation and Care of Health) between 2000 and 2008, Aboriginal people and/or Torres Strait Islanders accounted for approximately 1.1% of total BEACH encounters.

Beyond the mainstream - Health gains in remote Aboriginal communities

Paul Burgess, Albert Mileran, Ross Bailie
Aboriginal and Torres Strait Islander Australians have long asserted the health benefits of maintaining close links with the lands and seas to which they have ancestral connections.

Patient centred care - Cultural safety in indigenous health

Hung The Nguyen
The terms ‘cultural safety’ and ‘cultural competence’ are used widely in indigenous and culturally and linguistically diverse health contexts.

Motivational care planning - Self management in indigenous mental health

Trish Nagel, Carolyn Thompson
Detection and treatment of mental illness in indigenous communities is often complicated by cross cultural difference, social complexity and comorbid disorders.

Vitamin D - A review

Mark L Stroud, Simon Stilgoe, Valerie E Stott, Oula Alhabian, Khaled Salman
Vitamin D status affects musculoskeletal health. More recently, the nonmusculoskeletal actions of vitamin D have become increasingly documented including endocrine effect on kidneys and intestine, local autocrine effects on cell differentiation, proliferation and immune modulation, and cell membrane effects including promotion of the intestinal absorption of calcium and the secretion of insulin.

‘My knee is swollen’

Simon Burnet, Patrick J Phillips
‘It’s steadily getting worse. Over the past few days my knee has swelled up like a balloon. Now it hurts like hell and I have had to stop working’.

Flucloxacillin induced acute renal failure

Bo Xu, Michael Murray
Acute interstitial nephritis is a less frequently reported adverse effect of flucloxacillin compared with other well known associations such as hepatotoxicity.

AFP in Practice

AFP in Practice questions are designed to get you started in a small group learning (SGL) activity in your practice or with colleagues. Requirements to earn 40 Category 1 CPD points for a SGL activity are: minimum of four and a maximum of 10 people, minimum of 8 hours of discussion in a year, and at least two GPs.

Clinical Challenge

Questions for this month's clinical challenge are based on articles in this issue. The style and scope of questions is in keeping with the MCQ of the College Fellowship exam. The quiz is endorsed by the RACGP Quality Assurance and Continuing Professional Development Program and has been allocated 4 CPD points per issue.

Indigenous community members as teachers of indigenous health

Hung The Nguyen, Andrew Gardiner
Educating the health workforce in indigenous health has been set as a high priority by educational bodies and providers of general practice training.

Lost without translation

Sara Bird
Underuse of interpreters by medical practitioners is common. This may occur through lack of knowledge about access to interpreters, lack of understanding of the importance or need for interpreters, or refusal to use interpreters even in the knowledge that the service is available and free.

Book Reviews

Books reviewed this month are Clinical Cases in Obstetrics, Gynaecology and Women’s Health by Caroline De Costa and Paul Howat, Leadership and Teambuilding in Primary Care by Clare Mullins and Graham Constable, Key Topics in Pain Medicine by Kate Grady, Andrew Severn and Paul Eldridge, The Cardiovascular System at a Glance by Philip I Aaronson, Jeremy PT Ward, Charles M Wiener and The Gastrointestinal System at a Glance by Satish Keshav.

Teaching medical history to medical students - The Monash experience

Sanjiva S Wijesinha, David Dammery
It is important to provide medical students with the inspiration to explore, to acquire knowledge about matters outside the narrow range of clinical medicine, to develop ideas and opinions, to discuss them openly, and to write about these ideas in a way that nondoctors would find intelligible.

A nurse led model of chronic disease care - An interim report

Diann S Eley, Chris B Del Mar, Elizabeth Patterson, Robyn L Synnott, Peter G Baker, Desley Hegney
Chronic condition management in general practice is projected to account for 50% of all consultations by 2051. General practices under present workforce conditions will be unable to meet this demand.

Aboriginal and Torres Strait Islander health assessments - Barriers to improving uptake

Helen Kehoe, Ray W Lovett
This study investigated the reasons for low uptake of Medicare Benefits Schedule rebated health assessments for Aboriginal people and Torres Strait Islanders in mainstream general practice in the Australian Capital Territory region.

Trends in GP home visits

Catherine Joyce, Leon Piterman AM
To date there has been no detailed analysis of the profile of home visit patients, and the extent of any changes over time in Australian general practitioner home visiting patterns.



Last Modified: 3 December 2008
Authorised By: Australian family physician

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