Search

: Objectives: This research aimed to gain insights into the reporting of family violence (FV) and to explore any changes in FV reporting associated with a FV primary prevention initiative in Geraldton, Western Australia. Methods: An in‐depth analysis of articles published by the Geraldton Guardian in 2019 examined the nature of FV reporting. Analysis was based on deductive coding from existing literature and inductive identification of new themes. A comparative analysis examined articles from the Geraldton Guardian and Albany Advertiser over the same three‐month period in 2015, 2017 and 2019 to analyse trends in FV reporting. Results: Of 135 articles analysed, there was alignment with five previously reported themes and two new themes were identified: FV as a public health issue; and community responses to reduce FV. Episodic framing was overwhelmingly associated with court reporting. There was more reporting of efforts at primary prevention of FV over time in both newspapers. Conclusions: Local media can contribute to the promotion of community and public health issues related to FV. Efforts are needed to improve court reporting to situate FV in a broader context. Implications for public health: Concerted efforts to educate the public and journalists can support FV being recognised as a public health issue., Family violence (FV) is a gendered and serious public health issue in Australia.[sup.1-3] The pattern of violence also differs between genders, with women's most recent incident of physical assault most [...]

Background: The analysis aimed to assess the Indigenous status of an increasing number of deaths not coded with a useable Indigenous status from 1997 to 2002 and its impact on reported recent gains in Indigenous mortality. Methods: The Indigenous status of WA death records with a missing Indigenous status was determined based upon data linkage to three other data sources (Hospital Morbidity Database System, Mental Health Information System and Midwives Notification System). Results: Overall, the majority of un-coded cases were assigned an Indigenous status, with 5.9% identified as Indigenous from the M1 series and 7.5% from the M2 series. The significant increase in Indigenous male LE of 5.4 years from 1997 to 2002 decreased to 4.0 and 3.6 years using the M1 and M2 series, respectively, but remained significant. For Indigenous females, the non-significant increase in LE of 1.8 years from 1997 to 2002 decreased to 1.0 and 0.6 years. Furthermore, annual all-cause mortality rates were higher than in the original data for both genders, but the significant decline for males remained. Conclusion: Through data linkage, the increasing proportion of deaths not coded with a useable Indigenous status was shown to impact on Indigenous mortality statistics in Western Australia leading to an overestimate of improvements in life expectancy. Greater attention needs to be given to better identification and recording of Indigenous identifiers if real improvements in health status are to be demonstrated. A system that captures an individual's Indigenous status once and is reflected in all health and administrative data systems needs consideration within Australia. Key words: Indigenous, Aboriginal, mortality, life expectancy, data linkage. doi: 10.1111/j.1753-6405.2009.00403.x

Objective: Cancer among Indigenous populations in the developed world appears to have increased over past few decades. This article explores issues related to cancer among the Indigenous populations of Australia, Canada, New Zealand and the US and examines variations in the epidemiology, Indigenous peoples' perceptions about cancer and potential effects on care-seeking behaviour. Methods: A search of peer-reviewed journal articles, government reports, published and unpublished theses and other grey literature was undertaken using electronic databases and citation snowballing. Both epidemiological and qualitative studies were included. Results: Cancer in Indigenous populations in these four countries is characterised by high incidence and mortality rates for specific cancers and lower survival rates as a result of late diagnosis, lower participation and poorer compliance with treatment. A higher prevalence of many cancer risk factors occurs across these populations. Fear of death, fatalism, payback, shame and other spiritual and cultural issues are reported in the few qualitative studies examining Indigenous beliefs and understanding of cancer which undoubtedly influences participation in cancer screening and treatment. Conclusions and implications: The holistic approach (physical, mental, emotional and spiritual) to healing and well-being, and the concept that individual, family and community are inseparable underpin Indigenous care-seeking behaviour. Further community-based research is needed to increase understanding of the needs of Indigenous people with cancer, and to guide policy and practice towards more supportive and effective care. Key words: Health services, Indigenous, Neoplasms, culture, holistic health.

Objective: To provide practical advice to health care providers and public health practitioners regarding screening and management of sexually transmitted infections (STIs) in sex workers, and to examine the effectiveness of condoms in reducing transmission of STIs. Methods: Medline search using the key words sex workers, prostitutes, condoms and these terms in conjunction with pregnancy, sexually transmitted infections (including the names of individual STIs), infectivity, exclusion periods. Additional articles were identified from cited references. Articles were selected on the basis of information provided on efficacy of condoms in ST1 prevention, prevalence of STIs in sex workers and changes following condom promotion, and advice about management of STIs in infected workers. Results: Condoms offer some protection (30-90%) against STIs passed in semen, urethral, vaginal or cervical secretions (such as HIV, gonorrhoea, chlamydia). They give little to no protection (0-30%) against diseases due to skin-to-skin contact such as genital herpes and genital warts. Transmissibility of STIs varies according to the sex of the exposed person and the sexual practice. Condom effectiveness against STIs also varies with gender, and experience and consistency of condom use. Conclusions: Sex workers require regular screening for STIs as condom use is not fully protective. Management of sex workers identified with infection requires understanding of the issues faced by sex workers, biological characteristics of the infective organism, treatment efficacy, and test sensitivity and specificity. Advice on frequency of STI testing, supply of medical certificates, management of condom breakage, and management of infected sex workers is proposed.

Background: More than 30 million needle syringes are distributed per year in Australia as a component of harm-reduction strategies for injecting drug users (IDU). Discarded needle syringes create considerable anxiety within the community, but the extent of needlestick injuries and level of blood-borne virus transmission risk is unclear. We have undertaken a review of studies of blood-borne virus survival as the basis for advice and management of community needlestick injuries. Methods: A Medline review of published articles on blood-borne virus survival and outcome from community injuries. Results: Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) can all survive outside the human body for several weeks, with virus survival influenced by virus titer, volume of blood, ambient temperature, exposure to sunlight and humidity. HBV has the highest virus titers in untreated individuals and is viable for the most prolonged periods in needle syringes stored at room temperature. However, prevalence of HBV and HIV are only 1-2% within the Australian IDU population. In contrast, prevalence of HCV is 50-60% among Australian IDUs and virus survival in needle syringes has been documented for prolonged periods. There have been no published cases of blood-borne virus transmission following community needlestick injury in Australia. Conclusion: The risk of blood-borne virus transmission from syringes discarded in community settings appears to be very low. Despite this, procedures to systematically follow up individuals following significant needlestick exposures sustained in the community setting should be developed.

Inadequate rates of childhood immunization is a major concern in Australia. The number of people passing through the Melbourne Juvenile Justice Centre (MJJC) are believed to be from a background highly at risk for inadequate immunization. MJJC residents were invited to participate in this study by either giving a blood sample, completing a questionnaire, or both. The results showed suboptimal levels of immunity with the potential for disease outbreak.

Systematic on site HIV testing was undertaken on all bodies taken to the Victorian Institute of Forensic Medicine (VIFM) between 1989 and 1996. Information was collected and matched to surveillance database. It showed that in 8 years, 75 people were diagnosed wit HIV and all were male except one. The ranged between 14 and 70 years of age. Major causes of death were suicide, AIDS, drug toxity, natural causes, and injury. The major exposure groups were homosexual, 51%, male bisexual 11 %, homosexual/bisexual IDU 16%, and IDU other 8%.

A study to estimate prevalence of risk factors for liver disease, hepatitis B and hepatitis C (HCV) infections in particular, in a population-based series of hepatocellular carcinoma was carried out in Australia. Feasibility of retrospective surveys in determining risk factors for hepatocellular carcinoma was to be assessed. Alcoholic cirrhosis has a high contribution especially in Australian-born men. The growing epidemic of HCV will require better surveillance for sequelae. Medical records should be more complete. HBV and HCV testing were not sufficient to make it possible to find solid associations.

A 1994 survey of tattooists in Victoria is discussed in relation to self-reported and observed compliance with infection-control practices. Observed practices discussed include procedures before tattooing, during tattooing, use of ultrasonic cleaners, equipment cleaning and sterilization, disposal of sharps and infectious wastes, and separation of clean and contaminated areas.

A 1994 questionnaire given to tattooists in Victoria on attitudes and knowledge of infection control is discussed. Topics include needle-stick injuries, hepatitis testing and vaccination, sources of knowledge about infection control, understanding of the meaning of infection control, knowledge of diseases for which tattooing figures as a risk factor, and attitudes to infection control.

A survey of child care workers in Victoria, Australia, showed more were vaccinated against Hepatitis B than Hepatitis A. Only 11% of workers responding were vaccinated for hep. A, while nearly 66% were vaccinated for hep. B, although the latter has not been recommended as part of government policy. Most child care workers believe their profession places them at risk for exposure to hep. A and B.

Background: HIV‐related stigma, among other factors, has been shown to have an impact on the desire to have children among people living with HIV (PLHIV). Our objective was to explore the experiences of HIV‐related stigma among PLHIV in post‐conflict northern Uganda, a region of high HIV prevalence, high infant and child mortality and low contraception use, and to describe how stigma affected the desires of PLHIV to have children in the future. Methods: Semi‐structured interviews were conducted with 26 PLHIV in Gulu district, northern Uganda. The interviews, conducted in Luo, the local language, were audio recorded, transcribed and then translated into English. Thematic data analysis was undertaken using NVivo8 and was underpinned by the “Conceptual Model of HIV/AIDS Stigma”. Results: HIV‐related stigma continues to affect the quality of life of PLHIV in Gulu district, northern Uganda, and also influences PLHIV's desire to have children. PLHIV in northern Uganda continue to experience stigma in various forms, including internal stigma and verbal abuse from community members. While many PLHIV desire to have children and are strongly influenced by several factors including societal and cultural obligations, stigma and discrimination also affect this desire. Several dimensions of stigma, such as types of stigma (received, internal and associated stigma), stigmatizing behaviours (abusing and desertion) and agents of stigmatization (families, communities and health systems), either directly, or indirectly, enhanced or reduced PLHIV's desire to have more children. Conclusion: The social‐cultural context within which PLHIV continue to desire to have children must be better understood by all health professionals who hope to improve the quality of PLHIV's lives. By delineating the stigma process, the paper proposes interventions for reducing stigmatization of PLHIV in northern Uganda in order to improve the quality of life and health outcomes for PLHIV and their children., Background Desire to have children among people living with HIV (PLHIV) continues to have medical and public health implications, particularly in countries with low coverage of prevention of mother‐to‐child transmission [...]

Background: Early detection of breast cancer using screening mammography provides an opportunity for treatment which can lead to significantly improved outcomes. Despite considerable efforts having been made, the rate at which Aboriginal and Torres Strait Islander (hereafter respectfully referred to as Aboriginal) women in Western Australia participate in BreastScreen WA's screening mammogram program remains below that for the overall female population of Western Australia. This study aimed to examine perspectives on breast screening amongst Aboriginal women in Western Australia. We explored the factors which impact on participation in breast screening and sought to identify potential initiatives to address lower participation in screening.Methods: Semi-structured interviews, focus group discussions and yarning sessions were conducted with a total of 65 research participants. They were all Aboriginal and comprised consumers and health professionals from locations across the state.Results: Our findings show that research participants generally were willing to have a mammogram. Key reasons given were having a genetic predisposition to breast cancer and a perception of investing in health for the sake of the next generation, as well as personal well-being. Barriers identified included lack of education about or understanding of screening, inadequacies in cultural appropriateness in the screening program, cultural beliefs around cancer in general and breast cancer in particular, and competing health and life priorities. However, many enablers were identified which can serve as potential strategies to assuage fear and increase screening uptake. These included increased education delivered by respected Aboriginal women, culturally appropriate promotion and the provision of care and support from other women in the community.Conclusion: The higher participation rates for Aboriginal women in Western Australia than are found for Aboriginal women nationally demonstrate the success of the strategies put in place by BreastScreen WA. These efforts must be supported and existing policies and practices enhanced to address the limitations in the existing program. Only by implementing and evaluating such initiatives and making breast screening programs more accessible to Aboriginal women can the current disparity between the screening participation rates of Aboriginal and non-Aboriginal women be reduced. [ABSTRACT FROM AUTHOR]

Issues addressed: Preferences for topics and means of access to health information among newly arrived, culturally and linguistically diverse women in Perth, Western Australia, were explored. Methods: A mixed-methods approach was adopted. Qualitative material obtained from focus groups and interviews with 22 service providers and 26migrant women was used to develop a questionnaire, which was then administered to 268 newly arrived migrant and refugee women from 50 countries. Participants' information and support priorities were ascertained from a ranking exercise conducted in a non-threatening context. Responses of migrant and refugee women were compared quantitatively. Results: Women's top priorities for information and support included employment advice, as well as information regarding mental health issues, women's health, exercise and nutrition, family violence and alcohol and other drug issues. Their preferred methods for receiving information were interactive talks or presentations, with written material support. Audiovisual and Web-based material were also considered useful. There were differences between refugee women's and other migrants' preferences for means of receiving information and topics of most concern. Discussion: The use of a non-threatening ranking process encouraged women to prioritise sensitive topics, such as family violence, and revealed a need for such topics to be incorporated within general health information presentations. Internet-based technologies are becoming increasingly important methods for disseminating information to migrant women. [ABSTRACT FROM AUTHOR]

Background: Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of 'White', Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power. Methods: Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers' past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings. Results: Racism emerged as a key issue, leading us to more deeply interrogate the role 'Whiteness' plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised racism was manifest when Indigenous patients incorporated racist attitudes and beliefs into their lived experience, lowering expectations and their sense of self-worth. Conclusions: Current health policies and practices favour standardised care where the voice of those who are marginalised is often absent. Examining the effectiveness of such models in reducing health disparities requires health providers to critically reflect on whether policies and practices promote or compromise Indigenous health and wellbeing--an important step in changing the discourse that places Indigenous people at the centre of the problem. [ABSTRACT FROM AUTHOR]