Not many years ago a diagnosis of HIV-AIDS was generally regarded as a death sentence, and many gay men, or men who had occasional sex with men, began planning for the end of their days. Hoping to make the most of the time left, a good number sold up down south and moved to the NSW Northern Rivers, a place of tolerance, cultural and climatic appeal, and decent health services.
Most expected to die, but one of those rare medical ‘miracles’ occurred, slowly at first, as is the way with research, and then picked up pace: treatments for the HIV virus, and more recently, preventative medications, were developed, found successful, and became widely available. Today, the anti-viral prophylactic PREP and the ‘morning after’ pill PEP, both prescribed by GPs, are the new normal.
North Coast Primary Health Network is partnering with local organisation Desert Pea Media (DPM) to produce a social and emotional wellbeing program worth $800,000 to support local Aboriginal communities.
Young Aboriginal people on the North Coast experience disproportionate levels of mental health issues, including self-harm and suicide while cultural continuity and self-determination are protective factors for Aboriginal and Torres Strait Islander peoples' social and emotional wellbeing.
Since 2002, DPM has worked with Indigenous young people across Australia using contemporary storytelling techniques and audio-visual media to facilitate important social and cultural conversations. Working collaboratively with Elders, young people, community leaders and local service providers, DPM’s Break It Down is an Aboriginal youth mental health literacy program. The program is relevant and appropriate to the needs of individuals and communities.
Break it Down provides a safe space for young people to express themselves about difficult topics like mental health, and the use of alcohol and other drugs.
Aboriginal health priorities project Northern Rivers, NSW
Aboriginal staff at the University Centre for Rural Health (UCRH) in Lismore are leading the Health from the Grassroots Project aimed at giving voice to local mobs (from the Tweed to Clarence Valley) to talk about their priorities for community health and wellbeing and perspectives on what’s working well and what needs improvement to support community health and happiness.
We aim to collate the many comments and feedback received into actions to inform service provision and research.
- Written by Dr Tien K Khoo
Elderly patients are frequently admitted to hospital as the result of polypharmacy. Medications are reviewed and many are able to be stopped.
The list of medications that can cause problems is long. Anticholinergics, antispasmodics, antidepressants and anti-parkinonsian medications are frequent offenders. So too are sedatives and narcotics.
Unfortunately for the GP when patients return after hospital discharge they reportedly find life intolerable due to pain and/or severe insomnia. Despite the warnings medication is often restarted and the cycle begins again.
Dr Tien Khoo, staff physician at Ballina District Hospital, sees this cycle all too frequently. In this article he recommends the "7 step medication review" plan to break or at least slow the cycle.
Concurrent with the evolution of modern medicine practitioners are increasingly caught up in a career that is rife with guidelines and recommendations. Though well-meaning, many of theses are led by specialist groups and institutions that focus (understandably) on a particular condition. Things are then left to the astute clinician involved in the decision-making process of clinical management, often followed by safe prescribing.
The commencement and continuation of medication on the basis of primum non nocere (‘first do no harm’) requires careful consideration of the information at hand. Ideally, information that feeds into our clinical reasoning processes should involve core components of the clinical history, examination, investigation results, intended benefit and most importantly, patient preferences. In addition, I suggest reflecting on the available evidence and the patient’s time horizon.
The Northern Rivers Medical Exchange (NRMX) has closed due to the rising cost of insuring medical data transportation.
The Exchange started five years ago as a free service from the Northern Rivers General Practice Network for North Coast health practitioners. The Exchange used secure email to send documents between NRMX users.
The service underwent extensive penetration testing by the Brisbane security firm YellIT prior to its general release and no major vulnerabilities were uncovered.
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