Miscellaneous

Question 1

Barriers to receiving treatment in ATSI patients

Answer 1

Financial limitation
Lack of understanding of seriousness of diagnosis
Lack of access to medical care
Lack of trust in medical system
Undiagnosed substance misuse
Responsibilities to work / family prompting inability to seek treatment

Question 2

Hot topics of ATSI Health

Answer 2

Acute rheumatic fever
Post-streptococcal Glomerulonephritis
Impetigo
Scabies
Chronic suppurative otitis media
STI including syphilis and gonorrhoea
Tuberculosis
Leprosy
Ocular Trachoma
Respiratory infections (Bronchiectasis and COPD)
Chronic diseases (CKD, CVD, DM)
Immunisations (additional)

Question 3

Principles of Trauma-Informed Care

Answer 3

Prioritise Safety
Foster capacity to soothe psychological arousal
Validate person and perceptions
Collaborate and empower
Connect and stay involved

Rewritten
Safety
Arousal
Validate
Empower
Connect

Question 4

ATSI Identification in General Practice

Answer 4

RACGP believes that practitioners and patients should not be expected to demonstrate ATSI status in general practice context.

Ask - Are you of Aboriginal or Torres Strait Islander origin?

Three-tiered definition used by Department of Housing and Aging (DoHA) and National Community Controlled Health organisation (NACCHO)
1. Evidence of ATSI descent - Birth records or genealogies verified by a suitable authority
2. Evidence of self-identification as ATSI origin. Signed affirmation by applicant.
3. Evidence of community recognition - confirmation in writing by chairperson of an ATSI-incorporated organisation in a community in which the applicant lives or has previously lived.

Question 5

Women’s / Men’s business

Answer 5

• A range of experience and knowledge that is the exclusive preserve and domain of that gender in Indigenous society.
• Taboo to speak of such issues with the opposite sex, including healthcare workers of the opposite sex.
• Seen as a transgression of their indigenous natural law.

Women’s business
- Menstruation, pregnancy, childbirth, contraception.

Men’s business
- Manhood initiation rites, circumcision, sexuality, STIs

Question 6

Sorry business

Answer 6

Cultural obligation for mourners to grieve the death of a relative in a special way.
- Deliberate avoidance of any mention of the deceased person’s name or any portrayal of their likeness.
- The place where the person died is deserted for a time and then smoked out.

Question 7

Close the gap

Answer 7

Financial Assistance in purchase of PBS prescriptions

Eligibility
- ATSI registered with Medicare who, in the opinion of the prescriber
- Would experience major setbacks in in their health if they did not take the prescribed medicine
- Are unlikely to adhere to their medicines without assistance of CTG

Entitlement
- If registered with CTG but no concession card, will pay $6.6 for majority of PBS scripts
- If registered with CTG and has concession card. Will receive majority of PBS scripts for free.

Question 8

Leprosy

Answer 8

• Mycobacterium Leprae
• Chronic granulomatous disease affecting skin and peripheral nerves.
• Incubation period highly variable ( 2- 30 years)

Clinical presentation
- Skin lesions: Pale, coppery or erythematous patch
- Lion Facies (Shiny thickened skin on the face)
- Swelling or nodules on the face or earlobes.
- Neuro - Loss of sweating, loss of sensation, peripheral neuropathy, peripheral weakness or deformity.
- Peripheral nerve thickening (palpable change on exam)

Diagnosis
- M Leprae detected on slit skin smear for Acid Fast Bacilli, biopsy or PCR.
- Take samples from 3 separate sites.

Management
- Refer to Infectious diseases specialist
- Will receive 3 antibiotic therapy long-term (6 months to 2 years)/ Abx include dapsone, clozamine, rifampicin, fluoroquinolones, minocycline)
- Prednisolone to suppress immunoreactions. (lepra reactions.)
- Notify public health.
- Contact tracing for household members and offer single dose of rifampicin chemoprophylaxis.
- BCG vaccination for household contacts if unvaccinated.
- Opthalmology review if ocular signs noted on examiation.

Question 9

Role of Aboriginal Liaison Officer

Answer 9

• Help people to understand conditions, medications and treatments
• Assist people and their carers to manage severe chronic disease
• Arrange and remind people of their appointments
• Assist people to access specialist and allied health services
• Direct people to community programs
• Organise and assist with travel to and from medical appointments.