Injury
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Randomized Controlled Trial Multicenter Study
Low-intensity pulsed ultrasound (LIPUS) in fresh clavicle fractures: a multi-centre double blind randomised controlled trial.
Several randomised trials have been published on the effect of low-intensity pulsed ultrasound (LIPUS) on fracture healing in both distal radius and tibia fractures. Most studies showed a positive effect on time to clinical and radiological healing. We hypothesised that LIPUS has a beneficial effect on the healing of fresh clavicle fractures as well and studied its effect in non-operatively treated shaft fractures. ⋯ Level 1 evidence that low-intensity pulsed ultrasound does not accelerate clinical fracture healing in non-operatively treated fresh midshaft clavicle fractures.
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The study of indigenous health is an emerging specialty and differs from other health disciplines in that the traditions and beliefs of indigenous people must be considered in developing health policy. New Zealand Maori and Australian Aboriginal and Torres Straight Islanders face similar health issues but have followed a different historical path. New Zealand was settled by the Maori from Eastern Polynesia in approximately 1300AD. ⋯ A sustained period of protest in the years following World War II has resulted in the inclusion of the provisions of the Treaty of Waitangi in legislation. Historical grievances of Maori relating to land confiscations and injustice are being addressed with formal apology and compensation. This process has allowed Maori to create their own infrastructure, to begin to develop their own health-care initiatives and to advise health-care authorities and governments on interventions to reduce health disparities between Maori and non-Maori New Zealanders.
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Review
An analysis of national health strategies addressing Indigenous injury: consistencies and gaps.
This paper reviews the inclusion of injury in national Aboriginal and Torres Strait Islander health strategy. The review focused on strategies published during the period 2003 2008 or strategies which are otherwise identified as current for this period. ⋯ The review demonstrates that injury is recognised as a public health priority across Indigenous health strategy documents, and strategies that address social and emotional wellbeing (including violence and one of its antecedents, alcohol and substance misuse) are clearly reinforced across national strategy in Indigenous health. However, there are some significant gaps and fragmentation of injury strategy remains a continuing challenge in this field.
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While transport-related injuries represent a leading cause of death for all Australians, several disparities exist between Indigenous and non-Indigenous populations. Compared to non-Indigenous Australians, Indigenous Australians are more than twice as likely to have a transport-related fatal injury, with fatality risk remaining high with age while declining among the non-Indigenous community. Few studies and appropriate databases exist to elucidate the causes and solutions to this over-representation. This paper presents a summary of known risk factors, discusses the impact of road injury at multiple levels and suggests steps towards addressing this significant public health problem.
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Injury prevention in Indigenous communities in Australia is a continuing national challenge, with Indigenous fatality rates due to injury three times higher than the general population. Suicide and transport are the leading causes of injury mortality, and assault, transport and falls the primary causes of injury morbidity. ⋯ Poor data, lack of funding and absence of targeted programs are some of the issues that impede injury prevention activities. Traditional approaches to injury prevention can be used to highlight key areas of need, however adaptations are needed in keeping with Indigenous peoples' holistic approach to health, linked to land and linked to community in order to address the complex spiritual, emotional and social determinants of Indigenous injury.