High risk drinking is linked with high rates of physical harm. The reported incidence of alcohol - related trauma among Aboriginal and Torres Strait Islander people in the Northern Territory is the highest in the world. Facial fractures are common among young Aboriginal and Torres Strait Islanders. They are often linked with misuse of alcohol in the Northern Territory and are frequently secondary to assault. This review focuses on alcohol-related trauma in the Territory and draws attention to an urgent need for preventative health approach to address this critical issue.
BackgroundGlobally, alcohol-related injuries cause millions of deaths and huge economic loss each year . The incidence of facial (jawbone) fractures in the Northern Territory of Australia is second only to Greenland, due to a strong involvement of alcohol in its aetiology, and high levels of alcohol consumption. The highest incidences of alcohol-related trauma in the Territory are observed amongst patients in the Maxillofacial Surgery Unit of the Royal Darwin Hospital. Accordingly, this project aims to introduce screening and brief interventions into this unit, with the aims of changing health service provider practice, improving access to care, and improving patient outcomes.MethodsEstablishment of Project Governance: The project governance team includes a project manager, project leader, an Indigenous Reference Group (IRG) and an Expert Reference Group (ERG).Development of a best practice pathway: PACT project researchers collaborate with clinical staff to develop a best practice pathway suited to the setting of the surgical unit. The pathway provides clear guidelines for screening, assessment, intervention and referral.Implementation: The developed pathway is introduced to the unit through staff training workshops and associate resources and adapted in response to staff feedback.Evaluation: File audits, post workshop questionnaires and semi-structured interviews are administered.DiscussionThis project allows direct transfer of research findings into clinical practice and can inform future hospital-based injury prevention strategies.
BackgroundThe incidence of mandibular fractures in the Northern Territory of Australia is very high, especially among Indigenous people. Alcohol intoxication is implicated in the majority of facial injuries, and substance use is therefore an important target for secondary prevention. The current study tests the efficacy of a brief therapy, Motivational Care Planning, in improving wellbeing and substance misuse in youth and adults hospitalised with alcohol-related facial trauma.Methods and designThe study is a randomised controlled trial with 6 months of follow-up, to examine the effectiveness of a brief and culturally adapted intervention in improving outcomes for trauma patients with at-risk drinking admitted to the Royal Darwin Hospital maxillofacial surgery unit. Potential participants are identified using AUDIT-C questionnaire. Eligible participants are randomised to either Motivational Care Planning (MCP) or Treatment as Usual (TAU). The outcome measures will include quantity and frequency of alcohol and other substance use by Timeline Followback. The recruitment target is 154 participants, which with 20% dropout, is hoped to provide 124 people receiving treatment and follow-up.DiscussionThis project introduces screening and brief interventions for high-risk drinkers admitted to the hospital with facial trauma. It introduces a practical approach to integrating brief interventions in the hospital setting, and has potential to demonstrate significant benefits for at-risk drinkers with facial trauma.Trial RegistrationThe trial has been registered in Australian New Zealand Clinical Trials Registry (ANZCTR) and Trial Registration: ACTRN12611000135910.
Mortuary-based surveillance typically collates information from three sources: postmortem reports completed by forensic pathologists, police crime incident reports and chemical pathology laboratory results. The data are an important tool to inform prevention efforts and to monitor their effectiveness, and represent an underutilised source of descriptive epidemiological information to inform our understanding of fatal violence patterns, risk factors and groups at-risk. Following on earlier South African mortality surveillance initiatives, the current system provides a robust and simple surveillance tool that provides data that is congruent with, yet avoids the rigid confi nes of, the ICD10 coding system. We describe the process of consultation between participating research agencies to refi ne the data collection instrument, manual and automated data collection procedures and the systems institutionalisation with provincial government. The on 7 May 2018 by guest. Protected by copyright.
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