The Development of Indigenous Substance Misuse Services in Australia: Beliefs, Conflicts and Change

The aim of this paper is to overview earlier and recent issues in the field of Indigenous substance misuse intervention from its beginning to more recent developments. The overview will specifically analyse developments, advancements and change in the area of tertiary intervention or 'rehabilitation' as it is commonly referred to by Indigenous people. Firstly, the paper will focus on Indigenous historical and theoretical constructs that have impacted on the development of Indigenous notions of 'rehabilitation' or intervention. Indigenous interpretations of the disease model of alcoholism, particularly the Alcoholics Anonymous philosophy, will be analysed as well as the socio-cultural beliefs associated with those models. Secondly, conflicts with the mainstream management of substance misuse intervention will be overviewed. Thirdly, the paper will highlight the complexity of more recent evolutions of the services and discuss possible options for change. Attention is also devoted to Indigenous alternative interpretations of intervention and their relevance to the area of secondary intervention. Recent developments in the area of primary health care and their potential towards further improvement will also be considered as well as possible obstacles to those changes

Source reduction for prevention of methylene chloride hazards: cases from four industrial sectors

BACKGROUND: Source reduction, defined as chemical, equipment and process changes that intervene in an industrial process to eliminate or reduce hazards, has not figured as a front-line strategy for the protection of workers' health. Such initiatives are popular for environmental protection, but their feasibility and effectiveness as an industrial hygiene approach have not been well described. METHODS: We investigated four cases of source reduction as a hazard prevention strategy in Massachusetts companies that had used methylene chloride, an occupational carcinogen, for cleaning and adhesive thinning. Three cases were retrospective and one was prospective, where the researchers assisted with the source reduction process change. Data were collected using qualitative research methods, including in-depth interviews and site visits. RESULTS: Motivated by environmental restrictions, a new worker health standard, and opportunity for productivity improvements, three companies eliminated their use of methylene chloride by utilizing available technologies and drop-in substitutes. Aided by technical assistance from the investigators, a fourth case dramatically reduced its use of methylene chloride via process and chemistry changes. While the companies' evaluations of potential work environment impacts of substitutes were not extensive, and in two cases new potential hazards were introduced, the overall impact of the source reduction strategy was deemed beneficial, both from a worker health and a production standpoint. CONCLUSION: The findings from these four cases suggest that source reduction should be considered potentially feasible and effective for reducing or eliminating the potential hazards of methylene chloride exposure. Especially when faced with a hazard that is both an environmental and worker health concern, companies may chose to change their processes rather than rely on local exhaust ventilation equipment or personal protective equipment that might not be as effective, might transfer risk and/or not be integrated with financial goals. However, technical assistance sensitive to environmental and health and safety impacts as well as production issues should be provided to guide companies' source reduction efforts

Maternity and reproductive health in Asian societies

This collection examines enduring and topical questions in sexual and reproductive health in a range of contemporary Asian cultures. Beliefs and practices surrounding conception, pregnancy, birth, and confinement are studies in culturally specific contexts in Japan, Taiwan, the Philippines, Thailand, Laos, Cambodia, and Indonesia. Important and widely applicable health issues are also addressed, including the perception and management of HIV/AIDS, experiences of menopause and the interaction of cosmopolitan ("western") medicine with traditional healthcare

Ethics in health research

Research ethics has played a crucial part in health research(Israel 2016; Tolich 2016a; Christians 2018; Gray 2018; Banks 2019; Portney 2020). Due to many abusive events in the historical past, ethical and moral issues are major elements that health researchers must consider. Ethical issues must be considered throughout the research process and continue afterwards as research and its outcomes may have a lasting effect on research participants. Ethical considerations need to be an ongoing part of research: they should be part of planning the research, during the research, and after research has been completed. In health research, it is essential that we take serious consideration of ethical issues since our research requires the involvement of other people (research participants) for us to obtain new knowledge which can have a significant influence on their health, well-being and lives. Thus, it is the responsibility of researchers to warrant that research participants are treated with respect and their well-being and safety are protected (Portney 2020). In the process of conducting research, how can we be sure that we, as researchers, are acting morally or ethically? What are the rules for conducting research so that the research participants will not be harmed? How can we protect the research participants? These are some of the important questions that can be answered by research ethics, the subject matter of this chapter